06-0339 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO.
LA QUINTA, CALIFORNIA 92253
Application Number.
*-00000339
Property Address:
460 -41 --ROADRUNNER LN
APN:
649-040-007-2 -31816
Application description:
WALL/FENCE
Property Zoning:
MEDIUM DENSITY RES
Application valuation:
250.0
Applicant:
T-,�4t 4 4 Q"
Architect or Engineer:
PI1>
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
------------------- ------ - - - - -- --------------- - - -
LICENSED CONTRACT D RATION
I hereby affirm under penalty.of perjury thpt I a censed and ovis' s of Chapter 9 (commencing with,
Section 7000) of Division 3 of the Sr and ofessiona ode d my License is in full force and effect.
License Class: B ice No.: 808912
t ntractor• -
OWNEROWNER- ILDER�RATION
I hereby affirm under penalty of perjury that I am exe t from the Contra State License Law for the
following reason (Sec. 7031.5, Business and Profe ons Code: Any city or county that requires a permit to.
construct, alter, improve, demolish, or repair any s ructure, 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 ($500).:
(_) 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
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.).
( 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
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:
LQPERMIT
Owner:
LA QUINTA NORTH PARTNERS LP
2 CROOKED STICK DR
NEWPORT BEACH, CA 92660
(949) 5.33-9408
Contractor:
URBAN HABITAT
2 CROOKED STICK DRIVE
NEWPORT BEACH, CA 92660
(949)533-9408
Lic. No.: 808912
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/23/06
1
q
./q
city � �3?406
Fi��CF RValA
WORKER'S 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.
1L__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 1741937-2005
I certify that, in the performance of the work r hich this permit is issued, I shall not employ any
person in any manne so as t0 become ' t to t orkers' compensation laws of California,
and agree that, if I o Id become sub' to the o ers' compensation provisions of Section
3700 of the Lab�y,9e, I;hall fort th co y ith those provisions. _
WARNING: FAILURE TO SECURE WORKERS' CO)3PENSATIOUCOVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENAL S 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.
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 thelwork 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 cessa ' n of w rkfor 180 days will subject
permit to cancellation.
I certify that I have read this application and state t the a ove infor ti is c act. I agree to comply with all
city and county ordinances and state laws relatin o ildi g constru ti , and ereby authorize. representatives
of this cou to ter upon the bove-mention pr ert for ins n p ses.
D Si lure (Applicant or nt .
Application Number . . . . . 06-000003.39
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 54.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 2500
Expiration Date 7/22/06
Qty Unit Charge Per
Extension
BASE FEE
45.00
`1;00 9,0000 THOU BLDG 2,001-25.000
9.00
- - --------------------------------------------------
Special Notes and Comments
100 L.F. 6' GARDEN WALL, ORCO SYSTEM
- Fee summary Charged Paid Credited
Due
Permit Fee Total 54.00. .00
.00
54.00
Plan Check Total .00 .00
.00
.00
Grand Total 54.00 .00
.00
54.00
. LQPERMIT -
-
The Keith Companies
August 23, 2005
Mr. Timothy Jonasson
City Engineer .
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92201 '
RE: WESTWARD SHADOWS
Urban Habitat
Tract No. 31816
Form Certification
Lots 1 through 5
` Dear Mr. Jonasson:
I- hereby state that the building pads and forms, for the above referenced Lots, within Tract No. 31816, were
surveyed under my direct supervision and have been found to be within substantial conformarce, both horizontally
and vertically, to the Precise Grading Plan, as shown by the table below.
9
d
Lot No.
Address
Permit
Plan
Field
Difference
Plan
Feld
Difference
No..
Pad Elev.
Pad Elev.
FF Elev.
FF`Elev.
1
*4;6x007 `
047174
273.4
273.4
. 0.0
273.90
273.91
+0.01 I
sm
h4toa:diiiimer
i
2
-,w-4&0411,
047175
272.4
272.4
0.0
272.90
272.89
-0.01
Roadrunner
3
,447t,075-
053237
270.8
270.8
0.0
271.30
271.30
0.00
-Roadrunner•
-
4
446;1,0.9,
053239
269.4
269.4
0.0
269.90
2E9.92
+0.02
„
Roadrunner
5
4'6-.1'4 T1.
053246
268.0
268.0
0.0
268.50
2E8.52
+.0.02
Roadrunner
Sincerely,
THE ITH COMPANIES, INC.
R ss llJ Mullins, PLS 371
Dl ector of Survey
�O LAND s�
�5 AGF
V RUSSELL J. MUWNS p
No. 3712
r Palm Desert Division 1 w`�Q' Palm Desert Division.
O/�. •\_ 73-733 Fred Waring Drive
H Suite 100
Palm Desert
Caliiomia 92260-.590
T: 760.346.9844
0:\40921\4092100\docs\CERTS\C-LQ.FORM CERT.URBAN HABITAT.WESTWARD SHADOWS.T2 31816.doc F: 760.346.9368
www.keithco.com