COMB (9511-058)51770 Avenida Madero
9511-058
LICENSED -CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with
Section.7000) of Division 3 of the Business and Prcifesslonals Code, and my
License is in'full force and effect.
License #_ U63dgi 6 Exp. Date 1/ 1196
,.Date ei Signatureof Contractor
OWNER -BUILDER DiCLAR TION
I hereby affirm that I am exempt from the Contractor's License Law for the
following reason:
O 1, 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 000 of the Labo I r Code, for the performance of the work for which this
permit is issued.. My workers' compensation insurance carrier & policy no. are.:
Carrier . . Policy'No. -
(This SectI6h`1h69&QN66 completed if the permit valuaticMia , fV$11 00.00 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 those provisions.
Date: Applicant
Warning: Failure to secure Workers'Compensation coverage is unlawful and shall
subject an bmployer'.to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3106
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 pirson upon whose be , half this application is made & each.p"b rpon at
Whose request and for whose benefit work is performed under or puIrsuant to
any permit issued as a result of this application agrees to, &,shall, indemnify
hold, harmless the City of Indian Wells, its officers, agents and employees.
;;Any ppyrnit 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
7 errinit;-or,-cessalion of work for 180,days will subject permit to cancellation.
:1 66rii-fy that 11have read this application, and state that the above information is
correct. 1: agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representativis of this City to enter upon the
above riieniio red property for inspection purposes.
4r
Slgnature (Owner/Ager Date
ALC
BUILDING PERMIT
PERMIT
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DATE
-
VALUATION'' LOT
TRACT.
JOB SITE ADDRESS 77,D
--,A
APN
n V A,
OWNER
CONTRACTOR
.1CORONELCOMMUCTION
ELIZABEfff M & LUPE COPLONEI.
77,836 AVT.',.NIDA MOMM7MIA.
51-7170AVENIDAVELASCO
LA OUINTA CA 92253
.LA QlART'A CA 92251
(619)_%4-4604
USE OF PERMIT„ CO1, BINAna.
POOL VALMU XF.S8,4X*.60 iVNI3135 L.F. OF $1' 14.1014 GARMN 13LOCK WALL.
FEE DESCRIPTION
FEES
(IOL AMYORSPA 8,000.00 L8
'i FT. WAU 1351W LF
ESTIMATE D COST OF CONS71RUCMN
10,922.35
PEJUVUT FEEWNIMARY
PLAN CMCK FVX 101-000-439-3 18 $ fA. 35
CONTwucrlm FEE 1.01,000418-000
MECHANICI L FEE -- POOL 104-000-421-000 $24.60
F.LLK71TUCAL FEC - POOL 101011042044 9) $43.00
Pullfamo. lre.E Pool. $27.00'
N OV 15-11995
f
SB -TOTAL CONSTRUCTION AND PLAN.CHECK
LESS RRE-PlidD.FEES
$0.00
wirmt PERMIT,*EES DUE NOW
$286.35
TOTAL PROJEcr PERIMIT VELV
28,6.35
RECEIPT
DATE
BY
DATE RNALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
!VSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs {
Underground Ducts
Forms & Footings I
Ducts
Slab Grade I
Return Air
Steel i
Combustion Air
Roof Deck i
Exhaust Fans
0. K. to Wrap t
F.A.U.
Framing !
Compressor
Insulation I
Vents
Fireplace P.L. i
Grills
Fireplace T.O. t
Fans & Controls
Party Wali Insulation I
Condensate Lines
Party Wail Firewall I
Exterior Lath I
Drywall - Int. Lath I
I
i
(
Final
Final I
BLOCKWALL APPROVALS
steel
POOLS - SPAS
Set Backs 157
Electric Bond
Footings f Q
Main Drain
Bond Beam t
Approval to Cover
[
Equipment Location
(
Underground Electric
I
Underground Plbg. Test
// Z
Final (
Gas Piping
PLUMBING APPROVALS .
Gas Test
Electric Final
Waste Lines I
Heater Final
Water Piping [
Plumbing Final
Plumbing Top Out [
Equipment Enclosure
Shower Pans I
O.K. for Finish Plaster
Sewer Lateral [
Pool Cover
Sewer Connection I
Encapsulation
/
Gas Piping
Gas Test I
Appliances I
i
Final
i
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I
Final i
Utility Notice (Gas) I
ELECTRICAL APPROVALS
Temp. Power Pole r
Underground Conduit t
Rough Wiring f
Low Voltage Wiring ` {
Fixtures i
Main Service i
Sub Panels I
Exterior Receptacles I
G.F.I. i
Smoke Detectors
Temp. Use of Power
I
I
Final !
Utility Notice (Perm) l
COMMENTS:
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78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 - (760) 777-7000
FAX (760) 777-7101
TDD (760) 777=1227
December 19, 1997
Elizabeth M & Lupe Coronel
51-770 Avenida Madero
La Quinta, CA., 92253
RE: Pool Permit #9511-058
Dear Mr. & Mrs. Coronel
The purpose of this letter is to inform you that your Pool Permit #9511-058, for the project at
51-770 Avenida Madero, has expired. In accordance with 1994 UBC section 106.4.4, no
further work may be performed until a new permit has been issued.
Please contact Daniel P. Crawford Jr., Building Inspector I, at (760) 777-7012 to obtain any
information you need regarding a new permit and/or any required inspections. Should you
choose not to complete the project, we would then have to pursue any or all of the following
actions:
1) Abatement of the project through the City Attorney's Office and Code Compliance Division.
2) Notice of non -conforming structure placed upon property profile.
3) Action filed with Contractor State License Board. Optional if Owner/Builder. .
Please contact us at your earliest convenience prior to 10 working days to resolve this issue, and
for any questions you may have.
Sincerely,
Mark Harold
Buildin & Safety Manager
Daniel P. Crawford r.
Building Inspector I
cc: file
dpc
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i MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253 J
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