0007-093 (SFD)LICENSED CONTRACTOR DECLARATION..
!-1 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
591561 $ 03/,31J?�C�
Date Signature of Contractor �� V 4
WIF
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 pfoject (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:
( ), Lhave 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
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carver FREMONT C OMP INS Policy No. wRSO-! l99fl0 !4179
(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 of the Labor
Code,1 shall forthwith comply with those provisions. A
Date:°57�iApplicant '�1-ter
Warning: Failure,to secure Workers' Compensation cov r e' is unlawful and
shall subject an employer to criminal penalties and civil fine 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 inspection purposed ,
Signature (Owner/Agent) ' .r.�n Date' "%4( 0
BUILDING PERMIT PERMIT#
DATE`S VALUATION LOT `' ON7-o93 TRACT
X4,47.1..70 r i' 26152
JOB SITE n
ADDRESS �•7��•J+ ��VO/CND
APN
OWNER
CONTRACTOR/DESIGNER/EN INFER
0AAI'i4DAY C OMPA -MP
CANAAAY & COWAN Y'
17480 F. 17TH ST. 0106
17480 E 17MI 3T, 0106
TtJ`SAmCA 92780
111UMW G.A. M80
(714)508.4440 G'k3l.0 4483
'
USE OF PERMIT
WAC IX PA_•�illfY DWlt� e
Sis!?P P1.,AN 20.A R .LOT 79 PERMIT DOES NOT D CL.UDZ'BLOCK WALLS
E'A.t2 PCOI.r, 75` PLAN CHECK' FRGS REDUCTION FOR. ISSUANCE OF SAME 4
PL1:N CYPF,:'
TRACT 0ONSTRUCTION' x,593.00 SF
PdRCH/P.ATIO 391:40 SP
"RAO ARPORT (SF) 9,319.60
ESIM&TED COST OF CO.1Vlv'YRUC71103:d
!S4,471.70
PPI&OT M Si31 MARY
CONSTRICTION FEE 101-000--418.0100 $832.00
?L.W CHECK FEE 101;000-439-318 $172:54
DEPOSIT 101-000-439-318 4230100
MECHANICAL FEE 101-000421.000 $305.00
ELECTRICAL FU 101m,000-420-000 $344Y;8s.
PT,UMBI'NG1?1'.E 1'171-000-419-000
TRON47.MOTiON 0'U - RESIN 101-000-241.000 45
CIRA}T�1D1NyyQ��FE 101-000423-000LM �
gEy. } r� yep t p$110q.gRp4
- DC.tl M'.44�i'1.1`.31P7 }'fl}V� A'Lk r :, 4� 81,90 .VV
AUG 14 2000
.NJTY "✓F' LAL:1,L) T"
MM I01 AL GO�f:°Y1°.k2MI [ON AWD Pry' CMC,.
$3,328.09
1XS3 PREZ-PAIP.M. a r
4250.00
'1o.o/ar, Pnym FEFS ]3uy' Now
'►��i 7 3 �
RECEIPT
DATEBY
r';•
DATE FI ALED J
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings
�DC
Underground Ducts
Ducts
Slab Grade
=� �rj�
Return Air
Steel
Combustion Air
Roof Deck
2�-4/_ e -Z3
Exhaust Fans
OX to Wrap
z —
Q6
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
_
Drywall - Int. Lath
—fie
Final
Final56
BLOCKWALL A" PROVALS
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
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer Connection
/
(v
Pool Cover
Encapsulation
Gas Piping
Gas Test
Appliances
Final
C MMENTS:
,mss D��.� ��� z•�d
Final _C.)_
Utility Notice (Gas) //i97/_�
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors vl
Temp. Use of Power
Final
Utility Notice (Perm) 0-0� G'
tucfa
s
' P.O. Box 1504
78-495 CALLS .TAMPICO
(760) 777-70.00
shininBBrighterThanEver LAQUINTA; CALIFORNIA 92253
i
FAX (760) 777-7101.
March 26';' 2002
Postmaster
LA QUINTA POST OFFICE
51-321 Avenida Bermudas
La-Quinta, CA 92253-99.98
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, 47-865, 47-870,
47=895; 47-900, 47-925, 47-930 and 47-960 Via Trieste will now be acdressed 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
1-80[1-345-7334 2- 3 4 5 6 SCALE IN 1/10 of" Ixcx r `"
y
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T.R. A. 020-024
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R/VERS/DE COUNTr, CAI-IFRO Q SEP. 92
1rP�m 0. n S UU Vj a:Tr es +(Z--)�.. J!
,Certificate �fOccupancy.,T
.: to o .� - � •
citkof �a_u�nQ
Building and Safety Department Mo-
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`iergu/ating bui/ding cons(` truction or use. -For the following: .
BUILDING ADDRESS: 47-895 VIA TRIESTE
Us'e-Classification: SINGLE FAMILY DWELLING r t Bldg. Permit No.: 0007-093
Occupancy Group: R-3 Type of Construction: VN Land Use Zone:. RL
Owner of Building: "CANADAY &&'COMPANY "" •Address: 17480 E. 1.7T" ST: #106 _
4 City: TUSTIN, CA., 92780 .
�- By: GARY HARTMAN - .
Date:,', 10/24/0.1
7 • Building Official
POST INA CONSPICUOUS PLACE -
S.1