BLCK (04-3528)49535 Marne Ct
04-3528
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (7.60) 7774012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA .Q.UINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760)777-7153
BUILDING PERMIT
Application Number
x_0.0=0 -03`5:2 --PD Date 4/16/04
Property Address .
. . . . . 49535 MARNE CT
APN:
649-520-014-18 -290532-
Application description
. . . WALL/FENCE
Property Zoning
. . . . LOW DENSITY RESIDENTIAL
Application valuation
.... 1000
- Owner
Contractor
PM' -RENAISSANCE, ,LLC
TRANS 'WESVHOUSING,.
INC.
9968'."HIBERT STREET,
STE. 102. 9968 HIBERT STREET,
STE #102
SAN..DTEGO
CA. 92131 SAN DIEGO.
CA 92131
65
(858) 3=3003
WCC: -. ... STATE FUND;-
WC: 16488.13:..`'.: ..',
.:.10/.01/04
K !., ; z Z QSIi$ :_ .7 0<T:03'9 ?
01/31/05
CCC: B
Permit . ... . . .
--------------.77
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
25 000., ;. Op.,
25 . 00
Plan Check :Total`
00 >. , 4 .... .. r' : 00
.00
Grand Total
25..00; 00 00
25.00
P.O. BOX 1504e U / •
/ VOICE (760) 777-7012
78-495 CALLE TAMPICOTFAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 440
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Date: - o2 G - 0
Applicant: I Architect or Engineer:
Applicant's Mailing Addr
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my License js.y fun ffe/Li
cenforce and erx Q/ r C/3
se Class (S cense No. gy
' Daley— ?-0 ' 'y r -Y( t/G y i - O al p ( y4;
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, after. improve. demolish. or repair any structure, pricx 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 Meir sole compensation, will do the work and the structure is not intended or offered for sale (Sea 7044,
Business and Professions Code: The Contactors' 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 budding 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. , B.3 P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to seffansure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the perfomance
of the work for which this permit is issued.
1 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
y worms compensationnce carter a dpol ber re:
olicy Number (o Y Q -r
/ I certify that, in the performance of the work (or which permit is issued,) shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California. and agree Mat, if I should become subject to time workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Amt
WARNING: FAILURE TO SECURE WORKERS' C4WENSATION 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.).
Lendees 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 Qulnta, Its
officers, agents and employees for any act or omission related to the worts 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.
1 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`f ignature (Applignt or Agent):