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04-7392 (SFD).� 0- 6- TWf BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760),777-7012 OF Tim 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-71.53 BUILDING PERMIT Application Number . .04=0_00.0_7392 Date 11/24/04 Property Address . . . . :50105 VIA DE MODA APN: 772-380-006- - Application description . . . DWELLING,- SINGLE FAMILY DETACHED Property Zoning . . . . ... LOW DENSITY RESIDENTIAL. Application valuation 280144 Owner Contractor R J T HOMES RJT HOMES LLC 1425•E UNIVERSITY DR 1425 E. UNIVERSITY DRIVE PHOENIX AZ 8504 PHOENIX AZ 85034 D WCC: STATE FUND 6 10/01/05 CSLB< 690645 06/30/06 CCC: A - B ----------- - ------- -----,A��4 Structure Information ---------=--------------- Construction Type 6��F��Pc�TYPE V - NON RATED Occupancy Type . . /DWELLG/LODGING/CONG <=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 1248.00 NUMBER OF UNITS 1.00. 1ST FLOOR SQUARE FOOTAGE 4346.00 - ----------------=----=------------------------------------------------------- Permit . . BUILDING PERMIT Additional desc Permit Fee . . . . 1273.00. Plan Check Fee 827.45" Issue Date . . Valuation 280144 Qty Unit Charge Per Extension BASE' FEE .63'9. 50 181.00 3.5000 THOU BLDG 100,001-500,000 633.50 ------------------------------------------------------------------------------- Permit MECHANICAL Additional desc Permit Fee 11.4,.50 Plan Check Fee 28.63 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27:.00 6.00 6.5000 EA MECH VENT FAN 39.00' 1.00 6.5000 EA. MECH EXHAUST HOOD 6.50 Page 2 Application Number . . . . . 04-00007392. Date 11/24/04" Permit ELEC-NEW RESIDENTIAL Additional desc " Permit Fee. 182.37 Plan Check.Fee 45.59 Issue ,Date . . . . Valuation . . . '0 Qty Unit Charge Per Extension BASE FEE 15.00 4346.00 .0350 ELEC NEW RES - 1 OR 2 FP_MILY 152.11 763.0.0 .0200 ELEC GARAGE OR NON-RESIEENTIAL 15.26 " Permit PLUMBING Additional desc Permit Fee 240.00 Plan Check Fee 60.00 ..Issue Date Valuation 0 Qty Unit'Charge Per Extension BASE FEE 15.00 24.006.0000 EA PLB FIXTURE 144.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 4.00 6.0000 EA PLB ROOF DRAIN. 24..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 10..00 .7500 'EA PLB GAS PIPE >=5 7.50 .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 Qty Unit Charge_ Per Extension BASE FEE 15.00 Special'Notes and Comments SFD - LOT 6, PLAN SF3AC5 (reversed), -4346"SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS, OR DRIVEWAY APPROACH --------------- 'Other Fees . . . . . . . ART IN PUBLIC'PLACES-RES 200.36 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER .- RES 366:.00 ENERGY REVIEW FEE 82.75 ' DIF FIRE PROTECTION -RES 97.00, GRADING PLAN CHECK FEE .00 Page 3 .-)Application Number . . 04-00007392 Date 11/24/04 ------------------------------------------------------------------------------- Other Fees. . . . . DIF LIBRARIES -- RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES. 502.00 STRONG MOTION(SMI) = RES 2 8.01 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee 'summary Charged Paid Creditec, Due Permit Fee Total 1824.87 .0.0 CO 1824.87 Plan Check.Total 961.67 .00 co 961.67 Other Fee Total` 2716.12 .00 .co 2716.12 Grand Total 5502.66 .00 co 5502.66 X, P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (76.0) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: o 4- a Date: Applicant: hitect or Engineer: Applicant's Mailing Address: Ar Itect or Engineer'' - ddress: ` a Le) X),4 ."0 ��r^,r, No.: J� BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Cod , and my Licen s in full force and effect. p / cense Class cense No. Z 06 ate -D 9 e0fifractor I S, 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 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 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 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.). 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 of the work for which this permit is issued. 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 ///issu d. My ,"rkers' ompensation i nce camer f licx ry�mbar re: ., "timer `I V40 �—if + olicy Number I 6 I Y92 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, I shall forthwith comply with those provisions. WARNING: FAILURE TO SECURE WORKERS' COMPENSATISIN 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 IA - 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. ate D�` / Q� f/Signa/ture (Applicant or Agent):