BELC2017-00771`
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
&t,, 4 Q9&&
DESIGN & DEVELOPMENT DEPARTMENT
Application Number:
BELC2017-0077
Property Address:
52233 ROSEWOOD LN
APN:
777450072
Application Description:
CODORNIZ/TEMP POWER POLE
Property Zoning:
of the work for which this permit is issued.
Application Valuation:
$200.00
Applicant:
C
SW CONTRACTORS INC DBA
SW CONSTRUCTION
1130 E MISSOURI AVENUE
STE 890
PHOENIX, AZ 85014
BNUWC013700
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760)777-7153
Owner:
RJT HOMES CODORNIZ
1425 E UNIVERSITY DR
PHOENIX, AZ 0
Date: 9/15/2017
Contractor:
SW CONTRACTORS INC DBA SW CONSTRUCTION
SEP 2017 I I 1130 E MISSOURI AVENUE STE 890
PHOENIX, AZ 850(L4
-CITY OF LAQUINACoMmUNITYDEVELOPMENTDEPARTAIE
NT (602)257-1656
`~
Llc. No.: 1007591
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATON DECLARATION
I hereby affirm under Penalty of perjury that lam licensed under provisions of Chapter
I hereby affirm under penalty of perjury one oll the following declarations:
9 {commencing with Section 7000) of Division 3 of the Business and Professions Code,
I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect.
compensation, as provided for by Section 370C of the Labor Code, for the performance
License Class: B License No.: 1007591
of the work for which this permit is issued.
��
I have and will maintain workers' ccrnpensation insurance, as required by
Date: ,Contractor.
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:
OWNER-BUI R DECLARATION
Carrier: MIDWEST EMPLOYERS CASUALTY COMPANY Policy Number:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
BNUWC013700
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
I certify that in the performance of the work for which this permit is issued, 1
city or county that requires a permit to construct, alter, improve, demolish, or repair
shall not employ any person in any manner so :as to become subject to the workers'
any structure, prior to its issuance, also requires the applicant for the permit to file a
compensation laws of California, and agree that, if I should become subject to the
signed statement that he or she is licensed pursuant to the provisions of the
workers' compensation provisions of Section 3300 of the Labor Code, I shall forthwith
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
comply with those provisions.
3 of the Business and Professions Code) or that he or she is exempt therefrom and the
-y
&
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora
Date: �� / Applica_let
-,
.permit subjects the applicant to a civil penalty of not more than five hundred dollars `
. '
($500).:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
(_) I, as owner of the property, or my employees with wages as their sole
AND SHALL SUBJECT AN EMPLOYER.TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
compensation, will do the work, and the structure is not intended or offered for sale.
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
COMPENSATION, DAMAGES AS PROVIDED FORIN SECTION 3706 OF THE LABOR CODE,
apply to an owner of property who builds or improves thereon, and who does the work
INTEREST, AND ATTORNEY'S FEES.
himself or herself through his or her own employees, provided that the improvements
f
are not intended or offered for sale. If, however, the building or improvement is sold
APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
he or she did not build or improve for the purpose of sale.).
the conditions and restrictions set forth on this application.
(_) 1, as owner of the property, am exclusively contracting with licensed contractors
1. Each person upon whose behalf this appliotion is made, each person at whose
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
request and for whose benefit work is performed under or pursuant to any permit
State License Law does not apply to an owner of property who builds or improves
issued as a result of this application , the owner, and the applicant, each agrees to, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
shall defend, indemnify and hold harmless the city of La Quinta, its officers, agents, and
the Contractors' State License Law.).
employees for any actor omission related to th a work being performed under or
(_) I am exempt under Sec. B.&P.C. for this reason
following issuance of this permit.
2. Any permit issued as a result of this applic8tion becomes null and void if work is
not commenced within 180 days from date of i�uance of such permit, or cessation of
Date: Owner:
work for 180 days will subject permit to cancellation.
. 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
Lender's Address:
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 ordin antes and state laws relating to building
construction, and hereby authorize representatmes of this nter u 1m the
above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
Date: 9/15/2017 .
Application Number: BELC2017-0077
Owner:
Property Address; 52233 ROSEWOOD LN
RJT HOMES CODORNIZ
APN: 777450072
1425 E UNIVERSITY DR
Application Description: CODORNIZ /TEMP POWER POLE
PHOENIX, AZ 0
Property Zoning:
Application Valuation: $200.00
Applicant:
Contractor:
SW CONTRACTORS INC DBA SW CONSTRUCTION
SW CONTRACTO;ZS INC DBA SW CONSTRUCTION
1130 E MISSOURI AVENUE STE 890
1130 E MISSOUk- AVENUE STE 890
PHOENIX, AZ 85014
PHOENIX, AZ 85C14
(602)257-1656
Llc. No.: 1007591
Detail: TEMP POWER FOR CODORNIZ TRACT. PER 2016 CALIFORNIA BUILDING CODE
r
..FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS 581473 FEE
101-0000-20306. 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TEMP POWER SERVICE
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TEMP POWER SERVICE PC
101-0000-42600
0
$17.73
Total Paid for ELECTRICAL: $43.06
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE.'
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
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ADDRESS MAP
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Bin.#
Cj/ Of %d QI11ntd
Building 8L Safety Division .
P.O. Box 1504,78-493 Calle Tampico
La.Quinta, CA 92233 - (760) 777-7012
Building Permit' Application and Tracking Sheet
Permit #
ProjeaAddrm: 52 -233y -'Rosewood Lane
Owner'sxame:.R T Homes- Codot-liz LLC
Address: PO BOX 6089
A. P. Number.
Legal Description:
Contractor SW Contractors, Inc. DBA SW Constructi
City, ST, Zip: La Quinta, Ca. 92,248
nTelephone: 760-564-3470
Address: PO Box 6089
Project Description:
City, ST, Zip: La uinta Ca. 92248
Temp power pole With 100amp box
Telephone: 760-564-3470":
State Lic. # : 1007591
City Lie. #.: 763129
Arch., Engr., Designer.
Address:
City, ST. Zip:
C.
Telephone:
State Lic. #: , , . r
Name of Contact Person: Jim Martin
Construction Type: Residential Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stori : #Units:
Telephone *of Contact Person: 760-989-6438
Estimated Value of Project 2�7o
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted.-.
Mechanical
Grading plan
tad Review, ready i'or correctionsfissue
Electrical
Subcoutattor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
ILOA. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for eorrectionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
Ad.P.P.
Pub. Wks. Appr '
Date of permit issue
School Fees
Total Permit Fees