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04-7389 (SFD)N BUILDING & SAFETY"DEPARTMENT P.O. Box 1504. (760),77777012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253. INSPECTION REQUESTS (760) 777-71.53 BUILDING PERMIT Application Number . . . . . "C04_0_00,073-8-9 Date .11/24/04 Property Address 50110 VIA DE MODA APN: 772-380-001 - - Application description . DWELLING —•SINGLE FAMILY DETACHED Property Zoning LOW DENSITY RESIDENTIAL Application valuation 255181 Owner Contractor - - R J T HOMES RJTi HOMES LLC 1425 E UNIVERSITY DR 145 E. UNIVEZSITY DRIVE �r. ''PHOENIX. AZ 85034- RNGE-NIX AZ 85034 WSTATE FUND T%�C�\:� Q 05 LB:: ` 6906456 06/30/-06 / / ,- A B ------ -----'---.--------- Struct, I' n, rmation ------------------------- Construction. Type �PE V - NON RATED Occupancy Type . . . . DWELLG/LODGING/CONG <==0 Flood Zone . . . . . NON' _AO FLOOD ZONE Other struct info,:.. CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 729.00 PATIO SQ FTG 8'06:0:0 NUMBER OF UNITS 1.00 "1ST FLOOR SQUARE FOOTAGE 4024.00 --------------=---------------------------=-=- ----.------------------- Permit BUILDING PERMIT Additional desc Permit Fee 1185.50 Plan Check Fee 770.58 Issue Date . . . . Valuation 255181 Qty Unit Charge Per Extension -BASE FEE 639.50 156.00 3.5000 THOU BLDG 100,001-500,00,0 546.00 Permit MECHANICAL Additional desc Permit Fee 114.50 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 P.O. BOx 1504 • 44" VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (76.0) 777-7153 BUILDING & SAFETY DEPARTMENT Application, Number: 041- 73? 11 Date: /. 01 PO S Applicant:—Architect Applicant's Mailing Address: Arc 'tect Lic. No.: or Engineer: or Engineer's Address: V),%2,0 BUILDING PERMIT DECLARATIONS 36 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty 11 perjury that I am licensed u provisions of Chapter9(commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is � full force and effect. 6 fp �icense Class r_1 5se No. �ta // ��� (/� 0 to ractor _ .40M 0M OWNER -BUILDER DECLARATION I hereby affirm* u ndee 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 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 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. I have and will maintainworkers' compensation insurance, as required by Section 37d0 of the Labor Code, for the performance of the work for which this permit is 5 -Pa MyPork ompensation i ance carrier In ltcy num r arq: artier 5 '(l I L �olicv Number gY? l%V _ 1 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. Q ,,daieI 3-1—CSS 1.ITi. nt 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 1 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 tj 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 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 u on the above-mentioned property for inspection purposes. to �� �iignature (Applicant or Agent): �/ Page 2 Application Number . . . . . 04-00007389 Date 11/24/04 ; Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 170.42 Plan Check Fee .42.61 Issue.Date. Valuation- 0 Qty Unit Charge Per Extension BASE FEE 15.00 4024.00 - .0350. ELEC NEW RES - 1 OR 2 FAMILY '140.84 729..0.0 .0200 ELEC GARAGE OR NON-RESIDENTIAL 14.58 Permit PLUMBING Additional desc Permit Fee 270.75 Plan Check Fee 67.69 Issue.Date. Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 28.00 6.0000 EA PLB FIXTURE 168:00 1.00 15.,0000 EA PLB BUILDING SEWER 15.00 4.00..-. 6.0000 EA PLB ROOF DRAIN 2.4.00 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 9.0.000 EA PLB LAWN SPRINKLER SYSTEM 9.00 9'.00 7500 EA PLB GAS PIPE >=5 6.75 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: Qty Unit Charge Per Extension BASE FEE 15.00 Special Notes and Comments a SFD - LOT 1. PLAN.SFIBCI. - - 4024 SF. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. ,Other:FeeS . . . . . ART IN PUBLIC PLACES -RES 137.95 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366..00 ENERGY REVIEW FEE 77-:06' DIF FIRE PROTECTION -EES 97.00 GRADING PLAN CHECK FEE .00 Page 3 Application Number., 04-00007389. 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 2.5,.51 DIF STREET MAINT FAC -RES 15.0'0 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged- Paid Credited Due ' ------------ - - - -.-=- -- - - - - -- --:----- = ------- - - -- -"-- -= - - - - -- Permit Fee Total 1756.17 .00. .00 1756.17 Plan Check Total 909'.51 .00 .00 909.51 ' Other Fee'Total' 2645.52 _ .00 .00 2645.52 Grand 'Total 5311.20 .00 :00' 5311.20 i