0305-222 (RC)LICENSED CONTRACTOR DECLARATIPN �tn�I hereby affirm under penalty of perjury that I am licensed uncl&�,a,'sions, ofChapter 9 (commencing with Section 7000) of Division 3'of the Business andProf�ssionals Code, and my License is in full force and effect.License # Lic. Class Exp. Date513 099 B 4Datet— Signature of Contractor,,; kbc '. , . ("IOWNER-BUILDER DECLAR IONI hereby affirm under penalty of perjury that I am exempt from the Contractor'sLicense Law for the following reason: )( ) 1, as owner of the property, or my employees with wages as their �olecompensation,,will do the work, and the structure is not'intended or offered forsale (Sec. 7044, Business & Professionals Code).'1, as owner of the property, am exclusively contracting with licensedcontractors to construct the project (Sec. 7044, Business & ProfessionalsI am exempt under Section B&P.C. for this'reason.Date SignaliJ4 of OwnerWORKER'S COMPENSATION DECLARATIONI hereby affirm under penalty of perjuryone of the, following declarations:I have and will maintain' a certificate 1� 'consent to self-insur; forwdrkers'compensation, as provided for by Se,ction 3700 Of the Labor Code; for theperformance.of the work for which this.pprmit is issued.I have and Will maintain workers' cbm*pensation insurance, as required byS ction 3700 of the Labor Code, for t - he performance of the work for which thi�*Oermit is issued. My workers' compensation insurance carrier & policy no , are:Carrier(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 s(5 as to becoffie subject to th . eWorkers' compensation laws of Mifornia, and agree.tha-t if I should become� s bject to the workers compensation provisions -of Section 3700 of the LaborCode I shall forthwith comply with' h se �rbvilins\�Warning: Failure to secure Workers' Compensation coveradelis unlawful andshall subject an employer to criminal penalties and civil fines up to $100,000, inaddition to the cost of compensation, damages as provided for in Section 3706of the Labor Code, interest and attorney's fees.IMPORTANT Application is hereby made to the Director of Building and Safetyfor a permit subject to the conditions .and. restrictions set forth on his1. Each person upon whose behalf this application is made & each person atwhose request and for whose benefit work is performed under or pursuant toany permit issued as a result of this applicaton agrees to, & shall, indemnity& 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 ifwork is not commenced within 180 days from date of issuance of suchpermit, 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 iscorrect. I agree to corhply with all City, and State laws relating to the builcliw,construction, and herebyi-authorize representatives of this City to enter uponthe above-mentioned property foNnspe�ct!qp purposes,Signature (Owneir/Agent) Date.
` �`
BUILDING. PERMIT
.:.
DATE .VALUATION LOT: TRACT
JOB SITE
ADDRESS W-801 WAISHMOTOA-Yr(Sulto f4)
APN
P0.B0X 492029
31 3P&
LOS ANGEM CA 90044
C1,Lp Me CA 91 741
USE OF PERMIT
-644 SIF TEN AN TA I C8C
VALUATION 1A,
CONSTRUCTION.F'SE 1.01-060-,4,18-00o
XECHA�ICALFEE 101-000-421-000
PLUMBDIG RX
L W1 2`143 1
CITY OF. LA QUINT
EtXM-T0TKL C0
WE Fol E
786,2
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
p
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
/ p
Compressor
p
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
/ 3
Final D-?
