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05-4815 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: f0:5=000:0:4-8-1.5,� Property Address: 50110 VIA DE MODA APN: 772-380-001- - ,Application description:. POOL -'RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 15000 Applicant: Architect or Engineer: . BUILDING & SAFETY DEPARTMENT o1Mill: ING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011... INSPECTIONS (760) 777-7153' 10/01/06 . 06/30/06 Date: 10/27/05 LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION Owner: I hereby affirm under penalty of perjury one of the following declarations: R J T HOMES . C= Z a 1425 E UNIVERSITY DR cv _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is . - PHOENIX, AZ 85034` .--f W C",3V fa. Z OWNER -BUILDER DECLARATION 3 c$ I hereby affirm under penalty.of perjury that I am exempt from the Contractor's State License Law for the U u followinyieasun (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to - - O _ 1 certify that, in the performance of the work for which this permit is issued, I shall not employ any . ..Contractor: RJT HOMES LLC person in any manner so as'to become subject to the workers' compensation laws of California, WCC: STATE FUND p and agree that, if I should become subject to the workers' compensation provisions of Section WC: 0014793-2005 3700 of the Labor Code, I shall forthwith comply with those provisions. CSLB: 690645 VOICE (760) 777-7012 FAX (760) 777-7011... INSPECTIONS (760) 777-7153' 10/01/06 . 06/30/06 Date: 10/27/05 LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of.perjury that I am licensed under provisions of 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 Code, and 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 Class: ''` License No.:. _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is . - /�''• f� f DContctor: /\ '�"•��✓.Z CL� - issued. - x 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 penalty.of perjury that I am exempt from the Contractor's State License Law for the Carrier A -B Policy Number - - - - - - - - - - - - - - - followinyieasun (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to - - _ 1 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 workers' compensation 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 comply with those 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).: D�,��a3! -S Applicap4/ �i 's kce -e /%J i,.as owner of the property, or my employees with wages as their sole compensation, will do the work, and •. -structureis " the not intended or offered for sale (Sec. 7044, Business and Professions Code: The - WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL • Contractors' State LicenseLawdoes not apply to an owner of property who builds or improves thereon, - _ SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE .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 _ . . l� improve for the purpose of sale.). - - 1 APPLICANT ACKNOWLEDGEMENT (_ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044; Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. - - PrnP^rty ^!h^ 7vildu yr impro:ee lhmaan, 6Ad vrho 40�1t,uoto fv, Il,c yiuJacie oolth a wuuauui(s) iicenseu I. Eaen person upon w1`189e behalt this application is made, each person at whose request and for . pursuant to the Contractors' State License Law.).' ... whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_ 1 I am exempt under Sec._. - ,.B.