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11-1273 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUIN�A, CALIFORNIA 92253 T4ht * 4 4a QgA& BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: C 11=00001273 Property Address: 52170 DESERT SPOON CT APN: 777-450-063- - - Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 98426 Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under pro vis' Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals , and my License is in full force and effect. License Class: A B cense No.: 690645 D� .�1 �I Cp tractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State _ License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct -the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). I—) I am exempt under Sec. B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: RJT HOMES - CODORNIZ P.O. BOX 810 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/23/11 LA QUINTA, CA 92253 -) Qv --r d� Contractor: RJT INVESTMENTS INC 1425 E. UNIVERSITY DRIVE ��©r�Al�u• PHOENIX, AZ 85034 (602)257-1656 Lic. No.: 690645 ----------------------------------------------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1L I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor TT Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier LUMBERMEN' S AND Policy Number 419203 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to ;be workers' compensation provisions of Section 3700 of the Labor Code, I shall forth . omply with those provisions. ate:JI�ant: _ WARNING: FAILURE TO SEC E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under 'or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is I agree to comply with all city and unty ordinances and state laws relating to building constructs hereby authorize representatives oft ' count to enter upo the above-mentioned propertt for/in3p S. Date: % 6 ignature (Applicant or Agent): Application Number . . . . . 11-00001273 Permit . . BUILDING PERMIT Additional desc'. Permit Fee . . . . 635.00. Plan Check Fee 412.75 Issue Date . . . . Valuation . . . . 98426 Expiration Date 5/21/12- /21/12Qty Qty Unit Charge Per Extension BASE FEE 414.50 49.00 ------------------------------------------------------------- 4.5000 THOU BLDG 50,001-100,000 --------------- 220.50 Permit MECHANICAL Additional desc . Permit Fee . . . . 73.00 Plan Check Fee 18.25 Issue Date Valuation . . . . 0 Expiration Date 5/21/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH.FURNACE <=100K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 4.00 6.5000 EA' MECH VENT FAN 26.00 1.00 ---------------------------------------------------------------------------- 6..5000 EA MECH EXHAUST HOOD 6.50 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 76.88 Plan Check Fee 19.22 Issue Date . . . . Valuation . . . . 0 Expiration.Date 5/21/12 Qty Unit Charge Per Extension BASE FEE 15.00 1504.00' .0350 ELEC NEW RES - 1 OR 2 FAMILY 52.64 462.00 ------------------------------------------------------------------=--------- .0200 ELEC GARAGE OR -NON-RESIDENTIAL 9.24 PermitPLUMBING Additional desc . Permit Fee . . . . 140.25 Plan Check Fee 35.06 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/21/1.2 Qty Unit Charge Per Extension BASE FEE 15.00 12.00 6.0000 EA PLB FIXTURE 72.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 LQPERMIT 0 LQPERMIT Application Number . . . 11-00001273 --------=-------------------------------------------- Comments Permit . . . . PLUMBING PERMIT DOES NOT INCLUDE POOL, Qty Unit Charge Per WALLS OR DRIVEWAY APPROACH. 2010 CODES. Extension 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00. 5.00 .7500 EA PLB GAS PIPE >=5 3.75 1.00 ---------------------------------------------------------------------------- 15.0000 EA PLB GAS METER 15.00 Permit . . . Additional desc . Permit Fee . . Issue Date . . . . Expiration Date . . Qty Unit Charge GRADING PERMIT 15.00 Plan Check Fee .00 Valuation 0 5/21/12 .Per Extension BASE FEE 15.00 ----------------------- Special Notes and --------=-------------------------------------------- Comments SFD - LOT 115, PLAN SF2BR, 1504 SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2010 CODES. ------------------------------------------=--------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 4.00 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 41.28 DIF FIRE PROTECTION -RES 140.00 DIF LIBRARIES - RES 355.00 MULTI -SPECIES (MSHCP) FEE 521.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00. STRONG MOTION (SMI) - RES 9.84 DIF STREET MAINT FAC - RES 67..00- 7:00DIF DIFTRANSPORTATION - RES 1930.00 Fee summary Charged Paid Credited ---------- ---------- ---------- Due - -------------- - -- Permit Fee Total ---------- 940.13 .00 .00 940.13 Plan Check Total 485.28 .00 .00 485.28 Other Fee Total 5051.12 .00 .00 5051.12 Grand Total 6476.53 00 .00 6476.53