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0012-110 (SFD)LICENSED CONTRACTOR DECLARATION - I hereby affirm under penalty of perjury that 1 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 Date / 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). O 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 permif 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 shall not employ any,person in any 'manner so as to :become subject to the workers' compensation laws of California, and ag Be that if I should become subject to the or ers' compensation royvisions o Section 37b0•of the Labor 1 K• P P , Code, I shalVf Yth"w1lth�comply with those provision . Date: r �1..�'gpplicant Warning: Failure to secure Workers' Compensation coverage is unlawful 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 I# 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 nul( and void. if:` Work is not commenced within 180 days from date'of.issuance ofauch 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 en er upon the above-mentioned property for•insp'ectiO urposes. Signature (Owner/Agent) -, Date BUILDING PERMIT PERMT# DATE / VALUATION LOT '� TRACT �•1 .. / 1 ! 1e�.11751.7f� -2 JOB SITE / ',.044/ . . ,,/ ADDRESS 4 7-M �X.&� �'�.�.r���IT � /^V VD APN OWNER A CONTRACTOR/DESIGNER/ENGINEER CW:M.AY CtOMPMY . C—AMAT:%,f Y & C"0k ..�A14Y 17480 R 1 06 "xdl�7 CA 92790 IrUMN --. CA 92M _ . Mi? 10508.4440. MA 4465 . USE OF PERMIT i .a��:�'���muse DWEFaSAtG LOT 76; ty1,04 , OA EF ''PERMIT D0FS NOT r,°aCLUDX'igi.,CiCK , VAI". P0016 OR DIUVEW Y APPROACH. TkACT C014131RUC7'iON. OF 4��?�r~.ii/PA'r1C'D �'DS.�kB SN OARAGFYC�ORT (fY#t) 12,343.00 51.70 YM HMH V K SE ARV 1 �l �ttiOG�4l ��0�0 �y23.l COADSTRUICT3034,PLAN MR= fVB PER DEP(MIT IS -v zfAm 1�liY.r�Gk1ANICAL F1:11 s , , 10,1-000-421X000 $3 ffR(It31 FIX. `TRIC_A L,, E, . j 0.1..,000.420=tf$;+G1 ni°.G1i0AFG 4V1OV014 FEE,, - kWD.. 1'01,iO_ 00.241-€ 00 s iat1'A101-000-43-OW p ($EyO).�M ryE Jj/jPERIgPCT F,9 SV.L rd.V'-i" L>•v3TR.C3a; TION' M- D'PI.M t".T1`ECK $4,1.09.01 1=3 M9.1plM,PTIM9.9 4250,00 • �. ` TI�.'Vp�A. 1 �1cf lrf9��p�prT.�7f�o�'�y. �•�y t�,�JgT,�,.� - <YY.R?] S.Gt.RS.IY[.11ll �V1 n, 9J.L'�� nV S: • - • .. _ SAN ®�•.Z00� = k. RECEIPT DATE By- i DA E YNALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs 1 42, Underground Ducts Forms & Footings Ducts Slab Grade Z < - Return Air Steel Roof Deck O.K. to Wrap �• f a � Combustion Air Exhaust Fans F.A.U. Framing/ Insulation 7 ( llu Compressor Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall _ Exterior Lath Drywall - Int. Lath Final e $ —Oy- Final — �, �— v S 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 Sewer Connection /' / (�li` Pool Cover Encapsulation Gas Piping Gas Test Appliances Final f COMMENTS: Final - Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Wain Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final j _ pz Utility Notice (Perm) Q P.O. Box 1504 y 78-495 CALLS TAMPICO (760) 7,77-7000 ShInjngBrighter ThanEve, LA QUINTA, CALIFORNIA 92253" • ..FAX (760) 777-7101 March 26, 2002 Postmaster. LA QUINTA POST OFFICE 51-321 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, 47-805, 47-810, 47-835; 47=84047-865, 47-8707 47-895, 47-900, 47-925, 47-930 and 47-9.60 Via Trieste will now be addressed at the i same street numberronxVia-Livorno:, Please note this change and contact me directly at (760) 777-7012 if I may be of further _ assistance. Thunk you.. ` Sincerely, Mane Aaker ' Building & Safety Department ; ,. • _. 1 .. Fhb• - > . r SCALE IN 1/10 OF AN IN 3 1-80®-345-7334 ".,i z — 3 a s s t1 T///s . mAP /s `f'oR T.R. A. 020 - 024 6,43-14 ASSESSNENrN/RPOSES aver POR. SE -114 SEC.,3O, T.5S., R. 7E. 6/7-80 At _ c— �� J' i2 ,Al, • . ' : = - - -_ ___ �I�,�1_ I . �I � i, A • •+ /.r---� �� � /PRNATE � STREET/ LtE , 7t e! LOT Vr� A ,,4fB12 /12 F 74 �. n /Os I1 ,f79 cya37 e9 x c°ox 37.61 yB.a� d 49 g° Ae 75 4 n _0'a /�/ 94 B• )D sB�/ N8B . 1// 77] 5 /9 7 a �ytw� 1 , C .95 ^ Al C,ioi"50� Bq' -1 ns so - - - I -- -- n 94 - © pN 92 BS ai BJ VQ 76 /B 0 /BTo 72 0 n 0 649 ` 03 - � -•' , I �.r) �tii.Y.oe ��=:jDfBSc^d1S� h ` _ 9/4 BB ^ 82 b 77 o ` 7/- i�.�Vorno. ..s RW OQ T• 2W b '05.58 113 OD h�♦%/o9. 9B ' 3 ��50 I n0 - 96 8a 0 90 R h B/ .7B - p o - �. �- 0 - o B7 a a� Q C I�. n /Q4 � O .. II , >O �••i° s„B A It ` ; o o'IT�, . r e ss es\Jj • /2B.so ,,==fro J S �- _ _. ,e m/B.to 2 69 g �. 97 Q /6w B9 „ BB /B u „ BO 7y m b s 41 525 7.05 7 ,^ I ' 92 09 v5 68 , _ /2 m P /.6.7 At /PR/NATE �TR£ETJ �`'�• •� 720 77.0 57 SB 59 a 60 6/ 62 6 64 %��6\5 95' % 67 - 9 0 _ 7=o 720 72.99 /2gq) I3.94 LO BB /906. 5d 4 Y.a+aaa _ — — - /✓B9°3/'06"E' - ~ 29 64 (075 ASSESSORS MAP BK643 PG /4 No N.B.227/77-78 Tact No. 26/52 R/VERS/DE COUNTY, CALIF RG .SEP.,92 �m ertifincateof OccupancyC�. a. City of La Quinta Building. and Safety Department. 0 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 regu/ating.bui/ding construction or use. For the fo/%wing: BUILDING ADDRESS: 47-840 VIA LIVORNO Use Classification:' SINGLE FAMILY DWELLING Bldg. Permit No.:, 0012-110 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL ' Owner of Building: CANADAY AND COMPANY Address: 17480 EAST 17T" ST. #106 City: TUSTIN, CA 92780 By: STEVE TRAXEL Date: 01=23-02 , -. Building Official POST.IN A CONSPICUOUS PLACE '