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05-5326 (BLCK)N. P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 105-00005326___ 79640 WESTWARD HO DR 649-040-007-B -31816 WALL/FENCE MEDIUM DENSITY RES 21575 T-vy 4 XP.Q" Architect or Engine( ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 C29 License No.: 820821 Date: Contractor: OWNER -BUILDER DECLARATION I 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 ($500).: (_) 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.). 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. , BAP _C. for Apis reason l Date: Owner: CONSTRUCTION I hereby affirm under penalty of perjury that there is a constructi work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT AGENCY agency for the performance of the VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/06/05 Owner: LA QUINTA NORTH PARTNERS LP 2 CROOKED STICK DR NEWPORT BEACH, CA 92660 (949)533-9408 Contractor: M C D CONSTRUCTION 11600 PALM DRIVE DESERT HOT SPRINGS, CA 92240 (760)329-7114 Lic. No.: 820821 ------------------ 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. _ 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 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 b ome subject the orkers' compensation provisions of Section A� 37700 of the Labor C is all forthwi com with those provisions. Dai.€P—t 6 'wApplicant: 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. 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 ' rrect. I agree to comply with all city and county ordinances and state laws relating to b ing onstruction, here authorize representatives of this county to enter n the above-mentioned pr r f r inspection rpose -�6°--- Dat Signature (Applicant or Ag' i Application Number . . . . . 05-00005326 Permit WALL/FENCE PERMIT Additional desc . Permit Fee 225.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 21575 Expiration Date . . 6/04/06 _ Qty Unit Charge Per Extension BASE FEE 45.00 20.00 9.0000 THOU BLDG 2,001-25,000 180.00 ---------------------------------------------------------------------------- Special Notes and Comments 863 LF 6' GARDEN WALLS PER CDD & P/W'S APPROVED ROUGH GRADING PLAN & ORCO DETAIL. Fee summary Charged ------------------------------------- Paid Credited -------------------- Due Permit Fee Total 225.00 .00 .00 225.00 Plan Check Total .00 .00 .00 .00 Grand Total 225.00 .00 .00 225.00 LQPERMIT m5m Ftmt amE INSTALL BIIBBM BOX POR ElIFRGM GRADINGS TO ENSURE OVEWM IS DIRECTED 7MARD RIGHT--OF-WAY. GARDEN WALL ON TOP OF RETAINING WALL ' WAIF- j- 1 © TYPICAL COMPOSITE WALL GARDEN WALL OVER RETAINING WALL, PER SEP LTTE T ES1GGNN SAND PERMIT W I< r I Apbroved b . Date R so # CI ®FLAUUIN fA O Planning Commission E3 City Council I Public Works/Engineering Dept. ,�Cornm ty Dev. Dept. APP Dw� cases No. ~r7-3 i �t - API�Rc�xhibit _ his - w nti�sM P(D ELEY Pt7P PUN DdeT� r'+1O(ittoditions By: /yfiL S 1 j SEC' 6' &WMV I 00 ,�7Fo 1' AIN. 8DWH PERMIT leloop- Bin # City of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 0 Building Permit Application and Tracking Sheet Permit # Project Address: `� _ 'J�� A. P. Number: Owner's Nam Address: �t�ze Legal Description: Contractor: LQ7? X- Address: fl bob s sfLt. City, ST, Zip:W Qa Tele ho p �((�Q/ 0 ^ 7 ^ 3� Project Description: City, ST, Zip - S Telephone: 3aQ^ 71IZ71 State Lic. # : City Lic. #: Arch., Engr., Designer: U Construction Type: Occupancy: Address:F?- City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: _7 Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called ContactTerson Plan Check Balance Energy Cates. 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:- 'rd Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees