9911-125 (RPL)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
'P,rofe„signals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
%514127- A OW31120t
.10
.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 Siqnature 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:
Carrier ATIs” IZTND Policy No. 1.46.09-W931
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 sh II forthwith comply with those provisions. i.
Date: �'_ ",nor r Applicant
f � .
Warning: Failure 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 foci spection purposes.
Signature (Owner/AgbnE) — �' � ✓- Date ! / `%'•-'
BUILDING PERMIT PERMIT#
f y4l 1-12,'�
DATE � � j�j � f;C VALUATION 1-554.1 M.00 LOT TRACT
JOB SITE 54 - MO MVI},i RA
APN
ADDRESS
OWNER
CONTRACTOR /DESIGNER / ENGINEER
ALLISON CTUDWELL
STEVE f-lt DSON C:ONMUMON
34-340 RIVIERA
73011 c.:oLNNIXY CLUB DR.. SLIM F4
LA QUIN'TA CA 92253
PALM DESERT CA 92260
('160)34c).4032 CB1.4 IOU
USE OF PERMIT
PCx3I, AfgDi R SM
rIk,juL O'NL t , e%1.r1.{2 it AIAitktl AS S{LALL BE IN 1'f, ACki AT Vtt[:.k't,P►:sT.Ul t
Pi 0L r" ND i -DR ;PA 54, irm.01 4.,^,
1'''ERM iT FEE, 3i3d4iMARV
PLAN CHEc:"►;. FEE 101 •t?4Kf439-3113 5 �t4.tfS
NfM71IA13C•AL FI,I" --1,001, I01-000-411-00tD $23.w
.E1,[:G"TR;CAI. FF!L- -- #4_AjL 101 -t'100 -4204W S45.00
PLUMB(NO FhE -- 14001 101 -ft( -4119-(M 5277 (k
StTE3-'I1)Trii. 0N1,1;F1?T I+1-17014 hhai) P[.AN ('li CK
1Jtt"7{ts
t,ESS P1tF; I'Ati} FI:1'S
fU.!X?
TOTAL PERMIT MIt�,.�i DUE, NUW
5 17,05
RECEIPT
DATE
BY _T7`
FINALED
INSPECTOR
I
I
• INSPECTION RECORD
I r• -
OPERATION I DATE I INSPECTOR
BUILDING APPROVALS
Set Backs
Farms & Footings
Slab Grade
Steel
Roof Deck
O.K. to Wrap
Framing
Insulation
Fireplace P.L.
Fireplace T.O.
Party Wall Insulation
Party Wall Firewall
Exterior Lath
Drvwall - Int. Lath
OPERATION DATE INSPECTOR
MECHANICAL APPROVALS
Underground Ducts
Ducts
Return Air
Combustion Air
Exhaust Fans
F.A.U.
Compressor
Vents
Grills
Fans & Controls
Condensate Lines
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underaround Conduit
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
Final
COMMENTS:
Final
Final
BLOCKWALL APPROVALS
Set Hacks
steel
Electric Bond
POOLS - SPAS
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
fi
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
OX* for Finish Plaster
Sewer Lateral
Pool Cover
/1
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underaround Conduit
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
Final
COMMENTS:
REVISION
ALERT
\
( PUMPS FOR WATERFALL IN POOL
CHEM, FEEDER WATER BRITS
1
1/2 HP CIRCULATION IN POOL
(1)1) 11/2
(CHANGE TO RS 16)
DECK BY SDC SQ.
(1) 2HP FOR SPA,JET$
(1) 1HP FOR WATER FEATURE CIRCULATION
DECK TYPE ACID NTRL GREY
PLANTER WALL
STEP FT.
(1) 2HP FOR WATE MATURE
GOLF
1
1
COURSE
.5 {
1
�
RI LEVEL SEATS 22" 24" 27"
-� -• .y
/� •b w.�t�• wtaCwnl°d "WYd,Wi��I�'1jt�';�?
