04-8004 (SFD)r
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MAR 09 2005 U
BUILDING &
SAFETY DEPARTMENT
9
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.
Lo Box 1504
ICtPICO
fit W99 'I
,
(760)777-7012
FAX (760) 777-701.1
. ALIFORNIA
92253 INSPECTION. REQUESTS
(760) 777-7153
BUILDING PERMIT
Application Number . . . .
;0�0�0�0 0�8,0�0 4�
Da t e ' •12 / 2 9 / 0 4
Property Address . . . . .
79772 JOEY CT
APN:
649-520-998-26 -290533-
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
I
P.O. Box 1504 •ot.
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: O Date: 3 - 4 .06—
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
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
and my Licen n full force and effect. � // /y
rcense Class_ License No.//'��l
_� 0
bate ontractor
OWNER-BUILDER'DECLARATION
I hereby affirm under penally of perjury that I am exempt from th 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 her 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 Coode) 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 1, 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 Cbnlractors' 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 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
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.
_Cl 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
��isssue .. My ers' comp nsation , ran
ce carrier and l;*g nuj�be
Carrier �—K-f� z4--" 47 limy Number _ /O a
_ I certify that, in the performance of the work for which this permit is idsued, 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
forthwith 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 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
Lendefs 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, etch 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 I agree to comply with all city and county ordinances and state laws relating to building
construction,and
%Jreby authonze resentatives of this county to enter upon the above-mentioned property for inspection purposes.
/Date ` C / i
S gnature (Applicant or Agent):
r
Application Number 04-00008004
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h
------------------------- Structure Information -------------------------
Construction Type TYPE V - NON RATED
Occupancy Type . . . . . DWELLG/LODGING/LONG <=10
Flood Zone NON -AO FLOOD ZONE
Other struct info . . CODE EDITION 2001 CBC
FIRE SPRINKLERS NO
GARAGE SQ FTG 648.00
PATIO SQ FTG 474.00
NUMBER OF UNITS 1.00
1ST FLOOR SQUARE FOOTAGE 2873.00
----------------------------------------------------------------------------
Permit
Additional desc
Permit Fee . . .
Issue Date
. BUILDING PERMIT
933.50 Plan Check Fee 151.70
Valuation . . . . 183341
Qty
Unit`Charge
Per
Extension
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
--------------------------------------------------------------7-------------
.0200
ELEC GARAGE OR NON-RESIDENTIAL
12.96
Permit
PLUMBING
Additional
desc . .
Permit Fee
. . . .
184.50 Plan Check Fee`.`.
11.53
Issue Date
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
19.00
6.0000
EA
PLB FIXTURE
114.00
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
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Application Number . . . . . 04-00008004
%-----------------------------------------------------------------------------
Permit . . . . PLUMBING
Qty ' Unit Charge
Per
Extension
1.00 15.0000
-------------------.---------------------------------------------------------
EA PLB GAS METER
15.00
Permit . . . . .' . GRADING PERMIT
.00
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
S.FD - LOT 26, PLAN 3AR, 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
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged Paid
1345.02
.00
176.48
.00
2438.50
.00
3960.00
.00
Credited Due
.00
1345.02
.00
176.48
.00
2438.50
.00
3960.00
I