06-1145 (RPL)Y. P.O. BOX 1504 ^� , VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
r BUILDING PERMIT
Application Number: r06-00001145
Property Address: 79820 "VIA SIN CUIDADO
APN: 772-390-008- - - .
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 15000
Applicant: Architect or Eng r. �
ems'+
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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 is in full force and effect.
License Class: A -B_ L /-License No.: 6900645
fDate� 6 Conor: S T
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason ISec. 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 Contractor's 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).:
(_) 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 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.).
1 —1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Coder 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.).
I-) I am exempt under Sec. , B.&P.C. for this reason '
Date: Owner: .
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: -
LQPERMIT - . -
Date: 3'/21/06
Owner:
R J T HOMES
1425 E UNIVERSITY DR
PHOENIX, AZ 85034
Contractor:
RJT INVESTMENTS INC
1425 E. UNIVERSITY DRIVE
PHOENIX, AZ 85034
(602)257-1656
Lic. No.: 690645
WORKER'S 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 issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 0460014793
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.
Da -;O— Applican�
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.
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 Quinta, 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 inf rmation is correct. I agree to comply with all
city and county ordinances and state laws relating to building const r ction and hereby authorize representatives*
of this county to enter upon the above-mentioned property for inspe ion rposes.
Date Signature (Applicant or Agent): -
Application,Number 06-00001145
Permit . . . . . . BLDG POOL PERMIT..
Additional desc .
Permit Fee . . . 162.00. Plan Check
Fee
105.30
Issue Date Valuation
. . .
. 15000
Expiration.Date 9/17/06
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 9/17/06.
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 9/17/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 30.0000 EA ELEC PRIVATE SWIMMING.POOL
------------------------------
30.00
Permit PLUMBING
Additional desc .
Permit Fee . . . . 33.00 Plan Check
Fee
8.25
Issue Date Valuation
. . . .
0
Expiration Date 9/17/06
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
Special Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL.
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