BLCK (06-3895)52939 Madison St
06-3895
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760)777-7011
LA QUINTA, CALIFORNIA 92253' BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Application Number:
Property Address:
APN:
Application description
Property Zoning:
`t! Application valuation:
t Applicant:
06-00003895
5'2939 MADISON ST
772-420-9997E-298943-
-WALL/FENCE
LOW DENSITY RESIDENTIAL
1300
Architect or Engineer: .
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 is in full force and effect.
License Class: B LicenseNo.: 820821
Date: Contractor:
OWNER -BUILDER DECLARATION
hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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 (5500).:
(_ 1 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 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.).
( 1 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
eDat e
CONSTRU-T' c LENDIN AGEN
-I hereby affirm under penalty of perjury that there is a cons ruction lendin y for the perm a of the
wofk for which this permit is issued (Sec. 3097, Civ. C.). -
Lender's Name
Lender's Address. -
LQPERMIT
Owner:
ND LA QUINTA PARTNERS, LLC:
-80955 AVENUE 52
LA QUINTA, CA 92253
Ilfl
Contractor:
MCD CONSTRUCTION
49881 29 PALMS HIGHWAY
MORONGO VALLEY, CA 92256.
(760)363-7740
Lic. No.: 820821
Date: 11/06,/06
NOV 0 6 2006
----------------------------------------------
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following declarations:
1 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, '
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 issued. My workers' compensation
insurance carrier and policy number are: '
Carrier STATE FUND Policy Number 0442271205
I certify that, in 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 subje to th orkers' co tion provisions of Section
, / 3700 of the.Labor Code al fort ith Pty with tt) pro Bions.
LalApplicant:
WARNING: FAILURE TO SECURE WORKERS' COMP SATION OVER IS UNLAWFU ; A SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FI UP TO ONE HUNDR HOUSAND
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.
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 Quints, 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 her,;,, uthonze re r sentatives
of this cou/777t/ y/, to enter upon the above-mentioned grope ori spectic
_rDa // Y// c4 -le,v.l' _n. Gnnn l-(✓= r
r.
,.Application Number . . . . . 06-00003895
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee. 31.00.•
Plan Check
Fee-.
.00
Issue Date
Valuation
1300
Expiration Date 5/05/07
Qty. Unit Charge Per
Extension
BASE
FEE
15.00
•8:00 2.0000 HND BLDG
501-2,000
16.00
--------------------
Special Notes and Comments
52 LF 6' BLOCK WALL -TIE IN TO
PREVIOUSLY PERMITTED WALL Q SAME
ADDRESS PER APPROVED PLAN & ORCO
DETAIL.
Fee summary Charged
-------------------------------------
Paid Credited
--------------------
Due
Permit Fee Total. 31.00
.00
.00
31.00
Plan Check Total .00
.00
.00
.00
Grand Total 31.00
.00
00
31.00
LQPERMIT
Bin #
City of La Quinta
Building at Safety Division .
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permitff ` 2 �qU
b b "
Project Address: ^71-7 s77
Owner's Name: ND La Quinta Partners, LLC.
A. P. Number: 772-420-021
Address: 80955 Avenue 52
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Telephone: (760) 391-5072 MUM—
Contractor: MCD Construction
Address: 49881 29 Palms Highway
Project Description: Additional 52 l.f. of masonry
City,ST,Zip: Morongo Valley, CA 92256
wall/tie in of previously approved
Telephone: (760) 363-7740
walls for perimeter walls on Avenue 54
State Lic. # : City Lic. #: 820821
Arch., Eagr., Designer:
and Madison Street as approved under the
Madison Street Wall Palms/The Hideaway on i
Address:
/0/t-)/2006-
City, ST, Zip:
Tie in to match existing walls.
Telephone:
Construction Type: Wall Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Tony Smith, MCD Construction
Sq. Ft.: 52 / 1: f .
I#Stories: n/a
# Units: n/a
Telephone # of Contact Person: (7 60) 363-7740
Estimated Value of Project: $3,000.60
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Callcd Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Review, ready for correctio issue
lI G
Developer Impact Fee
Planning Approval
Called Contact Person
1 1
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
�� Q