\.AT H BASIN
i
mmmmmmmmmmmoill
ur
P/A I \
JANDY RS 16 \ 28'-6 "
18" HIGH STUCCO BLOCK
PLANTER WALL 14'-3"TO MATCH HOUSE
BY SDC
ANY ETRICAL VAIUNG `
EXPOSED DURING CONSTRUCMN
MUST BE REPORTED TO THE H.O.A.
CI -
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCT
p� ,
DATE `C q BY EIS I '1 \S
CE
ASHED LINE REPRESENTS
Q DECK TO BE REMOVED
20'-6 "
43'-0'y
Irot
--JPA 1
1
xis
CONTRACTOR cannot assume responsibilil� fQ1
..u:ae-.urbs.side.—iiu i
slabs. sewers, lawns.trees, fences.
walls. sprinklers, telephone lines or shrubs.
When access is made through a neighbor's
property it is understood that, owner,
responsibilityL
.•
NOTE:
BOULDERS BY
OWNER
UPPER BASIN
12'-6"
P/AN i
1
I
'El:
PUMPS NOTES:
(1) 1HP
(1) 1 1/2HP
(2) 2HP
(2) 3HP
ELECTRICAL NOTE . '
SURGE 98 AMPS
RUNNING 70 AMP
GENERAL SPECIFICATIONS
SIZE 176"X 35'
AREA 469 PERIMETER 96
)EPTH 3 X 4'6"
SILVER QUARTZITE WATERLINE
13
103
MOTOR HP HP
FILTER STA RffE 300 SQ FT
FILTER RATE 102 GPM
HEATER LAARS SIZE 400 BTU
TURNOVER 2 HRS
SUCTION LINES 2 "
RETURN LINES 2 to
rvluurn unnrl AT, AVDTP-A AT to
CHECK VALVE YES
GASLINE BY SDC FT. 70
TWO POOL LIGHT 400 CLOCK RS 16
IF:i ;:rTRtrAI W_ SDC CT 270
TOP OF WATER FEATURE @ +30"
"'— ` ".—A—
\
CHEM, FEEDER WATER BRITS
1
BLUE PEBBLE FINISH
DECK BY SDC SQ.
1
DECK TYPE ACID NTRL GREY
PLANTER WALL
STEP FT.
TO MATCH . HOUSE
SPA SPECS,
1
1
SIZE 7 RAISED +12"
LITE 10 WATTS
1
�
RI LEVEL SEATS 22" 24" 27"
1
1
DMMAtL- �� Tl�' �■ ■
1
1
P/L
1
1
SP!!! ""= Ewx. = = EWIDE
AIRPIPE
REVISED
PI! m
1
1
# JETS 8 UPER 1 LOWER
1
1
P/L
I�
`
Address: 54- 340 RIVIERA
QiWRACHIT�A
LOT#
O
P/A I \
JANDY RS 16 \ 28'-6 "
18" HIGH STUCCO BLOCK
PLANTER WALL 14'-3"TO MATCH HOUSE
BY SDC
ANY ETRICAL VAIUNG `
EXPOSED DURING CONSTRUCMN
MUST BE REPORTED TO THE H.O.A.
CI -
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCT
p� ,
DATE `C q BY EIS I '1 \S
CE
ASHED LINE REPRESENTS
Q DECK TO BE REMOVED
20'-6 "
43'-0'y
Irot
--JPA 1
1
xis
CONTRACTOR cannot assume responsibilil� fQ1
..u:ae-.urbs.side.—iiu i
slabs. sewers, lawns.trees, fences.
walls. sprinklers, telephone lines or shrubs.
