04-8002 (SFD)p o
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(760),777-7012
OFTV; 78-495 CALLS TAMPIC6
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
INSPECTION REQUESTS (760) 777-7153
BUILDING
PERMIT
Application.Number . . .
"0- OA -0.0.8.0-022.
Date 12/29/04
Property Address . . .
79769 JOEY CT
APN:
649-520-998-17 -29053'3-
Application description
DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . .
LOW DENSITY RESIDENTIAL
Application valuation . . . .
183341
Owner
------------------------------
Contractor
PM RENAISSANCE, LLC
---------------------------------
TRANS WEST HOUSING,
INC.
9968 HIBERT_ STREET,' STE. 102
9968 HIBERT STREET,
STE 4102
SAN DIEGO, CA 92131
SAN DIEGO, CA 92131
(858) 653-3003
WCC: STATE FUND
WC: 1648813
10/01/05
CSLB: 701039
01/31/05
CCC: B
0
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant: Architect
Applicant's Mailing Address: hitect
No.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3.4-05
or Engineer:
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
Code, and ss License is' full force and effect. 760/Z9
�nse Classnse 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 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 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.).
U 1 am exempt under Sec. , B.& 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.
NI -have and will maintain workers' compensate n insurance, as required by Section 3700 of the Labor Code, for the -performance wnce of the work for which
iss d. MY rs' co pensation i nce caner an ick np permit is
Cartier olicy Number l ACL l
_ I certify that, ih the performance of the work for which this permit is issued, I 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 the workers' compensation provisions of Section 3700 of the Labor Code, I shall
fprthwith comply with those provisions.
011/66
WARNING: FAILURE TO SECURt 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 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
IMPORTANT Application is hereby made to the Director of BuildingAPPLICANT
C
Safety Apermit subject to the CKNOWLEDGEMENT
1. Each person upon whose behalf this application is made. each person at whose request and for wholse benefions and t is forths set
rk perfo mred under or pursuant to an
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 I agree to comply with all city and county ordinances and slate laws relating to building
construction, and hereby authorizer resentatives of this county to enter upon the above-mentioned property for ins
` ( P Pe Y inspection purposes.
Date\lf Signature (Applicant or Agent): a
,-----------------------------
Application Number .
-----------------------------------
. . . 04-00008002
------------
--------------'--------------------------------------------------------------
Additional
desc
--------------------------
Structure Information -------------------------
Construction Type . :-•.
. . TYPE V - NON RATED
Occupancy Type . . ..
. . . DWELLG/LODGING/LONG <=10
Issue Date
Flood Zone . . . .
. . . NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION 2001 CBC
Unit Charge
FIRE SPRINKLERS NO
GARAGE SQ FTG
648.00
BASE FEE
PATIO SQ FTG
474.00
EA
NUMBER OF UNITS
1.00
-----------------=----------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
2873.00
Permit . . . . . .
BUILDING PERMIT
1.00
Additional desc'. .
EA
PLB
Permit Fee . . . .
933.50 Plan Check Fee
151.70
Issue Date . . . .
Valuation . . . .
183341
Qty Unit Charge,
Per
Extension
PLB
BASE FEE
639.50
84.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
294.00
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee
83.50 Plan Check Fee
5.22
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
8.03
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2873.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
100.56.
648.00 .0200
--- --------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
12.96
Permit
. . . . .
PLUMBING
Additional
desc
Permit Fee
. . . .
184.50
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
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
8.00
.7500
EA
PLB
GAS PIPE >=5
11.53
0
Extension
15.00
114.00
15.00.
7.50
3.00
9.00
6.00
----------------------------------------------------------------------------
Application Number 04-00008002
- ,----------------------------------------------------------------------------
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 17, PLAN 3A,
2873 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
15.17
DIF FIRE PROTECTION -RES
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
------------------------------
1345.02 .00 .00
1345.02
Plan Check Total
176.48 .00 .00
176.48
Other Fee Total
2438.50 .00 .00
2438.50
Grand Total
3960.00 .00. .00
3960.00