SATT (9710-044)78431 Magenta Dr
9710-044
LICENSED CONTRACTOR DECLARATION
I, 1 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.
License # } Cy f _, Lic. Class Ezp. DAte
U f t n
[ ' ..
ate . _ Signature .of Contractor L
OWNER -BUILDER DECLARATIO -
I hereby affirm under penalty of.perjury that I am exempt from the Contractor -'s
.License Law for the following reason:
( ) d, -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).
( ) • I am exempt under Section B&P.C. for this reason
Date Signature of Owner-
WORKER'S
wnerWORKER'S COMPENSATION DECLARATION
l.'hereby affirm. under penalty of perjury one:of the •following declarations:
( ). I have and will maintain a. certificate of consent toself-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.'
IMM
: i)tu b i19.17.s
(This section; need not be completed'if the•perrriit 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 h' if I should become
subject to the workers' compensation 4rovisions of S eta" n 3700 of the Labor
Code; I'shall orthwit comply withfthose provisions r
t%Date:IO ( Applicant
R
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
W 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.
I certify that I have read,this application and state that the above information'is
Correct. l 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'prope, y for inspection purposes.
/Signature (Owner/Agent). fA - < .'`"
Date
BUILDINGPERMITPERMIT# C°NTRDLN
}{ ,
DATE VALUATION LOT, fc TRACTJOB
SITE
ADDRESS X14- .i 5 ., fa 2.1 %.A1,! « M ,/_ 4
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APN 604-020-0 /
OWNER
CONTRACTOR/DESIGNER/ENGINEER
C
y•}/k• SI .!' 'ilf 1..s (:0,371DINr1) %PTC:
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1,,A. (XIN17A, C A 22 3
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111?Sl;li"1' 9V c.' a : S t 3!e CA. 92240
(619)329-5490 f dila# 4M. 5
USE OF PERMIT
S.P.A.
,P LAN Sri - irVS3W"%blvi7`_ PLAN AN MURC% FOtl,i1CA i:F rr ..RMUCUD
e.1.,NJVC3.-CON T'€i.i.iCTiON
CCYN'1rrR UM ON.FEF, 101 -000 -418 -ow
MAN MN'C9 M $7718
NI-XtllWCAL l''i E &279.5f)
F.I.XCITIUCAL FEE
PLt7MK PIC)l%t`:E; 1,01-000-419-000
a uto'wl trtC3'I"1ow nw - Rpm) 1.(3149) -?d i-000 tt to )cE
taR.AWN0 MIT, 101-000-423,000
11WRA.i'I`R CA OR11s PU 225-000-443-342 Wkl.20
E3R-W,;ISN 'PLAN 101,000-441-34,s S2a.11ti '
II -'!' 9': CtJ► S '.2UC TI AND PLAN r'+ t ?C:'1.
"Aft) FEES
'T0iFA P•O'RM:17"VK&S1)U1+;TX0 W fi't, i263,33
a
RECEIPT
DATE
By /
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & FootingsDucts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
Q -
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
,clooje
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
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
l -
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
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
Pictures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
_
Utility Notice (Perm)
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: 78-431 MAGENTA DRIVE
Use Classification: SFA
Occupancy Group: R 3 Type of Construction:
Owner of Building: BAY CITY ESTATES INC.
Building Official
VN
Bldg. Permit No.: 9710-044
Land Use Zone: RL
Address: 78-479 INDIGO DRIVE
City: LA QUINTA, CA 92253
By: STEVE TRAXEL
Date: 8-6-98
POST IN A CONSPICUOUS PLACE