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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.