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SATT (9710-039)78421 Magenta Dr 9710-039 D CONTRACTOR DECLARAi'101 11 I hereby.;affirm LIC under,'penalty of'pe'rjury that I am licensed Under pisi6iris of - '(9V 'Chapter 9'(commencing with Se6tion-7000) of Division 3 of the Business and Pe6fessionals''Codean'd my* Lice'nsb'is in full force and effect.. License #. 31 Lic.06iss E' D a q Ex 1: , .., v U nature of, Contractor '% OWNER -BUILDER DECLARATION, I'hereby affirm, under penalty of perjury that- 1. am exempt from the Contractor's 'License Law.for the following reason:.'­ a's owner of.the property, or my,.empldVees'with wages as:their,Sole compenS6tion, will do the work, and the structure'is not -intended' dr. offered -for' sale' (Sec: --7044,. Business& Professionals Code),, 4s owner of the property, am", exclusively. contracting with• licensed contractors . to construct the "project (Sec... 7044,. Business'& Professionals O I am exempt: under Section B&P.C. for this -reason. Date = Sig'n-aty-r'e- of Owner WORKER'S COMPENSATION'DECLARATIOW 1: hereby one of the •following declarations - I have and'will maintain a certificate of consent to self -insure for workers' compensation; -'as' pi i*o'vi`6ed foii.Ilby Section- 3700 of the. -Labor C 6de"; for 'the pbrformance of the workJ6rwhich this i5ermit-is,issued. I have and 1will . maintain- workers" compensation I . nsurance,-.as required by Seciio'n' .3700 of the' Labor. CodeAor the performance ance of the* work for -which : - this permit is issued. My", workers' compensation insurance carrier & policy "no. are: Gamer Tn- PolicV No­ secti`on'.neiBd not be completed if the- pormit.va.luatio'n is:f6f $1 0O.'00:6,r less). O I'certify th'di.,in,..thelperfo,rmanc.e.of the work fdrwhichJhis'peemit.is issued, I shall 'd6t. empl6y any, person in any manner so as:to-become subject to the workers'- compensation laws of California,- and agree thatfeif 1,§hould become Subject: to the'workers' c6rnpehSation provisions of Sect& 3700'of the Labor Code h'th'pl s'e "a 1,shaill forthwith comply wit ,,. pji io,s. -'1/1 y Waining: Failurejo secure Workers' ,CompensatiZl C. o*Y'erage'is "unlawful. and-S"hall Subject a&.ehioloyer to criminal penalties and civil Jines`bp'.to V100,000; in addition 'to*thd cost t of c6mpiensation,-damages as proVided for!ifi Section 3706 -.ofthieLab6r Code, interest and attorney's fees. IMPORTANT Application ishereby made, to the Director bf,Building and Safety, fora, permit. subject 16"the. conditions: and -restrictions, set forth on 'his application. 1. ita6h person upon whose behalf this application i§:mad6 & each person at `whose request ind;for whose benefit Workis performed under'. or, -pursuant to -any permit issued. -as a-result,of-this applicaton.agrees to, &.shall;. indemn.ify.w 8i ho.ld'harmless the City of La Quinta, its officers, agents and employees:' .2. An p rmit­issued,as'a result of this application. becomes null and void if,-,. 7 Any Pull work,. is not commenced within 180 .days from .date of issuance of such cl `permit, or cess.ation.of work for,180,'days will,subject permit to cancellation-. Certq..t6ait I have read this application and state' -that the above information is correct. I agree, to.. comply with'all City,- and'S.tate'. laws relating to the building,. construction, and hereby iuthoHz - e reoreseritai-ives of.this City. to 'enter Upon I.:He above mentioned prop'ert.y for inspection purposes,. VSignature (Owner/Agent] ge Date PEP!i CONTROL# BUILDING PERMIT 60 4 DATE, 2.1,40 - 10T _ 6 .41.97, VALUATION TkAdf' JOB SITE RVE, 'ENTAT I APN :446 .037 ADDRESS OWNER CONTRACTOR/DESIGNER/ENGINEER RUE R A, WKI 0 1 i 79,1117 114DIG(11 DR 11940 PA L&T 1A, ulmml 56, LA QkANT.A.. CA 40 CA 92240 WP29­5490. CA) 4,145 USE OF PERMIT 84 FA PLAN,,21 - DOW1,48TAIRS ljfifl. PLK9 CHROK PC)ia10Kk0FF Et REPLICM gy 7,s% vowt -i\A1LTjPLE'lis 3UA_N`CE 0'F SA P, PLAN TY1%, IRAC11 CON'STRWOON, • SPINIATE141) ICOSI 0F1.'C(MTWUCf 10N 4 552 FIVIRAfill J?Ekl SUM(6IARV CC. NSIMUCfION FEE '101-0010418-0W ITAN (IMMU11,93 !01 -QW -4.P -3,W. ", 9 1 S6 W W492 Pulmalwa 10 1, ,419.(W $97..5.0.- torkoNq M*Tlovi ave - fmsuo )(M. -OM -741-0M $4.95 QRMANG FX11 tnx* 01 12S-fK&443-342 st PKC,' 5 . fSEt? N AQ!,00 0-34 AND PLAN CHIP — LEM. PMPAMOUS RECEIPT JDATE BY-./ DATE FINALED' INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade /a Return Air Steel Combustion Air Roof Deck - 2-1 Exhaust Fans O.K to Wrap _ 5, F.A.U. Framing -,W—qA -,W— Compressor Insulation - Q Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall - Exterior Lath Drywall - Int. Lath o Am C, Final Final — - POOLS - SPAS BLOCKWALL APPROVALS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS 17 Gas Test Electric Final Waste Lines J Heater Final Water Piping Plumbing Final Plumbing Top Out - Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection / A$ f 7 Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: 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 L'a 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 78-421 MAGENTA DRIVE Type of Construction: Owner of Building: - BAY CITY ESTATES INC. Building Official Bldg. Permit No.: 9710-039 VN Land Use Zone: RL Address: 78-479 INDIGO DRIVE City: LA QUINTA, CA 92253 By: STEVE TRAXEL Date: 8-3-98 POST. IN A CONSPICUOUS PLACE