04-7388 (SATT)BUILDING & SAFETY DEPARTMENT
c P.O. Box 1504 (760)1.777-7012
`OF fF�9 78-495 CALL_ E TAMPICO " FAX (7 60) 777-7011
LA QUINTA; CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . 040000.7-3-8-8 Date 11,/24/04
Property Address. . .779800 VIA SIN CUIDADO
APN: 772-390-006-
Application description DWELLING SINGLE FAMILY ATTACHED
Property Zoning . . LOW DENSITY RESIDENTIAL
Application valuation . . . 200624
,
Owner Contractor
R J T HOMES RJT HOMES LLC
142.5,: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
CCC: A-B
------ Structure Information SATS - --
Construction Type TY�AE V NON RATED
Occupancy Type DWE-hLG/LODGING/CONG <=.10
Flood Zone :�NON�A�O FLOOD ZONE,
Other struct info . . p. j CODES EDITION 2001 CBC
R,AGE\,SQ FTG 5 3 8. 0 0
PATIIO S,Q, FTG 568.00
QT�OELIGIBLE NO
OF��N.UMBER OF UNITS 1.00
1ST FLOOR ,`SQUARE -FOOTAGE' 319I-00
F
---------------------- - - - - -- ---.----:------------- ------------------------
Permit . . ,BUILDING PERMIT - --
Additional desc
Permit Fee 993.00 Plan Check' Fee `` 645.45
Issue Date Valuat,ion 200624
Qty Unit Charge. Per Extension
BASE FEE 639.50
101.00 5000 THOU BLDG 100,0017500,000 353.50
-------------------------_,.---------------
Permit . . . . MECHANICAL
Additional desc
Permit Fee 90:00 Plan•.Check Fee 26.25
Issue Date Valuation 0
Qty Unit.Charge -Per Extension-
BASE FEE 15.00
2.00 9.0000 EA MECH FURNACE <=100K• -18.00'
2.00 9.0000 EA MECH B/C <=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
+!
P.O. BOX 1504
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04/- 7,3$,9 Date: h.7 -1-05-
A I;
PH Kant. ----Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer Address:
Address: �--
E'z,(t7V-0_t bd✓',t_ cGY/y�
V
c. No.: J
t3UILDING 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
Code, and my Licens 's in full force and effect. /_ / , J�
cense Class icense No. �/ (7 K
_01-6S
01-6S /am— 1/ L
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 safe.).
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
e iss d. My��y6y��4lrkers' ompensation rance carrier nd olic nu�r bh� �r
arrier ✓�-a' C) TIA. vL�_Policy Number 3' ��/C�U
_ I certify that, in the performance of the work for which this permit is is ued, 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.
/Date
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
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.
I 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 2L1%�ature (Applicant or Agent):
Page
2
Application
Number'
04-000.07388. Date
11/24/04
Qty
Unit Charge
Per
Extension
1.00
6.5.000
EA .. MECH EXHAUST HOOD
6.50
------------
Permit .
. ..
ELEC-NEW RESIDENTIAL
Additional
desc
Permit"Fee
137.45 Plan Check Fee
34:36
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 ..
39.75
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
6.000.0
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 83
PLAN P23,
3191• SF PERMIT DOES
NOT INCLUDE
BLOCK WALL,
POOL, SPA OR
DRIVEWAY APPROACH..
Other ,Fees
. .
. ART IN PUBLIC PLACES -RES
20.00
DIF.COMMUNITY-CENTERS-R•ES
68.00
DIF CIVIC CENTER - RES`.
229.00
w
Page 3
Application Number
. . . . .
04'-000-07388
Date
11/24/04
Other Fees: . . . .
. .
ENERGY REVIEW FEE
64.55
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'
.Fee summary
-Charged
Paid Credited.
Due
Permit Fee Total
1469:4,5
.00.
.00
1469.45..
Plan Check Total
745:81
.00
.00
74.5.81
Other Fee.Total
2105.61
_00
.00
2105.61
Grand Total
4320.87
.00
.00
4320.87`
o.