0304-003 (POOL)54800 Avenida Alvarado
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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
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date t
634981 i3 11 r t?i Inc
,.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 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.
‘(f) 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 ' sTA.T'U D Policy No. 1542937-03
(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 thoseaprovisions. ;
Date. ..w ', Applicants-- ,i;= ► _ d
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. r "
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 ttiis City to enter upon
the above-mentioned property for jnspebtion purposes J
6ignature (Owner/Agent) " - _ ` Date'• I t`. '•
BUILD NG PERMIT PERMIT#
DATE VALUATIONdd, LOT 030443°3 TRACT
F A. _ ! . ` .;.4 1$000X*
/
JOB SITE
APN
ADDRESS 54AVENIDA ALVAR.ADO
- -
OWNER
CONTRACTOR/DESIGNER/ENGINEER
CORONE... E ERP1 T E 1
C::RONFL., CONISTR.UC17O.' T
PO BOX 389
78-150 CALLE TA? P CO OUI 13230
LA, .Q e TA CA 92253
LA, QITlllTrA. CA 92253 -
(760)564.4604 f.3L# 2261
USE OF PERMIT
POOL AtO.R. SPA
POOL/SPA. Ai: AR,P19.`.iM't,RRI RS SHALL BE IN PLACE AT PRE -PLASTER
iN 1PECT1O 1, EQUIPMENT ENCLOSURE NOT :INCLUDED
POOL AND/OR SPA 080. 00 LS
ESTIMATED COST OF eons-m(no. N
QiaSPVLfFm
PERMITPX RAY
PUN c1'11?!Eu1:. PEE 101-000439.31€3 S&L 33
CONSTRUCTION PEE 101-000-418-000 4'99:00
,
MECHANICAL PRE -- POOL 101.000.421.000 $24,00
ELECTRICAL PEE - POOL, 101.000-420-€:300 44.10.
PLUMBINQ FE -- '1 1G 101A/00-41 9,000 S27.06
'RJ;-'iOT.` pju :'p ":... LOW AND PLAN CHEC x.
$259.2
LES` ,`3 PRE -PAID FERs
$0.00
• APR 0 4 2001.3)Y. ' EI MMI FEES iY B I --10W
S2,5935
CITY OF LA QUINT
FINANCE EPTTAA ! 111111111IIIIIII11111111154
jjj IE
RECEIPT
DATE (p ,,
BY
DSV ED/6.7.)
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Retum Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents 1
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 j
Set Backs
Electric Bond I
V=a3
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
4/_z_5--- ay
Underground Plbg. Test
Final
Gas Piping 1
PLUMBING
APPROVALS
Gas Test j
Electric Final I
Waste Lines
Heater Final I
Water Piping
Plumbing Final j
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
-.—:-.2o-
Sewer Connection
Encapsulation I
5 Q.
�—
Gas Piping
Gas Test
Appliances
Final
9-/ OS
Z \
COMMENTS:
✓ i
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)
I
S.C.D0012 .
GARAGE.
HOUSE
DRIVEWAY
ALVARADO
POOL EQ.UtP.
51BLOCKWALL
54-800 ALVARADO
POOL 11' X 16' W/1 H.P.PUMP
SPA W/HEATF.,R
TAGS 2000 CORONEL
SCALE.:
:3/16
DATE:
CORONEL CONST.
P.O.BOX.389
I.A. QUINTA, CA.92253
564-4604
APPROVED BY:
DRAWN 6Y
REVISED
REVISED
DRAWING NUMBER