0311-058 (SFD),- Certificate of Occupancy
_� .
OF9w Building & Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the .time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 80-919 VIA PUERTA AZUL
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 0311-058
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
Owner of Building: PUERTA AZUL PARTNERS, LLC Address: 17700 SW UPPER BOONES FERRY
City, ST, ZIP: PORTLAND, OR 97224
By: GARY HARTMAN
Date: AUGUST 26, 2004
Building Official
POST IN A CONSPICUOUS PLACE
LICENSED CONTRACTOR DECLARATION
U) I hereby affirm under penalty of perjury that I am licensed under provisions of
H Chapter 9 (commencing with Section 7000) of Division 3, of.the•Business and
N W Professionals Code, and my License is in full force,and effect.
C) License # Lic. Class' A �� Eio D4tte-
ZDate .d Signature of Contractoy°/
�� ✓ co
OWNER -BUILDER DECLARATION
WWCL I hereby affirm under penalty of perjury that I am exempt from the Contractor's
N License Law for the following reason:
Z_ ( ) 1, 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).
C'')() I am exempt under Section B&P.C. for this reason
N Date Signature of Owner
ON
rn
d Q WORKER'S COMPENSATION DECLARATION
CD (r I hereby affirm under penalty of perjury one of the following declarations:
Lo FZ O () 1 have and will maintain a certificate of consent to self -insure for workers'
X w �: compensation, as provided for by Section 3700 of the Labor Code, for the
Oro � Q performance of the work for which this permit is issued.
Q C) (.��) I have and will maintain workers' compensation insurance, as required by
O V Q Section 3700 of the Labor Code, for the performance of the work for which this
11LOH permit is issued. My workers' compensation insurance carrier & policy no. are:
Z Carrier Policy No.
J (This section need not be completed if the permit valuation its for'
$100.00 or less).
O I certify that in the performance of the ork-for,Which this permit is issued,
I shall not employ any person in any man ewr so as to become subject to the,
workers' compensation laws of California-d� d agree that-if'I should become
3 subject to the workers' compensation-prov dons of, §Section 3700rof the Labor
Code, I shall/forthwith comply with those provlslons1'/`!
Date: �' ^ Applicant e''
WarnirS'g:/r&ure 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 unde r,rstJant-to'
any permit issued as a result of this applicaton agrees to, & �61, inde��
& hold harmless the City of La Quinta, its officers, agents a loyees.
2. Any permit issued as a result of this application'becomes Ind x(04
work is not commenced, within 180 days from date of iss�9 c of I§tu.�
permit, or cessation, Of work for 180 days will subject permit tbb ca cellation.
I certify that I have read this application, and state that the above�informaii„on;sDf
correct. I agree to comply.,with alPCyty^.and State laws relating the build'rrlgAt
construction, and hereby'authgrizepresentatives.of this City en erupon
�.�
the above-mentioned�propetty for.,ink pection purposes.
Siggature (0 rl�gent)
Date.•v'
BUILDING PERMIT PERMIT#
DATE VALUATION LOTmi-omTRACT
Hca 101 97 2fif`�tF.
JOB SITE7A4.?
PN
ADDRESS
r
�6R. � ATEA -1y'11 PP1'A A71Tir
OWNER
CONTRACTOR/DESIGNER/EN (NEER
17700 nVAMPTIv P-00NES T PMY
16 .SAX<Y0Y F.OJO, 3M 10
polp-T);.AND OR 12.7f
Y6CG,2�A C:A� r12Q,14
/ (�
(760)63-2315LO M4 4220
USE OF PERMIT
;sI►L) . LOT 71 PLAN JJU. L 144h sib: pt& option). ItP..li1WIT DOES
NOT INCLUDE SUM.< WALLS, POOL, SPA OR, DR1V''rWAY APPROACH.
I`RACT Cc', S €RUCTION J,386, or, SF
POPC'I RAI h i.0 764.00 SIS
0ARAa&CA"ORT 244,04 W?
.' D cluvr OF
AA,, YYett"t�3y'1'
y��yy ����p ,,..,,�^ yy� 1111,39
.�1yy ri�,,,.,2� MIR
C046TRitt`•TION FU 101.000418.000 0617.10
PI-A.W CHECK MT, 101 -Ot14 -439-318 t497.9:t
MEC"•Ti.AXFi"Aa. $ ' 101-000-421-000 111261W
iw.LECYRIC.AL Mk, 103-0 0420^00 < top. Ia
NIUM01170FSSE fiI33.60 ,
ST.;'COW3 MOTIMT Imo'.? � i': ID 101-000-241-000 $$.33
OFANNO FEK 1 N -000423.000 61i1io
X11'lND I5dwi'1 l CI.3y:/4.2K
�V•7 t� A�.hMi
U133 FRElpi-M. 111TIO
$0100
4 2003 TMAL 14:ERWfr M.9 DUZ .KO
$3t,412.44
,A, QUINTA
..E CREPT. /
RECEIPT
DATE
BY J
DATE FINAiED
INSPECP
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wail Insulation
Condensate Lines
Party Wail Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
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
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
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)
COMMENTS: `