0206-051 (FIREPIT, BBQ, ELEC)79706 Arnold Palmer
LICENSED CONTRACTOR DECLARATION t
UI ING PERMIT PERMIT#
C/) I hereby affirm under penalty of perjury that I am licensed under provisions of d0206•051
F- Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ,
DATE VALUATION LOT TRACT
cel W Professionals Code,and my License is in full force and effect.
/,.
1
License# Lic.Class Exp.Date 1-0,
O dJOB SITE LU r 656128 C:53 HIC: i 101314:t ADDRESS 79- 'ARNOLD PALWIR APN
Z Date Signature of Contractor 8 It- 'fr. ^ • i OWNER CONTRACTOR/DESIGNER/EN (NEER `
00 N r
— o
F- OWNER-BUILDER DECLARATION . C FX4 T TBYRNE C;ALWOIYNIAPt:01-41 f'e SPAS(I C P X&M C0.'W
LU U 9.706.ARNOLD PAY-1 347'25 JONI 1a,} ,S IMTE 0A
W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's
Q_ LA QU•.iN A CP. 92253 PALM DE :IcT CA. 9220 -
License Law for the following reason:
Z_ ( ) I, as.owner of the property, or my employees with wages as their sole CI60,340-9000. MI-lul 00-55
compensation,will do the work,and the structure is not intended or offered for
sale(Sec.7044, Business&Professionals Code). USE OF PERMIT
( ) I, as owner of the property, am exclusively contracting with licensed tCy111I :S"a )3
contractors to construct the project (Sec. 7044, Business & Professionals
Code). 1 IREPIT 64.96 AC1A.J1°fTiQ A-NS1 Z21•59.i 9.05CiA's 1!f LL:+..C•TRIC TO
LO () I am exempt under Section , B&P.C.for this reason BOTH,
N Date Signature of Owner
ON
O
d Q WORKER'S COMPENSATION DECLARATION
Q I hereby affirm under penalty of perjury one of the following declarations: VALUATION Sgt IS
Lo r f•- O ( ) I have and will maintain a certificate of consent to self-insure for workers'
X W = compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
m Q U ,( g)yl have and will maintain workers'compensation insurance,as required by
O U Q Section 3700 of the Labor Code, for the performance of the work for which this
li rn permit is issued. My workers' compensation insurance carrier & policy no. are:.
t Z Carrier S7°AIT C.`!OMP)MAT] Policy No. 0460006168.01 EMIKKIIJ)CONT OF COMiltUMON
J (This section need not be completed if the permit valuation is for$100.00 or less). rmLCTRICAT,FZV. 101.000.420-000
( ) I certify that in the performance of the work for which this permit is issued, P1,I.iME1140 FTOI : 101_000)41.0-000 $10.00
I shall not employ any person in any manner so as to become subject to the 111LAN CHECK F91 101.000.435-318
workers' compensation laws of California, and agree that if I should become: CONSTRUC'T}: N: 10 1-000-4 1 R-000 $ At.Ofi
subject to the workers'compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions., , '
Date: ,;-•hApplicant r A --
—Warning: Failure to secure Workers'Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to$100,000 'r
addition to the cost of compensation,damages as provided for in Section 3 17 rj
l
1 of the Labor Code,interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Saf ' !\ ` 7002
for a permit subject to the conditions and restrictions set forth on J L
application.
1.Each person upon whose behalf this application is made&each personMY OF LAQU N'fU Tf ,CO1i t tLT t ] A1 It`3 (.x.,
FlNANCEDEP PLAM 12%,65
whose request and for whose benefit work is performed under or pursuant x`35'PRE-PAW 111 b C6C
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 TVICAL PERAW FF. S 3)A7IT,NOW $1<22185
r. 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. ! ''id`
I certify that I have read this application and state that the above information is IIIIIIIIIIIIIIIIIIIIIIIII 19
correct. I agree to comply with all City, and State laws relating to the building IE
construction, and hereby authorize representatives of this City to enter upon
f the above-mentioned prope : fo Ipspecf o" br,, ses.
p RECEIPT DATE BY DAT D I PECT
Signature (Owner/Agent) d Dat4e • ' t.F C
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 iYL
Underground Plbg.Test
Final Gas Piping {�
PLUMBING APPROVALS Gas Test �J
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:
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
Willy Notice(Perm)
JIN-05-2002 08:27 BARB HOLZAPFEL ' $ �
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t
6 �
7
IIIIIIIIIIIIIIIIIIIIIIIII 20 ,.
IE
;a WEST
KSIKNTIAL ASSOCIATION, INC.
