SATT (9710-030)78405 Magenta Dr
9710-030
LICENSED CONTRACTOR DECLARATION
Thereby 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' -✓ ' ` [`
OWNER -BUILDER DECLARATION
l.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 ofAhe following• declarations:
(,) I have and will maintain a certificate of consent to, self -insure for workers'
corripensation, as 'provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
3 (xS I have and will .maintain workers' compensation insurance, as required .by
Se tion 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, ''Policy No.
S; d f%. MIN;? > . : 12375; - .
(This section need not be completed if the permit valuation is for $100.00 or less). .
O 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'_ compensation `rovi ions. of Vection 3700 of the Labor
Code, l sh II fortrhwit • rcomply with tho e•pr vis o s.
s Date: ltr fS17 APPlicant __ .t'.
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.
I
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. s
A. 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. t
2. Any permit issued as a result of this application becomes null and void"if°Y
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 for inspection purposes. '
"Signature (Owner%Agent) Date_ o •' 3` 7
BUILDING PERMIT PERMIT# CONTROL#
G 1L 1 .
DATE VALUATION LOT TRACT10/14197- 14 655
JOB SITE APN t51P4"a-4a.
ADDRESS /1 49" Ir ,A,J.) V .. 9 , a.
CONTRACTOR / DESIGNER / ENGINEER
BAY C:P,'Y E.STA'7 FS (t:RUMINA) NC, pill '1?l, A V1;2.IGH , G. C1,
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:4 C" f1.#1. 43,15 .
USE OF PERMIT
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BY 73Yo FOR MULTITILk: ISSUANCE OF SAIlvfk PLAN TYPE.
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RECEIPT I DATE By DATE•FINALED IINSPECTOR
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
Z _ -9
Exhaust Fans
O.K to Wrap
- .- Q
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
- 3
Drywall - Int. Lath
Final
Final
7 -
POOLS
- SPAS
BLOCKWALL
AP ROVALS
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
p
Neater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
-vT3-9 7
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
,o
$vB $BGG d/A tiv aK •Zf g _1
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) `
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Bui/ding 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
78-405 MAGENTA DRIVE
Type of Construction:
Owner of Building: BAY CITY ESTATES INC.
Building Official
vni
Bldg. Permit No.: 9710-030
Land Use Zone: RL
Address: 78-477 INDIGO DR.
City: LA QUINTA, CA 92253
By: STEVE TRAXEL
Date: 5-27-98
POST IN A CONSPICUOUS PLACE