0305-227 (MFD5)Cl)
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LICENSED CONTRACTOR DECLARATION
I hj by 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 ° �' "� Signature of Contractor 1ti t �✓ ' ' �'t
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.
(.,/'j 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 rii,fgT 3tdC Policy No. s719.�2i-;f16i
(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' Qompynsation laws of California, and agree that if I should become
sub jec tdthe yuorkers' compensatior/� revisions of Section 3,7.00 of the Labor
Co s all1fdr�hwijjf• comply with th 's prov stens.
Date: Jf x,,Applicant�'E
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines u01b-$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 fir inspection purposes.
Signature (Owner/Agent)
BUILDING PERMIT PERM'«,-'v� -
DATE VALUATION tea. iy .3p.t�► :LOT. :t AR3l4 TRACT A 30
JOB SITE
ADDRESS 5W-666 KILM"THOWKI? .D VE
APN
OWNER
CONTRACTOR/DESIGNER/EN (NEER
RP,1.-IVJKAM Axy.Af��171+8?'l1VII.L�,�iI•,
1:t CAS t11?9,ERAL C0317 .Rfie NJ CORP.
f;34(. ,474-0221 C1:3AW 1756
USE OF PERMIT
1.6,111(.17-YATARIV .4
1W,7775 ) C_ 2 STC.1Z.T01240. 0,15, t r PEA, 1 a, ... J.. .
ill 'i."ilaE 0*400M WAL,IX OR I001_, IRI V.N 4PM-NI;:fXREI:r.
Esj:�rl.Ct11��.7'Ita 1,:�a,CL ��'
{, -- RL+.r1'DRI''iT1,0,.L 712M.00 aF
'=_'C; H TRACT AMOUNT 374? ti riC+.OG 1Z
l�':4 [�1t ATFID C0Si' OF
FII.A4 r, :r:t K FEE flit f:C!(1•�S�J-�1SC "�(r:*i.:��+
a 11S^.:4f.r W(I' l FEE WI -WO -421-000
k:Jr."",C"R AL hf?P.. 1t3?-%�1e]• 2f7-Qf)ti $St:l,�a '
FRE 101 -MO -419-000
3710;NC7 M )n,0 0AI FES I:T.OSID 101'-004-2,41-000
!.MRIkCT FEE
4z"O- 14 k1-UBLIC PLACES - RUM.' 3 70.000-44S•OCK!
F T4XT `f�i; t yxlxirG t7uAT I.,ki m ��' , Cx
�, �it � c �.���.➢ - `' �.. LMF'�a.i3AW R I✓-
`('�,f+(2
RECEIPT
DATE
BY (
DATE FINALED
- _Z3 '51
INSPECTO
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms 8 Footings
Ducts
Slab Grade
Return Air
Steel
p :-Z--Ls zes
Combustion Air
Roof Deck
f..
Exhaust Fans
O.K to WrapF.A.U.
I
Framing
Compressor
insulation
3 jig
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
EY
Final
Final — — S
BLOCKWALL APPROVALS
POOLS - SPAS
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 Unes
_ —,3
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Gas Piping
—
Encapsulation
Gas Test
_ y
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) /j p
COMMENTS:4•�-�
01/26/2005 08:44 17603401819 PALE 08127
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NS N C IC T
Y
This is to car* that insulation has been Insured in conformance with the current energy
regulation, Calflbmla Admits ifte Code. Title 24, Siete of California„in the building at
LA QUINTA VILLAGE APARTM 8CD0: �6ttLA QUINTA CA
CES - f
TYPE: BATTS MAUNFACTURER: Owens coming THICKNESS: R-30
WALLS: '
TYPE: BAITS MANUFACTURER:,Ce tainteed THICKNESS: R-13 Y
GENERAL CONTRACTOR: LUCAS GENERAL CONTRACTING CORP LICENSE # J
BY” 11Tl,E:
PARAGON`SCHMID BUILDING PRODUCTS A MASCO Cpm
pang LICENSE -#221517
11TLE: ACCOUNT REPRESENTIVE DATE. 7/ AIA2
•'•J /r.':.: rr r •/ •..I, • Y..'Y. r,vV /40 r V.'l ^ Y yr/ N.l v(i.y.'/rV. /.y.v Yyi•Y/a''•YVR/1 N'J' IV.•/.V.% YNNNrY/I t'V YN •�.Y//.•t Y.Y.V •i r I.•i •�..
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AYLATICN CIRTIFICATE
This M. ..►��
r�utatlon, H
TYPE: BATTS
WALLS:
TYPE: BATTS
GENERAL CON
BY: e
tU at ineUMDOn has been Installed to combrmanee with the a
Me Administrative Code, Tide 24, State pf Cal fbmla, In the
THICKNESS; R.3o
Certetnteed-*'-�CKNESS:'RA3
LUCAS GENERAL coNTRACflNo
TITLE
PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517
BY:
TITLE: ACCOUNT REPRESENTIVE
at
-- DATE.._,_ _, •
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OCT -27-04 WED 12:52 PM RI,V, CO., FIRE P&E IND'IO FAX H. 1 760 863 7072 P, 1
Craig Anthony
Fke Chief
Proudly serving the
Unincorporated
Areas of Riverside
County'arid the
Cities of:
Banning
Beaumont
Calimesa
Q
Canyon Lake
6
Coachella
Desert Hot Springs
Indian Wells
Indio
4
lAke El silxlre
4
l t Quinta
Moreno Valley
b
Palm Desert
Paris
fi
Rancho Mirage
San Jacinto
Temecula
Board of. Supervisors
Bob Buster.
DisirM 1
John Tavaghone,
Distri,il
Jim Vcnah1c,
DWiiet 3
Roy Witsrnr,
Dietria 4
Marion Ashley:
Diafriat 5
RIVERSIDE COUNTY FIRE DEPARTMENT
In emperat/an with the
California Depariment of Fore; try and Tire Protecuun
210 on i venue • Perils, Caffornia. . • Fax -0910
October 27, 2004
City Of La Quinta
Building Department
Re: La Quinta VBlege Apts,
Recreation Building and
Building 032 Only.
The Riverside County Fire Department is granting a fire and life safety clearance
with the following address 50-660 Eisenhower Di. La Quinta. Please call if you should
have any questions.
TDri
FRANK KAWASAKI
Chief Fine Department Planner
'—z
By N eu _ Dsoa`
Terry Des
Fire Syste (nspector
04MWAa SERVICES MVISION - PLANN C SeMON • INDIO OFFICE
92-675 FYylruray.111, 2^d A., Iii G 92201 � 7i� E6? -8886 - Fau,(760) 867072
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 # 25
Building Permit No.: 0305227
Occupancy Group: A
Type of Construction:
A-SPRINKED
Land Use Zone: V -C
Owner of Building: LUCAS GENERAL
CONTRACTING CORP
Address: 1111 -QUAIL
STREET
Building Official
INA
City, ST, ZIP: NEWPORT BEACH CA 92660
By: G. SHOWALTER
Date: 02/23/05