04-7386 (SFD)P.O. BOX 1504
78-495 CALLS. TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
BUILDING & SAFETY,DEPARTMEN•T
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 77.7-7153
Application Number
04-O_Q0.0738.6 Date
11/24/04
Property Address
79810 VIA SIN CUIDADO
APN:
772-390-007- - -
Application description
DWELLING -.SINGLE FAMILY ATTACHED
Property Zoning
LOW'DENSITY RESIDENTIAL
Application valuation
. . . 209259
Owner
Contractor
R J T HOMES
RJT HOMES LLC
-1425 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
SATT�
-----
Construction Type TYPE�U - NON RATED
Occupancy Type
,D,WELLG/LODGING/LONG <=10
Flood Zone . . . (� ...
�� NONE -AO FLOOD ZONE
Other struct info
1�� . CO-pEEDI`TION. , 2001
CBC
SQ FTG
568-.00
o��GARAGE
IO SQ FTG
773 00
TOT ELIGIBLE NO
NUMBER OF UNITS
1.00
1ST, -.,FLOOR -SQUARE FOOTAGE
3284.00
Permit
BUILDING PERMIT
Additional desc
Permit Fee
1024.50 Plan -.Check Fee `.,.
665.93
Issue Date
Valuation
209259
Qty Unit Charge
Per
Extension
BASE FEE
639:50
110.00 •3.50,00
THOU BLDG 100,001-500,000'
385.00
--------------------------
Permit . . . . .
MECHANICAL
Additional desc
Permit,Fee
6.5.50 _ Plan. Check Fee
18'..25
Issue'Date
Valuation
0
Qty Unit,Charge
Per
Extension
BASE. FEE
.15.00
1.00- 9. 0.000
EA MECH FURNACE <=100K
9.00
1..00 9.0000
EA MECH B/C_<=3HP/100K BTU
9.00
00 1.6.5000
EA MECH 9/C 53'-15HP%>100K-500.KBTU
0`0.
x4.00 6:5000
EA MECH`VENT FAN
.26.00
P.O. BOX 1504 •
VOICE (760) 777-7012
7$-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 7,38& Date:
Applicant: ---Architect or Engineer:
Applicant's Mailing Address: Arch' ect or Engineers dress:
L_Wc. No.. c) 3 b ��
BUILDING 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 License i full force and effect. / O�
cense Class_ erase No. b
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
C issu d. My "rkers ompensation ir!y� Ce carrier and olicy umbo are:
er ✓ �, F'.i .�_ iy6fcy Number 1 5 'W
_ 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.
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
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.
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
construction, and hereby authorize representatives of this county to ent r upo the above-mentioned property for inspection purposes.
Signature (Applicant or Agent):
i
Page
2
Application Number
.
. . .' 04-00007386. Date
11/24/04
Qty Unit
Charge
Per
Extension
1.00
6.5000
EA MECH•EXHAUST HOOD
6.50
Permit . . .
. . .
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee
141:30 Plan Check'Fee .
3.77
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 .
568.00
.020.0
ELEC GARAGE OR NON-RESIDENTIAL
11.36
Permit
PLUMBING
Additional desc
• Permit Fee
183.00 Plan Check Fee
45.-75
Issue Date
. .
Valuation
0
Qty Unit
Charge
Per _
Extension
BASE FEE
15-.00
1.9.00
6.0000'EA
PLB FIXTURE
114.00
1.00
15.0000
EA PLB BUILDING SEWER
15.0'0
1.00
.7.5000
EA PLB WATER HEATER/VENT
7.50
1.00
3.0000
EA IPLB 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
a
Special Notes
and Comments
;
SFA. LOT.84. PLAN
P3A.-PERMIT DOES NOT.
'INCLUDE BLOCK
WALL, POOL,,
SPA OR
DRIVEWAY APPROACH.
Other Fees ..
. . . .
ART IN PUBLIC PLACES -RES
23.14.
DIF COMMUNITY CENTERS -RES
68.00
DIF CIVIC'CENTER - RES.
229.00
ENERGY"REVIEW FEE
66.59
r,
Page
3
Application Number
04-00007386` Date
11/24/04
Other Fees . .
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
20.192 .
DIF'STREET MAINT FAC -RES
15.00..
DIFTRANSPORTATION.-RES
1098.00
Fee summary
---- - - - - -
Charged
Paid Credited
Due
-
- - - - - - - -
Permit Fee Total
---- - - - - --
1429.30
-'---- - - - - -•---- - - - - ----
.00-- .00,
-- -- -_-
1429..30,.
Plan Check Total•
733.70
.00`- .00
733.70
Other Fee -Total
21.11.65'
.00 .00
2111.65
Grand Total
4274.65
.00- .00
4274.65