0306-218 (MFD5)c)
L0
N
Ocm
IL a
U—
Nt
Q
Z
`.r -)a0
m
J Q
QU
CL 0)
Z
1"'o
g
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
Professionals Code, and my License is in full force and effect. `
Licensee Lic. Class % Exp. gate
Date Signature of Contractor('f,;
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.
'(moi) I have and will maintain workers' compensation insurance, as required by
SeAon 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance ca er .& policy no. are:
,
Carrier 11TATE, T/LY0,0 Policy No. t 1Q',,ti
(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' compen"tion laws of California, and 'agree th4t if'l• should become
subject o the wpfkers' compensation pro dons of Section 3700 of the Labor
Cod h he hw' comply with those vis ons.
,t�. t
Dater t:
Warning: Failure to secure Workers Compensation co rage 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 �allCity, and tate laws relating to the building
construction, and hereby au tforize representatives ,of this City to enter upon
the above-mentioned proper for inspection purposes. ' e'
,Signature (Owner/Agent) r." U0 -•Dated
BUILDING PERMIT PERMIT .
DATE VALUATION $423,53A),f}r) LOT 1.'AR.3A TRACT M11. .4 V7 21
JOB SITE�.1 :�7 �r •• a rZ IVE
WIVEADDR
APN :3 -73l0__r II
S
OWNER "�,CONTRACTOR! DESIGNER'/ EN (NEER
td.PA,RTYiET. TS AT LA C,tijTkTiA VTL:i: AGl-: LIL C�C.'� i ; i{A7r.�3 �J "'W'.7:d'AC:M� -3 t''QRP.
1 t 05 Qum, ',-Tn t T I I I) (�u po, ,mm, ma
,WEWP0R_T)3T?.ACft CIA 926-1610 -Fif"YNT01111", 11JUCIR, CA 92660
tML4 1756
USE OF PERMIT
t+9YIL,T:i•3�.A:t�xF X ;?''JJ:I'�i..��1�C3' I I
IMCLUDIF, BLOCK. V;i'AL1.411 on Pool', lam, wvf
PORCHIP.A`Y1 J
S�.PfPINK.LER
(� rr tif�,;ry3��y.^tii:,`'yIr
Pic_ =111 :.�i �! / �IRIJ X�,F.�e�a F;!!f W -
CONTRACT A1 IC"1Ltr1T w. oil 1,.0,
.G,TJ.'J.FYM11W 709f (V00NISI.A.J:1.4/M'JL0.i.'!
C0118-i'rV(K.110N MEEP e-000 'i;.1,l7';3. 13
)l.A; (G`tiL�C K I+T 10 E-{)�?d-•1:3�`-`i? w� } 466.5u
1vII.CKAIdIC;f�I.,FER i+:+:�000.42)._000 52M.0 -
ELECTfiilCAL FU 1(11-000-4204)(? *513..;56
P1,1I3hip"INO W9 - . . i 01 -WO-419-000 V1,611I.0+:+.
91'Rt•1T;13 ri8orfcm fra • .Rirsar) 1 J1-4 oo— U t di(tO
01RA))WO YFF, 101 -OW-4143-00D I .ttit
13V �a.0PF,R l.ti��'.!'h�.�' Y�t a l jcl
Qf�i.(IV
CES
AlV 1R: PUBLIC' PfA4GES ^
SrJ.-70TAL.;"C}�iJT[:ti't"i'iC? �tkl a I. 14 CJ%Q1y�
_101
iA[)y h..W,I.7li
7�133
-t.
RECEIPT
DATE'
BY
DATE FIN t
SPM
d
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings p _
Ducts
Slab Grade 1/0
Retum Air
Steel . 3
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
F.A.U.
Framing
Compressor
Insulation s*/ _ . <
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wail Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath of
Drywall - Int. Lath — D —
FinalW—Iff
—10
Final —
PO®
S 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
Heater Final
Water PipingJc
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
COMMENTS:
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
Urility Notice (Perm)
01/26/2005 08:44 17603401819 PAGE 03/27
LINSULATION CERTIFICATE
This is to codify that insulation has been Ineblied In conformance with the current , energy
Mgukftn, Calffornle Admin4t8ftv Code, Title 24, Stab of Caftfornle, In the building at
LA, QUWTA VILLAGE APART 1917
_'14; LA QUWrA CA
CEILING&
TYPE:BATTS MAUNFACTURER; Certainteed THICKNESS: R-30
151
WALLS;
ol
TYPE: BATTS MANUFACTURER: Owens Coming THICKNESS: R-13
f.
GENERAL CONTRACTOR: LUCAS GENERAL cowrmcmo CORP LICENSE 7.
TITLE:
PARAGON S A tum BUILDING PRODUCTS A MASCO Company LICENSE4 221517
TITLE: ACCOUNT REPRESENTIVE DATE: Z4I /(j /
PM
IIJSULATIQN CERTIFICATE
T�
M;�
UL �0� that as been installed In ponkrmence with the current energy
MIS AdministrativeCOCIS. Tft 24, $to% Of Caftmis. In the building Iocabed at
CEILINGS"
TYPE: BATTS
—WALLA -
TYPE: BATTS MAUWACTUREFt
GENERAL CONTRACTOR:
BY:
THICKNESS: R-30
DreI " FJL�'-01 I .r
TITLE:
Rv-13
0"
PARAGON SCHMID BUILDING PRODUCTS - A MASCO Company LICENSE x°221517
BY. 11TLJE; ACCOUNT REPRESENTNE DATE:
e
;4
Certificate of Occupancy
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 11
Use classification: A3
Occupancy Group: MFD
Type of Construction: V -N
Owner of Building: APARTMENTS AT LA QUINTA VILLAGE LP.
Building Official
POST IN A
Building Permit No.: 0306-218
Land Use Zone: V
Address: 1105 QUAIL STREET
City, ST, ZIP: NEWPORT BEACH CA 92660
By: G.SHOWALTER
Date: 11/15/04