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05-3246 (SFD)P.O BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: T4ht 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 05-00003246 46143 ROADRUNNER LN 649-040-007-5 -31816 DWELLING - SINGLE FAMILY DETACHED MEDIUM DENSITY RES 195966 ,.-I<rchitect or Engineer: G 4G21 Owner: LA QUINTA NORTH PARTNERS 2 CROOKED STICK DRIVE NEWPORT BEACH, CA 92660 Contractor: URBAN HABITAT 2 CROOKED STICK DRIVE NEWPORT BEACH, CA 92660 (949)759-1018 Lic. No.: 808912 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/27/05 ----------------------------------------------------------------77------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: B License No.: 808912 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is afei- "tC ntractor: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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1741937-2005 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or C3700 hwith comply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by �y( any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: —CA pplica' ..� 1 _ 1 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 WARNING: FAILURE TOS ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the - DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. , - 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.). APPLICANT ACKNOWLEDGEMENT 1—) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. -- - property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed -- 1. Each person upon whose behalf this application is made, each person at whose request and for • pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, I—) I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City 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 ISec. 3097, Civ. C.). Lender's Name: - Lender's Address: LQPERMIT 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 correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to en u o h d property for inspection purposes. T '/ igna pis t gen LQPERMIT Application Number . . . . . 05-000'03246- 5-00003246Structure StructureInformation Construction Type . . . . . TYPE V•- NON RATED Occupancy Type . . . . . . .DWELLG/LODGING/CONG <=10 Flood Zone . . . . . NON -AO FLOOD ZONE Other struct info CODE EDITION 2001 # BEDROOMS 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 743.00 PATIO SQ FTG 436.00 NUMBER OF UNITS ------------------------------------------------------------------------------ 1ST FLOOR SQUARE FOOTAGE 3070.00 Permit . . BUILDING PERMIT Additional desc . Permit Fee 975.50 Plan Check Fee 158.52 Issue Date . . Valuation 195966 Expiration Date .. 1/23/06 Qty Unit Charge Per ..Extension BASE FEE 639.50 96.00 3.5000 THOU BLDG 100,001-500,000 336.00 Permit . . . MECHANICAL Additional desc . Permit Fee 114.50 Plan Check Fee 7.16 Issue Date . . . . Valuation 0 Expiration Date 1/23/06 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 6.00 6.5000 EA MECH VENT -FAN 39.00 1.00 6.5000 --------------------7-----------------------------------7------------------- EA MECH EXHAUST HOOD 6.50 Permit . . ... ELEC-NEW RESIDENTIAL Additional desc Permit Fee 146.03 Plan Check Fee 9.13 jsgi�Q Date Valuation . . . 0 Expiratlon Date 1/23/06 Qty Unit Charge Per Extension BASE FEE 15.00 3070.00 0350 ELEC NEW RES - 1 OR 2 FAMILY 107.45 LQPERMIT Application Number . . . 05-00003246 Permit . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per, Extension 1179.00 .0200 ---------------------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 23..58 Permit PLUMBING Additional desc Permit Fee . . . . 161.25 Plan Check Fee 10.08 Issue Date Valuation 0 Expiration Date 1/23/06 Qty Unit Charge Per Extension BASE FEE' 15.00 15.00 6.0000 EA PLB FIXTURE 90.00 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 9.00 ..7500 EA PLB GAS PIPE >=5 6.75 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 Expiration Date •1/23/06 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------- Special Notes and Comments SFD - LOT 5 PLAN.TYPE 2A, 3,070 SQ.FT. 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 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 15.85 DIF FIRE PROTECTION -RES 97.00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES- 502.00 STRONG MOTION (SMI) - RES 19.59 DIF STREET MAINT FAC -RES 15.00 LQPERMIT LQPERAIIT Application Number .. . . . . 05-00003246 ----------------------------------------------------------- Other Fees... . . . . . . . DIF TRANSPORTATION - RES 1098.00 .Fee summary Charged Paid Credited Due Permit Fee Total - - -- 1412.28 ---- - - - - -- .00 ---- - - - - --- •.00 --- - - - - - - 1412.28 Plan Check Total 184.89 .00- .00. 184.89 Other Fee Total . 2440.44 .00 .00 2440.44 `Grand Total 4037.61 .00 .00 4037.61 LQPERAIIT 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 I 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 conformance, both horizontally and vertically, to the Precise Grading Plan, as shown by the table below. Lot No. Address Perinit Plan Field Difference Plan Hield Difference No. Pad Elev. Pad Elev. FF Elev. FF Elev. 1. X46;Q©76 047174 273.4 273.4 .0.0 273.90 2 3.91 +0.01 I ,­ + Rvor diunner i • 2 x.4,6=04=1~ 047175 272.4 272.4 0.0 272.90 2-,2.89 -0.01 Roadrunner 3'1.4;6-075_._ 053237 270.8 270.8. 0.0 271.30 271.30 0.00 •-Roadrunnerv� _ 4 4.64,0.9. 053239 269.4 269.4 0.0 269.90 269.92 +0.02 Roadrunner 5 " 4°6'`1'43 053246 268.0 268.0 0.0 268.50' 268.52 +0.02 Roadrunner Sincerely, LAND THE ITH COMPANIES, INC. �Q AND RUSSEliJ. MUWNS p J No. 3712 R ss 11 J Mullins, PLS 371 * Ellp D ector of Survey Palm Desert Division \_ Palm Desert Division OFC Suite 1 Fred Waring Drive �//' Suite 100 Palm Desert California 92260-2590 T: 760.346.9844 0:\40921\4092100\docs\CERTS\C-LQ.FORM CERT.URBAN HABITAT. WESTWARD SHADOWS.TR 31816.doc F:.760. 346.9368 www.keithco.com