0306-220 (MFD5)fn.
W W
O W
�lYr`
o Z
OLU LU
O
H�
Q.
C0
Z
cr)
L0
N
OQCJ
U
D_ —
Z
Lf)
a 0
XW�
m. U 0
O
a: rn H
Z
N d
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
Plr*bfessionals Code, and my License is in full force and effect.
License # Lic. Class Exp: -Date
S j,... t 1 A W1105
6ate Si�nature of Contractor 1,11i
' 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&RC. 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 issued. My workers' compensation insurance carrier & policy no. are:
Carrier 37!0T. FUNK) Policy No. 1:1.9h ;-2flflf
(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 so as to become subject to the
workers' compensation laws of Califomia,,and agree that if I;should become
subject o the workers' compensation pfrisions of Section,,a700 of the Labor
Cod e''(/sfialUfo hwith comDIV with thosenrovisions. .rY
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 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 author�e representatives �lthis City to enter upon
the above-mentioned property kbr Inspection purpp'ses. r
t� `��t _--�.,_ Date! ! 9 ;O
,_Signature (Owner/Agent) Yr•L- -
iy
BUILDING PERMIT PERM03061-2120
'
DATE VALUATION �.3�irf LOT i=,rti:X4 TRACT 14„ 4r, 21?JOB
SITE
ADDRESSfiQ7.�? ! i.i L?3b: x?Y;p
APN
CONTRACTOR / DESIGNER / ENGINEER
OWNER11
[[ nN�
A-1,i'W_-Ciuu: 4T�Srr��T JUT� 1.t 'i � IX CIAS :'� •.I.ts'':�7 t.�a.�:��.
�AQ% �.i i.,tJ,,G.�.t.
riYs..ii:i.�:•�,t+��+�"���:.it
♦�.l rG.��i�'
R 1(1S 'QUA0, 47A:f�i. T-1- 1 I �i:aad�W � ':I:•.�
iQ•1•�r)4?�I.02:� i �?L� 175''
USE OF PERMIT
a7JIMI.F.A iT.1"DW&UNG y
YpP8 7 .-, ... ♦ .. t , . 1r my ftfo . --ev i
INC LUO ial, ;:x: WALLS OR r=t1;'9f , R1 V.114 S PRMK.i.,E:!' V).
47 OWLIAW.1;
POW71101 ATIO 'I'a-- oo SP
:Ai3�''r' INyi1:1YlF..Rr O'
nd7'rooii'i7I,P
Y q ♦
Alk, .. lx.L I F.�r;F11q�I' 4l'i
i~.tJNT)LACT
�98�� 'IT sTLA COS7 Or
PERMIT 111111 910-MMAP"Y
0GNST1r,.T1C k`;(Y f i+1fi1fi_ )01,.(K*_418_00D
FL 4N t:11LCK FEF. 101-000-43.9-318 At'Di:. ri
NIF)CRKH'ft'.AL Pl% 1014,00 -421 -Wo
EM-EC:TRICAL, FF.1Z 101.000-420-00) 4lao6
PI.I1r. �tNrtFRY tni^000.-�'d9-000 % 00
STF.OtIC Jk9Ga'rito 4 i7,E -• li.uID 101 ••000-Z,41-000
GRAD1,013 IT.E. ),'01,000-411-000 '1!.5.or)
DF'arELDF1?,P. !M ACT HP I,c;:r..00
ART IN PI, BLIC Pl A T S 270-M0-145.000 0:,9-19:1
"T VA`TlcikN
!I JUL3TC3"[A 1'.i�.�'t1��1Irr .Ss'rf7 NOW
RECEIPT
DATEBY
DATE FINALED
INSPECTO _
I
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 —
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
Exterior Lath
Drywall - Int. Lath
49
4:i
Final /-
Final —
SLOCKWALL 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
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer-Leteral 1,,JA yx
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
=
Final
FinalFZO
Utility Notice (Gas)
ELECTRIC
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)
L APPROVALS
COMMENTS:
ow- )1,/ 104 k � f
g L GSA LL A)A,
/� � �, ., i3,93W a,
A z/5 /
01/26/2005 08:44 1760340181.9 PAGE 26/27
:,.,.•„r••K••,•,•..,.•.,,..etirwy�..,.w,w.,�. ... ,. nusowrnmrr~,.,..a+•�v.A•r+ror.rwcs..,,•.m,T,,.,.�.-,r,�.�,
813JULATION CERTI�
This is to cm* that Insulation has been kmMIled to oonfarmance vft the current energy
regulatan, Cawomia A irnintst um Code, Tide 24, Stste of Caldomia, in the building at #
t i
LA OUINTA VIL1AW APARTI>dENT9�BCKNe�7 LA QUINTA CA
s CEILINGS: J
TYPE BATTS MAUNFACTURER: Certaintaed THICKNESS: R-30
i
y
f TYPE: BATTS MANUFACTURER: Certainbeed THICKNESS: R-1 3
GENERAL CONTRACTOR: LUCAS GENERAL CON"MCTING CORP LICENSE P 7S 78S
6
r BY:
7
PARAGON SC41D BUILDING PRODUCTS A MASCO Company, LICENSE O 224517
y? -
TITLE: ACCOUNT REPRESEN TIVE DA
r .. •i':t�yvil.l •IN.!•Y/7�Y MIrpJ4lML/A/JYINK AAI��N IINR.Y/�.tI1fN/%Ma".VArI/I�//AI.NAIWA
INSULATION CERTIFICATE
This is to oertify that insulation has been installed In oonformance withthe curwt energy
mgukdbn, Catdamle AdmloWtaft Code, Tide 24, Staft of California, in Bre buddrng located at
LA QUINTA VILLAGE APARTMENTS 13; LA QUINTA CA
CEILINGS., I
` TTS MAUNFACTURER: Certaintsed THICKNESS: R-30
TYPE: BAITS MAUNFACTURER: Cermtnbeed THICKNESS- R-13
GENERAL CONTRACTOR:: LUCAS GENERAL CONTRACTING CORP LICENSE
TITLE:
PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221$17 1
BY: &&kA—AaTITLE: ACCOUNT REPRESENTIVE DATE / d
D
9
9
/
.•••r•.� . r••••r•r•I,�P•nkpl/w4X�Y}'///'N14Nd.M1�MN'ANYI►wY►AYoNNA'MNNhi9•N.dMIyA/�A'/YA'.TJ7VY.O�RAJO'MKl/�JRV/1.�'HFf/NOrA7NAN�Ir�A�+`iM�iCIYi•IYRNrvFA/•A
Certificate o,f Occupancy
Toaf 4�WQ�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.
Use classification: A3
BUILDING ADDRESS: 50-660 EISENHOWER DR. BLDG 14
Building Permit No.: 03016-220
Occupancy Group: MFD Type of Construction: V -N Land Use Zone: V -C
Owner of Building: APARTMENTS AT LA QUINTA VILLAGE LP. Address: 1105 QUAIL STREET
a�
Building Offi ial
I:1
City, ST, ZIP: NEWPORT BEACH CA 92660
By: G.SHOWALTER
Date: 11/01/04