SATT (9710-035)78413 Magenta Dr
9710-035
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. t / a .
License # t jT Lic. Class Ex Q ate, I y
9_1q
Date, Signature of Contractor , •(
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 isnot 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.
Se( ) I have and will maintain workers' compensation insurance, as required by
ction 3700 of the Labor Code, for the performance of the work for which this
permit is.issued. My workers' compensation insurance carrier & policyno. 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,
(shall riot 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 provisions of Secti6n 3700 of the Labor
Code, I shall fo it comply with those provisions.
'Date:' ! Applicant+- H `
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, 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: ; A`
I certify that I have_ read this application and state that the above information is '
correct. I agreeto 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) /r C Date A
BUILDING PERMIT PERMIT# - --. °°NTR°`"
DATE140A 17 VALUATION S4 1,43 B,90 LOT . `14 _ TRACT
JOB SITE ---- -._ _ ---
ADDRESS 79.411_ttKAOCt A 1.C,9 iC f ,jl
APN
6"020,037
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CONTRACTOR/DESIGNER/ENGINEER
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USE OF PERMIT
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PLAN .sit - 10W AIRS UKU . PUW C"kX1 K PORTI-014 OF F rX .F MI UCED
13Y'75%.FGX114A)VVI:f?I.H 319`it',[A:t CES'"O SA.Nti PLANS I.'YVI-.
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PL N 0197CK, FER, $77 79
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m6crRICAL rk-m 101-00042104M $82,74-
PiltMi[? itai 1U1_-UOtl 41s i $85.50
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CSFFW1 2,25-000-443-342
PR;6.cisr, PLAN
2",s PILSTAK), FEES
RECEIPT
DATE
BY' ''
DATE FINALED.
INSPECTOR
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
- S— b'
Exhaust Fans
O.K. to Wrap
_¢ _ Q T
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
Final
Final fl —
BLOCKWALL 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
W-11
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
/.2 34f -7
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final•f
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:
o By7 -% 4.
4.4
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
78-413 MAGENTA DRIVE
Type of Construction:, VN
Owner of Building: BAY CITY ESTATES INC.
Building Official
Bldg. Permit No.: 9710-035
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