0201-195 (RC)LICENSED CONTRACTOR 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 # Lic. Class Exp. Date
A-
Signature of Contractor IS
- _
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
( ) I have and will maintain a certificate of consenf,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.
)kI 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 & policy no. are:
Carrier �u>!'.ATZ FUND
Policy No. 11)3fFf Sx Q!
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those'provisions.
Date: 'a 6-4 > Applicant 71-P. ,., _ .."7
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the.Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth 'on his
application.
1. Each person upon whose behalf this application -is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indem
& hold harmless the City of La Quinta, its officers, agents and employe
2. Any permit issued as a result of this application becomes null and vo'
work is not commenced within 180 days from date of issuance of s
permit, or cessation of work for 180 days will subject permit to cancella
I certify that I have read this application and state that the above informati is
correct. I agree to comply with all City, and State laws relating to the buil ing
construction, and hereby authorize representatives of this City to enter
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) jf 1-� u5 a � +�"�-� Date
� , JX
BUILDING PERMIT. PERMTp
DATE j VALUATION LOT iitia��� Y TRACT
� i
JOB SITE' -'�
APN
ADDRESS
OWNER
CONTRACTOR/DESIGNER/EN (NEER
15001 ii�111.AVINUS Nil*,
15 755 'ryU91117TRUJI-C. "GIRKMN, to 92274
AM Qts"0
fi`i40l,"rSA1tilI) PP1 MB CA 9227$
(76V)'399.5,11,61 M1.01 6551
USE PERMIT
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10,2" :R , lRi'3i»'�fTttlATION? .tiSS81398D PER ir01FORM '
A.DMI14 CODY §304.: FDJ1 WORY': BEC IM WITHOUT :f►.U7LIA14C1Ptamil'.
CO PM"•'I' O'E)3P'i: W
CONST TR11C9'1W1 FEE 101 «00041 s-000 $1115210
P1,AIN tFT ECK 'n,?, 101-000-439-319 $1,194.96
I-V,E3JIiPOSIT 101-000-439-318 4800.00"
hilUC:H"1G'At., !t'EE.,s 101400_42,1-00(i o3a 50
ELYT-}t1M, FEE 101.000.420-000 S3100
Mf3MP;:Fi�1CO PSE 101. 00-:{619r0t) $240.36
TNifESTICIAVOW Pr3i 1.01-f11?C1»471 -00 11,05.110
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,Ftp 11 2002
C
Fq
RECEIPT
A
:BYC
DATE FINALED
INSPECTOR'
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath 3,-777-g--27
`
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines — gyp-
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS: �L
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm) - U!Z_ e4l-
I _J
T4t�t`4 4aQuiKrw
MEMORANDUM
To: Greg Butler, Building & Safety Manager
To CDD: /-11-0.1
From: Christine di lorio, Planning Manager . Due date: I - 1 1 - O Z
Status: c�Qrzw_ &/L
dram jo /an s
Building Plans Approval
(this is NOT an approval to issue a Building Permit)
The Community Development Department has reviewed the Building Plans for
the following project:
Description: L G ' S .5TE A ie_ 4ou S C
4
Address or general location: 78 _��aS /-�zclz� 1 I.� • / 11.
APN and/or legal description:
Applicant Contact: Om 3 qq - S44I
The Community Development Department finds that:
❑ ... these Building Plans do not require Community Development
Department approval.
these Building Plans are approved by the Community Development
Department.
❑ ...these Building Plans require corrections. Please forward a copy of the
attached corrections to the applicant. When the corrections are made
please return them to the Community Development Department for
review.
Christine di lorio, Plannft Manager
Date
ECTION
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Tom Tisdale
Fire Chief
Proudly serving the
unincorporated
areas of Riverside
County and the
Cities of -
Banning
e. -
Beaumont
Cahmesa
4. -
Canyon Lake
.;.
Coachella
Desert Hot Springs
4.
Indian Wells
Indio
.;.
Lake Elsinore:
4.
La Quinta
.y
Moreno Valley
Palm Desert
Perris
Rancho Mirage
San Jacinto
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione,
District 2
Jim Venable,.
