04-4010 (SFD)° • t��W
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760),777-7012
CpF'9 78-49 N ALLE TAMPICO FAX (760) 777-7011
lJ LA Q;&INTA,. CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
JJ 16 2. -
BUILDING PERMIT
7M6,LAMIW_W
App'licaionNmber04=00004010 Date 5/12/04
Property Address, 49410 ALI CT
APN: 649-520-014-27 -290532-
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . LOW DENSITY RESIDENTIAL
Application valuation 152736
Owner Contractor
PM RENAISSANCE, LLC TRANS WEST HOUSING, INC.
9968 HIBERT STREET, STE. 102 9968 HIBERT STREET, STE #102
SAN DIEGO CA 92131 SAN DIEGO CA 92131
(858) 653-3003
WCC: STATE FUND
WC: 1648813 10/01/04
CSLB: 701039 01/31/05
CCC: B
-------------------------- Structure Information -------------------------
ConstructionType . . . . TYPE V - NON RATED
Occupancy Type . . . . . . DWELLG/LODGING/LONG_<=10
Flood Zone . . . . . . . . NON -AO FLOOD ZONE
Other struct info . . . . . CODE EDITION 2001CBC
FIRE SPRINKLERS NO
GARAGE SQ FTG 461.00
PATIO SQ FTG 216.00
NUMBER.OF UNITS 1.00
FIRST FLOOR SQ FTG 2'462.00
---------------------------------------------
---=---------------------------
Permit . . . . . .. BUILDING PERMIT
Additional desc
Permit Fee 825.00 Plan -Check Fee 536.25
Issue Date Valuation . . . . 152736
Qty Unit Charge Per Extension
BASE FEE 639.50
53.00 3.5000 THOU BLDG.100,001-500,000 185.50
----------------------------------------------------------------------------
Permit . . . . MECHANICAL
Additional desc
Permit Fee . . . . 85.50 Plan Check Fee 21.38
Issue Date . . . . Valuation. 0
Qty Unit, Charge Per. Extension
BASE FEE 15.00
I IIIIIII VIII III VIII IIII 62
IE
1
P.O. BOX 1504 • �iI / 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:LLA
U Q Date: ie;—&— 04-/
Applicant:
Applicant's Mailing Address:
chitect or Engineer:
Architect or Engineer's Address:
O Sit rfe-- /oc)
la&Z /--&--.A<0 C - 12 66 a
,4 -ti -c. No.: a /o S-2 0
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
ode, and my License ' full force and effect.
License Class License No. % Or / 0,1!1
/B5Ce Com—/�— O Contractor /
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 1, 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 Owner
WORKERS' COMPENSATION DECLARATION
L hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self4nsure 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.
TTTTTI have and will maintain workers' compensation i nce, as required by Section 3700 of the labor Code, for the performance of the work for which this permit is
�" -jesu My orkers' compensation in nce carder �r+d po icy number ale
wrier �' f�J1 UYA licy Number / 6 `/ d"dr' / 7
_ 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.
�6ate If—
/� —!1C ted& Applicant
WARNING: FAILURE TO SECURE WORKERS' COMP SATION 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
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 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 1 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 enter upon the above-mentioned property for inspection purposes.
Date Lo '- o NI nnature (Applicant or Agent):
Page
2
- Application
Number
04-00004010 Date
5/12/04
Qty
Unit Charge
Per
Extension
2.00
9.0000
EA
MECH FURNACE <=100K
18.00
2.00
16.5000
EA
MECH B/C >3-15HP/>100K-500KBTU
33.00
2.00
6.5000
EA
MECH VENT FAN
13.00
1.00
6.5000
EA
MECH EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit .
. . . . .
ELEC-NEW RESIDENTIAL
Additional
desc
Permit Fee
. . . .
110.39 Plan Check Fee
25.29
Issue Date
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
2462.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
86.17
461.00
.0200
ELEC.GARAGE OR NON-RESIDENTIAL
9.22
----------------------------------------------------------------------------
Permit .
. . . . .
PLUMBING
Additional
desc . .
Permit Fee
. . . .
166.50 Plan Check Fee
33.38
Issue Date
. . . .
Valuation
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
16.00
6.0000
EA
PLB FIXTURE
96.00
1.00
15.0000
EA
PLB BUILDING SEWER
15.00
1.00
7.5000
EA
PLB WATER HEATER/VENT
7.50
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
SFD - LOT
27. PLAN 1B.
PERMIT DOES NOT
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged
1202.39
616.30
2473.90
4292.59
Paid
al
Credited
.00
.00
.00
.00
Due
1202.39
616.30
2473.90
4292.59
Page
3
Application Number
.04-00004010 Date
5/12/04
----------------------------------------------------------------------------
Special Notes and Comments
INCLUDE BLOCK WALLS, POOL,
SPA OR
DRIVEWAY APPROACH
----------------------------------------------------------------------------
Other Fees . . . . . . .
. ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY'REVIEW FEE
53.63
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
00
DIF LIBRARIES - RES
225.00
':DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI) - RES
15.27
DIF STREET MAINT FAC -RES
15.00.
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged
1202.39
616.30
2473.90
4292.59
Paid
al
Credited
.00
.00
.00
.00
Due
1202.39
616.30
2473.90
4292.59