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04-4000 (SFD)Titf 4 4 441�z 504 LE TAMPICO CALIFORNIA 92253 �Y,,BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Qty I IIIIIII 31 IIIA I I I VIII IIII . Unit Charge Per BASE FEE Extension 15.00 Application Number . . . . .r04-00004000 Date 5/12/04 Property Address1' .ti ., . - . 49590 ALI CT APN: 649-520-014-21 -290532- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 183341 .� of Owner Contractor _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _,_ --w7 _ _ _._ _ _"_. ----------- 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 ------------------------- 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 _1:00 FIRST FLOOR SQ FTG 2873.00 ----------- ---------------------------------------------------------------- Permit . . . . .... BUILDING PERMIT. Additional desc `,' Permit Fee . . . . 933.50 •"Plan Check Fee 606.78 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 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 98.50 Plan Check Fee 24.63 Issue Date . . . . Valuation . . . . 0 Qty I IIIIIII 31 IIIA I I I VIII IIII . Unit Charge Per BASE FEE Extension 15.00 P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 0 Applicant: Applicant's Mailing Address: Date: or Architect or Engineer's Address: a /6'/ SG/, 13tee k W&rle- /ou Nsl✓&wC'r CeAe,1-11� Ger- `f?-Z6C0 clo,�-2y 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 Professionals Codet, and my License i full force and effect. Y icense Class License No. a J Date C — <G-- �! CertrdC1tTt^—J'94� 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 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 �i�7 Myy�vA1� compensation i nce carrier gr}rd pplj�y ryy �betare: Carrier / f �= ---Policy Number r {p '�/p l' ,3 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. Bate (O ^ t/6` % AAp lican► ��i(l�- ll WARNING: FAILURE TO SECURE WORKERS' CO101, MPENSATION 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 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, 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. ---Date �O /Y– ianature (Applicant or Agent): Q �� an a±24 I Application Number . . . . . 04-00004000 Page 2 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 32.13 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 Permit . . . . PLUMBING Additional desc Permit Fee . . . . 184.50 Plan Check Fee 44.25 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 21. PLAN 3B. PERMIT DOES NOT 1 Page 3 Application.Number . . . . . 04-00004000 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 60.68 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 707.79 .00 .00 707.79 Other Fee Total 2484.01 .00 .00 2484.01 Grand Total 4551.82 .00 .00 4551.82 1