0305-224 (MFD5)F_
N to
W
O v C)
LLJ
C Z f`
O�
�(0
F_a~
CO
Z
Ch
L0
CV
O�
UQ
n. —
oZ
r i—O
X W �=
mVU
O
aLO
Z
rO
g
LICENSED CONTRACTOR DECLARATION
I nL&y 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.
Date ,-~ /= t � Signature of Contractor I V,' r
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.
( I have:and will maintain workers' compensation insurance, as required by
Se ion 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & _poli no. are:
Carrier ;•;'('A'< L:.,49 Policy No. 1'?14
(This section need not be completed ff 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 to.the workers' compensation provisions of Section,3500 of the Labor
Code!I Ilo lwith comply with thoe provisions.
,Dater" ppiicant_'
Warning: Failure- to secure Workers' Compensation coverage is u awful 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 appiicaton agrees to, & shall, indemnify
& hold harmless the City of La Ouinta, 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 Citi! to,enter. upon
the above-mentioned property for inspection purpose � /
Signature (Owner/Agent) Z .1 .•2 !
BUILDING PERMIT PERM�j33—�..� i
DATE VALUATION 1423,S•'0.00 LOT TRACT kvl307M1
JOB SITE _K9_ 4650 I`, dlf f M.081MW. VI TIT,".
APN ,';.,rye i!f} •f Yt�X
ADDRESS
OWNER CONTRACTOR /DESIGNER JEN INEER
AP QUITNTA. VILLAGE;. Ll IXX :� Cil-,t~!YiA A3,. (Ml 4Th =,Mr?0 OQU
Ali •lhrl%C.?:Cf'4" ' ' ,i `:4';: 0AA, sl wi'i60 � 1Li+1 T�'t)F i.1 i3x"' b t". i "•:r�. /S'.tik,t;
`7 49 `;'d •f);! 3 y�>3S 4 P56
USE OF PERMIT
I ya
W- l,f.UM, 81.%tt:+,'''!" T J1.,4 OR.(,, 001, it; V -IA .:PRIIPt?y1;Nit1 t),
10 1,JW,00 3F
E1114 i+.'rd C O I'{31n' i'{1�V�; 3 'D
1`34% A
l�iy;19 �' �+"�:�: � G„Tl+;•'Ilkadi,Y��f'
103-0004,418- 000
I'G.A!::.::rl rz'.G•`r: i� ?• 101;-•t1C&439-3'L 8
? r,t;IL`:. ?).et'.�1, FLtl3ri 101.000.422 I-0Of
Lt,���k'zzii.Ai:- Frti,�;; 7 tx 1-itrJU•�?.0-UAi'; �5R �. o;.
3�I:?fak!ilat��li?3�1?•R• `!rJI-C►nG•41�1MflL�:� A�47.v'
,
.rSTf�RIDN •'!//"33ai.0` I0111 FLEE , R1,31D y. 01-000-U, I -(ina
lTl.l.l`�.AJi?�'lS WE 101-000-423•00) - 'i:l SM
;�','`r 1�:3 ;Jt�"ri„f :114f.1`.A4"•'f iriJk-`�! 1,i3'�;t. i�G
kk1.i fel YU'S;_,1C: PLACES iiia J`N,' .Z7U-0W-445.-f.9{}V
3T�i 3-3°tl'1�,�LT Ct"3 ,`ii L1 'I'ICA'•'l+3dL x,Aly t`ilfiCnt
1,916,134-90
RECEIPT
DATEBY
""
DATE'FINALED
INSPECT
INSPECTION RECORD
s OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings--
Ducts
Slab Grade
-' j
Return Air
Steel
Combustion.Air
Roof Deck
+► .
Exhaust Fans
O.K to Wrap
-J
F.A.U.
