06-2296 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00002296`
LA QUINTA NORTH PARTNERS
Property Address:
4-6044 ROUDEL LN
APN:
649-040-007-17
-31816
Application description:
WALL/FENCE
Contractor:
Property Zoning:
MEDIUM DENSITY
RES
Application valuation:
2500
MORONGO VALLEY, CA 92256
I/
A
Applicant:
Architect or Engineer:
P l 13 -
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DEC ATION
I hereby affirm under penalty of perjury that I am icensed under provi: of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and fessionals Code d my License is in full force and effect.
Licen � lass: B Lice No.: 0821
Dfrac r
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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 _ 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—) 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/07/06
Owner: '
LA QUINTA NORTH PARTNERS
LP
2 CROOKED STICK'DR
NEWPORT BEACH, CA 92660-
(949)533-9468
Contractor:
MCD CONSTRUCTION
49881 29 PALMS HIGHWAY
MORONGO VALLEY, CA 92256
(760)363-7740
D
Lic. No.: 820821
n
GZJ /I
_ u_ _ _��++�� JUN 0 71006
WORKER'S COMPENSATION ECLARATfO%lYOP
I hereby affirm under penalty of perjury one of the following declarations: F/ida rc Q(f/N d
I have and.will maintain a certificate of consent to self -insure for workers eas�Gm provided
for by Section 3700 of the Labor Code, for the performance of the work for whic fai ' ermit 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 174857005
_ I certify that, in the performance of the work for which t ' permit is issued, I shall not employ any
person in any manner so as to become subjec t orkers' compensation laws of -California,
and agree that, if I should ecome subjec orkers' compensation provisions of Section
3700 of tl o e, I hall forthwit with those provisions.
lic
WARNING: FAILURE TO SECURE WORKERS' COMPE ATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES A D CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 15100,0001. 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 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.
certify that I have read this application and state that the above. informationorrect agree to comply with all
city and co ty ordinances and st laws relating to uildin construction d here uthorize representatives_
oft 's my foto enter upon t above-mentioned p y f r inspection
nature (Applicant or Ag
Application Number. . . . . 06-00002296
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee 54.00
Plan Check
Fee
.00
Issue Date
Valuation
2500
Expiration Date 12/04/06
Qty Unit Charge Per
Extension
BASE
FEE
45.00
1.00 9.0000 THOU• BLDG
2,001-25,000
9.00
--------------.------------------------------------------
l� Special Notes and Comments
R.
100 L.F. 6' GARDEN WALL, ORCO SYSTEM
. Fee summary Charged
Paid Credited
Due
Permit Fee Total 54.00
.00
.00
4.00
Plan Check Total .00
.00
.00
.00
Grand Total 54.00
.00
.00
54.00
1711a.070.4
Bin #
'• City, of La Quinta ;
Building U Safety Division
P:O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:' 1.KO
Owner's Name: 6�.
A. P. Number: �iQlgLp 7- J
Address:
Legal Description:
Contractor - /O. e-4. L9
City, t' -+111
Teleph 9' �j ' ,3- 9..a g
Address: / G D Q. %%% G (f�
Project Description:
City, ST, Zip: E.S�Pc� % !�O(
Telephone:
City Lic.
State Lic. # : D S
Arch., Engn, Designer:
Address:
G1 � �D�j/`'�, �Gl�e � C.4-rr�"aa5 6•
City, ST, Zip:'-
ip:'.Telephone:
Telephone:
MENEM
Construction Type: Occupancy:
State Lic. #: '
Project type (circle one): New Add's Alter Repair Demo
-T—
Sq. Ft.: # Stories: # Units:
Name of Contact Perso A-��' . �'(�:
Telephone # of Contact Person: 760 -
Estimated Value of Project:
APPLICANT: NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec°d
TRACKING.
PERMTF FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for, corrections
Plan CheckDeposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan.
Plans resubmitted
Mechanical.
Grading, plan
f
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 eorrectionsrssue
Developer Lupact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
71
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