0012-008 (CONR)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
667057 B 013ri 1/2(
Signature of Contractor
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).
�f,) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
O I,am ex mpt rider Section B&P.0 or this reasdin
�Qate f 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
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 STME MIND Policy No. 18074.0
(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 sh II forthwith comply with those `dons.
Date: W Applicant!
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $
addition to the cost of compensation, damages as provided for in S tSoq 706
of the Labor Code, interest and attorney's fees. U
IMPORTANT Application is hereby made to the Director of Building ety
for a permit subject to the conditions and restrictions set foli on his Af
application.
1. Each person upon whose behalf this application is made & eac I perso i at
whose request and for whose benefit work is performed under or )ursuar t tvC
any permit issued as a result of this applicaton agrees to, & shall indemnify
& hold harmless the City of La Quinta, its officers, agents and
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' f�rinspectio• purposes.
Sgnature (Owner/Agents Date
V
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 001:2-009 TRACT
JOB SITE
APN
ADDRESS 79-120 C..ORKOR M CMNTKR.D +R M
OWNER
CONTRACTOR / DESIGNER / ENGINEER
1A QUIN'TA SPC LLC
TMI WCOF2.PO E'D
.4255 W NINZLN
;
4921 MCII .9.r 7M I
X3'3CkIM. ON CA 9521,9
Xgw1='owrBRACH CA 9.2660
(714)851-2211. -'2'211. MIX 4834
USE OF PERMIT
MUM UrCTAL
SELF S OR A G E 'MC1I d'I Y (KIIt DS` o 8)
C014TRAVT AMOUNT NT 111f An.00 La
&S"I'RWRIND CSOS"1s' UP COz+7S RUC:",1;CO,N
1118,437.00
C10148TRUC3`ION FEE 101 -000-418-000 516+�,Ufi
PLAW CHFX.K ME 101-000-439418
FIFICTWIPIL FFYI 101-000.420.000 5179, 20
STR17WO MOTION 17F'., • COMM 100••%f O-211 $24.97
ORADING PU 10`C•f1.1C3.47.a-70t1 $20.00
DFVFAt)P1W JUPAr.T... .'E? $-%959.;o
.ART IN PUBLIC PLA&M9 - COW 701.000.25541:0 W2.19
A 0
-
R 3 2001
L CONSTRU011 MD > ILAYr (IMC °
r,9F.R.55
TY OF LA QUINTA Lys pF 2'im') �.s
S0100
FINANCE DEPT
I'C�''�'AL )F1aWT FEES D-0 K .lY'OW
RECEIPT
DA�TyE /
BY
DATE FINALED
INSPECTOR
if
�, ! . s•
t
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE 7T
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
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
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
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)
COMMENTS:
�p C7SIDEPARTIVIENT
QUINTA
UILD
2iINUEST LINE
3
r
Permit Number 0012-008
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB AD*DRES%9-120 CORPORATE CENTRE DRIVE
SELF STORAGE FACILITY (BUILDING B)
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK p li
FOOTING STEEL L
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SI ED
CONCRETE SLAB L
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC p /L
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT - A/C
FIREPLACE
ROOF 2
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
rwL rNr rLAO i r
f'Y . 11-1 O / ATC
FINALS
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED r
TEMP POWER
C��-,i1�rE-�i^✓C., TSG-E'.'I i��.� </3/0
/
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
Certificate.of Occupancy
City. of La Quinta
Building and Safety Department
This 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:
BUILDING ADDRESS: 79-120 CORPORATE CENTER DRIVE
Use Classification: SELF STORAGE FACILITY (BLDG A,B,C & D) Bldg. Permit No.: 0012-007,008,009 &
010
Occupancy Group: S-1 Type of Construction:
Owner of Building: LA QUINTA SPC LLC
TEMPORARY CERTIFICATE OF OCCUPANCY
Building -Official
II N Land Use Zone: CR
Address:
3255 W MARCH LN
City:
STOCKTON, CA., 95219
By:
DANIEL P. CRAWFORD JR.
Date:
30 DAY TEMPORARY - EXPIRES 9/8/01
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This 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:
BUILDING ADDRESS: 79-120 CORPORATE CENTER DR
Use Classification: STORAGE FACILITY Bldg. Permit No.: 0012-
007,008,009,010
Occupancy Group: S-1 Type of Construction: II N Land Use Zone: CR
Owner of Building: LA QUINTA SPC LLC
l
Building Official
Address: 3255 W MARCH LN
City: STOCKTON CA 95219
By: KIRK KIRKLAND
Date: 8-14-01