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SATT (9710-045)78433 Magenta Dr 9710-045 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. . s 17 q 'i = License # Lic. Class r.P. Date 34 5X R1 ate Ito - N 1611_'21 7 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, 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). 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 Sedtion -3700 of. the Labor Code, for the performance of the work for which. this permit is issued. My -workers' compensation ins urande Carrier & policy. no.. are: re: Cartier. Policy No.. STKIW7. UNP (This section need not be -completed if the permit valuation is for. $1 00.00,br less): () I certify that in.the performance of the work for which this permit is issued, i shall, riot 'employ any person in any manner so as to become subject to the work&`s' Compensation laws of California, and agree that if I -should become subject to the. workers' provisions of S/kItion. 3700. of he Labor . . I.. . I I Cod6j shall forthwith comply with those provion ,C - Applicant_ 5ate: !tC 71, Warning: Failure to secure Workers' Compen s&tion coverage is unlawful and Shall subject an employerto criminal penalties and civil fines up to $100,000;. in addition to the c'ost' of comp6risation,'daimages as provided for in:S66tion 3706 of -the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building a9d.Safety for a permit subject to the. conditions and, restrictions. set forth on. his application. 1. Each person upon whose behalf this application is made & each person at whose. request and forwhose benefit work'is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quihta,'its officers, agents'and employees. 2. Any-,perm.it issued as -a result of this application becomes null and void if work is not commended within 180 days from date of.issuance.of such, permit, or cessation of work for 180 days will subject permit to cancellation. I. certify that I have read this - application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and. hereby authorize representatives of this City to enter upon the above-mentioned property f6r inspection purposes. /S 'Date Ah 6vp -- '1-1 Signature (Owner/Agent)' PERMIT# CONTROL# BUILDING PERMIT DATE VALUATION LOT TRACT JOB SITE ADDRESS 40 .13 OWNER - CONTRACTOR DESIGNER ENGINEER SA Y ClefTEST)VI TS (,ARIWN.A).W Q Rff-43,k A. urkKAT.", G., C. k 7847 INDIGO- OR 11940 RALMOft, LIN -T 150 LA. QUIWA 911,25-1 9 413-45 USE OF PERMIT SFA 2R' DOWN$T AAS tNft. PLAN WriCk, PORT10N 40F HiE, . AN 21 REOUCED BY 75% FOR 1\1ULTWIX ISSUANCE OF NA1\41, PLAN TYVE-. TRACT GONS i"IRVIC'TION 912,00 SF VRI , TED 00Y. F C STRITMON E MA "Of MN 49,5210 CONSTRUCT101'14 FBIR 101 -OW -419-000 S4 14,N P1:.: 'ANY CHFC_1t REIP AZ*C%NN1CAL FIX tot 4)CO-11-121 _10111110 LWCMCA.[. pumN No, M, 101-000.419-000 GRA IDW01",1331L 114?' Xq e R0 CV, 1 PW F R PREISE VILAN, 1 -345 8 Q WRTAI, (-'(.-)N 91RAX"T 0 N, A N 1) PL ikN CIREC K 'SS - P1 E -PAID FEES U-00 T0rftUPVMNHT FERSDI)ENOW S1,S9&67 RECEIPT- DATE BY/ DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings A Ducts Slab Grade o Return Air Steel Combustion Air Roof Deck- 7— - Exhaust Fans O.K. to Wrap " -(o F.A.U. Framing qX 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 - Final Final IS -3- 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 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 Jr. 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 L Final rUdlity Notice (Perm) Certificate of Occupancy City of La Qu'inta 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: 78-433 MAGENTA DRIVE Use Classification: SFA Bldg. Permit No.: 9710-045 Occupancy Group: R 3 Type of Construction: Owner of Building: BAY CITY ESTATES INC. Building Official 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