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04-6577 (SFD)BUILDING & SAFETY DEPARTMENT P:0.—B1' 1504 (760).777-7012 �OFTt9 1 78-495 ALLE TAMPICOFAX (760) 777-7011 LA A IF Q i UINTA, C L ORNIA 1225.3 INSPECTION REQUESTS (760) 777-7153 . L o X04 BUILDING PERMIT 0i �.Ua(014Wa Application Number 04-00006577 _ Date ...10/01/04 Property Address99.15 VIA MARAVILLA APN: 772 -400 -045 - Application description DWELLING - SINGLE FAMILY DETACHED Property Zoning LOW DENSITY RESIDENTIAL Application valuation 20,9259 Owner Contractor, -----------.-----.-------- • `• 4•k. ..--- .--------.-----..+1 ^ 1' R J T HOMES t RJT HOMES LLC 1425 E UNIVERSITY DR 1425 E. -UNIVERSITY DRIVE PHOENIX AZ 85034 PHOENIX AZ 85034 WCC: STATE FUND WC: 1583906 10/01/05 CSLB•: 690645 06/30/06 CCC: A -B ----------- - --------- ----- Structure Information ------------------------- Construction Type TYPE V - NON RATED 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 568.00 'PATIO SQ FTG 773.00. NUMBER -OF UNITS 1.00 Ffk9T FLOOR SQ "FTG 3284.00 Permit . . BUILDING PERMIT Additional desc�:..•.� Permit Fee . . . . 1024,.50 .4+8* P 1 'a "n. 4+8Plan. Check Fee ; a66j5 .93 Issue Date Valuation . . . 209259 Qty Unit Charge Per Extension BASE FEE 639.50 .110.00 3.5000 THOU BLDG 100,001-500,000 385.00 Permit MECHANICAL Additional desc., Permit Fee . . 65-.50 Plan Check Pee 16.38 Issue Date. Valuation• . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 P.O. BOX 1504. • '�C�� 78-495 CALLE TAMPICO 4 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: O4- 6 5 % 7 Applicant: Applicant's Mailing Address: -Architect Architect 06, T4 n&& `eJ rs�tivz� +44c. No.: or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: /Ora.( 'O or Engineer's Address: 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 Code, and my Licen is i 11 force'and effect. [3 cense Class •�'[S cense No.. 7 ate / U'-W,aµntractor_ 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 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 maintain workers' compensati n insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issu d. My yrprker ' compensation , rance carrier and polic er re: .11 Career tf-j/� Policy Number '�P� 40.6 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. /DateplCpfcant R 4OMPi5LLC— 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 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. DatecQ ' Signature (Applicant or Agent): Page 2 Application Number . . . . 04-00006577 Date 10/01/04 1 Qty Unit Charge Per . Extension 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA 'MECH B/C <=3HP/100K BTU 9.00 4:00 6.50.00 EA MECH VENT FAN 26.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit ELEC-NEWRESIDENTIAL . Additional desc Permit Fee 141.30 Plan Check Fee 35.33 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3284.00 .0350 ELEC-NEW RES.- L OR 2 FAMILY 114.94 568.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 11.36 Permit PLUMBING Additional desc Permit Fee_ . 195.00 Plan Check Fee". 48.75 Issue Date Valuation 0 Qty. Unit. Charge Per' Extension BASE. FEE ; 15.00 19.-00 6;.0000 EA PLB FIXTURE 114.00 1..00 15.0000 EA PLB BUILDING SEWER 15.00 2.00 6.0000 EA': PLB ROOF DRAIN 12.00 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 9.00100 EA PLB LAWN SPRINKLER SYSTEM 9.00 6.00 .7500 EA PLB GAS PIPE >=5 4.50 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 5, P3AX,.3284 SF.PERMIT DOES is S Page 3 Application Number... 04-00006577 Date 10/01/04 ----------------------------------------------------------------------------- Special Notes and Comments NOT INCLUDE POOL, SPA, BLOCK -WALLS, OR DRIVEWAY APPROACH Other Fees . . . ART IN PUBLIC PLACES -RES 23.14 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 66.59 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 20.92 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION .- RES 1098.00 Fee summary -Charged Paid Credited Due Permit Fee Total 1441.30 .00 .00 1441.30 .Plan Check -Total 766.39 .00 .00 766.39. Other Fee Total 2515.65 .00 .00 2515.65 Grand Total 472.3.34 .,. 00 .00 4723.34 t