0310-332 (RC)3
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
a" Professionals Code, and my License is in full force and effect.
License # Lic. Class - Exp. Date
'Date ` Arl 4)Z Signature of Contra'%_ A=J��-'��;
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&RC. 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
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 �Y.ATx,. FLIM Policy
No. 467020000120'
(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 provis ons..t r✓
Date: "- %� APPlicarif ,�i . /i
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, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 thi's City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) f�7 r- !�%�''�` Date/1"��
.
#� '
- BUILDING PERMIT .r PERMIT0310-132
q
Mr+%•.10-1J2, h .
DATE f VALUATION'•,. k 9 LOT' TRACT
%= � aa• P J?1V129889 '
L
JOB SITE -
APN
ADDRESS 47—OW WAI .MT(—WrO S 10 ,410:&
10w2M)2
OWNER
CONTRACTOR / DESIGNER / EN (NEER
LA QY3TA3TA DEVELOPFMS, LLC
.41FFRIA'1D CO2 STRIX-';(' ON CO. DTC,
%7-900 AVE -NUE OF T101,TYAT'E9
PALM DES, re ' 0,A 92260
PAI -M. DRISIRT C°A, 922.11
{' 611)M-2626 MA .3089
TOM +S'CH FXSK &:d13e30C.M•rES
USE OF PERMIT
CONWMC.]A1: REM01 EJ,
106 S; PALM CANYON.DR]VE
TilRNMT pM1'I&OV FWE14T OF SWIT &4J02.-'F,1JTE LZ111?tN(
23.10 3Q, F'T, 9P OW, TYPEV-N COWST, LOCATED W PARC EIt 4
SHELL 8LDC1. 2001 COMS. IRM.ZVOC,;A:BLE FASENIIEFIT A,C RE+EP. 114' �
LrS7TKA1 COST OF CONS']CR,LTCr"S. ON
T�X,27�,(3Qi
PET£►WT FEF, 9U A: RY
PLAN CHECK I+'L:�', 5120,E
C ONS'.t'd26XT1iJ14 FE • , l (31-f�Cr1�11 S-Qt1i1 $198.00
MEL'HANIC&L IME -101-000 471-000, 131%0
1~L EC'1 TICAL, RE 101-000-420-000 $600
_. PLIU1'liI3l 0 ME
F.�D 09 2003
CITY OF LA QUINTA
FINANCE DEPT.
SUB -TOTAL CONWRU11014AITAP7ANCRC
.pp.M
TUrEss Sli-PlID
W�.IpW
TO -TAT, 7k'1�14 E:d'FEES DUE NOW
S495AG
RECEIPT
DATE �+ t
ABY !
DATEFINAJED
INSP TOR
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.
FramingFraming04
Compressor
Insulation 0 f
Vents'
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVA S
steel
POOLS - SPAS
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
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:
`.
_
_
;
10/12/2003 SUN 22:23 FAX 760 777 7112 Bldg & Saftey
R
I
1001/001
Sin #
acre pZ City of La Quinta
Building &I 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: Owner's Name: 11C-L&CW
A. P. Number. Address: - c -f- iw
Legal De-sc#ption: City. ST. Zi MA f —k-, k
U0Z11
contracioi: AffilIM-( �Iomdephone:
Address: :21 -qQ0 &Mluc OF-1wfatm XProject Description:
City, ST, Zip -,&A 2YIZ Orf-,IU�, FSULI-w, mord r
Telephone:
1,/ Z45 Q/ AICT Oil 2 FUS .
State Lie. # 9 6 -7--s City Lic.#: 0.30a1_ )�ray/ 1- PAO 3,3 Z 41,01
Arch, Engr, Designer.& e 4 ASSOC,
—�
Address:CAd /" 6A o
City, ST, Zip: P" 154 -46-5,6A
qU44
Telephone:-
Construction Type. Occupancy:
-2' Project type (circle one): Add'n Alter Repair Demo
State Lie. #:
Name of Contact Person: -- r6o Sq. Ft.: 3
8116fiCS: 2
tY Units:
12
'Telephone # of Contact Person: FESlima/teld Value of Project: 4 ?—S,,C>00
APPLICANT: DO NOT WFdTE BELOW THIS LINE
N
Submittal
Rtq'd
Rec'd
TRACYJNG
PER.%Iff FEES
Plan Sets
Of.
Plan Check submitted
lt;m
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cale
Called Contact Person
Plan Check Balance
Energy Cala.
—Fptans
Plans picked upConstruction—
(V A
Flood plain plan
resubmitted
Mechanical
Grading plan
2" Review, ready (orL--V-ti;n)sissue
Electrical
Subcoutactor List
Called Contact Person tt y2
Plumbing.
Grant Deed
Mons picked up
SAI.I.
H.O.A. Approval
Plans resu ted
Grading
IN HOUSE:-
Review, reJd y for corrcctio'Ass�c� 1A 9,
Developer Impact Fee
Planning Approval
I
Called Conta Perso
A.I.P.P.
