04-6471 (SATT)j/
Qy� .
BUILDING & SAFETY DEPARTMENT
w4 P.O. - X 1504 (760).777-7012
78-4.9"5 CALLE TAMPICO FAX (760) 777-7011
III FAX
CALIFORNIA 92253 INSPECTION 760 REQUESTS 777-7153
Q ( )
2 4.2004
BUILDING PERMIT
CITY ®� LA OUL'ITA-_
FINANCE DEPT.-
Application Number 04-00006471_ Date 10/01/04
Property Addre'ss'° -b' 79955 VIA MARAVILLA
APN: 772-400-043- - -
Application description . . . DWELLING - SINGLE'FAMILY ATTACHED
Property Zoning . . . . LOW DENSITY RESIDENTIAL
Application valuation . . . . 186025
Owner Contractor
- - - - - - - - - - - - - - - - - - - - - - Q ` - -------
-- - - - - - - - -
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: 1583906 10/01/05
CSLB: 690645 06/30/06
------ 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 457.00
PATIO SQ FTG 867.00
TOT ELIGIBLE NO
NUMBER .fqV,:-UNITS , 00
FIRST IFLOOR 1SQ FTG ' '2894. 00
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Permit• . BUILDING PERMIT
Additional desc`
°
Permit Fee . . . :Pl°an Check Fee v 613.60
Issue Date . . . . Valuation 186025
Qty Unit Charge Per Extension
BASE FEE 639.50
87.00 3.5000.THOU. BLDG 100,001-500.,000 304.50
-
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Permit . . . .. MECHANICAL
Additional desc-.
Permit Fee 72.00 Plan Check Fee 19.88
Issue Date Valuation 0
Qty Unit Charge Per
BASE FEE
Extension
15.00
P.O. Box 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-701 1��G��/
LA QUINTA, CALIFORNIA 92253 4 4 a
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 0g— (p,q 1 I Date:
Applicant:—Architect or Engineer:
Applicant's Mailing Address:, -Architect or Engineer's Address:
ownw�, V
ic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under ovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
e, and my Lic§Qse isgull force'and effect.
License Class f?' (9 License No. b
/ate/O-W-04- �� ntractor
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.
►{.have and will maintain workers' compen§xkqon insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
liCs`sped. work s' compensatio surance carrier a tic Vn be -are:
amer 11 Q� Policy Number � 000 .
I certify that, in the performance of the work for which his 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.
ppVlicant / YT
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 �/�
Lenders Address /A
-
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 rep of this county to enter upon the above-mentioned property for inspection purposes.
ate% �� .r7>�11Signature (Applicant or Agent): r
C
j Page
2
Application Number
04-00006471 Date
10/01/04
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
.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
125.43 Plan Check Fee
3.76
Issue Date
Valuation
0
Qty
Unit Charge
Per
Extension
BASE FEE.,
15.00
2894.00
0350:.
ELEC NEW RES - 1 OR 2 FAMILY
101.29
457.00
.0200
ELEC'GARAGE OR NON-RESIDENTIAL
9.14
Permit
PLUMBING
Additional
desc
Permit Fee
. . . .
207.00 - ',Plan Check Fee
51.75
Issue Date
Valuation'
0
" Qty
Unit.Charge
Per
Extension
BASE FEE.15.00
23.00
6.0000
EA PLB FIXTURE
138.00
.1.00
15.0000
EA PLB BUILDING SEWER
15.00
1.00
7.5000
EA PLB WATER HEATER/VENT
7.50
1.00
-3.0000
EA, PLB WATER INS.T/ALT/REP
3:00
1.00
9.0000
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
---------
SFA - LOT '3.
-PLAN P1B.
PERMIT.,DOES NOT-
�y
Page 3
-Application -Number
Page 3
-Application -Number
04-00006471 Date
-10/.01/04
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Special Notes and Comments
INCLUDE BLOCK WALL,
POOL, SPA
OR
DRIVEWAY APPROACH.
Other Fees
. . .
ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
68.00'
DIF CIVIC CENTER - RES
229.00
ENERGY REVIEW.FEE
61.36
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
18.60
DIF STREET MAIN.T. FAC -RES
15.00'
DIF -TRANSPORTATION - RES
1098.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
1363.43
.00. .00
1363.43
Plan Check Total
::688..99
.00, .00
688.99
Other Fee Total
2080.96
.00 .00
2080.96
Grand Total
4133`.38
00 .00
'4133.38