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RPL (0104-018)LICENSED CONTRACTOR DECLARATION N I hereby affirm under penalty of perjury that I am licensed under provisions of H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 04 W Professional's lode, and my License is in full force and effect. O :D C) License # Lic. Class Exp. Date r`O� 11 r-- X &gj 1. 28 C53 Mc trr ~o Z Date,— Sigriature of Contractor_a r ' CD O v� J U C:) OWNER -BUILDER DECLARATION H WW I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: Z( ) 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). ce) () I am exempt under Section B&P.C. for this reason LO N Date Signature of Owner ON rn Q_ z WORKER'S COMPENSATION DECLARATION C) Cc I hereby affirm under penalty of perjury one of the following declarations: Lo FZ O () 1 have and will maintain a certificate of consent to self -insure for workers' X W �: compensation, as provided for by Section 3700 of the Labor Code, for the O J Q performance of the work for which this permit is issued. Cal Q < ( ) I have and will maintain workers' compensation insurance, as required by OU Q Section 3700 of the Labor Code, for the performance of the work for which this rn H permit is issued. My workers' compensation insurance carrier & policy no. are: `t Z Carrier Policy No. CY J (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 3 Code, Ips all forthwith comply with FSo a pro isions./-) Date: Applicant Warning: Failure to secure Workers' Compensate n 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 4 ,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 �fV�ip & 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. 1 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 o, inspection. purposes/ Signature (Owner/Agent) !! " -" .Date BUILDING PERMIT PERMIT# DATE VALUATION LOT 0104-319 TRACT JOB SITE APN ADDRESS j OWNER CONTRACTOR / DESIGNER / EN (NEER J01 1 51 31eR t`ALMi.9MAPOOLS & SPAS CLOP MA14 COIF 1a7 Fa .A 1�3 .1•Cl'� 74725 J0141 DRIVE, .;,�i1R#i.A LA Q -011M. CdA 92259 PA ' A DMW CA 92260 (760)340A9WO MIX 355 USE OF PERMIT 110MLANI7JOR 0A PODUSPA, ALA.3ZKMAR 'iMS SHALL BE IN PLACE AT P P1_0.STXR INSPECTION. K)01, EQUIPMENT ENC UUI1 ?, NOT I'riCLXlDED. PO SPA LS X&MUTED CY06Y Or CONS 1.�i'.ucl1,,10K 21,C0003 p. sr G FRET- iRUMM 9sli' Y PLAN CH CK 1ER. 101-000-435: -31 iS 1140.40 CONSTRUCTION M 101-000-418-000 ty'amoo MKT1.1 NIC.F1,F -- P00"6 1#01.1100-4221-000 $24,00 9LIW,TRICAL PIPE _. POOL 101-000 -42"00 00 $4.9.00 PLUMIM0 YXF — 1'0011 101p000,419.000 fi23.i� L,4 Omlnmc .t �ii�18�31tiFIJl�A3'>�: ,t�K $452.40 U05 FRS-�PATD FEEV $0,00 TV L FYIESDUENOW $45.2.40 4 APR CITY OF tNQuINTA RECEIPT BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR ' BUILDING APPROVALS MECHANICAL APPROVALS S t Backs Underground Ducts FOrns & 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 Set Backs Steel Electric Bond��/�! POOLS - SPAS — Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test _ Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final 40. 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 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) Final COMMENTS: ' FROM : MONARCH March 29, 2001 Jonathan & Maria Blum 217 36"' Street NUnhattan Beach, CA 90266 FAX NO. : 7607765112 Mar. .30 2001 03:50PN P1 PGA WEST II 12LSIDE;NTIAL ASSOCIATION, INC P.O. HOX 1282, LA QUINTA, CA 9225;, (760) 776-.5100 FAX(760)71'6-511 i :^lofetence; 56-725 Mcrion, La Qulllta, ::A 92253 Architectural Change Request for Pool and Spa Dear Mr. & Mrs, Blum: rho Architectural Committee reviewed your revised plans for a pool and spa and approved your application. Review by the Committee Is only for genersi conformance with the architectural guidelines, it is the responsibility of the owner to fully understand and -conform to the architectural guidelines criteria whether or not all deficicucies are notes: during review, it is also the owner's full responsibility to field verify all :'.`tistittl; conditions. The Cotntnittee's decision with regard to project design will be final. Please refer to :he Archilecttual Rules for all required submittals: lease contact Raphael Villareal, supervisor for Valley Gardening Service at 760/399-1844 and Carol Fuller, the ASsociatian Manager, prior to any irrigation modifications associated with this change. Upon impletion of changes, please contact Carol Fuller. Damage to the landseapia;, i.c., shrubs, trees, flowers ;ind turf is the responsibility :)f the contractor. The Landscaping must be brought buck to its original condition when the project is completed:- Approvals given by the Architectural Committee are good for only lfx months From the date on the :approval letter, After that Limo a new application must be subaducd. Upon completion of your project, please complete and return The Notice of Completion of Architectural Change, .f you have any additional questions or concerns, please do not hesitate to contact Carol Fuller, Association :vlattager, at 760/776-5100, Ext. 20. sincerely, ?GA WEST 11 RFSLDLNTIAL ASSOCIA'1Tt.'