04-4011 (SFD)O. Box 1504
-495 CALLE TAMPICO
QUINTA, CALIFORNIA 92253
•BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760),777-7012
' FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
t1XDts�fu1�F
<
F���r DEM
<
Application Number .
. . . 04 00°0-0.40-1-1 Date-
5/12/04
Property Address• 3,. , ..:
4'9:445`ALI CT
APN:
649-520-014-29 -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
(85 8) 653-3003
WCC: STATE FUND
WC: 1648813
10/01/04
CSLB: 701.039
01/31/05
CCC: B
--------------------------
-Structure Information -------------------------
Construction Type . .
. 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
2462.00
----------------------------------------------------------------------------
Permit . . . . ...
BUILDING PERMIT
Additional desc
Permit Fee . . . .
825.00 Plan Check Fee
1134.06
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
5.35
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge Per Extension
BASE.FEE •15.00
�� IIIIIIIIIIIIIIIIIIIIIIIII 73 � -�� ` •��� . , x�� -�
IE I
P.O. Box 1504 • 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: e-110 - L40 I/ Date:
Applicant:
Applicant's Mailing Address:
:rfct O gine
_IaxehfteArchitect or Engineer's Address:
�2O/S"/ S; W. 131&-lCA SvifG— /aa
/UC.G✓ PdXT 13445-1k- S4-- 9 A Oal
�. No.: C ! oS-t-y
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed underovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
e, and my License.J� full force and effect.
License Class L9 License No.
Bate ` — 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 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 1, 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
��is � M-wprkers' compensation ncje carrierpp?oli n tuber re:
rrier %5 / 7 Z/A/Q "'Policy Number /6 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.
,---Crate 6- I6- O y App plicant '
WARNING: FAILURE TO SECURE WORKERS' C PENSATION 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.).
,�-LMH-dees Name le
/Lenders 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, indemnity 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 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 b C"O Signature (Applicant or Agent): ��i ! y
l
Page
2
Application Number
.
. . . . 04-00004011 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
6.32
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
8.35
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
BASEFEE
15.00
-----------------------------
--------
--=------------------------------------
Special Notes
and Comment•so ,,
SFD - LOT 29.
PLAN 1C.
�t ,
PERMIT DOES NOT
Fee summary Charged
Permit Fee Total 1202.39
.Plan Check Total 154.08
Other Fee Total 2433.68
Grand Total 3790.15
Paid Credited Due
------- ---------- ----------
00 .00 1202.39
.00 .00 154.08
.00 .00 2433.68
.00 .00 3790.15
Page
3
Application.Number . . .
. . 04-00004011. Date
5/12/04
----------------------------------------------------------------------------
Special Notes and Comments
INCLUDE BLOCK WALLS, POOL,
SPA OR
DRIVEWAY APPROACH.. 75% REDUCTION TO PLAN
CHECK FEE DUE TO MULTIPLE
ISSUANCE OF
SAME PLAN TYPE
--------------------------------------------=-------------------------------
Other Fees . . . . .
. . ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC .CENTER - RES
366.00
ENERGY REVIEW FEE
13.41
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 Charged
Permit Fee Total 1202.39
.Plan Check Total 154.08
Other Fee Total 2433.68
Grand Total 3790.15
Paid Credited Due
------- ---------- ----------
00 .00 1202.39
.00 .00 154.08
.00 .00 2433.68
.00 .00 3790.15
Certificate of.0ccupancy
4
�. 'AM
5
G OF'i19� Building & Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at, the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating. building
construction and/or use.
BUILDING ADDRESS: 49-445.AL1 ct.
Use classification: S.F.D. Building Permit No.: 04 4011
Occupancy Group: R-3 Type of Construction:' V -N Land Use Zone: R -L
Owner of Building: TRANS WEST HOUSING INC Address: 9968 HIBERT s t STE. 102
City, ST, ZIP: SAN DIEGO CA 92131
By: G. SHOWALTER
Date: 03/22/05
Building Official
POST IN A CONSPICUOUS PLACE