06-0357 (RPL)r -
P.O. BOX 1504
78-495 CALLE TAMPICO
LA' QUINTA, CALIFORNIA 92253
Application Number: ' 106 0.0.000357 -
Property Address: 79810 VIA SIN CUIDADO
APN: 772 -390 -007 -
Application description: POOL RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL,
Application valuation: 15000
Applicant:
Architect or Engineer:
A -la/
4 e4�Qumk
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
R J T HOMES
1425 E UNIVERSITY DR
PHOENIX, AZ 85034
- Contractor:
RJT INVESTMENTS INC
1425 E. UNIVERSITY D.
PHOENIX, AZ 85034
(602)257-1656
Lic. No.: 690645
t
VOICE (760) 777-7012
FAX (760) 777-7011 ,.
INSPECTIONS'(760) 777-7153 (
Date: 1/24/06
JAN 2 6 2006
WV OF LA
H
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION '
I hereby affirm under penalty of perjury that I amlicensedunder provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations: - -
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force.and effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: A -B — License No.: 690645
_'
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/issued.
e` `�� (D Contr or: _
�(' 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 issued. My workers' compensation
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 0460014793 '
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, Ishall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor'sState - •
and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor e, I shall forthwith comply with those provisions.
/
basis for the alleged exemption. Any violation of Section 7031.5 by
that he or she is exempt therefrom and P
any applicant for a permit subjects thea applicant to a civil penaltyof not more than five hundred dollars ($500).:
� pp , A _ I / �`�� I P e r
Date: A licant:�/c �tl-y`
(_ I 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED' THOU SAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.):
APPLICANT ACKNOWLEDGEMENT ,
(_ 1 I, as owner of the property, am exclusively contracting, with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalfthis application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I ani exempt under Sec.- , B.&P.C. for this reason
the owner, and -the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
Date: Owner:
2. Any permit issued as a result of this application becomes null and void if work isnot commenced
-
- within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
- CONSTRUCTION LENDING AGENCY
permit to cancellation. , ..
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above information is correct. I agree to comply with all '
work for which this permit is issued (Sec. 3097, Civ. C.).
city and co my ordinances and state laws relating to building onstruction, and hereby authorize representatives
of this unty to enter upon the above-mentioned prop for nspec pu r oses. '
Lender's Name:'
yin
-
Date: 6ignature (Applicant or Agen '
Lender's Address:
LQPERMIT
. i
- Application Number .. .'. 06-00000357 .
Permit BLDG POOL PERMIT
Additional desc
Permit Fee . . . . 162.00 Plan Check Fee
105.30
Issue Date, . . . Valuation
15000
`Expiration Date 7/23/06 _
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 . . 26.00 Plan Check Fee
6.50
Issue Date . . Valuation . . .
. . 0
Expiration Date 7/23/06
Qty Unit Charge Per
Extension
BASE FEE.
15.00
1.00 11.0000 EA MECH FURNACE >100K
------------------------------------------------=---------------------------
11.00
Permit ELEC POOL -PERMIT -RES
Additional desc.'
Permit Fee .` . . 45.00 Plan Check Fee
11:25
Issue Date Valuation . . .
0
Expiration Date 7/23/06'
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 30.00.00.EA ,ELEC PRIVATE SWIMMING POOL
------------------------------------------------------------------------
30.0'0
Permit. PLUMBING
Additional desc .
Permit Fee 33.00 Plan Check Fee
8.25
Issue Date' Valuation
0
Expiration Date 7/23/06
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
Specal Notes and Comments
------------
POOL & SPA -ONLY. ALARMS/BARRIERS SHALL
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P.0, Box 1504, 78 5�Calle f
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La Qulnta; CA
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Application
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Owner's N
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Address; �.' PO Oox 810
.vluaCWr • RJT Investments Inc,
Cily,ST, Zip: La Quints CA 91153:'
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Unlrerslly Or:
- Telephone: (.760) 564.61 55
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paunc (602)257.1650
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