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04-6580 (SATT)In . f��ft�Gv BUILDING & SAFETY DEPARTMENT Box 1504 (760).777-701.2 9 ® 78 495 - LLE TAMPICo �......- FAX (760) 777-7011 U LA QUINTOACALIFORNIA 92253 INSPECTION REQUESTS u h' 12004 � BUILDING PERMIT (760) 777-7153 SIS E�% U. SUINT:' Appl-ie�'ation�Number t k "." 4 C:0-4=0000658.0_ Date 10/01/04 Property Address,,*,,. ;,;` °,; -79935 VIA MARAVILLA --� APN: 772 -400 -044 - Application description DWELLING - SINGLE FAMILY ATTACHED Property Zoning LOW DENSITY RESIDENTIAL_ Application valuation 2.00624- •s Owner Contractor . R J T HOMES RJT HOMES LLC 1425 E UNIVERSITY DR 1425 E. UNIVERSITY DRIVE PHOENIX AZ 85034 PHOENIX AZ -85034 WCC: STATE FUND WC:' 158390.6 10/01/05 CSLB: 690645 06/30/06 CCC: A -B ------ Structure Information SATT ----- Construction Type TYPE V - NON RATED Occupancy Type DWELLG/LODGING/CONG <=10 Flood Zone . . . . NON -AO -FLOOD ZONE Other'struct .info . CODE EDITION.. 2001 CBC GARAGE SQ FTG 538.00 PATIO SQ FTG 568.00 TOT ELIGIBLE NO NUMBER OF .UNITS <: 1 , 0.0 FIRST' FBdOk`SQ FTG ' " 3191.00 Permit. . . . . . . BUILDING PERMIT Additional desc Permit Fee 993.00°`� x, P`~ Plan. Check'Fee "' 16:1 36 Issue Date Valuation 200624 Qty Unit Charge Per Extension BASE FEE 639.50 101.00 3.5000 THOU BLDG 100,001-500,000' 353.50 Permit MECHANICAL Additional desc Permit Fee 90.00 Plan Check Fee 6.56 Issue Date . . . Valuation 0 Qty Unit. Charge Per BASE FEE Extension 15.00 _, 1" . P.O. BOX 1504 • " VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4 4 a INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 04-(0580 Date: lo, a t• d y Applicant: - Applicant's Mailing Address: Architect or rchitect or Engineer: Engineer's Address: 00 wn:t4 IC. NO.: 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 e, and my Licen�^in II force and effect. / / o / License Class License No. �'J 6 0 OWNER -BUILDER DECLARATION 1 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 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 /�f issuMy Yorkers' compensation i ante carrier olicy numbe are: Camer 7200 Q �f olicy Number QQ 16 _ I certify that, in the performance of the work for which this pe i issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia, 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. Date�6 ��•4� PPI icant� 1 *yGs L� 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. e Uw �gnature (Applicant or Agent): Page 2 Application Number . . . : 04-00006580 Date 10/01/04 Qty Unit_Charge, Per _ Extension 2.00 9:,0000 EA MECH FURNACE <=100K 18.00 2.00 9._0000 EA MECH BIC <=3HP/100K BTU 18.00 .00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU .00 5.00 6.5000 EA MECH VENT FAN 32.50 1.00. '6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee 137.45 Plan Check Fee 8.59 Issue Date . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3191.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 111.69 538.00 .0200. ELEC GARAGE OR NON-RESIDENTIAL 10.76 Permit PLUMBING Additional desc Permit Fee . . . : 234.00 Plan. Check Fee 9.94 Issue Date . . ..Valuation . . . . 0 Qty. Unit Charge Per Extension BASE FEE" 15.00 24.00 6.0000 EA; PLB 'FIXTURE 144.00 1.00 15.0000 EA PLB BUILDING'SEWER 15.00 2.00 6.0000 EA PLB ROOF DRAIN;' 12.00 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 8.00 .7500 EA PLB GAS PIPE >=5 6.00 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 SFA;LOT 4 PLAN P2B, 3191 SF PERMIT DOES r - Page 3 Application Number 04-000;06580 Date. 10/01/04 ----------------------------------------------------------------------------- Special Notes and Comments , ' NOT INCLUDE BLOCK.WALL, 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 20.00 DIF COMMUNITY CENTERS -RES 68.00 DIF CIVIC CENTER - RES 229.00 ' ENERGY REVIEW FEE 16.14 - DIF FIRE PROTECTION -RES 78.00 . GRADING PLAN CHECK FEE 00 DIF LIBRARIES.- RES. 158.00, DIF PARK MAINT FAC - RES 3.00 DIF PARKS/REC - RES 352.00 - STRONG MOTION (SMI) - RES 20.06 DIF STREET MAINT.`FAC-RES 15.00 DIF TRANSPORTATION - RES 1098.00 t y Fee. -summary Charged ,Paid Credited Due ti Permit Fee Total '1469.45.. .00 .00 1469.45 Plan,Check Total. 186.45: -00 .00 186.45 Other Fee: Total 2057.2Q" 00; .00 2057.20 Grand Total 3713:10 00 .00 3713.10