May 21, 2(W
John Byrne II(
79-706 Arnold Palmer
La Quints,CA 92253 _
t3ear Mr. Byrne: /
Yuur request for an architectural vanaw has boon awroved by Mr.Dara Sheila*Axt,AvuhitcChiml
Committee Member.You have the approval to pmet ed with the modification of your near patio with
the rMcd exception:"Hed needed around bouldcm and scat area to define lawn and prevent damage
by mowing equipment.".T have enclosed a photo for your conwrdcncu.
We reserve the right to make a final inspection of this change to make sm.that It matebas the
original request. An approval is based only on the aesthetics of your proposed change and should
not be token as any wnlitiwdon as to the consMmUoa worthiness or hinictwW integrity of the
proposed cham"e.
We appreciate yams uuuperation iu submitting this request for approval. Should you have any Rothe r
questions regarding this matter,please feel free to contact rite at the HOA olliox, (760)771-1234,
W. 15.
SinceM ,
Kell Mc, lard _.
Operations Manager
KIvl/sno
enclosure(t)
cc: Architectural Committee
P.O.Box 1060, La OuWzL Cald&nia 92253,Telephone 760.771-1234 FAX 780771-5125
TOTAL P.02
5PECIFICAT ONS
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SWACE AREA OF POOL v
rmMETER DEPTHS MIN, MAX.
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Ta M DCTCRI�Mt TM APMOxMATC ATtON A A Y
T u our ON DAY oe rzcwAnoH
etEv of FOOL OR x
. . • ..> ' '- -ate" .� , ., , a�,' � �
� : , �_ � . •.� .� +� "t�� r .a TAICC NO'TKC THAT POOL Atm[r�JIFN9+T LaoAnar�AN aae.tc TO AGGEFTANOE or
LOCAL mIAI.DIN6 DEFAftTMENT AT TIME OF 189I)ANCLr OF FERMST
MT PCM AT L&6T TWICE ALLY FOR 000.q M STALLED
DAYS AF1lIt
1 � �rt 1 rlltS+j i ' (4) CGNGIIITC SFhll q SCNEN
Ae1QE THAT OALM'O A S"GIOLS iS NOr FOR SipERbROUlti CONDITIONS Olt OSr1L°GM
f _ ...__ � .` . ��, �I J 1 AND MK DM'AAW TO GS�IC3.'910V IL"DIRJVEWAY3,LJWyL�i•OR orfat ITL"N THE 9 AREA'
f� SGL NQ f il�u r ' ?zN ; 0 SCE THAT ALL FCtVC ft*AIM MV&ARAde DOORS MEET LOCAL CODES FOR A POOL EN CSAR O
FILL POOL R'MMWTELY AFTER FLASTCR POLLOA I►Es7 OTIONS--DO NOT USE MOM NOW
S ( (1) TAM NOT"THAT THtS DRAM7Nb 15 THE SOLE FIMOReRTY OF CAE FOWA FOALS AND THAT ANY
• ' USC MrrOff MrtiTM M904 BION OF CALM' MA FOOLS,M.rs FROHICITCD tri'LAW.
J Y I oMtlR�►PFROAS M4lJL FOOL.MD UMPMENT LOCATIONS IVa HAS READ TFe RES MSILMES APV WnCoft ABOVE
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!SWIATNIm W DATE
ry 5WIt�J. W_ POOL PLAN FOR:
r NAME` Cr
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STREET '' T>
JOB ADDRESS - p6A Vj=
ICITY
PHONE OFFICE RES
LOT TRACT PAGE 905K
a MAP ,800K PAGE NO. ICITY
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i t+AAIL ADDRESS
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CONSTRUCTION OFFICE PHONE NO. a
SCALE DTE.` : DRAW8YSOLD BY - CHEC D BY
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ur LA
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BUILDING INTA
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APPROVED
�— ,
SELECTIONS
CONSTRUCTION A.UTHORIzAn N STONE ��� tb[iS�rf 7 Z./r
30
SALES FIELD TILE — ILL BE CHARGED IF THE APP VED
r ; r BOULDERS PLANS AND 10 ON
DIG _ - -4 ;k" ia.�r., ,�,�: r� CHE LED
°..~ THE
PRE-GUNITE BECK COLOR T: , INSPECTION.
JANDY
UNDERGROUND r' '• fra
a
MASONARY PEtB.; '1:A5l'
s
DECK
SIGN
ATUtE
f
PRE-PEBBLE :` '' t3RAtNAGE NOTE: Drainage and irrigation for planters and pots, by
' others unless otherwise noted.
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