Pub. Wks. Appr
Date of perm issue
issue
School
Total Permit Fees
/qa
11/4 Re C'd PL4*J
UffrAxd 7V 160303..
tilt PL-M*—�( MW4
P144104 7 QVI
r Fe,
a
ig
To: Greg 'Butler, Building & Safety Manager To CDD: 11/24/2003
From: Oscar Orci, Planning Manager Due date: 12/01/20035
Status:2"d review
Building Plans Approval
(This is an approval to issue a Building Permit)
e
The Community Development Department has reviewed the Building Plans for the following project:
Description: Elite Lending T. 1.
Address or general location:.47-050 Washington St -Suites 4101, 4102 and 4201.
Applicant Contact: Tom Scherer 760-413-3003.
The Community Development Department finds that;
...these Building Plans do not require Community Development Depart ment-approval..
- F -
...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..
a- /0 l
Oscar Orci, Planning Manager Date
Sta. �a�P47- ll
RECVD FOR PROCESSING,
s , (DATE)
ASSIGNED TO
(INITIALS) .
4�
P.O. BOX 1504
BUILDING & SAFETY DEPARTMENT
94Ssv
OFTS
78-495 CALLE TAMPIco .'
(760) 777-7012
LA QUINTA,.CALIFORNIA 92253
FAX 760 777-7011
To: Greg 'Butler, Building & Safety Manager To CDD: 11/24/2003
From: Oscar Orci, Planning Manager Due date: 12/01/20035
Status:2"d review
Building Plans Approval
(This is an approval to issue a Building Permit)
e
The Community Development Department has reviewed the Building Plans for the following project:
Description: Elite Lending T. 1.
Address or general location:.47-050 Washington St -Suites 4101, 4102 and 4201.
Applicant Contact: Tom Scherer 760-413-3003.
The Community Development Department finds that;
...these Building Plans do not require Community Development Depart ment-approval..
- F -
...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..
a- /0 l
Oscar Orci, Planning Manager Date
Sta. �a�P47- ll
RECVD FOR PROCESSING,
s , (DATE)
ASSIGNED TO
(INITIALS) .
RIVERSIDE COUNTY FIRE DEPARTMENT
IN COOPERATION WITH'
CALIFORNIA DEPARTMENT OF FORESTRY
AND FIRE PROTECTION
4080 LEMON STREET, 2ND FLOOR
P.O. BOX 1549 {
couvri ti RIVERSIDE, CA 92502-1549
RIVERSIDE.
(909) 955-4777 FAX (909) 955-4886
JOB CARD
THIS INSPECTION RECORD, MUST BE "AT JOB SITE
WITH THE APPROVED SET OF PLANS
Owner LeDate
Location 44 oSo Washi.��
Case No. I D e - 1I.089
f II I
Sprinkler Company se-lawr.,c 1 attd%on
Underground Visual Date Inspector
(Joints and Thrust Blocks Must Be Exposed)
Underground'at Date Inspector
(200 PSI For 2 Hrs. Prior to Inspection Time)
A 1a Date Inspector
Underground Flush _
�Overhea 8tetie �,,) Date Inspector, v
7qfl 0- 56
Overheau Final Date Inspector
Fire Main Installer "
Underground Visual Date .. Inspector
(Joints and Thrust Blocks Mu t Be,:Exposed) --
t
Underground Stati Date Inspector
i
(200 PSI For 2 Hrs. Pr' r to Inspection Time)
Date Inspector
Undergroun Flush � j
fan Tisdale
Fire Chief
Proudly serving the
UnincoWlItai
Areas of Riverside
cmty and the
Cities of,
Denning
t�
Beaumont
.,..
Calimesa
<*
Carryon Lake
Coachella
JJ
Desert I lot Cprurgs
{
Indian Wells
Indio
d
Lake Elsinore
c•
La Qui "tit
0
Moreno Valley
0
Palm lkscrt
JJ
Perris
Ran" Mirage
San Jacinto
16
Temecula
Board ofSupa%iuora
Bob Buster,
Diwict I
John Ta va.glia+e.
District 2,
Jim Venable,
Distylet 3
Roy Wilson
Diswict 4
Marion Ashley,
District S
2;44 PM RIV, CO, .FIRE P&E INDIO FAX H, 1.760 863 707,2.. P, l
RIVERSIDE COUNTY FIF11 DEPARTMENT
In cooperation with the
California Department of 1~'oresny and ire Protection
an can o .venue • ears, at
(�• . ax )
t
April 21, 2004
City Of La Quints
Building Department
Re: Fire and Life Safety Clearance
LAQ-03-TI-089
Elite Lending
The Riverside County Fire De ance forthe
Following address located a 47050 Washingtonstreet ste-4101,4102,4201, a Quints.
Please call if you should have any questions.
FRANK KAWASAKI
Chief Fire Department Planner
By
Ce
rryDe
Fire Safety Specialist
DSI
r•
WERGENCY SERVICES DIVISION.* Pl4NNIHG SECTION • INDIO OFFICE
82.675 Highway I It, Z' R., Indto, CA 922(4 9 (760) 863-8886 • fax (760) 863.7072