0107-136 (RPL)LICENSED CONTRACTOR DECLARATION
I herebyaffirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Divisian 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
6....128 C6;3luc f, 1 F/31/moi
";491 .:
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).
( ) 1, 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:
Carrier Policy No.
wy A -'TR e✓���W000610
(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 t ds� provisions. 7
Date:' �� - ? • Applicant M
.FVr
Warning: Failure to secure Workers' Compensati n coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for .a permit subject to the conditions and restrictions set forth 'on his .
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of s:lch
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for/Iinspecton purposes
Signature (Owner/Agent) - Date 1�
BUILDING PERMIT PERMIT#
,(%
DATE .. VALUATION LOT etlj`,.-;�y TRACT D1v `'1�lO
d17d�¢5}, tAt: M11 42 283404
JOB SITE
APN
ADDRESS
OWNER
CONTRACTOR /DESIGNER / EN (NEER
C'lu:.WOWAA POM—, & 0M CWTa MAS;( C01
£Its -M iU,Ti'3 -M,A
74725 Ali
LA QWNTA A. CA 92233
X)MM DESERT 077 92260
355
USE
��O��F'y.PERMIT qjl] \ EPA
P001A'.1",AIR; UQ. F N51Fk��a� �$»3�9�sA�i�fa.R.11+ISt�3ft't..k.If��ta � MUST rig 4n
KAMAT .PP"k..0 l;R 00P.W,110M2 LF 3' q fARDEN WA;.*"1TY
STAN DAP.D
r
FOOL A1+di r"C1c' OPA 2,'%700,09 LS
3 FT. WA:IT L 13,00.1 �?
ESIMAIAWID COST or$;."•o.}?iuR'.d��JCr>rl`' N
mmn,
PLAIN 01 -IM 1?F—T; 111i t3O4-�6aAv�$�3 $1�°tt3
CONSTRUCTION FEE
firCKANICAL F99 -- FOOL 101-L)DO,-421.000 $24,00
cc.tt UL IMS — 21001,E 1001-0W420400
1- ILUN �idW0 FTZ .110011 101,1300 419x000 $37.00
S{r 1
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1JUSS P -RR -RAID, MZ
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i i. { J U L 16 2001 �1H 3t7i: r
V 7W
CITY Of LA WNTA
FINANCE DEN'
RECEIPT
DATE/ � '�
BY
DATE FINALED
INSPECTOR
- � t 3 c -i
rk
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
,BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs I i
Underground Ducts
Forms & Footings I
Ducts
Slab Grade i i
Return Air
Steel ] I
Combustion Air
Roof Deck ];
Exhaust Fans
O.K. to Wrap ;
F.A.U.
Framing I i
Compressor
Insulation ] t
Vents
Fireplace P.L. J J
Grills
Fireplace T.O. I?
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall'
Exterior Lath I ;
Drywall - Int. Lath I -
I 1
Final
Final ;
BLOCKWALL APPROVALS
Set Backs ] f
POOLS = SPAS
steel /J _
Electric Bond
Footings ; i
Main Drain
Bond Beam I;
Approval to Cover
I+
Equipment Location
Final I
PLUMBING APPROVALS
Underground Electric _
Underground Plbg. Test
Gas Piping
Gas Test
Electric Final
Waste Lines ;
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Paas !
0. K. for Finish Plaster
Sewer Lateral
Sewer Connection
,-1chcapsufation
Gas Piping
Gas Test r ;
Appliances I "
4
]
Final
COMMENTS: -•
I t
it
Final ► !
Utility Notice (Gas)
ErLECTRICAL APPROVALS
,
Temp. Power Pole
Underground Conduit
IPough Wiring ;;
mow Voltage Wiring
fixtures
- - Aain Service
Sub Panels
Exterior Receptacles
G.F.I. 1
Smoke Detectors!
Temp. Use of Power
1!
Final ];
Utility Notice (Perm)
FPOPr MOWP,CH PHONE NO. 750 776 5112 .Tui. 13 200 03:39PM P1 �•
A. ------- ----- PGA WEST II RESIDENTIAL ASSOCIATION, NC-
P.
