RPL (9808-181)78760 Lowe Dr
9808-181
LICENSED CONTRACTOR DECLARATION
I hereby a i ^ der 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
3t3 X52 C53 % I.7J31i98
Da t Signature of Contractor
OWNER-BUILDIFR DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Con actors
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
Sedtiov 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.
ISTPV. -117MIID 0517316-98
(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 pr2pvis
'ons of Section 3700 of the Labor
Code, I shall forthwith comply w'Ith t bseio' !/
,,,Date: h / tL CApplicant"X111VW I&
Warning: Failure to secureworkers' Compensation coverage i('jn'l(,
awful and
shall subject an employer to criminal penalties and civil fines up t0,000, 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 personat
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 II City, and State laws relating to the building
construction, and hereby authorize represent atiyes of this City to enter upon
the above-mentioned property foi in pec lox p I poses.
Sig ature (Owner/An e9 a " 1 Date
U
BUILDING PERMIT PERMITN CONTROLk
141408-181
DATE VALUATION . LOT TRACT 6
+ V
JOB SITE
ADDRESS Iii -764) LONVE DRIVE E
APN
OWNER
CONTRACTOR/DESIGNER/ENGINEER
ALICE G AL,1`Di"ME.
St INAIR POOLS
78-760 L{7WE' .DR.
P.O' BOX 835
LA QUiNTA CA 922,53
PALM DESERT CA. 91261
(019)568 4014 Cuff 529
USE OF PERMIT i
?1CX ,, AMCN(A SPA
PF:?CiLi`i`PA, At.AE MSMARZERS SHALL AB INT As Pk&PLASTEk
WSPECa10 N.
P00, A PMOR SPA 1000100 LS
ESTIMA:F ED COST OF COINS R C-11 IN
PERNIrf PCE. ;s 3.ti MARY
P1,.At`N 4:Eit1lX F 101-00-439-318 $87.75
CCi1V:"..'t'ft.[frmoNr,Frss IQ!_000-41000 $135.09
Xt tr`F1A'N Cr11, P , — POOL 10 1 *000-4.2 1 -000 s7i, 00
ELEICI 1tiCAL FILE -- Pool. IC11-000-420-000 $45.0)
1'GtiMBIt' .1 FRE, -1-1001; 101-000-=119-000 $27,
z
ag
SUB -TOTAL CR)NS`,V_RUCTf0N.AND PLAN CREKIK
LESS PH-11MO FEES
Si?.CC►
A T
d
_ _
TOT :AL V0,RJJV1VF 14+3+iF-S DVE NOW
'.318.75
DEC 14 1998
.7""'0,9 `"1 ;-•. r,F." ; ,
RECEIPTd '4°
'DATE'
BY
DATE FINALED
INSPECTOR
Sf
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
BLOCKWALL APPROVALS
steel
POOLS - SPAS
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
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
i
Final
Utility Notice (Perm)
COMMENTS: