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0007-092 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9;1commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. yCicense # , 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 (Secr7044, 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 4 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 providedfor 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 r the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrierl°'fiEMaNT COMP ITIS Policy No. 9n0- 11 (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 subject to the workers' compensation provisions of Section •3700 c 0h.e-Labor Code; hsh'�-IJ,fo 4k it �o nply with tf�os provlslo,.,' Date: r1 V + Applicant -�-`� � �J l a, _ v 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 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 prop .y'for inspec fon purposes A 11 t _ Signature (Owner/Agent)ryDatel. VV BUILDING PERMIT PERMIT# DAT,VALUATION LOT ' I1W7-04" TRACT t S� $145,146,40 ;0 26152 JOB SITE ADDRESS 47-9W VIA W. X I -k u 0lZA1 APN s 643-340-01.4 OWNER CONTRACTOR/DESIGNER/EN (NEER CANADAY 8c COMPANY CfiadA. DAY & COMPAW 174€I0 F_- 17111 ST, #106 174801 17 ni ST. #106 TUSM CA 92780 1USIT AI CA 92780 (714)508.44.40 t:'i3rA 4483 USE OF PERMIT SiNCf.1,S: FAMILY DWJA..WNG 3170- PLAN 10 3 IDT 70 PEPM111' DOES 'NOT INCLUDE BLOCK 'FieUa1, LB OR P001. 75%,4 LAN CHECK FFF. REDUCTION FOR ISSUANCE OF SAME PLA14 TRACT CONSTAUCTION 2,422.00 SF PORC 111pATIO 373,00 5It` 0ARAAGMA P.PORT (SF) 1`604,40 . • i XSUM . COST OF CO.1'1SI UG DO!`I 14$,146.40 CONSTRUCTION FEEL 101-000.418-000 6000.50 PLAN CHECK I ZE0 1�31�Oti0-�dS9-318 $Ib5.98 FEE DEPOSIT 101.000-439-318-625t?.00 MECHANICAL. n?,F, 1q,1-000-421-000 $98,50 1 ELECTRICAL IMF 1 thl -000.420.000 PLUMSIND F99i v4J(?-41 �'-i1af3 STRONG MOT1014 FF - REBID 101 «000.241-000 614,51 GRAVINt:I IBE 101.000-423-000 .120.40 17WELOPER IMPACT .FEE $1,907.00 AUG 14 2000 SUB -'TOTAL C0XFX'Rt*T1Y FD�60 ", ,274.29 J ES3 1 RR -PAID FM' -$250.00 f ' OTAT. 'MUM x, EES Diff NOW RECEIPT DATE BY. t DAT ALE 0 INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE TINSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck - — Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath 2-4— . —Drywall Drywall- Int. Lath Final 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 -—ftp Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral aal3ra Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test _ �3��� 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) 1 CV _ P.O. Box 1504 78-495 CALLE TAMPICO (760) 7'77-7000 ShiningBrighter Than Ever 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. T -1e structures formerly addressed on 47-780, 47-805, 47-810, 47-835, 47-840, 47-86-5,'47-870,. 47-895,-147-900-,A7=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 of further assistance. Thank you. Sincerely, Diane Aaker Building& Safety Department SCALE IN 1/10 OF An 1-800-345-7334 1 2 3_ a 7rr-r-ril I Ill if 11 111, s e rias NaP /s soR T.R. A. 020-024 643-14 - ASSESSNENrH/RPOSES ONLY POR SEI14 SEC 3O, T. 5S., R.7•E. - 6/7-e0 - Al' STREET/E ' 7747 71 GOT //2 } F .74 y Y n /05 A 7s [�N 1' 49 x cap.9c •0 38.165,J' ° 106 IAS —� e/e o/. s, ae♦ I�Bfo n° 75 Q ¢ /7 - o i �� '00 • I D - /SG 94 7s b 1BJ/ H98 7.7n 77 51 '1.07' /9 � a O _ tm at 95 h ^L 1 � aI y ios3d - /a- JO • - I -- — — " 9a L © Ory 92 B5 B4 B5 VQ 76 /B O /Bro 72 ti �.x.oe fes 3: =j0 II�B5• n-l� 4f� _" i��O h . I 95 a 9/ - p • B6 B2 k /777 I , p �. , C t O Q '7 © p ® ti � 2R 6 ® O C ` �•J _� �: n /may{ ,�� m i . � , oo!�=/oo.9B m L i vor no n695 412 •+�.P'• 1of.9S /oS.SB� `W 3 4 , . ti B/ 7B 0 p 70 per, O 96 a 90 O B7 2 N ^ _0 /]/ 7B /Oe.3b� O 3J / e. ss es/ l ' - O -69 97 .e f° Q /Bm B9 O BB /B F BO40 n s v 47.525 p 104.0 t'p - �� w y9.0 98.0 681.I . • _ NB9'9/'O6 •E G + WA -- 72.0 Q 72.0 .. •. •• .• .. 71.0 d 1. ' 57 58 59 60 6/ 62 6 64 �i 65 67 — 1 — — Iso sso 7i.if/2SA7 43.94 ' L071 BB M /904. 5d •51' 129 —AVENUE- - 64 @07 ASSESSOR'S MAP BK643 PG /4 N0 1_ U. B. 227/77-79 TroCI, NO. 26/52 ' R/ VERS/DE COUNTY, CALIF RG if SEP.' 92Li . Y C/ry t n S c:T Cert/flOfOccupahcy-..�- im..�- . ca to u City. ofta..Quinta Building and Safety Department F�oF ti 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: 47-900 VIA TRIESTE Use.Classification: ' SINGLE FAMILY DWELLING Bldg.'Permit No.: 0007-092 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL Owner of Building: CANADAY & COMPANY Address: ' 17480 E. 17TH ST. #106•. City: TUSTIN, CA., 92780 By: RICHARD K. KIRKLAND , ,Date:. 9/11/01 ° Building Official POST IN A CONSPICUOUS PLACE