District 3
Roy Wilson,
District 4
Tom Mullen,
District 5
RIVERSIDE COUNTY FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
210 West San Jacinto Avenue • Pems, Califomia 9 • (9W) 940.6900 • Fax 909) 1
January 22, 2002
PS Fire Pros
4633 E. Sunny Dunes Rd.
Palm Springs, CA 92264
Re: Fire Sprinkler T/I Plan Review
LAQ-02-SPK-100 / LG's Steakhouse
The sprinkler plans you submitted for the above referenced project have been reviewed by Riverside
County Fire Department Planning & Engineering personnel and are approved with the following
conditions:
1) Add sprinkler head protection as per plan corrections.
2) Review of these plans does not include the basement. A separate plan submittal for review shall
be required.
3) The following inspections/tests are required to be witnessed by the Fire Department Planning
Division staff:
a) Overhead: All piping must be visible with a hydrostatic pressure test at 200 psi for 2 hours.
b) Final inspection.
The Fire Department job card, approved plans and conditions letter must be at the job site or NO
inspection will be performed.
Applicantfinstaller shall be responsible to contact the Fire Department to schedule inspection.
All questions regarding the meaning of these conditions should be referred to the Fire Department
Planning & Engineering staff at (760) 863-8886.
Sincerely,
FRANK KAWASAKI
Chief Fire Department Planner
By
Walter Brandes
Fire Safety Specialist
H:WEPWPOATAUAQU NTA1PROJECTS%SPRINRLRM AQ-02-SPIF100(a).doc
EMERGENCY SEP.VICES DIVISION • PLANNING SECTION • INDIO OFFICE
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9 MEMORANDUM
oF
TO: Kirk Kirkland, Senior Building Inspector
FROM: Raoul Martinez, Assistant Engineer II P
DATE: March 20, 2002
RE: Parcel Map 29791, LG's Steakhouse
The Engineering Department agrees with issuing a Temporary Certificate of Occupancy, as all
punch list items have been addressed and/or completed, except for the following:
1. Placement of barricades along sidewalk to prevent pedestrian traffic in construction
area on Washington Street & Highway 111.
If you have any questions please call me at x7047.
cc: Project 29791 -file II
TAMDEMSTAFFNartinehnemo 02\Building & Safety\020320a.wpd
SPECIAL INSPECTION SERVICE'j
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF ]:oCol
INSPECTION
PERFORMED
REINFORCED CONCRETE TRUCT. STEEL ASSEMBLY ❑
POST TENSIONED CONCRETE ASPHALTTHER l�W
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DAY OF WEEK
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COPY SENT TO CLIENT ❑
CONTINUED ON NEXT PAGE ❑
PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF M1'
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
tl wV�
SIGNAT RE OF REGISTE INSPECTOR
DA E OF REPORT REGISTER NUMBFR
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE UCT. STEEL ASSEMBLY O Fie -GQ
❑ POST TENSIONED CONCRETE O ASPHALT THER
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CONTINUED ON E PAGE O
PAGE OF
CERTIFICATION OF COMPLIANCE
'HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF M`%
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
IG RE OF REGISTERON INSPE TOR
DAVE OF REPORT REGISTER NUMRFR
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETERUCT. STEEL ASSEMBLY ❑
13POST TENSIONED CONCRETE ASPHALT THER
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COPY SENT TO CLIENT O
CONTINUED ON NEXT PAGE O
PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
S GNATU E OF REGISTE INSPECTOR
'it Nib( D6
DAT OF PORT REGISTER NUMRFR
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
O REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY
O POST TENSIONED CONCRETE ❑ ASPHALT
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REPORT SEDUENCE NO.
TYPE RUCT_ URE ` ,
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CONTINUED ON NEXT PAGE O
PAGE
OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
cc l�
SI NAT RE OF REGISTERED IN PECTOR
L o oL_Twe o 6ct 7,S •
DA E OF REPORT REGISTER NUMRFR �,,
Certificate of -Occupancy
City of La Quinta
Building and Safety Department
This Temporary Certificate issued pursuant to the requirements of Section 109 of the Uniform Building
Code, certifying that, at the time of -issuance, this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following;
j
BUILDING ADDRESS: 78-525 HIGHWAY 111 SUITE 100 h&St
Use Classification: RESTAURANT Bldg. Permit No.: 0201-195
Occupancy Group: A 2.1 Type of Construction: V-1 Land Use Zone: CC
Owner of Building: JDD, LLC
Building Official
Address: 1500 18TH AVENUE NE
City: ISSAQUAH WA 98027
By: KIRK KIRKLAND
Date: MARCH 22. 2002 (EXPIRES 4/22/2002)
POST IN A CONSPICUOUS PLACE