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0306-215 (MFD5)c*i N ON U a _g Z a 0 X W LL mVU O � 0) qt � O R j LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Qhgpter 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 1/ Exp. Date ` B MIC c pate Signature of Contractor kf 7 J OWNER -BUILDER DECLARATION - hereby affirm under penalty of perjury that Lam 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. ( --) 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 issugd. My workers' compensation insurance cert er & •ppli ,y, no. are: Carver'.A.I: r,. 3X�i Policy No. �f4'o . `.:`J.:. (This section need not be completed If the permit valuation is.for$100.00 or less). () I certify that in the performance of the work for which' his permit is issued, I shall not employ any person in any manner so- as to become subject to the workers' compensation laws of California, arjd agree that if I should become subject tdt a wgfkers' compensation prove$ibns of Section '13700 of the Labor Code.') shi•fodhwith7comDly with those DrBvisions. r' Warnin4: 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 this City to enter upon the above-mentioned property,forlinspection purposes'. !' r Signature (Owner/Agent) � rL + �� ' _ Dater 07 BUILDING PERMIT ' PERMrraM DATE VALUATION *4234`.M 00 LOT. nidi ' ��r TRACT tl '10721 JOB SITE X"60 60 ERF'M 0, %VX1Z DRY . APN 173-3 M-0011 ADDRESS OWNER CONTRACTOR/DESIGNER/EN (NEER 14k:4£C2:i 11'S1f.!' F. �1i13. ixp, rl t..n�7 ,7 �_G��.'.P.:i cfi � 3:Et�►i. �"�J`a'.tT�: t;.;ORT. )105 r?U:►,r..,)I, �31�:)�►', � � ' ' art r�j;:.fT1��F.7 NEWPORT BRACH c"A 00m,60 ld i�rP ik��I' '�3:�,�►L;[3: �"ta '�;�f�� `t -,")47-4-02.21 0 is A?S6 -AL USE OF PERMIT JA0T 1 c'-YAhCLk, rl ViJJN0 or/ MR ,n�/�(.. s..p T • i.�� q • T� �10��, 1a ftrx l.1 u{^� ,� INCLUDE :J �Jtfi K y;YALT.,0 \!2'a P(71 �L, m, +Y -14 .0 BUIL011405 1,fr'12.Hf13F SIf+�Ryp' t i.(71�1Zk:.tll"..TA.;+, OU1"1I 1S',MUI':YU COW OF C'GNIuMUC'TCON 42,3m;MAX? C0148TRUCTIG1PWE 101-000,418000 tITK•sa FLAN t HMWCX. ft? M 0 k -400-A a0-310 ME CHAAMC:RL I;EIS.01-%300.4•2' I -4()•0 $284,00 ZGWC'T PJGAJ ;qL?F I01-000-4 fti••©(J() ::F�ri3.6b ,SiTrIONCI MOT1W14 r E ., REWD "? 0 _000-Z47 -000 X43. f 5 O€.AD1110 FEE 1,01 -000.443.000 II1S,06i D1!`,t{T►,•1.0P,TR fMP± CT 7-9, ''a41,8?'g,00 .AR7 IN PUBLIC P iuACf,� - RE -311 V0-000445,000 n15l5::41 .... J`("I'T0b" AND V..',. VK �i �I��...FiN•ni�J� yQ-41} ^^ �r� 1.822 1".l..i:/'f';.•1L.r.� L'.i'.L'rS r�.•�tq-'7Ct $ ,00 JUL O J 2CnRIiCT F'>:;.'.R.11IIYU?E;40W x"16,1 1�1t) -_J RECEIPT DATEBY DATE FINALED r INSP TO 11 1 t.' 1.- L 1 INSPECTION RECORD ' OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings C' Ducts Slab Grade Return Air Steel - Combustion Air Roof Deck Exhaust Fans O.K to Wrap 3 - - F.A.U. Framing _J Compressor Insulation - % - y Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wail Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath ` Final c9 Final BLOCKWALL AP OVALS P®OLS - S AS 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 - J -- Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring 3 - •� Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final 44 Utility Notice (Perm) COMMENTS: f'���G ""`' P ` 1Z.• 01/26/2005 08:44 17603401819 IN&LATIO N CERTIFICATE TMs Is to certify that insulation has been WwWwd in amftmence with thwcuffent energy mquia"n, Calftmia Administative COCIO, TIVe 24, State of Calftmla, In the building at LA QUINTA VILLAGE APARTMENT4UNk- QUWTA CA TYPE:BATTS MAUNFACTURER-.Certakdeed THICKNESS: R-30 WALLS: TYPE: BATTS MANUFACTURER: Certainteed THICKNESS: R-13 GENERAL CONTRACTOR: LUCAS GENERAL CONTRACTING CORP LICENSE BY: TITLE: 4- - I PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE 6 221617 ITFLE: ACCOUNT REPRESENTIVE DATE-*. 111JULATION CERTIFICATE This certify that Insuiation has been lnsWW In confbmmnw with the current:ene regu lifbmta Administrative Code, Title 24, State of Calftmie, in the bu ocaied at CEILIM, TYPE: BAITS MAUIN URER,THICKNESS: R-30 WALLS: f TYPE: BATTS FACTURER: Certain THICKNESS: R-13. GENERAL CO. CTOR: LUCAS GENERAL CONTRA CORP LICENSE # BY.. TITLE- PARAGON BUILDING PRODUCTS A MASCO Company LICEN 221517 BY; T!"ILE., ACCOUNT REPRESENTIVE DATE. PAGE 12/27 Certificate of Occupancy T4hf °F4Q�a 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. BL130 07 Use classification: A3 Occupancy :Group: MFD Type of Construction: V -N Owner of Building: APARTMENTS AT LA QUINTA VILLAGE LP. Building Offi ial POST IN A Building Permit No.: 0306-215 Land Use Zone: V -C Address:. 1105 QUAIL STREET City, ST, ZIP: NEWPORT BEACH CA 92660 By: G.SHOWALTER Date: 12/09/04