SATT (9710-052)78447 Magenta Dr
9710-052
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 # " ` " Lic. Class E Date11
VDteO i r ` 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).
() 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.
( )w 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. '
(This section need not be completed if the permit valuation is for $100.00 or less).
( ). I certify that in the performance of the work for which this permit is issued,
I shalLnot employ any person in any manner so as to become subject.to the
workers' compensation laws of California, and ag ee,that if I should become
subject to the'Workers' compensation provisions of S4ction 3700.of the Labor
Code, I shall ort with comply with those / pr o %f i I,o ns.'
Date: n , Applicantf ` ' r •5 r
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal pgnalties and civil,fines up to $100,000,.in
addition to the cost of compensation; damages as provided for in Se6tion-3706
of the Labor.Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building. and Safety
fora permit subject to the' conditions and restrictions set ;forth; on his
application.
1. Each person upon whose behalf this application is made & ea&person at
whose request and for: whose benefit work -is performed under or pursuant to
any -permit issued as •a result of this applicators.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 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 for inspection purposes../ .
VSignature (Owner/Agent " A - •- Date t`A,
)
BUILDINGPERMIT PERMIT" _-- °°NTROL#
DATE 1411104/97 VALUATION •, d`R At t4j 0.#)j)
LOT 1 — TRACT 4077
JOB SITE !
ADDRESS jklzfi! d lo-i tL41r% tJ'
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hitt 1iQ^ if:? 1
OWNER
CONTRACTOR/DESIGNER/ENGINEER
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USE OF PERMIT
PLAIN 3.k - DOi+w 146'17414KS UNIT, '1,AiN Gig E' -,C' .1k)f2V014 O.t' .r U
BY _Il50:9F()'MVVr11 LH'ISSUA.NCE.Or SAME PL A N. Ill OF11
C'Ci'i . `i'ttt E" 4 f .►rt ' Lel ; 141:>()( 3- '111~0(li} It 3el2.5 0
I'll AN CHYXIX. N'a '; $77,78,
R#f{{,t.;t-.t : t i p;[T(,``A 1001-f 11` K04244-Oy/t
yt, 't3F y
1A>,fiCTRICAL .f.: IJ 1011 l 0042"lI-W
P t'3iMBT.l9L1 FFYI 101 -00 -419 -{XV $31 St)
S"1`1 ONG MO'C3c3N0Kf;lot,-OW 24.4- l
ORA01140 Full 101-000-423.0.00
Jx'n1I'N AS'i 24ft;! Ia1c1a t p'2125}0 -4't 21i.",
ROME 5,00
S1 .Rt-'t'O"'?"AL i"`ON.-S I`PU tt::"f 10N AND ;€''IRAN c I-IAC'K
LESS !ARE-3':rLIWEES
$01M,
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings Tj
Ducts
Slab Grade - - -
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation 77
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath i
Final
Final
BLOCKWALL APPROVALS
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)
ELECTRICAL APPROVALS
Temp. Power Pole i
Underground Conduit
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:
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: 78-447 MAGENTA DRIVE
Use Classification: SINGLE FAMILY ATTACHED Bldg. Permit No.: 9710-052
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: NEIGHBORHOOD
COMMERCIAL
Owner of Building: BAY CITY ESTATES INC
y�)
Building Official
Address: 78-477 INDIGO DR
City: LA QUINTA, CA., 92253
By: DANIEL P. CRAWFORD JR.
Date: 3/24/99
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