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04-8008 (SFD)sy a, o MIAR 09 2005 CITFYOFU tUINim BUILDINC° & SAFETY DEPARTMENT (760).777-7012 OF9w`' 78-495 CALLS "1AMPICO. FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION. REQUESTS (760) 777-7153 BUILDING PERMIT Application Number 04-0000800.8 Date 12/29/04 Property Address . . . . . . 4"9955 PATTI`C APN: 649 -520 -998 -4 -290533 - Application description DWELLING - SINGLE FAMILY DETACHED 'Property Zoning LOW DENSITY RESIDENT=AL Application valuation 152736 . 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' i P.O. Box 1504 W 78-495 CALLS TAMPICO Uw � VOICE (760) 777.7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: e400. � Date: ✓� •9 .05 Applicant: Architect or Engineer: Applicant's Mailing Address: or Engineer's Address: tic'. No.: ovlLUIN%2 rtKMI I UtLLAKATIONS 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 C000C-n and License is i full force and effect. 7� leg 09 cense Class ss icense No._ A/ Date Contractor !/' G' �i(�t� ' 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.). (, 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. , BA P.C. for this reason Date Owner. 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. Xd n hasyse 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 Carrier �]J itT� � My ems' co pensatioo trance carrier and policy, n2T e7 , 0 /Policy Number !� u _ I certify that, in the performance of the work for which this permit is issued,. shall. 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 Mie workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /Date k!� plicant J22 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 ($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 hereaffirm by arm 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 Lendees 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 perforned 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. I certify that I have read this application and state that the above information is correct 1 agree to comply with all city and county ordinances and state laws relating to building const ction, and hereby authorize r presentatives of this county to enter upon the above-mentioned property for inspection purposes. Date Signature (Applicant or Agent):. ---------------------------------------------------------------------------- Application Number . . . . . 04-00008008 Structure Information Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <==0 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 461.00 PATIO SQ FTG. 216.00 NUMBER OF UNITS 1.00 ------------------------------------------------------------------------------ 1ST FLOOR SQUARE FOOTAGE 2462.00 Permit . . . . . . .BUILDING PERMIT Additional desc Permit Fee . . . . 825.00 Plan Check Fee 134.06 Issue Date . . Valuation . . . . 152736 Qty Unit Charge Per Extension BASE FEE 639.50 53.00 ---------------------------------------------------------------------------- 3.5000 THOU BLDG 100,001-500,000 185.50 Permit . . . . . . MECHANICAL Additional desc . . Permit Fee . . . ._ 70.50 Plan Check Fee 4.41 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 2.00 6.5000 EA MECH VENT FAN 13.00 1.00 -------------------.--------------------------=------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 .Permit . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee 110.39 Plan Check Fee 6.90 Issue Date . . . . Valuation 0 Qty Unit Charge Per. Extension BASE FEE 15.00 2462.00 .0350 ELEC NEW RES'- 1 OR 2 FAMILY 86.17 461.00 ----------------------------------------------------------=----------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.22 Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 166.50 Plan Check Fee 10.41 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00- 5.0016.00. 16.00. 6.0000 EA PLB FIXTURE" 96.00 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 'r Application Number . . . . 04-00008008 ----------------------------------------------------------------------------- Permit . . . . . . PLUMBING Qty Unit Charge Per Extension 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 4, PLAN 1A, 2462 SF. PERMIT DOES NOT INCLUDE POOL, 'SPA, BLOCK WALLS, OR DRIVEWAY APPROACH. 75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE ----------------------------------------------------------------------------- Other Fees . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 13.41 DIF FIRE PROTECTION-1RES 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 15.27 DIF STREET'MAINT'FAC-RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Creditec Due Permit Fee Total 1187.39 .00 .00 1187.39 Plan Check Total 155.78 .00 .00 155.78 Other Fee Total 2433.68 .00 .00 2433.68 Grand Total 3776.85 .00 .00 3776.85