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0007-091 (SFD)LICENSED CONTRACTOR DECLARATION hhereby 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 F'rclessionals Code, and my License is in full force and effect. ...... icense # Lic. Class Exp. Date S91:i6} /2-( Date'' C Signature of Contractor OWNER -BUILDER DECLARATION f 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). i () I am exempt under Section B&P.C. for this reason' Date ,.'Signature of Owner WORKER'S COMPENSATION DECLARATION 7 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. f(i)" 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 FRONT COMP INS Policy No. Sg ,.I1940U-1d9 (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 f3 0 f the Labor Code, I shall forthwith comply with those provision's. ----� Date- W Applicant Warning: Failure -to secure Workers' Compensation cover ge 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 property for inspect• n purp so es. r � f L� Signature (Owner/Agent) BUILDING PERMIT PERMIT# %//// � OW7'1 % DATE Z_ J VALUATION LOT TRACT f *16'0.751,70 69 26152 JOB SITE ADDRESS 4%r9.� Y n .HRMMXI . 4/ va eI/ o APN 64'3-140"013 OWNER CONTRACTOR/DESIGNER/EN (NEER CA1 ADA'Y & COMPANY' CANAD Y & COMPANY 17413016. 3 % B'T'. 0.106 .17480 S. 17U1 ST, 6106 TUSTM CA 92780 `CL .Tm CP. 92780 14)508.4440 CMA 4485 USE OF PERMIT SINCFU FAvI:II,,Y ll LUNG SFD- PLAN 30A R LLT 69 PERMFf ,00 S NOT MCLUDY, BLOCK WALLS OR POOL TRACT 0014STRUCWH '. 034,00 SP PORC1YP. A,TJO, x'13.00 Sly' OAkAGFJCAi-tPO,RT (SF) 12,348.00 FI�rrD&1'1'1 i COS':ir. Or C©MW.R[TC`-[TOi'V PEM3 f ITEE Si7A47MARY CONSTRUCTIO14FEE 101.000-415.000 $433,00 PLAN CHECK FEE 101-WO439-318 $144.04 FEE DEPOSIT 101-0300-439.318 4256100 .I11XHANICAL FEE 101-000421-000 $105.00 ELECTRICAL FEE • 101.000-420.000 g S167.29 PLUMBING TSE 101-Q0U 419-0flt1 ti's $142:50 STRONG MOTI014 F.99 �!R&fflD 101-000-241-000 t3ItAllIYdCF PEE 109 -00{b $30.00 DEVELOPER IMPACT' FEE ~tea AUG 14 2DOO a`]k/LA 0 0 1 K .J SUB -TOTAL CC3NS'L'R13MON' "D P C"1�FaOC $3,526.91 DESS PRE-PAED J. 0 4250,00 4' RECEIPT DATE B DATE FINALED INSPECTOR r'� INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION I DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings 7 _ / o {� Underground Ducts Ducts Slab Grade Steel /p-_� Return Air ' Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing —ZS d/6 Compressor Insulation (p p Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath o `� Drywall - Int. Lath Final�� z�v� �l9' BLOCKWALL APPROVALS 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 COMMENTS: Final Utility Notice (Gas)/�� (O ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Vottage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors 0 Temp. Use of Power Final Utility Notice (Perm) U�tfCv P.O. Box 1504 78-495 CALLE TAMPIC (760) 777-7000 Shining Brighter Than Eve, LA QUINTA, CALIFORNIA 92253 'FAX (7.60) 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. Tile structures- formerly addressed oh 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 addressed at.the . same street number onVia.tivorn:o.,. Please note this change and contact me directly at (760) 777=7012 if.1 may be of further. assistance. Thank you. Sincerely, Diane Aaker Building & Safety Department 3 1-8©0-345-7334 I 2 1 IT 3 4 5 6 SCALE IM 7110 OF All INCH +meq rH/s //AP /s Foe T. R. A. 020-024 �7 43 — �7 • .4ssEsswENrAvRPos£s oHLr PDR SE 14 SEC. 30, T. 5S, R.7E. 6/7-e0 Tf l i 7/I! <or a m '1!•73 t9A X. 747203 I4SBI'A � DB.LI /Blos ►/„ 49 by I Bi.O 73 4 ¢ /7 o /9 _ / /00 al. 71 ea 77 62 ,e 11441 `x "'%° O `B' I — ' © n a 9B a CN 92 84 B5. �. ®. `i B5 Q '411 7618 /Bs° 72 xA,0 bs 060 / c- 3a ca irk _ 9 y / u e2 k 77 7�/,_, ( ' .. �p.P IO f.Df /OSSB O 'ei �Or. 99 3 Q. 70 O _ C 96 a t 90 C 67 Z y n� V 7B C �. -S es) i /z] no'°� • - I 97 Q 89 b BB u •-.l /a. so ti 2 69 d m v • + _ /OAO • tl� - �t 78.0 9B.0 taD• V 4. 9x05 4�•4t5 ° 72 09 `'l�• •/2 I ' .. 1- — • °1 A bi 37 � SB 59 60 6/ 62 6 64 v 65 L 67 ;$.66 I . �" �V 78. - •so 77.ff /20.42 43.94 Be �.7s/321.01 • -- /eel — _ - h - r.veto A�B9°3/'Ob"E 2-9 AVENUS - ASSESSORS MAP BK 643 PG /4 � NO � M. B. 227/77-78 Tract No. 26/52 • R/VEkS/DE COUNTr; CAL/F. +�' RG • i • . , rtJJl'Y10.: l n S. V l•Q-�( SEP. 92 Certifidate'dfOccu an'cpY a. . City,:pf La'_Quinto : r1 Building and Safety Department �o - 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 comp/lance with the various: ordinances`, of the City regulating building construction of use. For the. following: -_ s BUILDING ADDRESS: 47-930 VIA z 4&ST4 Use Classification: SINGLE FAMILY DWELLING - - Bldg. Permit No.: 0007-091 Occupancy Group: R-3 Type of Construction: VN Land Use Zone:. RL .'Owner of Building: CANADAY & COMPANY Address: 17480 E'. 17T" ST. #106 City: TUSTIN, CA., 92780 - r -By: -GARY HARTMAN + .Date: 10/24/01 Building Official s POSE 1N A CONSPICUOUS PLACE