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SATT (9710-047)78437 Magenta Dr 9710-047 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. License # J ,— ` 1 :•. Lic. Class Exp: Date ~ D/ate. fir/ 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: ( ) 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). .. O I am exempt "under Section , %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: (,) V have and will maintain a certificate ofconsent 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. 4 1 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: CarriIT er, { y p\ Policy No. r 0 011 11-17, 5 (This section need not be completed if the permit valuation is for $100.00.or less). O 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 that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply withthose provis ons. /J Date:' Applicant' ' i a!' (. " Warning: Fail ee to secure Workers' Compensa`1 .coverage is unlawful and shall subject an employer to criminal penalties and civil.fines'u. 04b $100,000; in addition to the cost of compensation, damages as -provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to.the Director of Building and Safety, for a permit subject to the conditions and restrictions set forth. on .his application: 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to ' any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the .City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and voi& if work is not commenced within 180 days from date of issuance *of such permit, or cessation of work for 180 days will subject permit to cancellation. i certify that 1 -have read this application and state that the above information is correct. I agree to comply with all City, and:State laws relating to the building construction, and hereby authorize representatives of,this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) "" Date . r, , N PERMIT# CONTROL# BUILDING PERMIT > a/ // 0 DATEifl.ta i' VALUATION„ iii LOT TRACT 1 i; i7 ' 307Rlt G!4 , 1 KFVJV , f' JOB ADDRESS 1 APN 604-02fg)3/ OWNER CONTRACTOR/ DE..SIIGNER /ENGINEER ar 1ii'O i)NC yaiMt 78471.i;N1 -100 DR 119410 Ms.M DR.,'LM 156 L41t.4i.JiWA. CA 922,5.3 OF°Sl..i..e,i HOT 0,R &Q240 (619)"329,5490 .03114 11345 USE OF PERMIT SFA. ?%,Age' 1- DOWNSTAIRS' IMT. PLO c,iiEM P01i`J'IOW Oi ` KEDUC\ .N'Y 79:u F'CA.i'r U l'IPLP, ISSUANCE OF SAW. mwrymi TRACT Cv'idS'1 c(J4 7 is+ N927,00 Sig ,+',r9`, '1(.i .it" !' .r`Z:a ' l' f'' ; t0'•, '. °'$;i.9J :`n 1T dl, 3f .7• PERMIT FRE SUMMARY CONS"fRil4:'iICINFEE 101-00,0-418-M, 1'.f,A.tl0-tRIC* FEE; 1.011_-000-43p. 1 41t a.3? U11C (`EY.1C`,AL li8C- ICYJ-000-42:11-000 $88.145 i U:t 1N 1 `I:G 1101-000-419=110 i rri z tOT O.ns'1:FF-. ;v 1 .Sl -{t(1() -?4! {X. ZFi33•( 3((l U-f 2xi-(f00 3'{►;O i . ,`y;C' Zte}il:,ilrJi1'1 1., +1rrq d t 225-00&-4-43-342$0.32_56 LL:,P' .7l wY S l. C U1R ''i .EV 225- /l &-4—!3-3 Iii Si i':';b_56 C 4Ci~. .."' S1~ P :: i1J 113{.-tit?-4+$1;•• 4. $? .U St.1;EZ-'3'fil}`AL. V,0N,$`1T? (.,rtr'7” QN AND. PLAN CHECK $1,92143 LESS PR IE-l'I'O.iL 13.0 Ta.rm,if"f+,t".1'!: i oueNi oltV $1.922,93 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 O —5, - Return Air Steel Roof Deck — Z - Q TT Combustion Air Exhaust Fans O.K. to Wrap F.A.U. Framing / /S Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wail Insulation Condensate Lines Party Wali Firewall Exterior Lath Drywall - Int. Lath Final Final IA 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 Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduft 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) COMMENTS: dQ r 7 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: ..78-437 MAGENTA DRIVE Use Classification: SINGLE FAMILY ATTACHED Bldg. Permit No.: 9710-047 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: NEIGHBOR COMMERCIAL Owner of Building: BAY CITY ESTATES INC ►a Building Official Address: 78-441 MAGENTA DRIVE City: LA QUINTA, CA., 92253 By: DANIEL P. CRAWFORD JR Date: 3/25/99