SATT (9710-038)78419 Magenta Dr
9710-038
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I ani 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
"f f
v'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`.:
( ) 1, asowner 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:
O 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 requireii 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 Policy No.
"I'( `'U* `0 - AZ't-9f, i;r►;;:3't^, .
(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' compensation laws of California, and agree that if I should become
subject to the workers'.compensation provisions of. Sections 3700 of'the Labor
Code, I shall forth Ith comply with tho rovisio S. l /
Date:' `' Applicant , tit/' r, ✓ /t P )
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 ofcompensation, damages as provided forin 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 ofissuance of such
permit, or cessation of work for. 180 days will subject permit to cancellation:
1 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 propertrty for inspection`` purposes. ,s
z/Signat, a (Owner/Agent) l -- ' Date..
t BUILDING PERMIT PERM' u= °°"TR°`"
d
DATE Ill)[14197 . VALUATION fl 33ffi, 41 LOT 4 ; TRACTJOB
SITE
A.1 3tl c ,1 8. l
APN 604-020AW'
ADDRESS ,d'
lD
OWNER
CONTRACTOR / DESIGNER / ENGINEER
BAY CITY EMIT S PrRTZO.P3a1.) INC.
RI PIET k. !1 ' 'X t_t'.M', G -C -It
"►'8 # ! 7 INDIW DR..
U94011A LM Ilk.., R:lNIT 150
t1U(RtTA CA 9rw.63
C)'1s; .ER:k .fif: T E'iZltNG! CA 92240
19).Tn-.$490 MA 4:34c
USE OF PERMIT
SPS
PLAN IR.-.f-)OW14S IVVR.3 URIT. lei ikN MICK.TK'aiZi.if OF, C.,
It Y)ficEO.k9'ti' 'tS'3 .FZ%R, lt1:Ul:1'If!i IS Ut1YdO.E ill aAN 1'l,.aUT 1 Yk,
TRA.cr d'i'3Fd$'i pz now 927.00 SF.
' ft w Q.S.t►i!"►•i -'l i.•'U`.i'i k Ro.1iAY .,.l 4i M.+A_•!A /_. `1T
i .P:F 1.'l.iP
+; ONS'I'RUICTION 13% 101. -4*1&000 $419,00
$139.3!P vt1:K
ivX:.`•:IJAN1 iCAl..I`°i- ° ilii-tk Q- ut l'(is! 'sCi:t)!
4,E' RICAL FEE 1411400 420-4V $88-45
syl # f IA1C} 1~ w E l f)i ,W0419-000 $97.50
1911Mf ►14 I'iO i 1'' ' _ 3Zr € !,01-ClC►0-z4! OlK) $5.1}2
CaRAWN0 FEL 101-000-423-000 '61.Of3
1'NI!-trLS'1'I'ii (IlJI'cf: --PT1 22.5-000-443-342.
•I?RECISE:t:'#::.KNI 10I-{305)-4:.1.34 $2 i,r3f
C;ff3-"tK ' 'Rl Ct"1 f4'!' t!JuT't lk 1j 1 N !,,wry,
. 1'.1r 't'P•. ?- 't :l lw'5
X0,01;
TOTAL IFEEN 910,1, NOW
.
RECEIPT y ;
DATE
BY
DATE FINALED
INSPECTOR
r
r
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
/ 3
Ducts
Slab Grade
//
Return Air
Steel
Combustion Air
Roof Deck
S
Exhaust Fans
O.K to Wrap
—
F.A.U.
Framing
Ie
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wail Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
— �{
Drywall - Int. Lath
Final
Final -
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 I
I
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
3 Q7
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:
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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:
Occupancy Group:
SFA.
78-419 MAGENTA DRIVE
R 3 Type of Construction: VN
Owner of Building: BAY CITY ESTATES INC.
Building Official
Bldg. Permit No.: 9710-038
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