11-1276 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-00001276
Property Address: 52195 DESERT SPOON CT
APN: 777-450-051- - -
Application description: DWELLING - SINGLE FAMILY
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 109503
Tit!t-4 40"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
RJT HOMES - CODORF
P.O. BOX 810
DETACHED LA QUINTA, CA 922
RD
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/29/11
I
NOV
30 201YJ
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 _ 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.).
(_ 1 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
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 Quinta, 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 correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and here representatives
of this count to enter upo he above-mentioned property for inspection pu
!rate: 3d gnature (Applicant or Agent):
Contractor: C Tyl qp LA QUINTA
Applicant: Architect or Engineer:
RJT INVESTMENTS I C FIi�A�iCt i;_PT.
1425 E. UNIVERSIT
PHOENIX, AZ 85034
I"t
-
(602)257-1656
Lic. No.: 690645
----------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
---------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provis' ns- Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Clas : A B icense No.: 690645
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
Xontractor:
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalt perjury that I am exempt from the Contractor's State License Law for the
Carrier LUMBERMEN' S UND Policy Number 419203
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the worker ' sampensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, I shall forthwith co ty t ose provisions.
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).:ate
! pplicant:
1—) 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
WARNING: FAILURE TO SECURE W KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 _ 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.).
(_ 1 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
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 Quinta, 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 correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and here representatives
of this count to enter upo he above-mentioned property for inspection pu
!rate: 3d gnature (Applicant or Agent):
11
LQPERMIT
Application Number . . . . 11-00001276
Permit
. . .
BUILDING PERMIT
Additional
desc .
Permit Fee674.50
Plan Check Fee
438.43
Issue Date
. . . .
Valuation . . . .
109503
Expiration
Date
5/27/12
Qty Unit Charge
Per
Extension
BASE
FEE
639.50
10.00
----------------------------------------------------------------------------
3.5000
THOU BLDG
100,001-500,000
35.00
Permit
. . .
MECHANICAL
Additional
desc .
Permit Fee
. . . .
88.50
Plan Check Fee
22.13
Issue Date
. . . .
Valuation
0
Expiration
Date
5/27/12,
Qty Unit Charge
Per
Extension
BASE -
FEE
15.00
1.00
9.0000
EA MECH
FURNACE <=100K
9.00
1.00
9.0000
EA MECH
B/C <=3HP/100K BTU
9.00
1.00
16.5000
EA MECH
B/C >3-15HP/>100K-500KBTU
16:50
5.00
6.5000
EA .MECH
VENT FAN
32.50
1.00
-----------------=--------------------------------------------------=-------
6.5000
EA MECH
EXHAUST HOOD
6.50
Permit
ELEC-NEW RESIDENTIAL
Additional
desc .
Permit Fee
83.16
Plan Check Fee
20.79
Issue Date
Valuation . . . ..
0
Expiration
Date
5/27/12
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1692.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
59.22
447.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
8.94
PermitPLUMBING
Additional desc . .
Permit Fee . . . . 146.25
Issue Date . . . .
Expiration Date 5/27/12
Qty Unit Charge Per
BASE FEE
13.00 6.0000 EA PLB FIXTURE
Plan Check Fee 36.56
Valuation 0
Extension
15.00
78.00
Application Number .
. . . . 11-00001276
Permit . . . .
PLUMBING
Qty Unit Charge
Per
Extension
1.00 15.0000
EA PLB BUILDING SEWER
15.00
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 . . .
GRADING PERMIT
Additional desc .
Permit Fee . . . .
15.00 Plan Check Fee
.00
Issue Date
Valuation . . .
. 0
Expiration Date .
5/27/12
Qty Unit Charge
Per
Extension '
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 103, PLAN SF3B, 1692 SF.
PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK
WALLS OR DRIVEWAY APPROACH. 2010 CODES.
----------------------------------------------------------------------------
Other Fees ... . . .
. . BLDG STDS ADMIN (SB1473)
5.00
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00.
ENERGY REVIEW FEE
43.84
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
10.84
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged Paid Credited'
---------------------------
Due
.Permit Fee Total
------------------------------
1007.41. .00 .00''
1007.41
Plan Check Total
517.91 .00 .00
517.91
Other Fee Total
5055.68 .00 .00
5055.68
Grand Total
6581.00 .00 .00
6581.00
LQPERMIT