BLOCKWALL APPROVALS
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
WV/ 3z7i
Equipment Enclosure
Shower Part
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. Panner Pole
Underground Conduit
Rough Wiring $ ;�
Low Vottage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power ri
Final
Utility Notice (Perm) 4r
COMMENTS:
-
J
A
X
Bin #
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'
City, of La Quinta
� Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit S� Z'1i
D)
Project Address: 3 0 d s
-
s Name: L Q L n v mQ� S
A. P. Number:
TAddress:
Legal Description:
Contractor: I W V1 C
. Zip: LOS AnQ I s 60 . 0 C) /4
;Telephone. -310 — 3% _ 7o q b 1_
Address: 1 'Y e bb 1 (` 1
Project Description: I D `^ C l
City. ST. Zip: �pf'0,
"CR
G 174
Telephone: 6 - C,16
3
State Lic. # : 50C)qq
Arch.. Engr.. Designer:
City Lic. #:
Address:
City. ST. Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: �QY1
06
e
Sq. Ft.:' ZA
1 # Stories: U V) Q_
#Units:
Telephone # of Contact Person:
<p 3rEstimated
Value of Project: 6� d
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted ✓�/Z-�
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
�},
Called Contact Person �l ;J
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmittedMechanical
Grading plan
2sd Review, ready for correctisue
Electrical L
Subcontactor List
Called Contact Person
Plumbing v
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'n° Review, ready for correctionissue 6 11fo
Developer Impact Fee
Planning Approval
Called Contact Person i
1 �"� �. 3li
A.LP.P.
Pub. Wks. Appr
Date of per issue
School Fees
j
C
Total Permit Fees
66A __a�_Z" A.&I
,�.�c ysu�,c� 3 0
CvD C Si T i� COD s�
�� - 3 D
O� �x
2
t. -
' i Building & Safety Department
c
� of Public-WorksReleas . z
e to Issue
Building Permit
To: John Freeland, Senior Engineer Date`to PWD:6-18-2003
From: Greg. Butler, Building & Safety Manager. Permit #:0304-302
A release from Pub IicWorks. Department is required prior to building permit
issuance for the following project:
Description TI -DRY CLEANERS:
Address orgeneral location: 50-801 WASHINGTON STREET
APN and/or legal description:
Applicant contact and telephone number: DON HOOPER 626-963-7643
w Please do not return this form to'Building & Safety Department until released for
-building permit issuance.'For issues delaying or preventing release; please
contact applicant directly at,the. number above:
Note: Action required (reply to Building Department or contact Applicant) within
five (5) working days from date received by Public Works Department
To: Greg Butler,- Building & Safety Manager
From: John Freeland, Senior Engineer` ;
The Public Works D'epartmentr has reviewed the above project and finds that:
... issuanceof. this Building Permit does not require Public Works
Department approval .,
issuance of this Building Permit is approved by the Public Works Y
Department..
John Freel "d, Senior Engineer Date
50801T1pwgreen — 4/18/03
r ,
LO
F�OFTt�� -
To: Greg Butler, Building & Safety Manager To CDD: 6-18-2003
From: Oscar.Orci, Planning Manager Due date: 6-24-2003
Status` 2nd review
Building Plans Approval
(This is an approval to. issue a. Building Permit)
Y The Community Development Department.has reviewed the Building Plans forI4
.the following project:
Description: T1 -DRY CLEANERS..
Address or general.- location: 50-801 WASHINGTON STREET
Applicant Contact: DON HOOPER 626-963-7643
The Community Development Department finds that:
01 ...these Building Plans do not require Community Development
Department approval.
e Community Development
these Building Plans are approved by the .
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 Dyelopment Department for
k review.
400
60'sca,r Orci, Planning Manager 6ate 3'
7
�0a c
Certificate of Occupancy
14"
5
a �
'Z
Building & Safety DepartmentIJ
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
v;
construction and/or use.
;
6
BUILDING ADDRESS: 50-801 Washington Street Suite "B"
\
I
Use classification: Commercial Dry -Cleaners Building Permit No.: 0305-222
{q�
R
Occupancy Group: B Type of Construction: VN Sprinkler Land Use Zone: CN
y
Owner of Building: LQ Investments Address: P.O. Box 492029
'Y
City, ST, ZIP: Los Angeles, CA 90044
By: Daniel P. Crawford Jr.
Date: 11/19/03
Building Official
POST IN A CONSPICUOUS PLACE
3