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0012-118 (SFD)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 6343112 Date" ✓ �'+`/ Signature_ of Contractor V '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,empioyees with wages as their sole compensation, will do the. work, and, the structure is not intended or offered for sale (beC. /U44,'BUSIII@SS &.Prof e3mional3.06dc):' ( ) I, as owner•'of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). 2 ` O I am exempt under Section. B&P.C. for this reason Date. i Signature of Owner WORKER'S.COMPENSATION DECLARATION I hereby affirm u der penalty of.perjury one of the following declaration's: O 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`.thet' performance of the work for which this permit is'issued ( )JKI have and will maintain workers' compensation Insurance, as required by Secfion 3700 of the Labor Code, for the performance of fhe:work for which this permit is issued. 'My workers' compensation insurance' carrier '& policy no. are: C.'. Carrier- Policy No. A•> h F,�:dC.l N Aaa`i"i E. 20 C000ar, 9M00 (This section need not be corn pleted.if the, permit, valuation is for $100.00 or less). ( ).t 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 subject to th workers' compensation provisions of Section 3700 of the Labor Code; I shall fo ywi h` comply with those provisions! Date: `� 4f Applicant—'V' r .t Warning: Failure to secure Workers' CompensE(ti,on coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000; ih 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 • 7estri6ti6n5 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 vold-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 authorizes,rep 6sentatives-of this City to enter upon the above-mentioned property for inspectii n purposes' Signature (Owner/Agent) Date,--,• 1 BUILDING PERMIT PERMIT# DATE VALUATION LOTS TRACT rr �y a�q JOB SITE _•• r ADDRESS d P].M ,pro eivo APN OWNER CONTRACTOR /DESIGNER? ENGINE ER CA l+.iiASf & COMP"Y.:. C.MADAY COMPANY 17480 X 17tR1'J'. 0106 17480"R 0111,01T.01,06 . . CA 921801�7,'i�if _. CA 027,90 4'7105084440 COLO '.4485 I IRF nF PERMIT lR63a4.1i:.d'. FAM ;L7, 1 DWIEULT-4L 7,.% PLAN 3f3 .SM', PERMIT DOES NOT l-MLTtDE klC.- l�A1S ' nLOT C004 4R JIN.vAtAPPROACH. F]EdCTEyd'RE poiJLCpY16%,y}`g N11311i'[i=IA IS',"rUAMCIS USW S,AMY, PLA2+9'P• PE. 1f.1aCd '4r 0. NA7,4`RCTION:434.00 8P PORCH/PATIO 0AiaA.OWCARPCyI2'4 . g7.Sv1�.,1v�A a.• ,fs,P•L �.yryiT ,!�t•yt.�. t�•r .I�.tl.?�..14toa.�A�11.i!�r� \..4J'iJd. ,.�C 4.•'W'.ivc�a�-w r�..��L�I ` �.a'id�.}.%��Q� ITM. , FEV SUNAWIM P:4.AW G;:tIECK FER, 101 -000 -d39 -:11f, M, DEPOSIT 101-000439-318 42A00 IM;N:CHAWIC:AL FFX- • . #:>i1'-t.l(10 � 1-Othf3' If93,00 XIACTRI ..-1"'td1• . ' l dl A Jt1-!I RtI�O(t4 �" �1 ?. � • Pi.iD1e4H1id�E I�I31;• 1G�1 •G�it}•�f•14-fip(I . ' -` ;$19d.9D 5TI'_t%40 MO'T'ION 1119 itZ0I) " let1-,(XYJ441 000 1JA42 DEV R:%OPE R JMFA.CT R I>ia0"i;li0 s 'r � r sXrrCr01M, .