SATT (9710-054)78451 Magenta Dr
9710-054
LICENSED CONTRACTOR DECLARATION
_Sh,ereby 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. Exp. ,,,at
ate f _ Signature of Contractor 4
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 thein 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 N. '
I hereby- affirm under penalty- of perjury one of the following declarations:
O I have and will maintain a certificate of consent to self -insure -for workers'
compgnsation,.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:
CarFier Policy No.
ftIME11, FUND
(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 shall not employ any person in any manner so as to become subject to the
workers' compensation laws of 'California, and a`ree'that if I should become
supbject to the workers' compensation/provisions f Section 3700 of the Labor
CodeI shall forth., ith complywlth'those ii dons
ypate: Ia `7 Applicant
Warning: Failure to secure Workers Comp ne sation coverage is unlawful and
shall subject an employer to criminal penalties and ci0'fines up to:$100;000,-in
addition to the cost of:compensation damages as provided for in Section 3706
of. the Labor Code, interest and attorney's fees.,
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit. subject to the conditions. and restrictions set, forth on. his
application.
1.: Each person.upon whose behalf this application is made & each person at
whose. request and for whose benefit work, is performed under or pursuant to
any permit issued as a result of this applicator agrees to, & shall; indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
t 2. Any. permit issued as a result of this application becomes null and void, if
work is not commenced within •180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I ceitify that I have read this application and state that the above information is ,
correct; I agree to comply'with all City, and State laws relating to the building
construction, and hereby authorize representatives of.this City to enter upon
the above-mentioned.property for 1inspe.tio , purposes.
611C' ,. i fir' /
VSignature (Owner/Agent) " -"" to r ✓`1` 7`
- --`
BUILDING PERMIT PERM':" °°NTR°`#
DATE VALUATION LOT TRACT
3igi 4i97 407-$ O w% 4
N W
JOB SITE--- 1
ADDRESS ,WIy.1 X41'1(%i`:a S bI!r
APN
OWNER
CONTRACTOR/DESIGNER/ENGINEER
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LA Q INT A CA, 9.F 253
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1343 \EW 1.t .iF S1 .1 Nf3r CA. 02240
(619)129x5400 C40- 4345 .
USE OF PERMIT
SPA
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':I'}2./ 4L. r V -0J 1STJZUC 4 1` LV 912.00 S,`r
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y y@ p } t7 g$11
.1 . .i ' i A A. .7 .R' ,i':F.+: CJ I•iMARV
tv'OMTMUC'1'ION MEF. 101 -M -08,0M. d4;tft..5ii
PLAN CWEIM PT. 101-000,439-3 18
hs;,l , n "d', ,1"ta xCi1, QOtftb3.-t}G;} f
LI.t:I`kLi4J.T.iif~ ', }p1.32e7 E300 57.92
t'! 3? IkS1 fiC11 >I7 101-t3W-419-000 $97.50
0'f R01401 NfC` TO -17.1+' E— R -BI l'J 101.001-241-f„Nli}
M\D Mo 161
IN Tf-R}.1C!°MF• F'Oil 5-000-443-•_4? $1,1.14,24
PRF..0}'RFs PLAN
LESS 11ya-PAID FEES
$0.00
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.
RECEIPT
DATE
1.13Y "
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
. INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
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 & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
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
Q.K. for Finish Plaster
Sewer Lateral ,07
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
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
Final
Utility Notice (Perm)
COMMENTS:
/ G
w,vTa s i/G/94
Certificate of Occupancy
City -of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the
certifying that, at the time of issuance, Uniform Building Code,
this structure was in compliance with the various ordinances
of the City regulating building construction or use. For, the fol%wing.
BUILDING ADDRESS: 78-451 MAGENTA DRIVE
Use Classification: SINGLE FAMILY ATTACHED
Bldg. Permit No.: 9710-054
Occupancy Group: R-3 Type of Construction: VN
Land Use Zone: RM
Owner of Building: BAY CITY ESTATES INC
Address:
Building'Offici°aI
City:
0
Date:
POST IN A CONSPICUOUS PLACE
78-477 INDIGO DR
LA QUINTA, CA., 92253
DANIEL P. CRAWFORD JR.
3/26/99
i