04-8028 (SFD)agwo
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IU I %I WJ BUILDING & SAFETY DEPARTMENT
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P.
GINTA (760),777-7012
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MPICO FAX (760)- 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION. -REQUESTS (760) 777-7153
BUILDING PERMIT
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Application Number Ito 4M0'D'0:00-2jDate 12/29/04
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Property. Address . . . . . . -79T9-4-'DANIELLE
APN:.' 649-520-998-15 -290533-
Application description . . . DWELLING SINGLE.FAMILY DETACHED
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation 163482
Owner Contractor
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PM RENAISSANCE, LLC TRANS WEST HOUSING, INC.
9968 HIBERT STREET, STE.. 102. 9968 HIBERT STREET, STE #102
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
P.O. Brix 1504 VOICE (760) 777-7012
79-495 CALLS TAMPICO FAX (760) 777-7.011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
'r BUILDING & SAFETY DEPARTMENT
Application Number: Date: 3 •ct • D,�
Applicant:
Architect or Erigineer:
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
Code, and my License i in full force and effect. ^-7 (, 2
Ja�nse Class . nse No. 2l
/mate ontractor
,-Dale
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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 pemtit 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 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.).
I am exempt under Sec. , B.& P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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
tj of the work for which this permit is issued.
I have and will maintain workers' compensate insurance, as required by Section 3700 of the Labor Code, for the performance of the worts for which this permit is
�
pie M pensatio urance carrie
/r a d Q�li
/r:artier �'r,17 V . me( (J� Policy Number
1 certify that, in the performance of the work for which this perm 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 die workers' compensation provisions of Section 3700 of the Labor Code, I strap
forthwith comply with those provisions.
ate�� �B� ppiicant
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
Lender's Address /A
-
APPLICANT
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 Quinta, 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 cor6tft I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize repres ntatives of this county to enter upon the above-mentioned property for inspection purposes.
ate ,4u Signature (Applicant or Agent): �J
+� ---------------------------------------------------------=------------------
Application Number 04-00008028
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Structure Information
Construction Type . .
. . . TYPE V - NON RATED
Occupancy. Type . . .
. . . DWELLG/LODGING/LONG <=10
18.00
Flood Zone . . . . .
. . . NON -AO FLOOD ZONE
PLB
Other struct info . .
. . . CODE EDITION
2001 CBC
EA
FIRE SPRINKLERS
NO
1.00
GARAGE SQ FTG
589.00
PLB
PATIO SQ FTG
328.00
3.0000
NUMBER OF UNITS
1.00
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1ST FLOOR SQUARE FOOTAGE
2580.00
Permit . . . . . .
BUILDING PERMIT
LAWN SPRINKLER SYSTEM
Additional desc
7500
EA
Permit Fee . . . .
863.50 Plan Check Fee
140.32
Issue Date
Valuation . .
. . 163482
Qty Unit Charge
Per
Extension
BASE FEE
639.50
64.00 3.5000
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THOU BLDG 100,001-500,000
224.00
Permit . . . . . .
MECHANICAL
Additional desc . .
Permit Fee
77.00 Plan Check Fee
4.81
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
3.00 6.5000
EA MECH VENT FAN
19.50
1.00 6.5000
--------------------------------------------------------
EA MECH EXHAUST HOOD
--------------------
6.5'0
Permit . . . . . .
Additional desc
Permit Fee.
Issue Date . . . .
ELEC-NEW RESIDENTIAL
117.08 Plan Check Fee . 7.32
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
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Permit . . . . . . PLUMBING
Additional desc
Permit Fee . . . . 178.50
Issue Date . . .
Qty . Unit Charge Per
Plan Check Fee . . 11.16
Valuation . . . . 0
Extension
.15.00
108.00
15.00
7.50
3.00
9.00
6.00
BASE
FEE
18.00
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
Extension
.15.00
108.00
15.00
7.50
3.00
9.00
6.00
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Application Number . . . . . 04-00008028
------------------------ --
Permit . . . . . PLUMBING
Qty Unit Charge
Per
Extension
1.00 15.0000
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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
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Special Notes and Comments
SFD - LOT 15, PLAN 2A,
2580 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
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Other Fees . . . . .
. . . . ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
14.03
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
16.34
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged Paid Credited
Due .
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Permit Fee Total
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1251.08 .00 .00
1251.08
Plan Check Total
163.61 .00 .00
163.61
Other Fee Total
2435.37 .00 .00
2435.37
Grand Total .
3850.06 .00 .00
3850.06