SATT (9710-043)78429 Magenta Dr
9710-043
LICENSED CONTRACTOR DECLARATION.
U) I hereby affirm under penalty of perjury that I 'am licensed under provisions of
r: Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
N. Professionals Code and my License is in full force and effect.
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'License # s j f , Lib. Class Exp. Date
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O LU 3 i'J f. I . . f9'
oZ r- /Dale ` ,Signature of Contractor__
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r` H OWNER -BUILDER DECLARATION .
J
W LIJ I hereby affirm under penalty of perjury that) am.exempt from the Contractor's
~ .d License .Law for the following reason:.
Z_ ' ' (.) 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).
C'') (.) I am exempt under Section B&P.C., for this reason
Ln
N Date Signature of, Owner
ON
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U Q WORKER'S COMPENSATION DECLARATION
CL
O Z I hereby affirm unifier penalty of perjury one of the. following declarations:
Lo O () 1 have•and will maintain a -certificate of consent to self insure for workers'
X tyl`compensation, as provided for by Section 3700 of the Labor Code, for the
m . Q performance of the work for whicK this permit is issued..
Q,.orkers' compensation insurance, as required by
L) ('-Y)^ I have and will maintain w
O U - Section. 3700 of the Labor Code, for the performance of the work for which this
.H permit is issued. My workers' compensation insurance. carrier &policy no. are:
Z Carrier., Policy No.
g (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,
e: I shalt 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
subjectto the Workers' compensation pS
rovisions'of e ion 37 of the'
Code,'l shall forthwith comply with/ those provision !
Date: M r Applicant' s) " :
%:
r. e /
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
who"se 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.,
..,?.Any 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.
I certify that I have read this application and state that the a6ove,information is
• correct.1 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.
X'gnature (Owner/Agent) Date
.. - "
BUILDINGPERMIT' PERMIT# ._. CONTROL#
DATE 110114197. VALUATION $41,3Mr,9fJ LOT lA TRACT V
JOB SITE 1
ADDRESS % i i P r t7 DRIVE
OWNER
CONTRACTOR / DESIGNER /ENGINEER
HAY.Cr! FS1*, T` ,S (MNZONA) ;Nt
P(e. 1`. A..11 K1,GK1', C. L
784r, NUIC30 DR
11940 PALIvit DR_ arur
'LAQ',?liV'7!!, CA 92?.3
lX.1,8EKTIii . fiYRANcat CA 92240
CRTA - 4345
,
USE OF PERMIT
SFA.
i'ii :fit .• Dowmtumi Uwr. PLAN CMM KJ:it%'TtntN OF irk
MY'L if CED BY 7eg$,FOR. itilUL T1,0;.Is" f S llAt r'•F C!t< 5.AN1k: .A.'hf "d'1,'.I'k5. ;
. Eri x-Ilt AA @ i1,1r/ i.•VIST OF COANNI'Ma15.r..i.lON
41,430,M)
f7**£jAA 'rr7i'a{lJ</`"1'1ClMidQ SM2,S50
{{
Itlt-Ct3 2:t-417t} $39.50
IOC -Otto .. .
1'J..ixNIB NO F171, S 8 5 3t3
moNw), - $4.14
GRADI TOX I' l.ttii_ tlOt1 'd3 )i?q S-20.00
i._*Q %STRi=.}OYURV FN 05-0000-44.9-342,
PRf 0SE' PLAN101-000-441-345 $2,15,Oti
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irS9 PKE— fAID.. LEES
WOO
10;#:AI, 8'K@%Sl T U►'E.MOVENOW
$ 'r(► ° :
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
Jr — Z
Exhaust Fans
OK to Wrap
—!o -
F.A.U.
Framing
_ (
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wali 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 PI . Test
Final
Gas Piping _
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
--t j —q f
Equipment Enclosure
Shower Pans
O.IC for Finish Piaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Law Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final /
Utility Notice (Penn)
COMMENTS:
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:
78-429 MAGENTA DRIVE
Use Classification: SFA Bldg. Permit No.: 9710-043
Occupancy Group: R 3 Type of Construction: VN Land. Use Zone: RL
Owner of Building: BAY CITY ESTATES INC. Address: 78-479 INDIGO DRIVE
City: LA QUINTA, CA 92253
Building Official
By: STEVE TRAXEL
Date: 8-6-98
POST IN A CONSPICUOUS PLACE