RPL (0212-052)54835 Avenida Madero
0212-052
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
-W3 1102
Date, ':4 Signature of Contractor
e.
t OWNER -BUILDER DECLARATION
Thereby 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 thkwork, 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" " Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty oU 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.
S c). I have and will maintain workers' compensation insurance, as required by
tion 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 5TAI''Is C:C?Mp Policy,No. 76 8-01
(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.
,gate: " Applicant
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'•«
A hold harmless the City of La Quinta, its officers, agents and employees. i..
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 inspection purposes,
re (Owner/Agent)
Date
BUILDING PERMIT
DATE t` VALUATION LOT k TRACT
d g07 :vtl
ti
JOB SITE
ADDRESS v. Sai EAi} tALk'..t 1
APN
OWNER
CONTRACTOR / DESIGNER / EN (NEER
11At`.TLDIN EWA UE TCOT TMC.
PAC3LD7 r11'ANS DE. ,GN WC
C
P. 0. Bk YX b 21
qPi- 92501
,vl` ',C:stADYE CA 92501
i'6t1 31 £C! C-SLO 6246
USE OF PERMIT
Ftp L AMIOR SPA
POC1i SPA. tU A,tAMSMA.RRIERS dUALL PAZ rN 'LACE' AT PRE- }L.AS"I'ER
P6/Mli.F1wJiOR SPA LS
AFS; UTATED COSTr- 3:83,NS:ERLICw110V
y
18. MOM
PLAN CHECK FE 101-000-439-338
C01ia'i`RUCTIOH YZE 141,.0Cj(3-418.0('1:3 18 ,OG
lvlMLAVI AL Tg. -- POOL 101-000.421-000 524.0
E } CTIRIC,A L FFE — .POOL .101-f1 )I -4M, V15100
i'I.UMBINO FM.,. BOOL 101,000-419-000 $27,06
h,
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a1 r ' a',i'." I"Ct },r `,'. 'lC ai'iI iT CIOUX
9407JSi
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RECEIPT
DATE
By
i
DA7 FINA ,ZED
//
INSPECTOR
INSPECTION RECORD
OPERATION
I DATE
INSPECTOR
OPERATION
I DATE I
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
'� G
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
_
PLUMBING APPROVALS
Gas Test
Electric Final
Way ' Lines
Heater Final
Y ` �� 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
Utility Notice (Gas)
ELECTRICAL APPROVALS
'emp. Power Pole
' rxierground 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)
Final
COMMENTS:
Im
UNAUTHORIZED USE WARING
THESE DESIGNS ARE THE PROPERTY OF
LENCH DESIGN GROUP. REPRODUCTION
----------v--------- IN ANY FORM WITHOUT WRITTEN CONSENT
ADJACENT AREA -4' ABOVE
t IS EXPRESSLY PROHIBITED. UNAUTHORIZED
I SUBJECT PROPERTY I DERIVATIVE PLANS AND IS APPLICABLE TO
-OPEN SPACE BEYOND USE EXTENDS TO ORIGINAL AND MODIFIED
L ----------------------J
INTENTIONAL AND UNINTENTIONAL
INFRINGEMENTS.
PROPERTY LINE 75.0' .._.-•—•
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NEW 6' HIGH BROWN / _-.__•-
BLOCK WALL _ --
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PROPERTY ✓ i
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AVENIDA MADERO
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REVISIONS BY
01 1 C r-L./11V
FOUNDATION PLAN
...............♦....................
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FLOOR PLAN.............
...............................2
ELEVATIONS.......3
...........
4
J ELEVATION & 'SECTIONS b ea ,aa (li O V
F . i.'. J ,JI 4
ROOF LA
• 'SIDEWALK m t 'r ....................................................5
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STRUCTURAL RAL & TRUSS PLAN 8
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ELECTRICAUMECHANICAL
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A.P.N.. 774=284-027
lair 3! GATE
5
_
.•, . , ,• , .a New 5 srucco ADDRESS: 54-835 AVENIDA MAD
ERO
COVERED BLOCK WALL
uin
, ! • . 'CONCRETE
LEGAL: -14+1/20F
,! DRIVEWAY a'• ' ` •, § o LQT # LOT #15, BLOCK # 274,
.. •..• , b OR
SANTA CARMELITA AT VALE
4( E LA QUINTA
.
VA
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- NEW 4' HIGH BROWN
BLOCK WALL
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PROPA4ETANK r v • +x ,>4'"F "fie.,.
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PLANTINGS TO SCREEN
r
•. PROPANE TANK
' PROPERTY LINE 75.0'
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W
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(3) QUEEN PALM oC
15 GAL.OR EQUAL w ' •. t';
MIN. 1 1/2" TRUNK WATERSERVICE,,-
.. '. ,
URB
DATUM POINT @
MIDPOINT OF LOT DRIVEWAY APPROACH REQUIRES A
GROUND COVER SEPARATE FROM CITY OFT AND LA QUI TA PUBI
ON
PALM SPRINGS GOLD WORKS DEPARTMENT ///111
OR EQUAL
54-835 AVE N I DA MAD ERO PLANS PREPARED BY:
LENDEL VENTURES, INC.
dba
SITE PLAN
,'I LENCH DESIGN GROUP
SCALE: 1/8"=V-0"
A.P. LENCH H
PRESIDENT
1
L
DRAWN
A.R
CHECKED
S.L.
DATE
09-27-02
SCALE
1/811=11-011
JOB NO.
SHEET
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