&P.C. for this reason 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. ' ' Date: Owner: - - 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 . - - - CONSTRUCTION LENDING AGENCY `permit to cancellation. . _ I hereby affirm under -penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all " work for which this permit is issued (Sec. 3097, Civ. C.). _ city and county. ordinances and state laws relating to building construction, and hereby authorize representatives - • - - - of thi -ou toy to enter upon the above-mentioned prope y�for i pest n pu oses. - - " Lender's Name: ��' � � //r� - �gnature .Date; • V' (Applicant orAgentV - • Lender's Address:• - LQPERMIT Application Number, 05-00004815 Permit. BLDG POOL PERMIT Additional.desc : Permit Fee 162.00 Plan Check Fee .. 105:30 Issue Date- Valuation 1500.0 Expiration Date 4/25/06 Qty Unit Charge Per ::Extension BASE FEE < 45.00 13.00. 9.00.00 THOU BLDG.2,001-25,000 117..00 it Permit MECH POOL Additional desc " Permit Fee ,' . X26.0.0 P1 -an Check Fee 6-.50 . Issue Date- Valuation -0 -" Expiration Date 4/25/06 . Qty" Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA- MECH FURNACE >100K .11.00, Permit' ELEC POOL•PERMIT-RES Additional desc.: Permit Fee . . . . 45:00 Plan Check Fee 11.25" IssuerDate Valuation- . . . . 0 Expiration Date 4/25/06. Qty Unit Charge Per Extension. BASE FEE, 15.00. 1.00 30.0000 EA ELEC ,PRIVATE SWIMMING POOL 30.00 Permit . .". PLUMBING Additional desc . Permit Fee 33.00 Plan:Check Fee 8.25 'Issue Date Valuation 0 Expiration Date:". 4/25/06 .. Qty Unit; Charge Per `Extension BASE FEE 15.00 2.00 6.0000 EA PLB FIXTURE 12.00 1:00 3:0000 EA PLB WATER INST/ALT/REP 3.00 . x`. 1.00 3..0000 EA PLB. GAS PIPE 1-4 OUTLETS 3.00. ----------- ------------- Special Notes and Comments - -- --- POOL & SPA ONLY. ALARMS/BARRIERS SHALL .,. LQPERMIT Bin p :T. ..3. :City of La Qu n ta',:,:.. . Permit p . ', B.ullding u Safety Dlvlslon Calle PQ 1504, 78.495�TampleQ La ul nta CA 922(619)'777-7012 ,• . . r 53 Building.Perml A . ,: ,4r w '101(cl A00tc3t: ppllc atlon and Tracking She`e"( � {Owner's 4 N r !":Number. �O'® OA4 erne: RJT Homes, ,LLC s Dcscripl,on: Address: PO'pox 810 —" . - v • ; � •. •• . -- Y� Cit ST - :��uacwr , Zip: ' La i k r RJT lnreslments, lQui CA 92253 - ric. ;:vress jags B. I Telephone: (760) 564.65: `r Unlrers ly Dr', 5 i' �1 3T Z 85034 on' p Photnlx, AZ •• PtOjecl Dcscripli :I:pnun<, (602) 2:7.1650 - 690645 —_ City Llc. N: 4990 Engs:,.Ocsigncr: �C.^ftff •_ R � � • _ , Conatruetlon TYPe: . 4 Occupancy:.., Vl:nc vi Cunlact Pcrsop: Projocl tYPe (circle one), New r Chad Meyer Add'n. Alter ,Rep,,:- of COnlBel per son: S Fl.; 9 (760) 564.6555 N Slorie:: R Bilim4Ied value o PI•olt:ct: —' iLPR��I� f�i' c!^!•b41 0 • 1 5vomillit Rtq'd Q4, rs.. T�,} Rwd Phil StIJ: AAs. 0 f Suvrlvi7i C'slcs4 Plsp : s, w MIT FEES _ %�iS}Ot�U.CJpJ1J.f,�•�: ., , PER`e. I" I TrvilCrlcs. , tOfrSillp9; :_'I•`.j. j' 11 on:Chcc�'Dcposil- I �- TCtlu,�1 5 ��•"i r--"—;--_,__� jr �i�r1' CixS t:pYianci !. C1141 OC(d r. :i :.1';; r I Sc 1 n bol Fees s.) p. • �vocv°IrclorList 1; �,.... l , �; %'cam; p; .N .NI'�i? ��•• I �''Y „ �.. • -- I ` c'volf1clor Eck.. • Into ' 7. ';� � ;> >: IY�R►t,g. L i CQ' Bulincss llc, •+� 'll aI'7,i,,� ''} - .I 11 ar►<n' Comp, {� I• %.1 r . I ! .) '1i ''I,t •�' �c I '�+� ;• i Plino, pprovii i:.��F.$/: .I , P�'' S, �Alilstruclu:t 4' • '.i Pvo. _ sYv, w Appr,- •' � , �: APDrorel `r A;1:P.P. r , '1 • Fut bltr. ,GPPr. . • , I Ar. Approrsl .. GCpjJl'F�.c7 ,_ ,. < .. r �:,,....,.. _ ....,....� . , ... ,.., mss: .. .......,�. .�..,..._..... .. . .. .... _ -