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04-3532 (BLCK)�F�a�rw BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760)-7 77-7153 BUILDING PERMIT�� IIII 22 Application Number 04 00.0.03.532---__) Date 4/16/04 Property Address . . . . . . 49560 ALI CT APN: 649-520-014-22 -290532- Application description . . . WALL/FENCE Property Zoning . . . . . . .• LOW DENSITY RESIDENTIAL Application valuation .. 1000 .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) 6.53=3003 WCC: STATE FUND` WC: 1648813 10/01/04 CSLB: .7.01:039.. 01/3-1/05 CCC: B Permit . ... . . . WALL/FENCE PERMIT - Additional desc 'Permit Fee 25.00 Plan Check Fee .00 Issue Date Valuation 1000 Qty Unit -Charge Per Extension BASE FEE 15.00 5.00 2.0000 HND' BLDG 501-2,000 10.00 Special Notes and .Comments 40 L.F.. 6' PROPERTY. LINE WALL, ORCO SYSTEM Fee summary Charged Paid Credited Due Permit Fee Total 25.00 .00 .00 .25.00. Plan Check Total 00 .00 .00 :00 Grand Total 25.00 .00 .00 25.00 I IIIIIII VIII III VIII IIII 22 IE P.O. BOX 1504 '�C�� VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4 4 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: _ 3�,3a Date: a0 -0'� Applicant: I Architect or Engineer. Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 Pmfessionals, and my Lice fun tice and effect. se Class cese No. P/ C%yc I hereby affirm under penally of perjury that I am OWNER -BUILDER DECLARATION 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 strudura, priori 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 (Sea 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 appy 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 1 hereby affirm under penalty of perjury one of Cie following declarations: _ I have and will maintain a certificate of consent to seC4nsure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the peromran foe of the work for which this permit is issued. I have yand 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 /Cartier �" (/ d MY compensation' career arnd he iy�nb�r e i �J 1 ��cy Number I_(� g T' I' ( I _ 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 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, l shall forthwith comply with Grose provisions. WARNING: FAILURE TO SECURE WORKERS' C6MPENSATION 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 ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that Care is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lenders Address r APPLICANT ACKNOWLEDGEMENT IMPORTANT Application Is hereby made to the Director of Building and Safety for a peril 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 Ouinta, its officers, agents and employees for any act or omission related to the worts being performed under or following issuance of this pentill. 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. ig.tur. (Applicant or Agent): . 't