04-8033 (SFD)ol
° MSR 09 200 tGi�trCt/
CITY OF LA NI E pt= INTA
FINA
pY BUILDING &SAFETY DEPARTMENT
OF 78-495 CALLS TAMPICO (760).777-7012 _ FAX (760) 777-7011
LA QUINTA•, CALIFORNIA 92253 INSPECTION.REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number 0044 0000-8033 Date 12/29/04
Property Address . . . 4-9865 PATTI CT
APN: 649-520-998-7 290833
Application description DWELLING - SINGLE FAMILY DETACHED
'Property Zoning LOW DENSITY RESIDENT=AL
Application valuation . . . 183341
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 92=31
.(858)'653-3003
WCC: STATE FUND
WC: 1648813 10/01/05
CSLB: .701039 01/31/05
CCC:. B
P.O. Box 1504
78-495 CALLS TAMPICO r VOICE (760) 777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: d �- 903, aj Date: 3.4 • � �
Applicant:
Appiicanrs Mailing Address:
%A Engineer.
Itect or Engineer's Address:
'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
Cod rid my License isjn full force and effect. s-�� L* 3
cense Clas,23
s rcense No. /
,--Oate �ontractor
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 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, 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 Owner
WORKERS' COMPENSATION DECLARATION
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
bt 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
ed. rkers' cc pensation ms ce prier and poI qy r a
Cartier \� .I1Policyma.Number_ 1 (� f&l�__721
I certify that, in the perf6r ance of the work for which this permit is issued,.1 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 die workers' compensation provisions of Section 3700 of the Labor Codd,1 shad
Q
forthwith comply with those provisions.
/
Date / 1 c7i 3m�1i1s" wnr
WARNING: FAILURE -TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN. EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (s100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3708 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.).
Lender's 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 Ouinta, 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.
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
constructi n, and hereby authorize represen lives of this county to enter upon the above-mentioned property for inspection purposes.'
ate ignature (Applicant or Agent):
------=---------------------------------------------------------------------
•j Application Number . . . . . 04-00008033
----------------------------------------------------------------------------
Structure Information
Construction Type .
. . . TYPE V - NON RATED
PLUMBING
Occupancy Type
Additional
. . . DWELLG/LODGING/LONG <=10
Flood Zone
NON -AO FLOOD ZONE
. . . .
Other struct info
. .
. . . CODE EDITION 2001 CBC
Issue Date
. . . .
FIRE SPRINKLERS. NO
Valuation
Qty
GARAGE SQ FTG
648.00
PATIO SQ FTG
474.00
BASE
FEE
NUMBER OF UNITS
1.00
---------------------------------
PLB
1ST FLOOR SQUARE FOOTAGE
-------------------------------------------
2873.00
Permit . .
. .
BUILDING PERMIT
BUILDING SEWER
Additional desc
6.0000
EA
PLB
Permit Fee . .
. .
933.50 Plan Check Fee
606.78
Issue Date . .
. .
Valuation . . . .
183341
Qty Unit
Charge
Per
Extension
9.0000
EA
BASE FEE
�100,001-500,000
639.5'0
84.00
-----------------------------------------------------------------------------
3.5000
THOU BLDG
294.00
Permit . . . .
. .
MECHANICAL
Additional desc
Permit Fee
83.50 Plan Check Fee
20.88
Issue Date . .
. .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
2.00 .9.0000
EA MECH FURNACE <=100K
18.00
2.00
9.0000
EA MECH B/C <=3HP/100K BTU
18.00
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 FP_MILY
100.56
648.00
----------------------------------------------------------------------------
.0200
ELEC GARAGE OR NON-RESIDENTIAL
12.96
Permit .
. . . . .
PLUMBING
Additional
desc
Permit Fee
. . . .
238.50
Plan Check Fee
Issue Date
. . . .
Valuation
Qty
Unit Charge
Per
BASE
FEE
19.00
6.0000
EA
PLB
FIXTURE
1.00
15.0000
EA
PLB
BUILDING SEWER
.9.00
6.0000
EA
PLB
ROOF DRAIN
1.00
7.5000
EA
PLB
WATER HEATER/VENT
1.00
3.0000
EA
PLB
WATER INST/ALT/REP
1.00
9.0000
EA
PLB
LAWN SPRINKLER SYSTEM
59.63
0
Extension
15.00
114.00
15.00
54.00
7.50
3.00
9.00
------------------------------------------------------------------------------
Application'Number .
. . 04700008033
-Permit . . . . . PLUMBING
Qty Unit Charge
Per
Extension
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
---------------------------------- 7 -----------------------------------------
Special Notes and Comments
SFD - LOT 7, PLAN 3CR,
2873 SF. PERMIT
DOES NOT INCLUDE POOL,
SPA, BLOCK WALLS
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-F_ES
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
-----------------------
1399.02 .00 C0
-------
1399.02
Plan Check Total
719.42 .00 C0
719.42
Other Fee Total
2484.01 .00 C0
2484.01
Grand Total
4602.45 .00 C0
4602.45.