0306-211 (MFD5)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
Cn
N kProfessionals Code, and my License is in full force and effect.
p 5 ch License # Lic. Class .,Exp -Date
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c• ^�� Signature of Contractor
Z ti Date"
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OWNER -BUILDER DECLARATION
W LU I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
Z ( ) 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).
M() I am exempt under SectionUl) B&P.C. for this reason
N _ Date Signature of Owner
ON
W
a Z' WORKER'S COMPENSATION DECLARATION
o 1 hereby affirm under penalty of perjury one of the following declarations:
Lo H O O 1 have and will maintain a certificate of consent to self -insure for workers'
X W Y= compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
m Q p (;O 1 have and will maintain workers' compensation insurance, as required. by
O U Q Section 3700 of the Labor Code, for the performance of the work for which this
H permit is issued. My workers' compensation insurance carrier & policy no. are:
'? Z Cartier J;;Tif Ftf°4;;= Policy No. 1I�i4`rf;•i�U,s
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g (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 b come subject to the
workers' composation laws of California,. -rind agree t at if I should become
3 subje °to%
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms 8 Footings
Ducts
Stab Grade
-
Return Air
Steel
.,It AC5
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
g
F.A.U.
Framing
— 2
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
ELOCKWALL APPROVALS
POOLS -SPAS'
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
Heater Final
Water Piping
4 Pa el
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
_
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
I
Gas Test
- J
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS'�--
Temp. Power Pole
Underground Conduit..
Rough Wiring b ..
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
F)derior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice.(Perm) Z
COMMENT'S:
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Certificate of Occupancy
Tlhf ot 4 12"
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.
BUILDING ADDRESS: 50-660 EISENHOWER DR. BLDG 02
Use classification: A3
Occupancy Group: MFD
Type of Construction: V -N
Owner of Building; APARTMENTS AT LA QUINTA VILLAGE LP.
..__ �.._All
IN A
Building Permit No.: 0306-211
Land Use Zone: V -C
Address: 1105 QUAIL STREET
City, ST, ZIP: NEWPORT BEACH CA 92660
By: G.SHOWALTER
Date: 11/29/04