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05-1804 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4ht 4 4 a" Application Number: 05-00001804 Property Address: 50060 VIA PUENTE APN: 772-370-005- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 15000 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT MAY 16 2005 qF LA auris.. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that Iam licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3npf the Business and Professions Code, and my License is in full force and effect. License Class: K'3 License No.: 4 �i ta:I ' I Contractor% LC C OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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 ($5001.: (_) 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 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.). (_ 1 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.). I—) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: 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.I. Lender's Name: _ Lender's Address: LQPERMIT Owner: R J T HOMES 1425 E UNIVERSITY DR PHOENIX, AZ 85034 Contractor: RJT HOMES LLC WCC: STATE FUND WC: 1583906 CSLB: 690645 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 10/01/05 06/30/06 Date: 5/11/05 WORKER'S 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' 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 insurance carrier and policy number are: Qi Carrier A -B $rATEFUA4 Policy Number ----15 +r 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. ate: BApplicants:/ ' `c_— 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. 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 co �truction, and hereby authorize representatives of this c unty to enter upon the above-mentioned propertyfor in pecti purpo es. D�� `s Signature (Applicant or Agent): Application Number . . . . . 05-00001804 Permit . . . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date --. . . . Valuation . . . . 150.00 Expiration Date 11/07/05 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000 THOU BLDG 2,001-25,000 117.00 ---------------------------------------------------------------------------- Permit . . MECH POOL Additional desc . . Permit Fee . . . 26.00 Issue Date . . . . Expiration Date . . 11/07/05 Plan Check Fee 6.50 Valuation . . . . 0 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 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/07/05 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 11/07/05 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 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ----------------'------------------------------------------------------------ Special Notes and Comments POOL & SPA ONLY. GAS/ELEC, DRAIN STUB OUT FOR FUTURE BBQ (BY SEPARATE PERMIT). ALARMS/BARRIERS SHALL BE _IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN LQPERMIT Application Number . . . . . 05-00001804 ---------------------------------------------------------------------------- Special Notes and Comments PERMIT. Fee summary ----------------- Charged ---------- Paid Credited Due Permit Fee Total 266.00 ------------------------------ .00 .00 266.00 Plan Check Total 131.30 .00 .00 131.30 Grand Total 397.30 .00 .00 397.30 LQPERNIIT M � 00 JO jrj o ; r _ j 60-020 j VIA PUEN7E w ; FF=42.30pFItA UINT4 I PAD=41.8a I NG ca 8i SAF DEP. m PP a ED �, FF=43.30 ; I O CONSTRU N li 3 PAfl=42.8 47.67 TO o, - 7X 126.71' __�-= 'tea 47.00 TM 41. '48 T# T kti�v L, y` I s wIto IF ��- 1 SII PAD. 6.46' IIs I GF= � 42.10 a $I$ r N Os G , � ].., �ZX + � � 0 O 0 ` ` 47.00 TW 41.00 38.99 TF 46,33 1'W Cli k 38 - y