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04-4004 (SFD)L/ Q•� a/ Td* U BUILDING & SAFETY DEPARTMENT _Yk P -ON B°Ox 1504 (760).777-7012 ocF X7-8-495 CALLS TAMPICO • FAX 760 777-7011 G �� A Q,uINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 77.7-7153 � ea U gt1'6� 1J• i✓ -BUILDING PERMIT FINANCE DEPT: - r Application 'Number 04-00004004 Date 5/12/04 Property Address•-... 49505 ALI CT APN: 649-520-014-31 -290532- Application description DWELLING - SINGLE FAMILY DETACHED' Property Zoning . . . . . LOW DENSITY RESIDENTIAL Application valuation 183341 Owner Contractor -- - - - - - - - - - - - - - - - - - - - --- - -- ;- ,-_ `-_.-----------.---� PM RENAISSANCE, LLC TRANS•{WEST HOUSING, INC. 9968 HIBERT STREET, STE. 102 9968 HIBERT STREET, STE 4102 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 ------------------------- 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 648.00 PATIO SQ FTG 474.00 NUMBER OF."' UNITS L.00 FIRST FLOOR SQ FTG 'y' 2873.00 ---------------------------------------------------------------------------- Permit . . . . ... BUILDING PERMIT Additional desc - Permit Fee . I. . . 933.50 '�'{='-Plan CYieck',Fee ` ' 1'51.70 Issue Date . . . . Valuation 183341 Qty Unit Charge Per Extension BASE FEE 639.'50 84.00 3.5000 THOU BLDG 100,001-500,000 294.00 ------------------------------------------------------------7--------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee 98.50 Plan Check Fee 6.16 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per BASE FEE IIII II (IIII III I IIII 12 �6 IE Extension 15.00 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: - 4004 Date: (c - Applicant: Applicant's Mailing Address: 4 W - 'r -"X/ -A 1bgr LIZ / %.0 Architect erngi�Agr: t/ Architector Engineer's Address: �2O/S/ S.,60-1. S&r14- too �!/eyc✓ /0d/C-,T— 136�cI+ ccc c. No.: L' /G'S'A N BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirn 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 Licensei full force and effect. .� �nse Class License No. 2 0 / G.Zei Date — r-- &R/Ac/J ,,,�..r 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.). (_) I am exempt under Sec. , B.& 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' compgDsation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is �„sued„Jvl_ y w ers' compensate ins rance carrie�a9d�li�ry�mpe� re: amer 76/ —PolicyNumber _ 6 d I certify that, 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. ate_ �� /` G `I A nt�j,�pA�/y hiX�•� 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. 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.). Lenders Name Menders Address 7 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 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. ate L'�t7H Signature (Applicant or Agent): a •t„ � 1 Page 2 Application Number . . . . . 04-00004004 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 4.00 6.5000 EA MECH VENT FAN 26.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 128.52 Plan Check Fee 8.03 Issue Date. Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 2873.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 100.56 648..00 ------------ .0200 ELEC GARAGE OR NON-RESIDENTIAL 12.96 I- - - Permit . - - - - - - - - - - - - - - - - . . . . . PLUMBING - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Additional desc . . Permit Fee . . . . 184.50 Plan Check Fee 11.06 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 19.00 6.0000 EA PLB FIXTURE 114.00 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 31. PLAN 3A. PERMIT DOES NOT Page 3 Application Number . . . . .. 04-00004004 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 15.17 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 18.33 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total ---------- 1360.02 ---------- -------------------- .00 .00 1360.02 Plan Check Total 176.95 .00 .00 176.95 Other Fee Total 2438.50 .00 .00 2438.50 Grand Total 3975.47 .00 .00 3975.47 Certificate of Occupancy 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. Use classification: S.F.D. Occupancy Group: R-3 BUILDING ADDRESS: 49-505 ALI ct. Type of Construction: V -N Owner of Building: TRANS WEST HOUSING INC Building Official 1013aI:1.1 A IIIIII VIII I I I IIII 10 Building Permit No.: 04 4004 Land Use Zone: R -L Address: 9968 HIBERT s t STE. 102 City, ST, ZIP: SAN DIEGO CA 92131 By: G. SHOWALTER Date: 03/22/05