0306-226 (MFD5)co
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LICENSED CONTRACTOR DECLARATION
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
Date, 6i6nature 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).
( ) 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 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.
NX I have and will maintain workers' compensation insurance, as required' by
Suction 3700 of the Labor Code, for the performance of the work for which this
permit is issued. MyY workers' compensation insurance carrier & policy no. are:
Carrier Policy No. ?';.�i3�•:3Stit:
(This section need not be completed if the permit valuation is for $100.00 or less).
O 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' compen tion laws of California, and agree that if%'I should become
subject to tfie w kers' compensatioh1provisions of Section 3700 of the Labor
Code's alLfp `withcomply with diose p A ions^ f11 ter 6
Applicant
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 appiicaton 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 this City to entgr upon
the above-mentioned property,for inspection purposes. 1 F' /
Signature (Owner/Agent) Datei {!=y
BUILDING PERMIT PFRMITO
DATE VALUATION rIy:'1 LOT,TRACT;;
JOB ADDRESS e� %r �> .� a�3 ' 1� .3} Ori
APN 7:13 3 70 -VA
OWNER CONTRACTOR '/ DESIGNER IEN INFER
APAYI1W�i 1'� A iA A(41iligT.A.'v':)`f..:►..IY3.1.K, U. I.lY1Ans a-P.RtRxf.,
1? 05 Q1.JA;ff, 7ff-LtiWr 1111 QTivi, a"flws'i'
?�1 ri=JP�Ji,'°1'ttZLp—IC-i f r•.A 926;66 Cit :M)Fld
(949)474-0221 an- •i'156
USE OF PERMIT
_MA'i S A d � �:, ��� aq
Ar
INCLUN�f i3[.t)(:1 LYr1L� `t�1t 1' ►!)L;. I<I "�•4e I'Pti'tAi :LIi.It .
47 WIML ING3
i;Prc�CN'Y..1,,P;it iI,32� tX'i fid'
AW--1tEStMN'".IA..L 71It% (Vt SF
C:OzXITRAOCT .'4i> TAI14 3i4� t Fit .90 ::+r3
ti:5rTJ �119►TKD CO'..T OF Cf,)PIS-T RL?CT:dtsN
423,5WA 0
C01•431TRUCTfON F1?�. 101.1t.)OO.418-000 t1 n.4.130
RL.AY i^,i•1F,G} YEE 109-000-439-318 $4zL3.SF'
1+1��?�:7frie?:�d1t;.Ay Fxf 101.000-421.000 %Moo
XLW!i !UCAL FZtS 11)1-=)(10-420-00 0 3.13.66
PLUMEF1;;C: Fila! jQ1�ayLl 19.01)1) b57.40
STRC1%NX1M.i`,f 1fM "M • R10i1D 101-0001 ,241 000
OI,.;~.f)C1dC4101-000- -23-000 Pit"
T)Lr "i:'I.ZF7 :R IWJPAO' nZ X ?l i t,i#7i.I1Ct
Al'tr1' �W PUBIAIC MACK,— W.ir 270.001-441.000 !61!il
is m-;cauq, cKJa�t": "I 1'J�"> MOM �iLJIJLrM � Zi!?t :�C
1$16,134.90
[RECEIPT-
DATE
l a
r
BY
f; ' C f
DATE FINAL*ED r
INSPE R
Jr
-7. —
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
(MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
8 —
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
AV
Exterior Lath
Drywall - Int. Lath
— y -
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 P, P
Heater Final
Water PipingPlumbing
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: sr�LB� •t"°i' �1c �l o�
AS
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)
Certificate of Occupancy
4
Building & Safety Department
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
construction and/or use.
Use classification: M.F.D.
BUILDING ADDRESS: 50-660 EISENHOWER DRIVE # 24
Building Permit No.: 0305-226
Occupancy Group: A Type of Construction: A-SPRINKED Land Use Zone: V -C
Owner of Building: LUCAS GENERAL CONTRACTING CORP Address: 1111 -QUAIL STREET
Building Official
u,i
City, ST, ZIP: NEWPORT BEACH CA 92660
By: G. SHOWALTER
Date: 02/23/05
01/2612005 08:44 17603401819
IlLSULATION CEFMFI9M
This is to cw* that insubdion has been In MOW In conformance with the cuenergy
energyi
regulation, California AdmirdsM" Code. Me 24, State of C4difomia, In the, build!ng at
LA QUWTA VILLAGE APARWOMEM- A&iA!. LA QUINTA CA
CFJu
WPE- BATTS MAUNFACTURER: Cefthileed THICKNESS.- R-30
TYPE! BATTS MANUFACTURER: Owens Coming THICKNESS: R-13
GENERAL CONTRACTOR: LUCAS M.CONTRACTING CORP LICENSE #.
TITLE.
PARAGOu SCHMID BUILDING PRODUCTS A MASCO Company LICENSE 9 221517
TrFLE: ACCOUNT REPRESENTIVE DATE. -4 (d
• .. ........
This IS to 06rtIrY that 1
regulation, California
CEILINGS&
TYPE. BATTS
W&M,
TYPE: BATTS
GENERAL CONTRA
BY:
INSULATION CERT) KATE
has been Insbiled In wdarmance with Vw current energy
Ova Code, Tille 24, Ste* of dallibmi I a. In the buldlnij�
MAUNFACTUREER.'
CertaIrfted
GENERAL CONTRACTING
R-30
R43
LICENSE#
PARAGON
.411-11MID BUILDING PRODUCTS A MASCO Company LICENSE # 221
BY.. TITLE:, ACCOUNT REPRESENTIVE DATE:
PAGE 16/27
FEB- 7-0.5 MON 1:14 PM RIV, C'0, FIRE PU INDIO FAX YO, 1 760 863 7072 P. 1
Crafo E. Anthony
Fire Chief
Proudly serving 1110
unincorporated
areas of ltiversWe
County'and the
rides or:
Banning
4
Beaumont
4
Calimesa
Canyon Lake
fi
Coachella
Ps
Dcsert Hot spaings
a
Indian Wells
0
Tndio
4
Lake Elsinore
4
La Quinta
.Moreno Valley
Palrn Desett
4
Perris
Rancho Mirage
a
San Jacinto
4
Tcimcula
Board of Supervisors
Doh BU q1 x,
NOW I
John'ravaglianc.
uimict.2
klT stone,
Di4tiiiat3
Roy Wilson,
l..)istriout 4
Marlon MINIev,
Dietrict 5
'RIVERSIDE (]OUNTY
FIRE DEPAF:TMENT
�1
82-675 Highway 111 • Indio, California 82201 • (.'60) 8638886 • Fax (760;863-7072
i
February 7, 2005
'lye
City of La Quinta
Building Department'
Re: LAQ-05-BP-044
C'
Buildings 19 thru 25 and.27
i
The Riverside County Fire Department is granting the clearance for a building
permit for the following project located at, 50-oF—Eisenhower Drive. La Quinta.
Please call if you should have Questions. W
Respa-dfully
FRANK KAWASAKI
Battflion Chief / Fire Marshall
By •fitORS
-O�'`t -
Tarry De oucy
Fire System Inspectors