BLCK (04-3530)49595 Marne Ct
04-3530
F Q(ArC4V
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)777-7153
BUILDING PERMIT
Application Number
X04=000030 Date 4/19/04
.Property Address
4.9595—MARNE—C *
APN:
649-52-0=014=2-0 -290532-
Application description WALL/FENCE
Prbperty Zoning . .
. . . . LOW DENSITY RESIDENTIAL
Application valuation . . . 1.000
Owner
Contractor
----------------
PM RENAISSANCE, LLC
WEST HOUSING,
-TRANS
INC.
996.8-HIBERT STREET,
STE.-102 9968 HIBERT STREET,'STE
#102
SAN DIEGO
CA"9213-1' ' ; SAN DIEGO
CA 92131
i 858): 653`-3003
WCC: STATE FUND
WC:, 1648813.
10/01/04.
CSLB.: 701039
01/31/05
CCC.::... B
---------------------- ----
Permit
----.--::---- ------------ -------------- - --------
WALL)/FENCE.' PERMIT
- - -- - - - -
Additional desc
-Permit Fee
25.00 Plan Check Fee
..00
Issue Date. . . .
Valuation
1000
Expiration Date
10/19/04
Qty Unit Charge Per
Extension
BASE FEE
15.00
5.00 2.0000 HND BLDG -501=2,000
10.00
Special_Notes'and Comments -t.'
40-L.F. 6 ' . PROPERTY
LINE.. WALL , ORCO
.SYSTEM
P.O. BOX 1504 e :
VOICE (760) 777-7012
78-495 CALLS TAM►ICO FAX (760) 777-7011
LA QUINTA. CALIFORNIA 92253 a INSPECTIONS (760) 777-7153
Application Number:
Applicant:
Applicant's Mailing Address:
BUILDING & SAFETY DEPARTMENT
Date: Z/ - a0
Architect or Engineer.
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 (cornnendng with section 7000) of Division 3 of the Business and Prolessionets
Code. and my License lull force and effect
License CWss L3 License No.
Date' Contractor_ %-/ l'.J (': s i NOV $ NG
OWNER43ULDER DECLARATION
I hereby affirm under penalty of perjury that I am exernpt from the Contractors• State License Low for the following reason (Sec, 7031.5. Business and Professions Code: Any
city or county tathr- ww o pemmt b canwuumX, ah w. improve. dernobsh or repair any structure• priorto Its issuance. also requires the applicant for the permit b lie a signed
statenm that he or she is licensed pursuant to the provisions of the Contractors' State Licethse Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Profession$ applicant Code) or that he or she is exempt ameborm
n and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a prit subjects
the Dir of not more than five hundred dolars %=).y
th I, as owner of the
property, or my a mPbYees with wages as their sole compensatiah• will do the wok and the structure is not intended or offered for sale (Sec. 7044.
Business and Professions Code: The Contractors• State license Law does not appy to an owner of property who bui is or improves thereon, and who does the work
himself or herself or trough his or her own employees, provided ghat the improvements aro not intended or offered for sale. K, however, the buid'rg or improvement is
toad within one year of completion. the owner -Wider wig have the burden of proving Ona$ he or she did not build or improve for the purpose of sale.)_
U L as owner of the property, am exclusively contacling with licensed coniraaors 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
1 hereby affirm under WARS' COMPENSATION DECLARATION
D ltY of Pe+lury one of the fotbwing declarations:
—I have and wit maintain a certificate of consent to sef4inwre for workers* compensation. as provided for by Section 3700 of the Labor Code. for the perfomwoe
of the work for which this pen, 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
qre , Ay w kers motion insurance number are:
Gamier S (?JrvA Nreer—Policy ( 7
_ I catty that, in the performance of the work for which this pemvt is issued. I shad not
cortmper sa6an laws of California. and agree that. I I should become e"'a0y any person in any mirrors w e to become3700subject b the de.I sh'
forthwith comply with those p wAsiiorrs, a the workers' compensation provisions of section 3700 of tlne Lebo Code. l Ahad
Date'- 2- f Appiwnt
WARNING: FAILURE TO SECURE WORKERS* TION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE.Hl1NDRED 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. .
1 hereby affirm underf Y of perjury tat there trCONSTRUCTION LENDING AGENCY
isaconsuction
WXWV agency for One performance of the work for which this permit is issued (Sec. 3097. Civ. C.).
Lendees Name
Lenders Address _ G
IMPORTANT APPLICANT ACKNOWLEDGEMENT
Application n is hereby made al the Director of Budding and Safety for a Permit subject b the conditions and restrictions set forth on this appicafio►
1. Each person upon f this
penal( this application is made. each Person at whose request and for whose benefit work is performed under or pursuant b a
Issued a result of Orris application, the owner. armit
nd the applicant, each agrees b. and Chad, defend. indemnity and fold harmless the City of La Ouintamils
agents and employees tor any actor 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 I work is not commenced within 150 days from date of issuance of such permit, or
cessation of work for 160 days will subject permit b 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 unrelating to building
construction. and hereby autthorin representatives of this county to enter upon the above-mentioned property for inspection purposes.
Date 4W-2'-r'4y Signature (Appicantor •— " _ _ _
A9e1t)