0206-195 (RPL)LICENSED CONTRACTOR DECLARATION
U) 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
WProfessionals Code, and my License is in full force and effect.
O =) M License # Lic. Class Exp. Date
'w 778780 B 1/2(
Z , �' Date - >' ?Signature of Contractor
� O P < I -'1
r` I.— o OWN ER -113 UILDER'DECLARATION
CID
H (-)
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
N License Law for the following reason:
Z_ ( ) I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and thd:gtructure is not intended or offered for
sale (Sec. 7044, Business & Prof essionals,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
N Date Signature of Owner
ON
rn
a Z WORKER'S COMPENSATION DECLARATION
0 Q Z . I hereby affirm under penalty of perjury one of the following declarations:
F -m O () 1 have and will maintain a certificate of consent .to self -insure for workers'
>< W �: compensation, as provided for by Section 3700 of the Labor Code, for the
J Q pertormance of the work for which this permit is issued.
Yl Q U 4(' I have and will maintain workers' compensation insurance, as required by
j U Q Section 3700 of the Labor Code, for the performance of the work for which this
i LO 1 --
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier 1X13t�PT Policy No.
w�
�a
Q (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
3subject to the workers' compensation provisions of Section/3700 of the Labor
Code„ll forth
w” comply with those pco`visions.
Date: ;� fPPlicant if„�!•,
Warning FailIire 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 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 -purposes: 4
Signature (Owrie•emt), o'' . Date
BUILDING PERMIT
PERMIT#
DATELOT
p VALUATION ��Gam' (.1,+1�+i4�.�kt1
TRACT
ADDRESS �i� : tii3 OUIRN JOB SITE
1°0
APN
'
OWNER
CONTRACTOR/DESIGNER/EN (NEER
(YOVE 13Tz"tT;E11OP.B ENT
JLE GAC Y HO1ViE49
2214 R.T/.3UBWIC)OD
4 7.750 AD',,T~I' i,7 9228
SANTAANA CA 92705
1:.A QUNTA CA 9223:3
(760)564-7820 CI LIO 02063,
USE OF PERMIT
P001, K4..D10R.,"'A
POOL ONLY, NO PiKATER, AL ARMSJ't3t RPUIERS SHALL BE IN PLACE
P:RIOR.'t 0 t RE.PWTKR T141POCTION
POOL, ANWOR.49PA 1"00100 1'3
F.FrIN.ATD COUT OF CO3Nfi;"'#c'.`(3^C'nUH :3fl�CiS1{�.t3t�
PLAID C"REC`.K FEE 101 -OW -439-318 SI&OS
CONa°!RUCT1034 FEE 1(l4 -(l 0.418-000 $1117. of
ELECTRICAL FUR -- PLCX 101.000-420.000 545,00
PLU'M81180 FEE .. POOL. 101 -00t7 -SD 19_000 �27.40
SUB -TOTAL C013'&.�I7CT10N .A1:3"D PLAW CWX $265.05
1:�WS FRE-PAIDPEAS $0100
RECEIPT r+}.' DATE / Q v '? BY� DAT��I�A E/nom INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade i
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation '
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
steel
POOLS - SPAS
Set Backs Backs
Electric Bond
!/y
Footings
Main Drain
Bond Beam
Approval to Cover
-
Equipment Location
Underground Electric
OZ.
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
LL
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
�2
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:
-- EXIST. 6' HIGH
i WOOD FENCE /—PROPERTY LINE.50.0'
H
2? m l BLOCK ALL
Lij
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POOL O
EQUIP. — PUMP
.CaJC, PAD
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8 Z
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w 40' 0., 5'-0"
= LL. 5'-U' -SET
too SET MALI
� BACK
W I BACK IViA L L U V
Vo
F.F.:1'-0" ABOVE THE CURB _
PAD: 0'-6"ABOVE CURB MEASURED @Y
� U
CENTER OF LOT @ AVENIDA'OBREGON X. -i
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(:gip;; �•!•
ul
Z _ Z .
I
iLENDESIGN GROUP
0 o (L
V) LL I P.O. BOR 460
LL
LA QUUVTA, CA 92261
rnonu "mi s���,+e rwun�m xua+
.1 A P.N.: 779-075,007.. ARCllfl'ECTURE, & CONSI•RUMQN
ADDRESS: 53=380'AVENIDA OBREGON -
LEGAL: LOT s T. BLOCK 1eT i
+ §.RMEU
TACATAATVALE1OJ-TA / �)
'.... _
I Q�., ••
' ROLL -UP GARAGE -DOOR
AUTO p
\
HIGH BROWN
<' 5
ATN ISG V�
0 BL CK WALL
CONCRETE
DRIVEWAY20
z ' POOL'Y. o
w POOL m DECK.,,"
I q U .- ',', NEW 5'
HIGH i NEW 'HIGH BROWN
::.
;:• -' Nm '' BLOCK WALL BLOC WALL
I
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I. W c .1.: —
j NpDRAI , ` Z . *� o
.!;'� •`�; , ^0 a Fa- I \�� PLANTINGS TO SCREEN
.• ; •. .';'. .:•..+: `..: y� PROPANE TANK
/ ,•. •SKIM ER�, r e.
I _.�•,--��--PROPERTY LINE 50.9 ,y ••� '-�.. ._ — ---
�\
\NEW 5 HIGH
BLO i
r1ANS PRFPARED BY:
LENDEL VENTURES, INC.
dba`
LENCH DESIGN GROUP
/ r A.P. LENCH 11
PRESIDENT
CURB � '
-AVEN.IDA OBREGON Ie
SHEET # 1
m a'
. I
SECTION
SCALE: NONE
,
3,'A"
04
BENCH DETAIL
SCALE: NONE
LE!oICH DESIGN GROUP
P.O. BOR 450
LA QVINTA, CA 92351
RIONC,1611ldltfb IAi„TV.O.-..ml
ARCIIITEC7'URE & CON51'RUMON
A. P. N.: 774-075-007
ADDRESS: 53-380 AVENIDA OBREGON
LEGAL:LOTANe 7 BLOCK 187.
STA CABMELITA AT VALE LA W07TA
PLANS PREPARED BY:
NI)EL VENPURES, INC.
dba
E CH DESIGNG UP
P. LE H H
PRF (DENT
SHEET # 2
FINISH SALT
WATERLINE
o
M
G
6._0..
LONGITUDINAL SECTION_
SCALE: NONE
SECTION
SCALE: NONE
,
3,'A"
04
BENCH DETAIL
SCALE: NONE
LE!oICH DESIGN GROUP
P.O. BOR 450
LA QVINTA, CA 92351
RIONC,1611ldltfb IAi„TV.O.-..ml
ARCIIITEC7'URE & CON51'RUMON
A. P. N.: 774-075-007
ADDRESS: 53-380 AVENIDA OBREGON
LEGAL:LOTANe 7 BLOCK 187.
STA CABMELITA AT VALE LA W07TA
PLANS PREPARED BY:
NI)EL VENPURES, INC.
dba
E CH DESIGNG UP
P. LE H H
PRF (DENT
SHEET # 2