Framing
007—
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wail Insulation
Condensate Unes
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
_Final —
®LOCKWALL APPROVALS
POOLS a SPAS
Steel
Set Backs
-
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PL9. MBING APPROVALS
Gas Test
Electric Final
Waste Lines
—3
Heater Final
Water Piping
3 —22—
Plumbing Final
Plumbing Top Out
01—
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
— — .41
Pool Cover
Sewer Connection
_ +y
Encapsulation
Gas Piping
Gas Test
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 09/27
INS-U-I.Allom CE811FIg
_Ajg
This Is is cw* OW insulation 11M been installed in cont mance wfth the current energy
ne
mgulation, California AdminialroWeCoft, TMe 24, StIft ofCaltromla, in the building at f.
LA QUINTA VILLAGE APARTMENTI(libiLCIC-*'-1-9'.,LA QUINTA CA
CEILINGS:
TYM' BATES MAUNFACTURER: CortainloodTHICKNESS: R -W
WALLS:
TYPE: BATTS MANUFACTURER- CortahteM
THICKNESS: R-13
r.
GENERAL CONTRACTOR: LUCAS GENERAL CONTRACTING CORP LICENSE -2
TITL
PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE 0221517
E: ACCOUNT REPRESENTI)JIF DATE:
t 7. INMIr 11,7
INSULATION CERTIFICATE
to.pertf�r that InsuMon has been installed im =ftmence wb4ac'urfent ermMy
mu California AdmInjs&aWsCQft, TWO 24, State of Califb
mW In,the-bu!
Jv
TYPE: 13ATTS MAUN RER.- Certs THICKNESS: R.W •
WALLS:
TYPE. RAWS MAU
TURER-- Certs THICKNESS: k-13.
GENERAL C OR: LUCAS GENERAL CONTRACT, RP LICENSE 0 .
TITLE:
PNi;GONSCHMID'SUILDINOPRODUCTS AMASCO Company LICENSE #221
EM TITLE *
ACCOUNT REPRESENTIVE DATE-
FEB- 7-0.5 MON 1:14 PM RIV, C'0, FIRE PU INDIO FAX YO, 1 760 863 7072 P. 1
Crafo E. Anthony
Fire Chief
Proudly serving 1110
unincorporated
areas of ltiversWe
County'and the
rides or:
Banning
4
Beaumont
4
Calimesa
Canyon Lake
fi
Coachella
Ps
Dcsert Hot spaings
a
Indian Wells
0
Tndio
4
Lake Elsinore
4
La Quinta
.Moreno Valley
Palrn Desett
4
Perris
Rancho Mirage
a
San Jacinto
4
Tcimcula
Board of Supervisors
Doh BU q1 x,
NOW I
John'ravaglianc.
uimict.2
klT stone,
Di4tiiiat3
Roy Wilson,
l..)istriout 4
Marlon MINIev,
Dietrict 5
'RIVERSIDE (]OUNTY
FIRE DEPAF:TMENT
�1
82-675 Highway 111 • Indio, California 82201 • (.'60) 8638886 • Fax (760;863-7072
i
February 7, 2005
'lye
City of La Quinta
Building Department'
Re: LAQ-05-BP-044
C'
Buildings 19 thru 25 and.27
i
The Riverside County Fire Department is granting the clearance for a building
permit for the following project located at, 50-oF—Eisenhower Drive. La Quinta.
Please call if you should have Questions. W
Respa-dfully
FRANK KAWASAKI
Battflion Chief / Fire Marshall
By •fitORS
-O�'`t -
Tarry De oucy
Fire System Inspectors
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.
Use classification: M.F.D.
BUILDING ADDRESS: 50-660 EISENHOWER DRIVE # 19
Building Permit. No.: 0305-224
Occupancy Group: A
Type of Construction:
A-SPRINKED
Land Use Zone: V -C
Owner of Building: LUCAS GENERAL
CONTRACTING CORP
Address: 1111 -QUAIL
STREET
7T� Z:�2�
Building Offici I
r_i
City, ST, ZIP: NEWPORT BEACH CA 92660
By: G. SHOWALTER
Date: 02/23/05