When access is made through a neighbor's
property it is understood that, owner,
responsibilityL
.•
NOTE:
BOULDERS BY
OWNER
UPPER BASIN
12'-6"
P/AN i
1
I
'El:
PUMPS NOTES:
(1) 1HP
(1) 1 1/2HP
(2) 2HP
(2) 3HP
ELECTRICAL NOTE . '
SURGE 98 AMPS
RUNNING 70 AMP
GENERAL SPECIFICATIONS
SIZE 176"X 35'
AREA 469 PERIMETER 96
)EPTH 3 X 4'6"
SILVER QUARTZITE WATERLINE
13
103
MOTOR HP HP
FILTER STA RffE 300 SQ FT
FILTER RATE 102 GPM
HEATER LAARS SIZE 400 BTU
TURNOVER 2 HRS
SUCTION LINES 2 "
RETURN LINES 2 to
rvluurn unnrl AT, AVDTP-A AT to
CHECK VALVE YES
GASLINE BY SDC FT. 70
TWO POOL LIGHT 400 CLOCK RS 16
IF:i ;:rTRtrAI W_ SDC CT 270
TOP OF WATER FEATURE @ +30"
"'— ` ".—A—
CHEM, FEEDER WATER BRITS
BLUE PEBBLE FINISH
DECK BY SDC SQ.
18" HIGH STUCCO BLOCK
DECK TYPE ACID NTRL GREY
PLANTER WALL
STEP FT.
TO MATCH . HOUSE
SPA SPECS,
BY SDC
DESIGNER
SIZE 7 RAISED +12"
LITE 10 WATTS
JOHN/EV
RI LEVEL SEATS 22" 24" 27"
DATE
DMMAtL- �� Tl�' �■ ■
— :RY-6•
DAIAWA1 It.T" m m = m i
8-4-99
SP!!! ""= Ewx. = = EWIDE
AIRPIPE
REVISED
PI! m
# JETS 8 UPER 1 LOWER
SPA SIDE SWITCH
10-15-99
P/L
NaMe: ALISON/ GLIDEWELL
`
Address: 54- 340 RIVIERA
QiWRACHIT�A
LOT#
r,;,y^,�,,.
PALM DESERT
73-011 COUNTRY
1/8"-1' SCALE CLUB DR. STE F-4
PALM DESERT CA.
IDSCAPE AND FURNITURE 92260
SHOWN FOR ILLUSTRATION .(760) 346-4032
Y AND ARE NOT-=INCL-UDED.. , ,,. * „
TEMECULA
28910 RANCHO
CALIFORNIA 8D.
STE 206 r
TEMECULA CA.
92590
(909)676 -.SWIM
rr
PGA WEST
RESIDENTIAL ASSOCIATION, INC.
November 4, 1999
James R: -Glidewell
4141 MacArthur Blvd.
Newport Beach, CA 92660
Dear Mr. Glidewell: t,
Your request for an architectural variance has been approved by Mr. Don Adolph, Architectural
Committee Chairman. Specifically, you have the approval to proceed,with the installation of a pool
at your 54-340 Riviera residence. Upon completion please submit the enclosed Notice of
Completion form to this office. Please be advised that the following must be satisfied or adhered'
to.
1. Please work with Bill Bobbitt, Landscape Manager and Dave Graham,
Maintenance Manager regarding irrigation/landscape and electrical changes.
2. Any landscape lighting additions must be approved by the Architectural
Committee.
3. You must secure approval from golf course maintenance personnel, if you intend
to use their property for access.
4. The rear walls of rock work (raised areas) must be natural stone or stuccoed to
match the side walls.
The signed PGA West Residential Association, Inc. Notice of Architectural Approval form must be
submitted to the City of La Quinta prior to their issuance of permits.
We reserve the right to make a final inspection of this change to make sure that it matches the
original request. An approval is based only on the aesthetics of your proposed plan and should not,,
be taken as any certification as to the construction worthiness or structural integrity of the proposed
change.
We appreciate your cooperation in submitting this request for approval. If I may be of further
assistance; please contact me at the HOA office, (760) 771-1234.
Sincer 1
Kelly cGalliard
Operations Manager
cc: . Architectural Committee
enclosure (2)
P.O. Box 1060; La Quinta, California 92253, Telephone 760-771-1234 FAX 760-771-5125