RPL (0001-063)52010 Avenida Madero
0001-063
LICENSED CONTRACTOR DECLARATION "
l' 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
59-t7 4 8 C19g S}121
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 f- It-'R:rsmo Signature of Owner • ijri ,.
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.
pT A+1'!^ r^r T .h ?A (N\ t mrv., r1 r n.s
>. a ar t u i F.sr•vr ts.t,tc t. ivy
(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 those provisions.
Date: C%rt Applicant L j f`I r° dtww 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, 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
r inspection pr rposes.
Signature (Owner/Agent) Date f " I "`Z-
1 J.
•.1
BUILDING PERMIT PERMIT Ii
DATE VALUATION LOT TRACT
1 (rtp0
JOB SITE
ADDRESS :- 52-010 A.!/EiNIDA Ar9.1•VOf".RC4D - •. - .._
APN r :
-OWNER
CONTRACTOR DESIGNER ENGINEER
aSyiA ti'J1 i
.i
C0
JLZ%rnMMUr"'!vN
PO BOX 134
541 E kOSS
LAt;;,fUtWal' CA 92253 -
EL{'.EiVilR0 CA 92243 -
(7(4))353-9772 COIL # 55P
USE OF PERMIT
17)t.)LJi.,A J171f & SPA
S2 n•
P60t. 05 NI.Y. 0 i•.1%/V l .t K G; 1.411 LF. _ s (1:-r) dMRDE- WALL -01-V
POOL AND/101Z STIPI.. i '.tVi!,tiei is
5 FT. WALL 14U.()0 Lf
` u#taei%,a ,,u vagi %-#A t lAL k a'ab VA6 A%il
n yyTr t fl
Nt klt+i (.>ff'C1+, ;Z~:EE t Ut (?UU-43!x- f P3 $81.90
r0'NXTRt,W,'rJ ON 101-0ffA-418.000 5126.00
-
i LECTRICAL ti:tk -- P OC)L 101-000-•42"04
PLUNIBtlIi4HE --POOL 101-000-419-000
t R1• jr - r(Yi'yA7, d;'tlN '1 ttT ttw fit fT T Q NT? I N f'?iFtr;'.fs
$3014(1
'ESS PRIE-•l"AI D FEES
$0.00
TUfAt, :d'.i(:.tMAT VES DUI!; "NOW'
$303.90
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
Vents
Insulation
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
i
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Set Backs
Footings
Steel
Electric Bond
Main Drain
7
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
d
Final
Underground Plbg. Test
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:
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)
9
5 STEPS
6 RISERS
(5) QUEEN PALMS
15 GAL. OR EQUAL
1-1" DIA. TRUNK SIZE
1 u,-0"
< j o
C
10' X 0- C ONE.
PAD'FOR SRA
5' 0"
f .
o
21
-Oil 2
HP
.. I 3'X3' A/C
$
CONCRETE P14
a _ i
3'X3'
CONC. PAD
33'-5"
PROPOSED RESIDE CE:
"MESQUITE ADOBE -211
(SANTA FE)
017-
. 0.1 v611ABOVE CURB_ _
.--
W 2 -°3l c PAD:
11 011 ABOVECURB
GA E .PRO .E TION MEASURE CENTER OF
——
THE. l T _ CENTER OF
aRO
1.0' -a„ I .
SETBACK
i
*.:
/LHIS AREA OF POOL TO
RECEIVE ADDITIONAL*
STEEL PER .ENGINEERS_'_
REQUIREMENTS. ; -
\,• "`moi- .
\ PLANTER
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE I Z BY,e&&
PLANTE R
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f
5'-0" 11 x
SETBAQIK
I
.aR
W
m
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ROLL UP GARA E DOOR'
SCORE 4 BRO1
.INES BLOCK
I Y POOI... E
Q ---PROPAt
fA --' -- - -'-
I.•
ll f PL,
CONCRETE DRE SWAY I SC
:3 oili
PROPERTY LINE G
30''-0"
SEWER LOCATION CURB
52 -oto AVENIDA MADERO
S 1 T E PLA 1\I
SCALE: 1/8" =1'-0"
i
r
f
5'-0" 11 x
SETBAQIK
I
.aR
W
m
J
N
I PRO
ROLL UP GARA E DOOR'
SCORE 4 BRO1
.INES BLOCK
I Y POOI... E
Q ---PROPAt
fA --' -- - -'-
I.•
ll f PL,
CONCRETE DRE SWAY I SC
:3 oili
PROPERTY LINE G
30''-0"
SEWER LOCATION CURB
52 -oto AVENIDA MADERO
S 1 T E PLA 1\I
SCALE: 1/8" =1'-0"