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04-7387 (SATT)- T -to �Q�rw BUILDING & SA'FETY DEPARTMENT P.O. Box 1504. (760).777-7012 78-495 CALLE TAMPICo FAX (760) 777-7011 LA QUINTA; _CALIFORNIA'92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number04-00'007387 Date_ 11/24/04 Property Address . . . 7-9-790 VIA SIN CUIDADO CT APN':• 772-390-005- - - Application description DWELLING - SINGLE:FAMILY ATTACHED Property Zoning.. LOW DENSITY RESIDENTIAL Application valuation 210416_ Owner Contractor R J T HOMES RJT HOMES LLC 1425 E UNIVERSITY DR 1425 E. UNIVERSITY DRIVE PHOENIX AZ 85034 PHOENIX, AZ 85034- WCC: 5034WCC: STATE FUND WC: 1583906 10/01/05 CSLB: 690645 06/30/06 GCC: A- B ----=----------------- --1-, Stru,ct`ure✓hn_�formation ------ Construction Type �P. �. , �ME�NON RATED Occupancy Type . .DW,EL,LG/LODGING/LONG <=10 Flood Zone . ON AO FLOOD ZONE Other- struct info COD,EoEDITI0N 2001 CBC �kFLOOD ZONE NO /RAGE \�Q FTG 568.00 D \yA�TI/O SQ FTG 860.00 fi -, !ELIGIBLE NO; G� � 1ST BFLOOR QUARE FOOTAGE .3284.00 . --------------------=-------------------------=---------=------------------- Permit . . .. . .' .UB ILDING PERMIT Additional desc Permit Fee 1028.00 Plan Check Fee 668.20 Issue Date Valuation . . . . 210416 Qty Unit Charge. Per Extension BASE FEE 639.50 111.00 3.5000 THOU BLDG 100,001-500,000 388.50 Permit . . MECHANICAL., - Additional desc Permit Fee, 65.50 Plan Check Fee 16.38 Issue Date . . . . Valuation . '0 Qty Unit Charge Per Extension BASE FEE 15.00 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 6.5000 EA MECH VENT FAN 26.00 P.O. BOX 1504 �� VOICE (760) 777-7012 78-495 CALLE O FAX (760) 777-7011 LA QUINTA, CALIFORNIAFOR 92253 4 4 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 0-44 % 87 Date: /"2/.097 Applicant:—Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: No.:_—� tSUILUINU 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 co e, and my Licen in full force and effect. z Q S nse Class L�vse No. U G 6 o - 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' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is Ciss ed. y workers' compensation i P'nce carrier anp c are: �rder i/ c0 }- ,_ m,,Policy Number _ 1 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/'a��%i —,,-'APp,,cant WARNING: FAILURE TO SECURE WORKERS' COMPENSATI 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 Ouinta, 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. 1 certify that I have read this application and state that the above information is correct. 1 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. Date i -(JS Signature (Applicant or Agent): Page 2 ' Application Number 04=00007387 Date -11/24/04 Qty Unit Charge Per Extension 1:00 6.5000 EA MECH.EXHAUST HOOD6.50 Permit ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . 141.30 Plan Check"Fee 3.5.33 Issue Date Valuation . . . . 0 Qty Unit Charge. Per Extension" BASE FEE 15.00 3284.00 0350" ELEC NEW RES - 1 OR 2 FAMILY 114..94 5.68.0'0 ..0200 ELEC GARAGE -OR NON-RESIDENTIAL 11.36 Permit PLUMBING Additional desc Permit Fee 19.5:00 Plan Che.ck'-Pee 48.75 Issue Date Valuation 0 Qty- Unit -Charge Per Extension BASE_ FEE 15.00 19.00 6.0000EA 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` 9.0000 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 82. PLAN P3B,_3284"SF. PERMIT -DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. Other Fees . . . . . . . ART IN PUBLIC PLACES -RES 26.04 DIF COMMUNITY CENTERS -RES 68.00 DIF CIVIC CENTER - RES 229`.00 Page 3' Application Number 04-00007387 Date 11/.24/04 Other Fees ENERGY REVIEW FEE 66.82 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 21.04 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES_ 1098.00 Fee summary Charged ..Paid 'Credited Due. Permit Fee Total 1444.80 00 00 1444.80 Plan Check Total 768.66 .00 00 768.66 Other. Fee Total 2114.90 .00 .00 .2114.90 Grand Total'. 4328.36 .00 00 4328.36