�,�ie.;'PI09 A ,C+ k\♦'J..�f�g�+?{y6yall-t .6.9 $3, .6.9 f�.�t y (y�y. . r; X2001 SAN 0 MAL Y%ftff ]WIN, DUS NO IN RECEIPT DATE jr BY% , D F D 6 INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set BacksJ_ Forms & Footings / �l Underground Ducts Ducts Slab Grade Return Air Steel Roof Deck _ _ _ Combustion Air Exhaust Fans O.K. to Wrap _ i _ �, _ F.A.U. Framing Q� 6� Compressor Vents Grills _ Insulation _ _��_ ��' Fireplace P.L. Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall -Int. Lath Final% BLOCKWALL A' PROVALS Final 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 —/ _ d Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection _ �� 6 Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Z _ 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) d C29 P.O. Box 1504 78-495 CALIE TAMPICO (7 6 0) 777-7000 ining Brighter Than Eve, LA QUIN-tA, CALIFORNIA 92253 FAX (7 6 0) 777-7101 March 26, 2002 Postmaster LA QUINTA POST OFFICE 61-321 Avenida Bermudas La Quinta, CA 92253-9998 Dear. Postmaster: Please be advised of a new street name for the following structures. The structures- formerly addressed on 47-780,,_,47805, 47-810, 47-835, 47-840, 47-8E57 47-870, 47-895, 47-900,.47-925, 47-930 and 47-960 Via Trieste will now, be addressed at the same street number oh-,Via_-LiV6—rnd. "Please note this change and contact me directly at (760) 777-7012 if I may be.of further assistance. Thank you. Sincerely, Diane-Aaker. Building & Safety Department 12 16 21 ' -800-345-7334 2 3 4 5 g SCALE IN I/10 OF AN INCH M/S MAP /S FOR - + • T. R. A. 020 - 024 643 — 14 ASSESSME/VT fT/RPOSES ONLY . +POR 'SE//4 SEC. 30, T. SS., +R.7E i;17- 80 G C'. AV I ry Q �2 ;q.�,'1� R 50 J - f ♦ ��� ,• I 4 ..I-3 / X191' - �� .�k. ,0 ti - ,, 7/ I 72a3 GOT A . •r -' II QNm b3a ar7l ' n ! osa®�/_ �1•//Z /BT^4 —07 98.65 y �' I . /05•A s9a49 ® 6 F+/07 /08 I 9 //Oa - V 9.0 8 n° 7 J F 75 O /00• 7l YI . , Q Q .b O 7a 49.0- 7.z// 77 52 w D B/.7/ a&,o //4.1/ T` /�► �A�QI` ct Ji l,'i �t� If' � r 0 © 649 s r. 84 Vt ^LsTebWso..: Bm I - _ —• N O .O ?® �o ®i J r V%1 O 76 /8 h / Q�2f�{• C I - 03 .3.4.3 ' + - d16.Sa ,j05 g5 oD' '�. T / .� G ♦ �j p1 W w �M N��a ���ioCsoQ./ 71 /05.58 � �O /09.98 �� 3 4 7O r 0 L `�Qr:iiO + 96 .� . � ` 90 •` y 6 •8/ , 7B ' p o Q k , s /2B. So lOZ, , „AoM1 /fi 50 -/22 TOl�l. S-�S 121 78 , O "..C. 97 .e m 4 /Bs7 89 h BB /B o ti 8O � 79 h '6.9'Is." / v t7a p� a9.o, 9B.a asD• 9ao5 Tz o9 a•5 6B m I '� _ . _ _ .F• a//� + _ NH9^9/'06 •E- ,+ _ /2 , 77.0 •• .• .. 72.0 s7si�/ °ISi .b I a •• v 65 M1k 1 67 ` I 57 58 59 60 " 6/ 67 6 64 V , 66 `& - o 'n o 9 /23.47 -43.94 720 77.9 ' �`Iilflll LO B9 ' •� /904. Sd 4' I. i , ----1— -- — /do/ --- --� i —_ • -.. o.,�ao - - --- - - - P AVEA/UF- - ✓89'3/'061'8 _ 1-�- 29 - 3/ 32 6-1 ' 14 TA• M.Y. l/I/R9. of - •r 07 .- r. •.. ,. /•V O W..B.227/77-78 rraCt No. 26/52 4 ASSESSORS MAP BK643 PG 14 RIVERSIDE COUNTY, CALIF. 1. • , RG • SEP. 92 al l 4L c rt