0001-060 (RPL)tLIZENS CONTRACTOR DECLARATION `
�I .am under penalty -of perjury that I am licensed under provisions of
-'Chap ebr 9 (commencing 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
056128, C53, �1toi1/2rJf
Date t f+ .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:
Carrier "Policy No.
f 9 .M.6.1:. 5},`W - V�'fV•';�fj.Gtt J
(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 Sect6!3700'of�the;Labor
Code, I shall forthwith comply with those provisions. ti ; '`"¢ ,
Date: f f i jib Applicant + k ti: i�Aj 4„ � A
Warning: Failure to secure WorWrs' 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:
Signature (Owner/Agent) - r �- 1( _ !t { Date t 1f 1
BUILDING PERMIT PERMIT#
DATE VALUATION �,9II.l�fQ LOT TRACT
JOB SITE
ADDRESS SO -153 EUVIERA
OWNER
CONTRACTOR / DESIGNER / ENGINEER
7 f* 11%1 6•U1TYJ1 ra
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lµ il.. at 1.J l�iv l4'f, t l+'.+..e1 l�.r epi .rl.�
80-153'MVIER—
74-725 JON! DIVE,!{A ,
_ L.AOC11iVrA f,:.c'! 52253
PALM DVSKIM' CA 92260
(760)340-90W Cflf.#I 355'
USE OF PERMIT
!'CiOL.AfVl.WOR SPA
11000. P7?,..M Ldp (ANSU221581995)uN"L I'- .I. a«A(sar s.`vu2t� iU:
MALL BE IN F1I.ACLE KI' € KE k?L&S'9'ER DY+fyt'2 4 i'€i ijtt
POOL ti141T11hZ)R`r_A 15,5i"0.00 ILa
E "A LsfUXa:.) COAST 01r
ti'iL;�Sta�i'.� �' i<� r:><�� �kJi�'i��.d.daT►r
:I LAN CHECK jrtW tiit-i)(Dv 43y 318 $1 I..l. is .
f'r'ihT�•TI 17C."}';f1?�! "Fi Ti. lii!-(tlifl-dj ' f1(i() $771.00
:t%It._7:f. VJxCA4,..f."ra--i'Ot�3. 1(T1-rrr-2$"RAO
%,rv; T ft t0i%L VL. -- L 454 01-M)_41,110-000 <i ,
PLUAVANO FEL? Ni".>QA, 101-W0-41.9-00 $2fi<Uf�
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St,ixi-',.f 1"A:I.,ON I��a.IC1 iC)l�i' A i�rt s 3�r,RI tw'11C`'
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RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
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
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
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
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
E7=d7 &4f- -791 .44F low, ��-
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.1.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
"1 FROM CALIFORNIA POOLS AND SPAS
ire• ��.
1'
rA W"EST.
December 17, 1999
Mr. & Mrs. Lynn Spuhler
1-18-20 Nakane #4, Meguro-Ku
Tokyo, Japan.
PHONE NO. : 7603465407 Jan. 10 2000 05:19PM P1
PGA WEST II RESIDENTIAL ASSOCIATION, INC.
RO. BOX 1282, LA QUINTA, CA 92253
(760) 776-5100 FAX (760) 776-5111
Reference: 80-153 Riviera, La Quinta, CA
Architectural Change Request — Instal( Pool/Spa, Patio Decking and BBQ
Dear Mr. & Mrs. Spuhler:
The Planned Unit Development Architectural Committee at its December 14,1999 meeting has
reviewed your plans to install a pool, spa, patio decking and BBQ and wishes to advise that your
pians have been approved as submitted with the following condition:
Association requires a 5' set back from the property line and -maximum wall
height of 20". If installation is to be made at the property line, homeowner will
need to get written approval from KSL Golf Operations (Bill Dodds) to do so. If
permission is granted by KSL, the adjusted wall height to be at the guideline
level and determined prior to the beginning of construction.
Please contact Miguel Valenzuela, supervisor for Valley Gardening Service at 760/399-1844 and
Carol Fuller, the Association Manager, prior to any irrigation modifications associated with this
change. Upon completion of changes, please contact Carol Fuller. Damage to the landscaping,
i.e., shrubs, trees, flowers and turf is the responsibility of the contractor. The landscaping must
be brought back to its original condition when the project is completed.
Review 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 architectural guidelines
criteria whether or not all deficiencies are noted during review. It is also the owner's full
responsibility to field verify all existing conditions. The Committee's decision with regard to
project design will be final. Please refer to the PUD Architectural Guidelines and Application for
Change for all required submittals.
Approvals given by the Architectural Committee are good for only six months from the date
on the approval letter. After that time a new application must be submitted.
If you have any additional questions or concerns, please do not hesitate to contact Carol Fuller,
Association Manager, at 760/776-5100, Ext 20. _
Sincerely,
PGA WEST II RESIDENTIAL ASSOCIATION.
For the PUD Architectural Committee '
Carol Fuller
Association Manager
cc: Board of Directors
Unit File