SATT (9710-048)78439 Magenta Dr
9710-048
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,'', , r j Lic. Class. Exp. D' to C
Sig, o<
Waite Mact <.t. ' h• 1SI . I. C-
/ 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 structureJs 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.
t C'r"P.,t iryry %} 1.M tF.. i1rjY a AAttii t v99
(This section need not be completed if the permit valuation is for $100.00 or less).
() I certify thatin 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 -Labbe
%ode, I shall,fort with comply wit hf those provisrion .
yDate: J&'i i i ADDlicant t
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 Jorth 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 applicator agrees to, & shalll,'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. 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
t e above mentioned property fofr inspection purposes.
ly
Signature (Owner/Agent)°x / % -" Date f7/ls ,i' 7
PERMIT # CONTROL,#
BUILDING PERMIT,,
'y qqq^
DATE 0/14J9 r VALUATION 49M.?21..6I) LOT' I TRACT 9 6,0 ?' e
X117 V
JOB SITE y !
ADDRESS , 1Sy A i.[•1. Q rFa
APN
, 44i 'E1.2Ei+;O.ao %
OWNER
CONTRACTOR / DESIGNER / ENGINEER
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1194o c,.&L to. oft-, UKtr i 5o
LA QUINi•A. CA 922,5:1
.0F`1 €1.T1 O'rSN'R1:1 G (:A. 32240
USE OF PERMIT
TSTA.
KLAN DOt+ NSTAIR. i UN z'. IL.i2*i 04i;CK T'f7R1014 OF FUM.Ur`i:11
BY 75%, FOR P! UL 7' IX. !SSCP r M'2 ('.11< S 114 P1,AN TYPE,
`.0"RACT ('ONS'3`,RUC710 .91100 Sr
C;O14S111R iC111CM 1 11.11; 101 -000 -418 -WO $414..50
1: );•r1:Pd '?i}"s.e:,'"ih, :r`F,s 10 f. 0( .►-" -°'4 9 !? $ .
A iT'CHANICAL F"I."9: 101-000-4,21-0W SU.(tt4
I..i:t;%f..iLAL FLIM 101=Qfki,f•1ZO-000 $87.9.2
PLUMBING fW? 10.1-000-419-000
S"q'11.O1 yN:t! 1'rJTd Flr, .',310 1111 {1(}i?,41-€1 a?: 1g
O- KAIDING 1713,E 101-00-421-wo S i1:t70
iNFRAS1'RUC°TURE FIX 225000 43 342, $1,:1] 1.24
P17,I f ISI. f'.1„A"I`t
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LFS, FIRE—PAID FE, US
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TOTAI., PFAMr: CF'S 00YKNOW
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings lowwl
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROV S
POOLS - SPAS
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
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)`110/4
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G. F.1.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
Ise -., (2 -4 -.)ed- JV
Certificate of Occupancy
City of La Quinta
II Building and Safety -Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Buildin
certifying that, at the time of issuance, - 9 Code,
this structure was in compliance with the various ordinances
Of the City regulating building construction or use. For the following. -
BUILD ' ING
ollowing:
BUILDING ADDRESS: 78-439 MAGENTA DRIVE
Use Classification: SINGLE FAMILY ATTACHED
Bldg: Permit No.: 9710-048
Occupancy Group: R-3 Type of Construction: VN
Land Use Zone: RM
Owner of Building: BAY CITY ESTATES INC
r
Building Official
4._.
Address: 78-477 INDIGO DR
City: LA QUINTA, CA., 92253
By: DANIEL P. CRAWFORD JR.
Date: 3/26/99
POST IN A CONSPICUOUS PLACE