SATT (9906-232)78487 Magenta Dr
9906-232
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
Vb/ate .702 Signature of Contractor—
OWNER-BUILDER
ontractor OWNER -BUILDER DECLARATION
4-
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.
(,4 1 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.
STATE 11:7 142,257699
(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
sugject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those.provi i, ns.
ate: Applicant—
Warning:
pplicant - -,j/'' a
Warning: Failure to secure Workers' Cb'mp nsation coverages 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 inspectio p rposes.
S1d ignature (Owner/Agent) -' ''' Date
' . PERMIT #
1,0J06-23?
BUILDING PERMIT 1,0J06-23?DATE
[,BUILDING
VALUATION IW I.4; 400 LOT j 5 TRACT
JOB
7 9% "JA(;-9N'r1 Dl"VF"
APN
ADDRESS
OWNER i r
CONTRACTOR / DESIGNER / ENGINEER
e . 'r• rvyc:gr•'l I'nT°rir Zh 'en1'J*f0
1.1. ♦f. ,..t i i 1r1 J,LA1 Arl. tr'?.f.4Ai.Itilt 9l l i.V y.
i`1ATa'erYr'F'tC^P bft? AfVP• ;hrrt nlTgn Y eS
.! A11T 111,1.1.11Ji .lk)l ,J.. as l..II %-t !V i. Y.W t,Jtl.
14S CA.PXZ CIRCLE
74-965 aON1 Lift. C HTF I
RANCHO MIR'.AGE CA 92270
PALM DESEWr CA. 92260
[^b0}'779•-!9 Gf 3I. :3' R2
USE OF PERMIT
SINGLE, FAMILir,AI"AAOHED
SFA, Cri,,Jtit4 3.L, PE014'r DOES NOT .iNI CLUDE BLOCK WALL Olt I'OO:L.
PLAN CKEC:K FEE RFDUCED 15°•0 FOR MUL"i'LF`.LU ISSUANCE (A' SAW,
PLAN `fYPS.
°r 14 C M72=110ii 70.00 Sr
r
f
ESTIMATED COST OF C;ONSTRilrJON
1,43w)o
C''ONS1 RIXT:i.ON is I E > 0141 x'1•^418-000 S362.50
PLf\.1` CfflzCK ins
MEETMANtWAL Mis : ,.€-000.4?!-U'Q(t 3-19.50
GLOMICeAL:M-: A01-000-420-000 982.7.1
,P)JYMM(I FEE "101-00040-000 $85.50
? Ttra.t riC3`t Lf>N ! 1~ w -11 11 ih i 01-000-241-000 $4.14
t31Z.ADING FEE; 101-000-423-000$2001111`1111
t STRUCT-UR ; PU4 2,25 -WO -443 `42
PREC' ASH.RLAN' 104-000-441-31115 $.'x5.00
SrJB-"! ".1' YAL CO N."MR-L `:T!t7N AM) R -AN c;HtgCK
11,6, 014
i JE.iS PRE -PAID FEESV,,,00
TOTAL PERMIT :0'115 ES ` U E NOW
S1,6"2933
a
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
X—/"o
Exhaust Fans
O.K. to Wrap
3 — d -p
F.A.U.
Framing
A
Compressor
Insulation
-- _pa
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
rOF
Drywall - Int. Lath_
Final
G�
Final
POOLS - SPAS
BLOCKWALL
APPROVALS
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
zf
Gas Test
Appliances
01
Final
COMMENTS:
oaC >r 5�c� 6`
Final —QtJ17<7��✓9yS
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)
s
r '
(Cerrincate.ofAccu anc -
City of LaQuinta
V
fr
Buflding and Safety Department OF
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: 78-487 MAGENTA DRIVE
Use Classification: SFA Bldg. Permit No.: 9906-232
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RN
Owner of Building: BAY CITY
ESTATES(ARIZONA)INC.
Building Official
Address: 16 CADIZ CIRCLE
City: RANCHO MIRAGE,CA.92270
By: GARY HARTMAN
Date: 8-4-00