0006-364 (OFC)D
�# s
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
693077 :8 07131 /2(
Date . r�� Signature of.Contractor��✓?�
OWNER -BUILDER DECLARATIO>
_/
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). ,s. - .
() 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 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
Secion 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 STATE FUND Policy No. Ji 242324
(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.
f
Date: �. >^
`�' �)�+ P Applicant—
Warning:
�-
Warning: Failure to secure Wor�r' Compensation coverage is unlawful and
shall subject an employer to cnnal 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 petmit 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, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees!IT
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
fiSignature (Owner/Agent)' �� % �? Date
BUILDING PERMIT PERMIT#
DATE VALUATION . LOT (K*6--364 TRACT
x ,41166
JOB SITE
APN
ADDRESS
79-440 C ORPOMVI X C.PN'A.XF DTZFVF
649-020--cf,
OWNER
CONTRACTOR / DESIGNER / ENGINEER
N.i/m 1Afle,1i.AtL
OtR Bi3ZI-ks
' 55-525 0-IF8RLldAl
711 -.17 0 VMG.l9 T y ENTE, =TB. D
LP, P,�,Ji31�1'1:A CA 92253
PALMnL`r5'F�f�"k° 0_11k9221
,76P)3606632 C.S.L11 13d�
USE OF PERMIT
M. ILTI-TY.-WART t:O.MU EP.CIA,L 8U'1,D1'Htf . '1,5 P*t &K
AA ; .- e:i:?MA4IACIA k. 2 ,9 5.00 S?
C ONT:RACT AMOUNT LS
1tgfn"IrD COST or 4':C+N4MTK 1'1011f
:193,412,66
11E '11A1T FXL'' &X1A MARY
CONISTR1XTION P'EJ.- 101-000-418,000 S31121.50.
PL.&H CHECK nly, '1101-004-439-3118 $'kS.W0.64
FEE D OSIT 101.00CI-439-3113 a1,210,00
M9Cf1,A NIC AL, F9F $51r; 00
RLECTRICAL 'iF"M 10i -000-4210-M,0 $6K 16
PLA)MWND.PES 101.°00 -419-000 $393.00
STRONG MOTION YZE • COMM 100-000-24 0.24 I-000 46810
awiniva nf? it01-000-423 $20.00
DEViblrt'VER IMPA.C1 FEE 531,313, w
�
AltT n4 PUBLIC P11`1".La - d.OMI?01-000-1;IS-Cli'3Ct $6;467.06
i
JAN 2 5
'1'0fAL 1~°:Ii;.l&W 1PF.080VA NOW
�4�r�t�7.8t3
RECEIPT
DATE ++
BY i��i
DATE FIN/�AL D
INSPE
tk
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
Ut
Exhaust Fans
OX 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
_
/. (j
Drywall - Int. Lath
i
Final
Final p
-
POOLS -SPAS
BLOCIkWA1
L 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
-U(
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
r
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
�Q
( ,/lam •Is �— 0-1
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 7.27. d Gr
Utility Notice (Perm)
MAIN GROUND SYSTEM
DO NOT POUR CONCRETE UNTil. All. ACOItIF. H&S OEEN AAQAJ�_f!
JOISTS & GIRDERS
Uffr;L ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC 1
ROUGH PLUMBING
ROUGH GAS & GAS TEST
WFAInkin A VFNT - Air
FIREPLACE
0 4' 0 8'
N �LATION W�f r7
PRE
COVE1 MI: AUL'U!. HAS SEE.! '_101!1
DRYWALL INTERIOR 7-
POO� FENCE A GATE
GMR SEPTIC TANK
FINALS
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
07
A13OVE APPROVALS DO NOT INCLUDE RIGH To
TURN ON UTILITIES OR OCCUPY WILDING
CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
00 777-7012
INSPECTIW)ILkST LINE
.7 56FLA OUINT40
i
M/M JAMES PAUL JAN 2 5
owner
Contreew ORR BU1LDERS;=jiVAAjpI--
0006-364
Per" Number
POST ON JOB IN CONSPICUOUS PL;kCF-
INSPECTOR,MUST SiGN ALL APPLICAB; r- rcr-ACES
7944G CGRPORATE CENT= D.qxr%'E
JOBADDREESS—
MULTI-TENNANT C -Ort, M1=AZ1A_7.
BUILD) G - 21,958 SF
YYK OF 114SPEC71ON I NOW.
FOUNDATION & SETBACK 127�f_ 0 i( Aec"L.
FMTING STFEL I /wt
MAIN GROUND SYSTEM
DO NOT POUR CONCRETE UNTil. All. ACOItIF. H&S OEEN AAQAJ�_f!
JOISTS & GIRDERS
Uffr;L ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC 1
ROUGH PLUMBING
ROUGH GAS & GAS TEST
WFAInkin A VFNT - Air
FIREPLACE
0 4' 0 8'
N �LATION W�f r7
PRE
COVE1 MI: AUL'U!. HAS SEE.! '_101!1
DRYWALL INTERIOR 7-
POO� FENCE A GATE
GMR SEPTIC TANK
FINALS
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
07
A13OVE APPROVALS DO NOT INCLUDE RIGH To
TURN ON UTILITIES OR OCCUPY WILDING
rs 2--
7-d
yj,
I< .
I
Certificate of Occupancy
City of La Quinta
Building and Safety Department.
This Certificate issued pursuant:_ to,, the requirements of Section 109 of the ,Uniform _Bui/ding 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:
BUILDING ADDRESS: 79-440 CORPORATE CENTER DR
Use Classification: COMMERCIAL
Occupancy Group: B Type of Construction:
Owner of Building: M/M JAMES PAUL
Building Official
Bldg. Permit No.: 0006-364
VN Land Use Zone: CR
Address: 55-525 CHERRY HILLS
City: LA QUINTA CA 92253
By: KIRK KIRKLAND
Date: 7-11-01
POST IN A CONSPICUOUS PLACE