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04-8013 (SFD)MAR. 09.2005( CITY OF LA QUINTA P.O. BOX 1504 78-495 CALLS TAMPICO LA QUINTA•, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760),777-7012 FAX (760) 777-7011 INSPECTION.REQUESTS (760) 777-7153 Application Number 04-00008013 Date 12/29/04 Property. Address . . . . . 49960 P T CT APN: 649-520-998-3 -290533- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 163482 Owner ------------------- ------------- PM RENAISSANCE, LLC 9968 HIBERT STREET, STE.. 102 SAN DIEGO, CA 92131 Contractor TRANS WEST HOUSING, INC. 9968 HIBERT STREET, STE #102 SAN .DIEGO, CA 92131 (858) 653-3003 WCC: STATE FUND WC: 1648813 10/01/05 CSLB: 701039 01/31/05 CCC: B P.O. BOX 1504 78-495 CALLE TAMPICD � VOICE (760) 777-7012. LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7.011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: - Date: 3.4 • oS Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: No. _ �-- (B j D LL '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 Professions and my License is iry(ull fon and effect. �D 9 rcense Class L`f 'cense No. 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 ft 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 pemat 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. 7040, Business and Professions Code: The Contractors' State License Law dos 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 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.), V 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 Nof 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 / i ed rkers' tro pensation injWmce prier and poli gum r amer icy Number 4 4g —A certify that, in the performance of the work for which this permit is iss ed,.l shall not employ any person in any manner so as to become subject to the wofkeW compensation laws of California, and agree that, If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shad fort comply with those provisions. 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 tiy 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 Lender's Address IMPORTANT Application is hereby made to the Director of Building APPLICANT C Safety Apermit subject to the CKNOWLEDGEMENT 1. Each person upon whose behalf this application is, made, each person at whose request and forwhosewhose benefit work snditions and nperfo set fmied under or puorth on this rsuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnity 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 constructi and hereby authorize representatives of this county toenter upon the above-mentioned property for inspection purposes. ate 1 /9��I<griaturepplicant or Agent): i --------------------------------------------------------------------------- . .� Application Number . ------------------ ---------------------------------------------------------- . . .'. 04-00008013 1.00 --------------------------- Structure Information ------------------------- 13.00 Construction Type . . . . . TYPE V - NON RATED 1.00 Occupancy Type . . . DWELLG/LODGING/LONG <=10 1.00 Flood Zone NON -AO FLOOD ZONE 1.00 Other struct info . . . . . CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 589.00 PATIO SQ FTG 328.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 2580'.00 Permit BUILDING PERMIT Additional desc Permit Fee . . . . 863.50 Plan Check Fee 561.28 Issue Date . . . . Valuation . . . . 163482 Qty Unit Charge Per Extension BASE FEE 639.50 64.00 3.5000 THOU BLDG 100,001-500,000 224.00 Permit . . . . . . MECHANICAL. Additional desc Permit Fee 77.00 Plan Check Fee 19.25 Issue Date . . . . Valuation 0 Qty Unit Charge. Per Extension BASE FEE 15.00 2.00 9.0000 EAMECH FURNACE <=100K 18.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU 18.00 3.00 6.5000 EA MECH•VENT FAN 19.50 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit . . Additional desc Permit Fee Issue Date . ELEC-NEW RESIDENTIAL 117.-08 Plan Check F•ee 29.27 Valuation . . 0 Qty Unit Charge Per _ Extension BASE FEE 15.00 2580.00 .0350 ELEC NEW•RES - 1 OR.2 FAMILY 90.30 589.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 11.78 -------------------------------=-------------------------------------------- Permit . . . . PLUMBING Additional desc Permit Fee . . . . 256.50 Issue Date Qty Unit Charge Per 18.00 6.0000 EA 1.00 15.0000 EA 13.00 6.0000 EA 1.00 7.5000 EA 1.00 3.0000 EA 1.00 9.0000 EA Plan Check Fee 44.63 Valuation . . . 0 BASE FEE PLB FIXTURE PLB BUILDING SEWER PLB ROOF DRAIN PLB WATER HEATER/VENT PLB WATER INST/ALT/REP PLB LAWN SPRINKLER SYSTEM Extension - 15.00 108.00 15.00 78.00 7.50 3.00 9.00 v Application Number. . ---------------------------------------------------------------------------- . . . . 04-00008013 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 ----------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 3, PLAN 2CR, 2580 SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALL, 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 56.13 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 16.34 DIF STREET MAINT.FAC-RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Creditec Due. Permit Fee Total 1329.08 .00 C0 1329.08 Plan Check Total 654.43 .00 .CO 654.43 Other Fee Total 2477.47 .00 C0 2477.47 Grand Total 4460.98 .00 C0 4460.98