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0007-087 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of r49 (coynm'bncing 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,A 117( Y~ 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 (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. 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 f,REMONT COMM INS Policy No. SESO.1199010-14179 (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, I shall forthwith comply with those provsions. Date:�� : u ., x- Applicant - �a Warning: Failure to secure Workers' Compensation cove'rafe 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 f r inspection purposes. r f Signature (Owni 7 ..Date , BUILDING PERMIT PERMIT# f 0007-087 DAT VALUATION LOT TRACT $IS4,471.70 65 26152 JOB SITE - ADDRESS 78-.7, mw APN 6b440 -W9 OWNER CONTRACTOR / DESIGNER / EN (NEER C"ADAY & COIDARY CANADAY & COWANY 17180 E, 17T -IJ- VT. #106 17480 E, 17111 91'. #106 'CCTa"f1 CA 92786 'i US111W CA 92780 (714)508-44441 C -BU 4485 USE OF PERMIT SWGIX FAIW X' 1::1VTF.. -LDIG Std- PLAN 20A R. LOT65 PERMIT GOES NOT I1pCLUDE BLOCK WALLS OR POOL. TRACT CONSTRUCTION 2,595.04 3F PORCHIPATIO 392.00 SF OARAQElCARPOI'N (SP) 0:349.60 ESTWATED COW O1+ C(.NS11Rt7'GM0N 154,471.70 CONSTRUCTION FEE 101-000.418.000 $832,00 PLA14 CHECK FEE 101.000.439.318 $690.16 RE DEPOSIT 101-000-439-318 425O.00 MECHANICAL FEE 101-000-421-000 $105.00 ELFXTWC.A.:L FEC 101-000420-000 $147.83. PLUMBINQ FEE 401-000-419-000 $129.25 STRONG M: TION FEE" - i4k,9tt) , 101 -l.104 -MI -000 ORADNO PIEJ� 101-004-4 3r 00 $20.00 DEVEWPER IMPACT FEE , $i,9it7;00 AUG 14 2000 SUB-7?07'AL C.OlsWl RUCTd09 MD PLM CMCK. $3,8543.? 1 U-33 PRE -PAM, tom" : 3 -$250,00 t i 'TOTAL 1`100W MS YXIF IYOW rte••-�,� RECEIPT DATE BY .. DAT LED INSPECTOR 'INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR �. BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Fbrms & Footings Ducts slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap _ UU �,� F.A.U. Framing — __0 Compressor Insulation _ , �J� 6' Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath 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 Heater Final —�� Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral �'J' Pool Cover Sewer Connection ( Encapsulation Gas Piping Gas Test30 Appliance 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) t Sep 11 01 01:01p Canaday Const LLQ O � O t 760 564 8981 CIJ s CITY OF LA QUINTA CF"OF'TN�• BUILDING & SAFETY DEPARTMENT 777-7012 INSPECTION REQUEST LINE 777-7153 Owner CANADAY & COMPANY Contractor CANADAY & COMPANY Permit Number 0007-087 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 78-975 VIA TRIESTE SFD- PLAN 20AR LOT 65 - PERMIT DOES NOT INCLUDE BLOCK WALLS OR POOL. ZSySTEM F INDATE INSP. & SETBACK EL D SYSTEMMBING �,OPOUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB JOISTS &GIRDERS ELECTRICAL GROUND WORK DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS & GAS TEST HEATING & VENT • A/C ROOF - BOND BEAM �._� . ,; a 7 O.K. TO WRAP POOL PRE PLASTER GROUT ❑ 4' ❑ g' POOL FENCE & GATE FRAMING _ INSULATION PRE -ROOF COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED DRYWALL INTERIOR EXTERIOR LATH __ 2.� POOL PRE PLASTER POOL FENCE & GATE SEWER SEPTIC TANK/ wZ/-C b 1lrr FINALS ELECTRICAL PLUMBING FINAL GAS TEST HEATING - A/C JOB COMPLETED TEMP POWER ; .t lm olF.Po j��% ?0 0r ABOVE APPROVALS DO NOT INCLUDE RIGH TO TURN ON UTILITIES OR OCCUPY BUILDING p.2 _.� Certificate.Occupancyfo �. City of La, Quinta Building and Safety Department ��,oF11ti r 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: 78-975 VIA TRIESTE Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0007-087 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: 8/20/01 Building Official POST IN A CONSPICUOUS PLACE + �1=