RPL (0206-194)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
-�
Date � • � G Signature of Contract or��
OWNER -BUILDER DE_CLARATION—
I hereby affirm under penalty of perjury4hai 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.
V-1 have and will maintain workers' compensation insurance, as required by
Section 3700 of the Latior Code, for the performance of the work for which this
"permit is issued. My workers' compensation insurance carrier: & policy no. are:
Carrier STATE FUMP, Policy No. t14.61J't0i3 469001
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) I certify that in the performance of thework for which this permit is issued,
I shall not employ any personAn�a yn manner)so as to become subject to the
workers' compensation laws of California and agree that_if-I.should become
subiect to the workers'{compensationlpro..visions-of-Se'ction,3700"of the Labor
comply
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 suchl
permit, or cessation of work for 180 days will subject permit to cancellation:
I certify that I have read this° pplication 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, reprr`esentativ6s, -tl: sKbity-to enter upon
the above-mentioned property forgspection purposees-401—,
Signature (Owner/Agent) Date
_BUILDING PERMIT PERMIT#
DATE VALUATION LOT TRACT
1.
JOB SITE
ADDRESS -�' 3 s .lr+/d T%1�Q 1� APN r
OWNER CONTRACTOR //DESIGNER EN 1NEER
W/R. LtlILRX+ 1IKS J. ry.lIRRMI "SU
Oy
1860 MaAGO AVE � 3I'E , G-7 6) 47 CEWRMG3 QOM; UTIE
7C°.'tVEIR'SWE CA. .92507 kd OU3?7`f Alil C:�.9M, CA 92$61
C760)349-9825 i-1111.4 3365
USE OF PERMIT
.1)00L...lilifDIOR 6%)
r
PRF-PLAWI L 049MT1024
POOL AVLVOR SPA
k000.00 I's
ETIDUMD COST OF CONSMUCTION
810001W
PrAW11 MY, Sil'. t4ARY
PLM CHECK
101-000-4. 9.31$
564.39
CONSTRIUCTION fesE
101-000--418-000
$99,00
MECFtAMCAL FAA— POOL
101.001.421.000
524.00
Ei.Jr�CTP'i4.1CAL FEE _• POOL
101 -ON -420 -WO
$45.00
1'I.;UMMO FEE -• P00114
101-.000.419.001
5.2'7A
�L ati iOW&TE TTC 1; ON A14D PLAN C,'I Cf.LK $.25.9.35
;e L
C� 0 NC OE�, ,it48
D/AT�E DATE FINALED INSPECTOR %4�
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 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
l%2_6r- ,
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
_
GZ
Underground Plbg. Test
Q 0
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
Final
Utility Notice (Perm)
COMMENTS:
r•�
• g
SET
8
BACK
1
w
Lu
Z
z
J
I
I
w
Z
0-
O
I o
W
Z
w i
a
a
a
3
0
a
O
J
C+_
O
U)
u -
NEW 6' HIGH WOOD FENCE
t 2' HIGH RETAINIG WALL
H.P.
,FILTER\�
MP S�OR�O�\C1
F�
NEW 5' HIG
BROWN BLOCK
WALL
EXIST. 6' HIGH
WOOD FENCE -PROPERTY LINE 50.0'
sZoA
i
U FSO Fri
m �4NF MSN
F-
W
U) i
MALIBU 1
F.F.Y-0" ABOVE THE URB
PAD: 0' -6" -ABOVE Cu B MEASURED cLD
CENTER OF LOT c@ A ENIDA MENDOZA
2
V` W
z
0 W
u-
�O
w 3�
SET i
g
BACK
g
Lu
z
I
rJ
Y -
z
W
w i
a
JLx-
•• �: :�.
a
3
C+_
O
in
u,
A.P.N.: 774-173-010
ADDRESS: 53-950 AVENIDA MENDOZA
LEGAL: BLOCK #249
SANTA CARMELITA ® VALE LA QUINTA
`CURB o\iFniinn upmn07A
LENCH DESIGN GROUP
P.O. BOX 450
LA QUNITA, G 97367 -
PIIUN 11.154.-1 0. -
AR(.71ffECTURE & CON5fRUCTION
PIANS PREPARED BY:
.l: )EI. VENTURES, INC.
dba
L, CH DESIGN GROUT
A.P. LENCR
SHEET # 1
•+';
j!; , '
.j
•• �: :�.
`•; " . '�' �
ROLL -UP GARAGE DOOR
in
�F�
`�. WATER �.
i.. �:'.
i.
RETURN••.r
: 7!
;:• i • r
•
•
LIC
HT
'�"
V,.
CONCRETE
••
,. '
DRIVEWAY
.W cr
—
m
,POOL•
�.
Lu
DECK' I
NEW 5' HIGH
POOL
o
��
BLOCK WALL
•,�•
• Z•j
V7
W R'' ..l••
Z
" Iol
DRAIN
F
3 w�..
w
R1 8
q
ti
E CH
0
,SKIMMER:... : A:
,PROPERTY LINE 50.0'
FIBLOCK
O
NEW 5'HIGH BROWN
WALL n'AW
`CURB o\iFniinn upmn07A
LENCH DESIGN GROUP
P.O. BOX 450
LA QUNITA, G 97367 -
PIIUN 11.154.-1 0. -
AR(.71ffECTURE & CON5fRUCTION
PIANS PREPARED BY:
.l: )EI. VENTURES, INC.
dba
L, CH DESIGN GROUT
A.P. LENCR
SHEET # 1
FINISH SALT
W R LIN
...1 l.' r.1'1;... � •i
9
LONGITUDINAL SECTION
SCALE: NONE
(D SECTION
SCALE: NONE
3' 4"
b "
BENCH DETAIL
SCALE: NONE
LENCH DESIGN GROUP
P.O. Box 4.50
LA QUINTA, U 92253
R10Ni.i 1)W1=NIt651 \'rf.�!GSmI
ARCllil'ECTURF, & CONSIRUCTION
+
A.P.N.: 774-173-010
ADDRESS: 53-950 AVENIDA MENDOZA
LEGAL: LOT
uls BLOCK #249,
SANTA CARMELITA (CP VALE LA QUINTA
PLANS PREPARED BY:
LENDEL VENTURES, INC.
ab
LENCH DESIGN GROUP
A.P. LENCH II
PRESIDEIv P
SHEET # 2
4
FINISH SALT
W R LIN
...1 l.' r.1'1;... � •i
9
LONGITUDINAL SECTION
SCALE: NONE
(D SECTION
SCALE: NONE
3' 4"
b "
BENCH DETAIL
SCALE: NONE
LENCH DESIGN GROUP
P.O. Box 4.50
LA QUINTA, U 92253
R10Ni.i 1)W1=NIt651 \'rf.�!GSmI
ARCllil'ECTURF, & CONSIRUCTION
+
A.P.N.: 774-173-010
ADDRESS: 53-950 AVENIDA MENDOZA
LEGAL: LOT
uls BLOCK #249,
SANTA CARMELITA (CP VALE LA QUINTA
PLANS PREPARED BY:
LENDEL VENTURES, INC.
ab
LENCH DESIGN GROUP
A.P. LENCH II
PRESIDEIv P
SHEET # 2