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04-4596 (RPL)1 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT Application Number . . . . Property Address . . . . . APN: Application description Property Zoning . . . . . . Application valuation . . . Owner ------------------------ R J T HOMES 1425 E UNIVERSITY DR PHOENIX AZ 85034 BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 CPA-- 000045.9.6 Date 50375 VIA PUENTE 772-370-031-41 -29858 - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 15000 5/26/04 Contractor ------------------------ RJT HOMES LLC 1425 E. UNIVERSITY DRIVE PHOENIX AZ 85034 WCC: STATE FUND WC: 1583906 10/01/04 CSLB: 690645 06/30/04 CCC: A -B ---------------------------------------------------------------------------- Permit . . . . . . BLDG POOL PERMIT Additional desc Permit Fee 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation . . 15000 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 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 ----==-------------------------------------------------------------------- Permit . . . . . . ELEC POOL PERMIT -RES Additional desc Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 P.O. Box 1504 78-495 CALLE TAMPICO VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-701 1 INSPECTIONS (760) 777-71153 BUILDING & SAFETY DEPARTMENT Application Number: 041- 4154& I Date: e wv Applicant's Mailing Address: Architect or Engineer: r- Arcnitect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 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 Licensg is ipfull force and effect. License Class /�`7 i icense No.y_ Date J R`7) `inCoyaactor 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, andwho 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 Owner 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' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is is;ued. My wo�Sers' compensation hence artier an Policy number are: ,,--Carrier .41 v Nom_ o/� licy Number 5 "� _ 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. —late plicant WARNING: FAILURE TO SECURE WO ERS' 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. I herebyaffirm under CONSTRUCTION LENDING AGENCY 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 IMPORTANT Appljption is hereby made to the Director of BuildingAPPLICANT ACKNOWLEDGEMENT Safety Ato 1. Each person upon whose behalf this application is made, each person at Permit le request t anda di for whose benefit works rk restrictions under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnity and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being perforned 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 dayd from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certity 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 enter upon the bove-me6boned property for inspection purposes. Date 7'D ignwure (Applicant or Agent Page 2 Application Number . . . . . 04-00004596 Date 5/26/04 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc . . 'Permit Fee 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 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, BBQ (UL#ETL3020914) ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 264.00 .00 .00 264.00 Plan Check Total 130.80 .00 .00 130.80 Grand Total 394.80 .00 .00 394.80 17XI E -XI ON TRACT E 36.7 7 61 .�j 21 4.9 '1 36.00 TG 35.20 IM ------ — — — 37.20 37 P 36.7 6.4PAD 4. C) /FF -38 A- cn S7.1 0 .50%. .4 -1 �M C3 "n ii I 00 lb � o-4 Q 36.7 Ln C-2Ak, 36.7FG , TG 373B. 2 3B 9. 65 3 37 FG pADz - 44-.4 TW rn 4:69� TF 35.60, TG, c r%. 53-1 GF = 37.70 35.6 FL -GB C) 2.46% 6C14 r 33.36 5.30 TG 41 IV 50 JW .00, qv /X+ -L6 rr #4 FG 7 61 .�j 21 4.9 '1 36.00 TG 35.20 IM ------ — — — 37.20 37 P 36.7 6.4PAD 4. C) /FF -38 A- cn S7.1 0 .50%. .4 -1 �M C3 "n ii I 00 lb � o-4 Q 36.7 Ln C-2Ak, 36.7FG , TG 373B. 2 3B 9. 65 3 37 FG pADz - 44-.4 TW rn 4:69� TF 35.60, TG, c r%. 53-1 GF = 37.70 35.6 FL -GB C) 2.46% 6C14 r 33.36 5.30 TG 41 IV 50 JW .00, qv /X+ -L6 rr #4