BLCK (04-3523)49415 Marne Ct
04-3523
F w4 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).777-.7153
BUILDING PERMIT
Application Number
04"0_0,0.03=5-213' Date, 4/16/04
Property Address . . . . . .
49415 MARNE CT
APN:
649-520-014-14 -290532-
A.plication 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. D.IEGO. CA 92131
SAN DIEGO.
CA 92131
(858)'..65.'3- 3 0 0 3
WCC: STATE FUND
.
WC: 16488.1.3
10/01/04
CSLB: •,.701039.
01/31/05
CCC: g
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
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: 04 — 3sa3 Date: z4 -20 - o y
Applicant: I Architect or Engineer.
Applicant's Mailing Address:
Architect or Engineer's Address:
— 04
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby offer under penally of perjury that I erre licensed un rovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and'Professanals
Code and my Lice nsQ i in full force and effect. Gy
rice Class License No. '70-10 1
ate 2a' • ntrador_ f 1e*1v-? T4oa3 /NG
OWNER.BUILDER DECLARATION
Ihereby affirm under penalty of perjury that I am exempt
h e county that from the Contractors' State License Law for the following reason (Sec 7031.5. Business and Professions Code: Any
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 dviil penalty of not more than five hundred dollars ($500).):
U I, as owner of the property, or my employees with wages as their sole compensation, will do the work and the structure is not Intended or offered for sale (Sec 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work
himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, howeyer, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that tie or she did not build or improve for the purpose of sale.).
U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor($) 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:
1 have and will maintain a certificate of consent to SO4nsure 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' compensa insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit Is
"MV
sabon ria nnce carrier age p fiy
a Carier I U/V POticy Number / 6 `7fry
_ I certify that, In the performance of the work for which this penbit is issued. I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Califomia, 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 those provisions.
L --
WARNING: FAILURE TO SECURE WORKERS' COMF(6NSATION 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.).
Lendefs Name
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application Is hereby mode 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 Le Oulnta, 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 pemuL 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.
jfate ` - ' y Signature (Applicant or Agent):