.:� For the Architectural Conwhittee Carol Fuller:: f Association Manager L-:rz 1c: Board of Directors Unit File T a 0 4tyl 4 4 Q" P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 56-725 Herion LA QUINTA, CALIFORNIA 92253 Owner Mailing Address 42-600 Cook Street Shite 200 City Zip Tel. Palm Desert 92260 1 558-2828 kati©nal Mortme & Land Same City lZip Tela State Lic.I City & Classif. 288130 Lic. # 308 Designer Address CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section effect.. Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION 1 hereby affirin that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5.8usi cess and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to fta signed statement that he is licensed pursuant to the pmvfsbns of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Divisor 3 of Me Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the appi:ant to a civilpenally of not more than Five hundred dollars ($500). ❑ 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, Buisness and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, prodded that such improvements are not intended or offered for sale. If, however, the building or improvement is said within one year of completion, the owner -builder will have the burden or proving that he did not build or inprove for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner or property who builds or improves thereon, and who contracts for such projects with a contractorfs) ioensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION WorkI hereby Compensation that 1 have a certificate of consent to self -insure, or a certificate of Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed ff the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg 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 Date Owner NOTICE TO APPLICANT: ft, after making this Certificate of Exemption you should become sullject to the Workers' Compensation provisions or the labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when property filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 160 days. I certity that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, zip y� No. 07240 I-V_ t+ BUILDING: TYPE CONST. OCC. GRP..• A.P. Number PGA Legal Description Tract 24801 Project Description Phase 48 — Plan H3A ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date 2/28/90 Permit Validated by: Validation: Sq. Ft. 2899 Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $214,923 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 4 838. � Const. 1,V41, OU Mech. 13,QO Electrical 13.Z. 1 Plumbing 1W.50 S.M.I. 1 Grading Driveway Enc. Infrastructure 441,835.7T Less bre 13; Z,41.1.df 1" ra Due TOTAL REMARKS ,ns tis c i; A ��; tt * .h7ti -yt• S (r 1V ;i1:;=f 3. tliifit_ t ':L'�ir. r i ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date 2/28/90 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL SQ. FT. 0 STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK FOR. SQ. FT. ® ROCK STORAGE FOUND. REINF. GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEQUIP. DRAINAGE PIPING CAR P. I SO. FT. GAS (FINAL) TEMP. POLE WALL SQ. FT. DRINKING FOUNTAIN. SO FT ® WATER HEATER URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES _$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER O GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. @ c BATH TUB SQ. FT. ® c WATER HEATER MAX HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® V4c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK ^a .,��) v ROUND PLUMBINj-/ q UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR I ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. AS (ROUGH) 0r i 1 V (J METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR//. INAL INSI !� G� �/ / L /�RAMING6 - �VI tJt9J1/ROOFING [�3 FINAL INSP. / O �. _ 1 2 —�/) /% L REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL THING O MESH SULATIONISOUN V-7 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL t