0306-246 (MFD5)N CO
CN W
' W
rZ
O Z r�
0 C
�LU
a.
rA
Z
CO
LO
N
ON
U_ °)
etn'Z
o<�
Tl -;0
0 J J
m<LL
0
O
QMH
.qZ
Cb
a
Ri
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.
License # Lic. Class Exp. Date
t i
Rate / Si�nature of Contractor `l
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 underSectie 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 issued. My workers' compensation insurance carrier & polio no. are:
Carrier 3TAT9 Policy No. I1)` 3_211,Ni
(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 California;"and agree that if I should become
subject to the workers' compensationr provisions of Section 3,700 of the Labor
Code IlVahfokwith,comply with tHo a provisions.
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, indemnity
& 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 ter upon
the above-mentioned property for inspectiompurposes. J
- F I,,.;
nature Owner/A ent " 's i I 'k ` F��' I}_ Dat�r' i %' r 1 i �
Ir7
BUILDING PERMIT PEM
0305-146
DATE VALUATION $1_50,UMO LOT XIAR314 TRACT 11V 73T. ti
t _
JOB SITE �::'i1C��11�UEZC F��S
ADDRESS
APN
OWNER
CONTRACTOR/DESIGNER'/EN (NEER
APAB'Ctr>'!<`VIN R 'i,A QtT.i1` rA U
I-ViCAS Cit:En2lcfcAJ3 ('0NT ft.ACTd'^,fG C:t;)-P '.
i 10 5 QLfbjI,'STR F,P,,
" I : 14;,jTa a -iLT1°6Li-m'-T .
W0711'r l EAC;'h'. CA 92660
VM4 WT OTt,iBEkM CH. ;'.1266 1
(94V)474,0121 C :iL 1756
USE OF PERMIT
.
. s VNI IaN I QKTa , 1, FE, 0 1,'1-u 7A
PE iTlSiIT t0l;:q NOT It CLUD1+' BLOCK Wr".ULS on INOOK ,,
K*C) YP A't M 044,0 SI'!
1.13y�.9fY)U fR, r
it ••fr(lI G'i:4''1 l.ai.r I,SitiY.m UCS
93 ,21 ,,,d0 I -`s
t:`ONS9'bt1FCT OT FIR, ) 01 -000.41 flt-000 91810€+
WAN C'i'l CHECK nit D.)I I -000-43 7-31 C �'i y _U
MIFICIMN111CALTEL; 101-000,421.000
V- 1yrYpii`.1:t., FEE 101-000-1120-000
PLUN."BrOO 'FFIR. 11,01.000419.000
L'I'F:Cibif.lVIDTIONFEM,RESID 101-0004AI-000 S1.3.ff1
OR ADRIO F&R 101 -000-4233-WO SIg.fsd
IIF PACT YKE
�II:7�-`ii +';::�,:.,+ UAI:�'.l`1�:rSf�'fig'C�iE�1�^).1:,:i!.,43 t:"1.33�.0"•�:
�+i,tt.,�l.;�i
- - _--
RECEIPT
DATE y
BY
DAT FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts 17e -
Slab GradeZva
ReturnAirSteel
Combustion Air
Roof Deck
ExhaustFans
OX to Wrap
Framing .�Compressor
F.A.U.
>
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath ✓ y
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 Lateral j,
Pool Cover
Sewer ConnectionEncapsulation
Gas Piping
Gas Test a- 2 —
Appliances
Final
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) —
COMMENTS:
01/26/2005 08:44 17603401819
PAGE 151.27.
I,••f"r•J•/•N!f'J•%V•/•J.InNIr1�IINMF/'I�/'•/•'MNH/.•/t•NN..I'Nn•JI•I.•NJi•II:: I../•/•nI.•1JJ•I /'/��•�•r•n•/SNI h�vl'/•/••/•/•J. /.�'.: I•r.�'
. . . .... .. • I•J: ••♦•: •1 �1•f I'f•I:% I
CEILINGS-
TYPE- BATTS
MAUNF RER: Cerlgi THICKNESS: R-30
WALL •.
CE[MFICATE
TYPE: BATTS
/
IAULA71ON
R: LUCAS GENERAL CO O CORP LICENSE B
RY:
This is to ow* that insulation has been insured is conforrnanCO wflh ttie current energy
regulation, California Administrative Code. Ta 24, State of Calftmia, in the building at
LA OWNTA VILLAGE APARTMENTW 41YLA 4WNTA CA '>
CEILINGS,
TYPE BAITS MAUNFACTURER: Certahbwd THICKNESS: R-38 y
r
TYPE: BATTS MANUFACTURER: Owens Coming THICKNESS: R-13
GENERAL CONTRACTOR: LUCAS GENERAL CONMCTING CORP LICENSE'•-� �
/
BY•
TITIe.
e. P�
PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517
's
TITLE: ACCOUNT REPRESENTIVE DATE:41A6
r
i. r: F r V.'f J "// !: ^Y•J �. /JY//.'/•X M.:•.<I Y.+.J•lNN/I.v'NNN.✓//IVMNN/�MA!V•✓N•r//11NJI.NN.Y9�MYNHM.YNN/IN//�XJY Y•X•YK 1•'Y/IIYN'.Y.Y+I.If1. lV y:.•{•.:•NV./ •/ vN • / •I •/i%:
„";••�•.,..-...•.•r•v::-•r:e�►•r.wn•a.w•�•[•'•:w.x•r•c••�;y.a:•E9N✓.Y.iM•7•+►•sxr'r:w•arrrtV•�+Mtl�d+✓�+.�P•�'^•�<ry vM.Yw�e'iGwJ 30VW'.wi<rf•••:.. �•vfrr.I.••�.n :-W ••;w :y• ••• /; +...••
i
INSULOON CERTIF&ME
Y
This oertif�r that insuWon has been ftlalled.In carformance with the current energy
reguladon, Iffomis Administrative Cude, Title 24, Stabs of California, In the bind' at
S• .-. sYvv•i•.:I:!/J.Y.••••YI/•.Y•i.V/.M.v rIMy JYM14/JN/M.V.Y•✓qVN%%/i�rrlNM/fY•/'INM•�%f�f�:P•r •/V•J.,•
CEILINGS-
TYPE- BATTS
MAUNF RER: Cerlgi THICKNESS: R-30
WALL •.
•
TYPE: BATTS
MAU URER: CertA THICKNESS: R-13
GENERAL CON
R: LUCAS GENERAL CO O CORP LICENSE B
RY:
TITLE:
P7 N SCHMID BUILDING PRODUCTS A MASCO Company LI SE # 221517
BY:
r
TITLE: ACCOUNT REPRESENTIVE DATE:
/
!
S• .-. sYvv•i•.:I:!/J.Y.••••YI/•.Y•i.V/.M.v rIMy JYM14/JN/M.V.Y•✓qVN%%/i�rrlNM/fY•/'INM•�%f�f�:P•r •/V•J.,•
Certificate of Occupancy
Toar °F 4 Q"
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 17
Building Permit No.. 0306-246
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
City, ST, ZIP: NEWPORT BEACH CA 92660
By: G.SHOWALTER
Date: 12/21/04
Building OffioKal,