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0007-090 (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 # r Lic. Class. Exp. Date ' 5Q15G1 � '(� �/ G � % Date7,37 Signature of Contractor ✓9f f!1. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure isnot 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 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. K) 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: Carrier FRl? t 011'r COMP INS, Policy No. SE50-1199013.14779 (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' compensatio�,provisions �pf Sectio^3700 the Labor Code., shall forthwith comply with thole provi i s. Date: Applicant �"f� Warning: Failure to secure Workers' Compensation cover#ge is unlawful and shall subject an employer to criminal penalties and civil fihes 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 representativef, his City to enter upon the above-mentioned property -for inspection purposes. Signature (Owner/Agent) BUILDING PERMIT PERMIT# ,/y J 000 74KJO TRACT DATE !'R//G//4t•"2 VALUATION LOT $154 } rye, sq� ry (�,�/Y✓J'l V"�% �iA.aA7 �.8. dV 4l{7 -261.52 JOB SITEA^//nn ADDRESS 47-.960 VIA=� �D,v`v APN [ . 643-140-012 OWNER CONTRACTOR/DESIGNER/ENGINEER CMADAY fir.• .COMPANY CANADAY & COMPANY 11480 F. 171H W. #106 17480 1., 17711 �W, 0106 T 1 CA 927£30 TusnN CA 92790 ('714)108.4440 CLI.# 4465 USE OFF PERMIT `� 4�A� r y T�tY=1,U40 e71.ty V�.1'.C'i.►V1RL.+). D w ... `r SFb- PIAN 20B R LOT 68 PERMIT IMES NOT I]MCLUVE BLOCK WALLS OR POOL, 75% PLA)4 CHIE CK FRE REDUCT.IONdF.OR ISS UANCZ OF S.I.1,ME TRACT CONSTRUCTION I..'s oo SP PORCWPAI'10 :302.00 Sip GARAOMARPORT (SF) 0,349,60 / miNS[Am i osr of C`imm>i7t:"1! om 1544A.TO 'P E:PINI:i1: FEE ISLM94",V - COMI TRUCTION FEE 101-000-418-000 -000 €=00 PLAN CHECK RE. 101-000-439-318 �i'id.34 FEE DEPOSIT 101-000-439.318 4250,0 MECHANICAL FEE 101-000.421-000 4105.00 ELECTRICAL RE 101-000-420-000 PLUM NO FPS � � �t �� � 101-000-419-000 ST11.01140 MOTION FIVE- RESID7 .101-000-2 41-000 10,0 ORM)ING PELF ' 101-000-423-000 .$2b.00 nE.'i ELOPER. IMPACT FEE S'i.90%Q9 AUG 141000 sUB-. V AL CO3 1 L1CTSON AND PLAN Ck C1 X3,32$.09 TOTAL Y} tWTIWS DVE NOW RECEIPT - DATE BY D!T� INSPECTOR INSPECTION RECORD t OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings Underground Ducts Ducts Slab Grade ZQ - Return Air Steel Combustion Air Roof Deck _/gyp Exhaust Fans O.K. to Wrap 2 —/Y y2 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 7 /S Drywall - Int. Lath / Final /a Q BLOCKWAL AP. ROVALS 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 Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Sewer Connection Pool Cover Encapsulation Gas Piping Gas Test Appliances Final Final �� Utility Notice (Gas) �- L ELECTRICAL AP ROVALS 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 00, Utility Notice (Perm) COMMENTS: 7 P.O. Box,1504 78-49,5' CABLE TAMPICo (760) 777-7000 SW ingBrighterThanEver LA QUINTA, CALIFORNIA 92253 FAX ( 760) 777-71011 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, 47-86+5, 47-870, 47-895, 47-900, 47=925, 47-930 and -4:7.=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 A SCALE IN 7/10 OF AN INCH 1-800-345-7334 , 2 3 a 5 ' TN/SYAP /S FOR f .. , .. ` %R A. o20 - 024 643-14 POR SE %/4 SEC. 30, T. 5S., R 7E. ' ASSES6N£NT A7RPoS£S ONLY . 617-80 �---��- •� � � •* 4.• rte•• --- � � � + /PRNATE 1 �. � �p � 6, � I� i S�TREET/� VIS E 57• Y. w e. \ _ m � j. . .. . • .. • _ I ... i. ". • tor .4 w ros J -Maw [. A - Q �• b i rS87Z r/2.� G 74 �� 11 I ®. 43 O /07 /Oe�'75 ` I JI 1D f 72 7s Bo 2BJI 4?98 4i W 73 M 7.zn 71 /9 LI / ,'00 . w B/.7/ O •93 •� _ g6 .0 III I! li 4� i06 sr� 84 VQ 41 i"t Dio1:'�d ' w 94 w © p 92 $ ® ® ^ 85 B5 ® q es © t 76 iB �' 4so 72 C � "d ,e �C I I _ 64.9 03 O 91 * Qti��Vy ° ©. R ® V�Q, ® ^d.i/ �m I. �^ : n3 ♦Q x �. �M n��s W DO ' i� 1 qy h� -1{?0 Livorno - _ /� _ • R69! ^. O /o1.9B GII+� 3 70 •�io�• i O 96 a 90 O B7, ,� h ^, V' z , 0 n' /4 N p I ' f' e Ss es) /A2 Aro�O+. �. �..s 19179.97 • .. 4/ .e to Q © © /B ° ,°. 79 M 59 n f 1� w ,Ba -® g9'/I��dbT • �� _ _ P b iPi.O l'p1 too ? Y 98.0 LCL' 41-YZS 7P 09 v5 68 �jf !4 I • I �7 - - . 770 S 57 .. 58 .. 59 - 60 ^ 6/ '• 61 •• 72.0 64 Dy.51 . 65 67 9 78 7 •• 720 77.11 /26.47 4A94 I - - X900. 5d 4 ' L07f BB - -48 R- r AVENUl� - 3/ 32 64 - 0�7�. r.i.1/4ias•s, . ASSESSORS MAP 8K 643 PG /4� M.S.227177-78 Tract No. 26/52 - - RIVERSIDE COUNTY, CALIF RG CA XSEP.' es -+eJ 92 I "`� aTr Cert/flocp-�- ca.te Oancy -'.-Ci sof L'auin. Building and Safety Depa"rtment � 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 fiance with the various nc ordinaes t� Y. . of the City regulating bui/ding"construction or use. For the following: Lwo Rr10 BUILDING ADDRESS - 47 -960 VIA TR,IEST E J Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0007.-090_ . 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; ; x _ - By: GARY-HARTMAN • � .;. . � - —! °�� - _ J � : .Date.: 10/24%01 fi Building Official POST. IN A•CONSPICUOUS PLACE t a