04-7394 (SFD)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504_1 (760),777-7012
OF9�%' 78-495 CALLE TAMPICO FAX (760) 777-70.11
LA QuINTA, CALIFORNIA 92253INSPECTION REQL:ESTS (760) 777-71.53
BUILDING PERMIT
Application Number . . 0:4-000_073-94 Date. -''11/24/04
Property Address,, 50025 VIA DE MODA!
rAPN: 772-380-004- 7 -
Application description.'. DWELLING — SINGLE FAMILY DETACHED`
Property Zoning LOW;DENSITY RESIDENT=AL
Application valuation -295702
Owner co
�ntractor
X11------= - '---- ------
R . J T HOMES R1j)TR HOMES LLC
.. 1425 E UNIVERSITY DR O Z��S 1,4'25 E. UNIVERSITY DRIVE
PHOENIX AZ 8503%%\ PHOENIX .AZ 85034
cel��O�WCC : STATE FUND
WC:, 15.83906 10'/01/05
CSLB: 690645 06/30/06
CCC:' A -B
----- Structure Information -
Construction Type TYPE V - NONRATED
Occupancy Type . . . DWELLG/LODGING/LONG <=10
Flood Zone NON' -AO FLOOD ZONE
Other struct info.. . . CODE. EDITION 2001 CBC
FIRE'SPRINKLERS NO
GARAGE,SQ FTG 763.00
PATIO SQ FTG, 1248.0.0
NUMBER OF UNITS
1ST FLOOR SQUARE FOOTAGE 4618.00
---__--------------- --=------==------------------------ ----.--•------------------
Permit . BUILDING PERMIT
Additional desc
Permit Fee . . . . 1325.50 Plan Check ,ee 215.40
Issue Date Valuation 295702
Qty Unit Charge Per Extension
BASE FEE 639.50
196.00 3.5000 THOU BLDG 100,001-500,000 686.00
Permit MECHANICAL
Additional desc
Permit Fee 132.50 Plan Check Fee 8.28
Issue Date Valuation 0
Qty Unit Charge Per Extension
BASE FEE 15.00
4.00 9.0000 EA MECH FURNACE <=100K 36.00
4.00 9.0000 EA MECH B/C <=3HP/100K BTU' 36.00
6.00 6.5000 EA, MECH VENT FAN 39.00
.1.00 6.5000 EA MECH.EXHAUST HOOD 6.50
P.O. Box 1504• �� VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760)777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 4- 7 39 At Date: /• aZ /• O S
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Arc 'tect or Engineer's Address:
Jtrd. No. ✓ b a"
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions ofChapter9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my License i full force and effect. b 7� O(9S
cense Class cense No.
WJ
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 1, 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 or 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.).
U 1, 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner.
WORKERS' 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
Kof the work for which this permit is issued.
I have and will maintainworkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
� )� i sued. work compensation��ance carrier a d olicy nu berg re:
-`mer 5T o�P licy Number I I
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 the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall
forthwith comply with those provisions.
WARNING: FAILURE TO SECURE 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.
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
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 hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
/"'
Date -9145 / Signature (Applicant or Agent): V
.1
a
Page
2
Application Number
04-00007394 Date
11/24/04
--------------------
*Permit
------------------------------------------------
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee
191.89 Plan Check Fee
11.99
Issue Date:
Valuation
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
4618.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
161.63
763.00 ..0200
ELEC GARAGE OR NON-RESIDENTIAL
15.26
Permit
PLUMBING
Additional desc
Permit Fee
267.00 Plan Check gee
16.69
Issue.Date
Valuation
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
27.00 6.0000
EA PLB FIXTURE
162..00
1.00 15.0000
EA PLB BUILDING SEWER
15.00
4.00 6.0000
EA PLB ROOF DRAIN
24.00
2.00 7.5000
EA PLB WATER HEATER/VENT
15.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.,00
12.00 .7500
EA PLB GAS PIPE >=5'
9..00
1.00 15.0000
EA PLB GAS METER
15.00
Permit . . .
GRADING PERMIT
Additional desc
Permit Fee . .
15.00 Plan Check -ee
.00
Issue Date . . . .
Valuation
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
Special Notes and Comments
SFD - LOT,4, SF3AC3 (reversed),
4618 SF.
PERMIT DOES NOT INCLUDE
BLOCK WALLS,
POOL, SPA OR DRIVEWAY
APPROACH. 75%
-reduction to plan check
fee due to
multiple.issuance of
same plan type
Other Fees . . .
. . . . ART -IN PUBLIC PLACES RES,
239.25'
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER -,RES .366:.00
ENERGY REVIEW -FEE
21.54
Page
3
Application Number
04-00007394 Date
11/24/04
Other'Fees
. . . .
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5:00
DIF PARKS/REC -,RES
502.00
STRONG.MOTION (SMI) - RES
29.57
DIF STREET MAINT FAC -RES
15.0.0
DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged
Paid Credited
Due
--------------
Permit Fee -Total
----------
1931.89
------------------------------
.00 .00
1931.89
Plan Check Total
252.36
.00 .00
252.36
Other Fee Total
2695.36.
.00 00'
2695.36
Grand Total4879.61
.00' .00
4879.61