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0012-107 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Ckiapter 9 (commencing with Section 7000)'9f Division'3 of the Business and Ptofessionals Code, and my License is in full force and effect. . �TL�gnse # Lic. Class Exp. Date Jul F3 0313112C . Date • r t Signature of Contractors ; OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjurythat 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 acertificate 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. ` (def 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 perr'iii'is issued. My workers' compensation insurance carrier & policy no. are: CarrierPolicy No. AMERMAt,7J A1:RRX' 29/2 �►CflOflS9S404 (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� I should become subject to tFye w.rkers' compensation `provlsion§4i Se� n 13700 of the. Labor Code, I sh' l.fo huvith comply with those provisionx,(,y✓ Date: �: .i j Applicant Warning: F� secure Workers' CompensatioAzOv are are ge is unlawful and shall subject an employer -to criminal penalties and civil fines up to $1-00,000, in addition to the cost of compensation, damages a's 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.. r 1. Each person upon whose behalf this application is.made & eaco.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 A above-mentioned property for inspection �urposes. • "' Si nature (Owner/Anent)Date �. BUILDING PERMIT PERMTk DATE f VALUATION LOT. TRACT U544471.70 7i 26152 JOB SITE APN ADDRESS 47-870 V ..« m F. 41/04 /O ' , 643440-0.15 OWNER CONTRACTOR DESIGNER ENGINEER " .]y'i1E & CVinEY CARADAY & COMPANY 17480K 17111H UTI 41106 17480 &1 17rli ur, 4106 TtjSml°I 1 , : Com. 92790 • TDITIN CA 92780 (714.)508.4440 CRO 4485 USE OF PERMIT ,cM4G}I L PISYA i. "YT DVffU1WG LOT 71, PLAN' 208 = SFD -**MIT ti ys. NO—I: INC,:L&DY, BLOCK"WJAL. PO(A� Oft Y3RTVP`NTA Y APPROACH. TRACT CONI.I I Rt3t;;'IION 01? PORCHIPATIf'3 302.00 SP GARAOCfC.ARPORTi (piny P049.00 : 'i1B/iA73D COQ' OF 4�{)1.?1b.6'it:4T Ol�T '- 1"14,4711.70 CONSTRUCTION 1I1; 101-000-418-000 6932.00 PLAN CHECK FEE $690.16 ,.Z DEPOSI`r 109 �-000.439.318. •3250,00 z�ir..� FUC`iRI AL- FE..E. ' 141.--000-420.000 %14103 PLUMB010 PEE 101-000-419-0011 STRONG MOTION FEER • =911) 101.00-241-000 DRADINIG FEL? <: 10'1-000-423••001? DWELOP'ER IMPACTW �I,4tl1' •fSfl . . s*: STYB-`1~'OTA9'.• COMI 1✓1'C 110R� AND PILM Cl I. 0C T ` .P F9=3 4250.00 :> .•$ �pN Q 8 2001 .: RECEIPTDAT'' �(1 �qBY rr�� t/ DATE NALED 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 Roof Deck 3�cj Combustion Air Exhaust Fans 0. K. to Wrap F.A.U. Framing _ _ Compressor Insulation � � � -� Vents. Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wali Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall Int. Lath - Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Hacks Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final 1-3-Z4- a I S Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines =/�� p 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 6) Appliances Final COMMENTS: 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) P.O. Box 1504- /j/y�' 78-495 CALLS TAMPICO (760.) 777-7000 Sh'ping8righterThan Eve, 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, 47-840, 47-8E5,-47-870-1-,-_ 47-895, 47-900, 47-925, 47-930 and 47-960 Via Trieste will now be addressed at the` same street number on Via'Livorno 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 - 1 -7#9/ 7 SCALE IN 1/10 OF AN INCH 1 1-800-345-7334 ' 2 3 4 5 s. y TN/S YAP /S FOR - T.R.A. o20 -o24 643- /4 - ASSESSNEN7MRPOS£S ONLY. - •. POR SE -114 SEC 30,, T. 5S., R. %'E. , r 617-e0 �• /PRNATE �,� —J�� I 1 i STREET/ �pE 5i 1. • ' q + �� -- - �. 7783 LOT /1 / 4f8� //2 3 G 74 I m /vs A tr7i c9 « cx% ar.0 3B.0 49 e. ee 7/. sl 7=or Blo Oe 759. c /7 o i. / /OO' 77 52-95 - 84' 01 so /n w t ® w © pN 92 BS B3 oQ / 76 /6 1 /B�o 72 U n ( 6'¢9 ® ® o ®a © p /6 ° I I 03 :. O N { • 95 e - BB 82 la 77 - a 7/ O .. —9.jrMI01 d, RW O 7` aQ 41 OD "I•e /09.98 / �1 \tQr no-,, r 0 /O9.➢S /OS.SB J 4 O-96 �Op rBl- 2 4r. 78 n 0 I'r. n (4 ..O.ti .aa. 50 /21 !10>0:- 1 ^9.{% /9 /B.To / 78. /. Z 69 97 ,e >b Q /es7 B9 o BB !e ti .. BO m : 47-5i5 . , `. / � �«-• _ — /04.0 t96 7 yB.O 9B.a �aL• fP '9zos 7709 v5 68 e, • _ N99" 91'06'E + G v +—e= _ —7 72.0 .o sDSOa, 2111 Of, 57 , SB 59. @. 60 6/ 62 6 64 65 44' 67 Q /O // m 78- 7 �720 72.119 /3$A)' x3.949? =O r.�egT -—L LO L+B ' /90a. A�B9'3/'Ob"E 29 - -_ AVENUES- - - - r 3/ 32 0/7e, er.i. r/4ie9.e, (!64 'I7 ASSESSORS MAP'BK643 PG /4 , ( MB.227/77-78 Troo1 NO. 26/52 R/VER SIDE COUNTY; CALIF RG x SEP. 92 7 V Y�P�rY1 a n - S �i Qtr t es +e --:OI , Certificate of Occupancy City of La Quinta (� Building and Safety 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: 47-870 VIA LIVORNO Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0012-107 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: 03-26-02' Building Official POST IN A CONSPICUOUS PLACE