SATT (9710-049)78441 Magenta Dr
9710-049
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 # Y G' 4` Lic. Class Exp"Date,3 f
;Y1. 545
Date , z ignature 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).
( ) 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:
Cartier. Policy No.
STA c9ru =_9 01012.
'r
(This section need not be completed if the permit valuation is for $106.0.0 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 thatjf I should become
subject to the'workers' compensation'p rrovislons of Section 3700 of the Labor
Code, I shall fo hwith comply with those'.provlsions.
yDate: s Applicants tt % /I j —
4
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 B. 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 perfrmed 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 certifyAhat I have read this application and state that the above information. is
coiTect. 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.
ignature (Owner/Agent). -y -- f Date -Z-46-'7
9' t
PERMIT# CONTROL#
BUILDING_ PERMIT
9714-049.Q74
J x
DATE, 10114197 VALUATION 'U ( LOT TRACTJOB
SITE
ADDRESS dg FSA iR'VA-MMr A WR V f 7
APN Fitt q ib id-l J 1
OWNER.
CONTRACTOR DESIGNER/ENGINEER
SAY wry, L,'sioYf:W (,k -R ,)Ni f n.,c
(!".R Ax111,11 1( r, }
G. _. /
78477 i:t' IXG0 DR.
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11940 PALM 0k, UNIT 154
E A.QUdlrWFA, CA, 922_53
LVISi:;lo'1" H01..1.'ePtLIN(Yt C:Fi '512240
USE OF PERMIT
SFA
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'i Li,ACT C01Na17RUC .GAN 763.00 S:t'
COO OF COINISTRUCT107N,
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RECEIPT
DATE
BY/ '
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
I INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Gradep
—j — fi
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 & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
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
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
aleEncapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS: /
—0U 7 / 2—tf / -4/7
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 &Z40W
Final
Utility Notice (Perm) 21 llfkTT
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:
78-441 MAGENTA DRIVE
Use Classification: SINGLE FAMILY ATTACHED Bldg. Permit No.:
Occupancy Group: R-3 Type of Construction: VN Land Use Zone:
Owner of Building: BAY CITY ESTATES INC Address:
City:
Mot
Building Official
9710-049
NEIGHBOR
COMMERCIAL
78-441 MAGENTA DRIVE
LA-QUINTA, CA., 92253
By: DANIEL P. CRAWFORD JR
Date: 3/25/99
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: 78-441 MAGENTA DRIVE
Use Classification: SINGLE FAMILY ATTACHED Bldg. Permit No.: 9710-049
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RM
Owner of Building: BAY CITY ESTATES INC
Building Official &10/1— --
Address: 78-479 INDIGO
City: LA QUINTA CA 92253
By: DANIEL P. CRAWFORD JR
Date: 3/25/99 .
POST IN A CONSPICUOUS PLACE