SATT (9710-040)78423 Magenta Dr
9710-040
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. 3'
;
License # p• Cf c9 Lia Class Exp. Date
` . ry/
4Dte
l Signature of .Contractor °..+. f
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 structureis 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:
() 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 required 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.
(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 th t if I should become
subject to the "workers' compensation rovisions of dctlon 3700'of the Labor
Code, I shall ;fgythwit comply withe p"rovis'b _ns
;
Date: (( jj OplicantV11 Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer•'to criminal' penalties and civil fines up"to $100,000, in
Addition to the cost -of compensation, damages as provided for•in Section 3706
of the Labor Code,interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject . to the conditions and restrictions• set forth . on his ,
application.
1. Each person upon whose.behalf this application is made .& each person at
whose request and for whose benefit work is performed under or. pursuant to
any permit issued.as a result of this applicaton.agrees-to, & shall, indemnify , F
& hold harmless the City of -La Quinta, its officers, agents and employees`.
2. Any. permit issued as a.result.of this, application becomes null and void -if
work is not commenced within 180 days from date of issuance of such,
permit, or cessation of work for 180 days will subject perliiit 'to. cancellation:
I certify that I have read this application and state that the above information is
correct. I -agree to comply with all City, and State laws relatingto the. building
construction, and hereby authorize representatives of. this City to enter upon
the above-mentioned property for inspection purposes. "
> iu,' J
dSign_aiure (Owner/Agent)
PERMIT# CONTROL#
BUILDING PERMIT
DATE _.10/ 41!7 VALUATION y iQSrar1. LOT " 4 ,- TRACT '®
JOB SITE
ADDRESS!°ey1 1 d1 1.FE i i; ;
APN U3 aiU 1
OWNER
CONTRACTORDESIGNERe
0 AY0 f1Vr1}S1[W11r!.61?iZi Tt`rlg-
. .t11v' 4 i•n.7 `'`pfd,AMYti . t
l'cENGINEER
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114-VAS.,R
aiaR.,% I i5+U-&M
11940CM
. v1 CA 9b453
DC`U(TAM•CYRbNCeCA 92 740
ff 9',J):'i 9-S•9S1(3 Cal° (..# 4' 4
USE OF PERMIT
PLAT -2 - Lrf-SAf;*8 tJ"NTT..l"LAN 3f,t'.fw.17OW1140N LAS' ;7Ar! 1"ZEDUCl',o
BY 7$%F'0T.JMU:r.lP1.!? 13-80ANC1r0V $ATNSPLANTYPEs.
'i'KAcr cofusmilwc.`. ix -4 91 . =E15 .
X119 1n CONISTM CTIGIN
491, 101111
CON :"1'i'f$Vai':tc)NFEfi 10.1.-000-418-000 K50
CE31 f.•'[ E1101-OW-439-318P**W
1 't3:.i4 1
LFIOM 101-M, 421-001J3^fV.EiC
.
'ELfiCT;A1+. A lt1'l-1100-420X300 8`7'. 2
KUNUM' O M, 101-{? -X419-Ofx1 `f,9 7. 0
ZT—RONQ WWI ON ri~t:-.RXSK) 101-000-4 414X) $4,05
01'tADING''FFE 101-000-Q 3_000 $20:00
fN RAS'TRU(Q=Rj3 rFF1 225.-M441-342
PRE, CISS € l.A _N 111i: 000-441 ;_A45 S S.i1tr '
• , '.t f '?•'! s ?p Chi't l r ';. '? .f ..1 . I.w i l~ 1: ,'14
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L1j8 1?u-",A.fL%n S
$0.03
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 -a-
Exhaust Fans
O.K. to Wrap _
F.A.U.
Framing -(g _ 4 _
Compressor
Insulation - ap - ?
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath '
F/oae A1,¢[ 3 -4-Q _
Final
Final — —
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground PI . Test
Final I I -
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines a
Neater Final '
Water Piping
Plumbing Final
Plumbing Top Out -1 - Q
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection / 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
Citylof La Quinta
Building and Safety Department -
This Certificate issued pursuant to the requirements of Section 109 of the Uniform BuildingCode,
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
ollowing.
BUILDING ADDRESS: 78-423 MAGENTA DRIVE
Use Classification: SFA Bldg. Permit No.: 9710-040
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
Owner of Building: BAY CITY ESTATES INC.
Td'hi
Building Official
Address: 78-479 INDIGO DRIVE
City: LA QUINTA, CA 92253
By: STEVE TRAXEL
Date: 8-3-98
POST IN A CONSPICUOUS PLACE