SATT (9710-028)78401 Magenta Dr
9710-028
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 # } • / si' Lic. Class Exp Date / /
Yr 4
Bi :. IU 97.
YDate f` { r Signature of Contractor''tA fib 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, Busine'ss•& Professionals Code).
( ) 1, asowner 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',$ 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, .1as- 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
p rmit•:is'issu
' ed. My'workers' compensation insurance carrier, & policy. no. are:
Carrier . ' Policy NO'.'
(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'-comp'ensation Jaws of California, and agree that if I should become
subject to the workers' compensailo pr visions 9. S 9 on 3700 of the Labor
Code I shall forthwith comply with th{ose Jr vi 10 s. y
Date r r : PPlicant f ! :
Warning: Fail re -to secure Workers' Compensa ion 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 F have read this application and state. that the above information°is'
Correct. I agree to comply with all.Clty and State -laws relating to the building
construction, and.hereby authorize representatives"of. this City toenter upon
the above-mentioned property for inspection purposes. .
ySignature (Owner/Agent): 0 Date l
BUILDINGPERMIT
PERMIT#
CONTROL#
DATE 40/14197. VALUATION $r%4),3yp,10 LOT
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RECEIPT
DATE
By, ,% ""
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
. MECHANICAL APPROVALS
Set Backs
A
Underground Ducts
Forms & Footings
/
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
--S =
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
- /7 -
Final
Final ar
BLOCKUVAIII'APkOVALS
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
Pool Cover
Sewer Connection
Z -.p-5 -Y 7
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
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Certificate of Occupancy
City of La Quinta .'
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification: SFA
Occupancy Group: R 3
78-401 MAGENTA DRIVE
Type of Construction: VN
Bldg. Permit No.: 9710-028
Land Use Zone: RL
Owner of Building: BAY CITY ESTATES INC. Address: 78-477 INDIGO DR.
City: LA QUINTA, CA 92253
By: STEVE TRAXEL
Date: 5-27-98
Building Official
POST IN A CONSPICUOUS PLACE