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SATT (9906-229)78481 Magenta Dr 9906-229 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 Exp. Date 54118 B t09;^ +200 /ate- Signature of Contractor f OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the C latractor'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: Carrier STATE FUND Policy No. id22S7fi94 (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 agree that if I should become V ci to the workers' compensation provisions of Section 3700 of the Labor ,I shall forthwith comply with those provisions. r Applicant Warning: Failure to secure Workers' Compensation cov age is nlawful 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 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 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 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. gnature (Owner/Agent) .•"~ Date BUILDING PERMIT PERMIT DATE VALUATION 30,,121,6# LOT IS TRACT I&I5 JOB SlfE ADDRESS ' MAGA T 1 APN 613.79"15 OWNER! CONTRACTOR / DESIGNER / ENGINEER BAY CfiY ESTATES ftA.R17ONAj INC D RMELII.1.1 COMPANY GEN CONTRACTOR 16 CADIZ CIRCLE 74.a S JONI DR UNIT 1 RANCHO MIkAUE CA 92270 PALM DESERT CA 92260 (7601779.1954 CBL# 1792 USE OF PERMIT 10NOLE FAMILY ATTACHED SF& PLAN 2U, PELT DOGS 140T INCLUDE BLOCK WiALA. OR POOL PLAN ClihCK FEE REDUCED 7Y% FOR 1411a LT1PLE IS8lUANC,'E (*SAME PIAN TYPE. TRACT CONSTRUCTION 912,00 3F EST:MATZEli COST Of CON3TRJL"'i`1ON 49,521AO PERMIT FEE SUMMARY CONSTRtR-nON FEE 101 -OW 418-040 5414.313 t s 9n, AN rTI ?VK F" !0)-000419-118 Stt - V MMIANNICAL !-M 101-000-421-444 546.00 UW Rx. AL l' f ZI 101-000-420-004) U792 PLUMBINU FEE 101-004.419-400 "7.50 :41'ROW(14 MOTTON FFF - RF'WO 1014-7414>a1() f14 91 GRA1]M Flffi 101.440--423-000 $20.00 i WRAsrREk:`ft1REFFE 225-000443342 $1.114.24 f4WC[SE PLAN 101-000-441-345 $25.00 4trn-'ITynki, CONST ix-rm AND P1 -AN (HECK $I W* 67 LESS PRE-PiUD FEES $0.00 TOTAI, PERMIT FFES DUE Nf2'1+1V S',8 6.67 1 RECEIPT DATE By 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 /p- Exhaust Fans O.K to Wrap eqC> 6T 6 e F.A.U. Framing - %p -p Compressor Insulation G -a 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 / BLOCKWAII A PROVALS 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 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) C0MMENSio_���g V �o vl3Ges.�� d 3 9-� 6 •6 Certificate of;Occupancy pity of.fLa Quinta ff Building analSafety 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: `' 78-481 MAGENTA DRIVE Use Classification: SFA Bldg. Permit No.: 9906-229 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RM Owner of Building: BAY CITY ESTATES(ARIZONA)INC. Building Official Address: 16 CADIZ CIRCLE ' City: RANCHO MIRAGE, CA.92270 By: GARY HARTMAN Date: 8-15-00 POST IN A CONSPICUOUS PLACE