SATT (9710-050)78443 Magenta Dr
9710-050
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.
Lnse # ; t Llc. Class Ezp Date 11111'
f4. pp
vbatel 7 'Signature ofContractor
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; avid the structure. is not•intencled or offered for
sale•(Sec._7044;:Business.&:Professionals Code).
,I, : as .owner: of. the property, am eicclusively contracting with licensed
contractors,to: co, nstruct the -project' (Sec. 7044, Business & f?Fofessionals
Code)'.
(.) .I am exempt under Section _ ; B&P.C. for this reason
Date i ' " Signature' of Owner .
•WORKER'S COMPENSATION DECLARATION"
F 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 is"sued. .
(. 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:
.Fe1tl sumo
(This section -need not,be:completed if the'permit.valuation is for $100.00 ogles§):
( :) 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 l'should become
subject to -the work ers''compensation provisions of. S Asti n' 3700' of the Labor
Code, Ishall foitMjwith, comply with tho e, roviions. r
Date r . Applicant ••@ V - /
Warnmg: •Failure,to secure -Workers' ,Compensation coverage Is; unlawful and
shall subject.an'employer to.criminal.penaltibs and'civil'.fines upto'$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:
IMP ORTANT`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
00 Each person upon whose behalf'this application is''made & each,persori.at
-whose request and formhose,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' resum
It of this application becoes'null,and void. if
work'- i.s not commenced within 180'd y sfrom• date, of 'issuance .of •such
permit; or,cessation of work for -180 -days will subject perm -it -to, cancellation:
.'
I certify that I have read this application and state that the above information is
corrects"l agree to comply with'all City, and State laws relating to. the buildingRs.
construction, and hereby'•authorize representatives of this. City;to enter upon
the above mentioned property four nspection purposes.
Signature ,(Owner/Agent) 'f fi / Date 3l
BUILDING PERMIT PERMIT#. CONTROL#
(bel PERMIT
DATE VALUATIONLOT TRACT407 5.
JOB SITE —
ADDRESS
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OWNER _
CONTRACTOR / DESIGNER / ENGINEER
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RM i CIT- t 3` `' n TT, -.S (A.f ' ON A) INC,
LAv: ta' - 4A 91753
CA.
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USE OF PERMIT
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RECEIPT
DATE . ??,
BY r
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-- 3
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
y
Grills
Fireplace T.O.
Fans & Controls
Party Wall insulation
Condensate Lines
Party Wall Firewall
Exterior Lath -
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVAIZS
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
I
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 Conduit
Rough Wiring
Law Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
T%J' 4,4 -r / 2 51- t Z
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section X09 of the Uniform Building certifying that, at the time of issuance, this structure was in comp/lance with the various or 9 Code
of the City regulating building construction or use. For the following: dinances
BUILDING ADDRESS: 78-443 MAGENTA DRIVE
Use Classification: SINGLE FAMILY ATTACHED
Bldg. Permit No.: 9710-050
Occupancy Group: R-3 Type of Construction: VN
Land 'Use Zone: RM
Owner of Building: BAY CITY' ESTATES INC
Building Official
Address: 78-477 INDIGO DR
City: LA QUINTA, CA., 92253
By: DANIEL P. CRAWFORD JR.
Date: 3/26/99
POST IN A•CONSPICUOUS PLACE