C_
Fn.SO. l2t?2, L-A Qr1YI4'TA, CA 92253
1�tZ .l.1
(7601)770-5100 FAX (76t)) 776-5111
PGAVFEW
Z la
Italy 13, 2001
Air. & Mrs. Marx Lucovsky
8 Windsor Drive, SE
Redmond, WA 98053-3423
R,�fereuce: 80-080 Riviera - Architectural and Landscape Request to add Barbecue, Patio Deck':,g
Extension, Pool and Spa and Additional Landscaping
Pear Mr. & Mrs. Lacovsky:
Iha Architcctaral Committee and the Landscape Committee have reviewed ,your plans for the addition of a
barbecue, patio decking exuasion, pool, spa and additional lardecaping. The Architectural Cornttuttw,
approved your plans as submitted.
Rcview by the Committee is only for general conformance with the architectural guidelines. It is the
responsibility of the owner to fully understand and conform to the archit.ctural guidelines eritera whether
or not all deficiencies are noted during rmicw- It is also the owner's Rill responsibility to field verify :11
axisting conditions. Tile Committee's decision �Aith regard to project design will be final. Please refe!• to
the Architectural Rules for all required submittals.
he landscape committee h;m the following comments:
• Any trees that are transplanted, should they die, will be replaced at homeowner's expense w t'.,
trees that are on the plant palette.
• Fort rite lily (moraea) is not on the plant palette: all moraeas were removed from the RES I:
grounds a few years ago.
• Purple grass is nat on the plant palette.
• Butterfly iris is not on the plant palette.
• For those items not on the plant palette, please replace with sorn'ething that is.
• It is required by tate Association that you obtain a 90 day warranty or, shrubs and a one-year
warranty- on trees.
Please contact Raphael Villareal, supervisor for Valley Gardening Ser%ice at 760/399.1344 and ::arol
Faller, the Assoeiatiori -Manager, prior to any irrigation modifications associated with this change. Damage
tc the landscaping, i.e., shrubs, trees, flowers and turf is the responsibility of the contractor. The
landscaping must be brougbi back to its original condition when the project is completed.
Approvals given by tha A__hiteetural C'ommitxo arc good for only nix mombs from the datz' on the
approval letter. Ager that time a new application must be submitted.
anon completion of your project,.please cor:rplete and ratum The Notice of Completion of Architectuial
Chan;
Fibs : MONRRCH PHONE NO. 760 776 5112 JU 1. 13 2001 03: 40PM/ P2 1_
Mr. & 11drs, Mark Lt1covsky,
July 13, 2001
Page Two
If you have any additional questions or concerns, please do not hesitate to cont7ct Carol Fuller, Association
Msaager, at 760/776-5100, Ext 20.
:ancerely,
PGA WEST II RES1DENVIAL ASSOCIATION
For the Architectural Committee
Fc: the Landscape Committee
Carol Fuller
Association Manager
M Board of Directors
Unit File
,
La Qr
�� u�ftrGv
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OF T
November.5, 2001
California Pools & Spas
74-725 Joni Drive, #A
Palm Desert, CA., 92260
RE: Pool Permits finaled 11/2/01 without Pre-plaster/Alarm-Barrier inspection.
Permit #
Address
0108-060
57-025 Mountain View
0108-062
57-045 Mountain View
0108-058
57-065 Mountain View
0108-303
81-135 Golf View Drive
0107-136
80-080 Riviera
0011-154
55-495 Royal Saint George
Dear California Pools;
The purpose of this letter is to inform you that the above noted permits were finaled on the 2nd
of November 2001 by JAS Contract Building Inspector Gary Hartman as scheduled by your
company. Office records do not reflect the required Pre-Plaster/Alarm-Barrier inspection
observation prior to plastering and filling the pool and/or spas with water. This letter is a follow-
up to the courtesy call placed this morning to your company. Please fax copies of the field job
cards for the noted permits above to the Building Department to verify field records against those
in-house, for required inspection signature verification. Should any record submitted confirm the
omission of the Pre-Plaster/Alarm-Barrier inspection, that permit final shall be revoked until
such field verification can be completed.
Please contact Daniel P. Crawford Jr., Building Inspector II, at (760) 777-7027 to obtain any
information you need regarding required inspections. Please contact us at your earliest
convenience within 10 working days to resolve this issue, Thank you.
Building
cc: file