9906-010 (RPL)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
5741227 :1. MI.)1/19!
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 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 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.
4`C.f.Ti's :r'tlt�il3 1 ',%794ro
(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: Z :r: 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
& 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 inspection purposes.
,,Signature (Owner/Agent' 2 - ' % -`^ -- Date
BUILDING PERMIT PERMIT#
<l911fi-1)�Il
DATE (j6/J)Q1.99VALUATION $32,41)% 0 LOT TRACT
JOB SITE
ADDR SS +180-000 AMM(3N-
APN
I
OWNER
CONTRACTOR/DESIGNER/ENGINEER
HAINX. Sr EI1?fM,
S E'VP D0DSG1Nt C NSXRUCI10N
W-00E11efEMON
'7301.1 COUN'1':RY CLUB DR., SUFFE, F4 .
LA, Qt31N'1'A. CA X25.3
"{BALM 01 SFX1' C.A. 92260
(760)3464032 CRU, 10,1
USE OF PERMIT
POOL fiNDIOR SPA
P00USPA ONLY - A -L ARIuu�' 3A1i12.iFR11UST BE TAI WlwlCE AT �
PRE -PLA IR.1141S14-;CT10N ,
VOC1. A+iDIOR SPA ,r2,400,00 LS
Olvf'I IOA.ii A.BS+D l.:PAS i.3?'CO!"1140.21'4il.X.li,71y
32,400.L173
P,B]IRM If TA FERP SU NIMA RV
INIE C i]MtC'AL, FF93 --P001, 101 -OW -421-00 $24.00
?Y t,i?r"i'i?1f••;,nY. H"i+'h ... FN'?f:1#,1{►►-0{3{j-4�{)dtili7 ri.l.� On
PLAN C ,Cts. F(X 101-000-439-318 SI47.itl
trc,�t+l�•iliai3r;.`!'i.��rlrl�' 10i-1K3(1�t9EK-Ut`1S3 �_��i,uv
SUM -IMA -11', CONIS3'RUC,PION AND V( -NN CHECK
$597.0
LESS PR13411.t ID FEES
. $0.00
1' D"IAS., PERA'! T -FE.0% 3" "Wel NOW
S59710
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
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
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
44 4'a
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
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 /a 6
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring a
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
• ,• f I y + R - r9
GOLF,
tCONTRACTOR cannot assume rec on ibili y for GENERAL SPECIFICATIONS�OURSE
_damage to curbs; sidewalks, driveways cementSIZE AIRPIPE''' f
slabs, sewers jawns- rRes, fenced r aMina 9 X 42
+:x ,. • , . '. r "� walls, s n�etirsrteI6hone lines or shrubs AREA zPERIMETER, 108
SPA @ +18" i w When access is made through a neighbor's DEPTH 3
t •' F • + � REVI S I ;�I N ALERT ` ��Y it is understood that you, the owner, TILE CHOICE GROUP 3 80
have that nei hbor' permission and assume full' gg• 2T@+6" 10'@+18"
P/L
responsibility. COPING CANTILEVER
DATE signature APA I 11,300 L
PUMP
- CITY
• 4
> . - 121 f P , g �,.�€ �x. ;, ter: STA RITE
CAPACITY 103 GPM
;: • $ F MOTOR 1.5
� ` .y ,, s � • x .- ..; . S.R � t �;' yt n' ' - 'STAC.rFO WA RFALI � '
t • ."* ,' .. �[i'`•!,W /ROCKY MOUNTAIN OII oT MOTpR� t. � vwP
'' •+ * T I _ b ,• -.. - , i-Fy:: L 4, yj, .}• 1 . WATERLINE A ApFog kccAOF n • , FILTER
SQ FT.
k - l x 'L .. + E 1 • t .•fi•• . i - -�c ' - • e c _.."� '<' i.' HB"BB• -
�t
1 f'
4(t •ar
I ♦IS
TOP F 1
F .
OF? OAA/ 02 GPM
F
I, 'J i/::<.i'::2!�':'':5:::::::::v;.:$:'j`:`.'$�'i�••::`y.`r.::: �:i':,':5'.;� .
2 M.
8 :f,( vi- t
_ r Y1
� 4 _
S'1HEATER
P/L 11�! w. 5 , .. , ai . s�!{A'T.EaG'::::'>;?:?.sz:::>.�;a •t�bP.. 'ry� ,r I _
•
t is _
k- •" c - TURNOVER 2 HRS
_ P `3 .i i '
y •�
tl'
.ter . !� W1t1ER:?•"»;?+`z"�bz<�?� WATERLINE ' rr
! LEAVE D I 2
Wtr IRT.& BAC
a.
r•
/. TO BOND BEAM
i
!
r
"B
. n
,
@ +6 RETURN ! f:= U LINES
11
1
CK
SIDE 1
y
• r.
+6
L
rr
A
I M R AMERICAN
E
1' n MODEL AN
- ;9^ fNFip,E^,
Y
27 6
h41-6"! t
1� YES
18 WIDE
S.
"c"
f
SDC"`
FT.1
A I 25
91
,DAM'.� GSL NE BY
'r
SPA
9
fi;
POOL LIGHT G 4 W
1
:WALL^ -r 00 CLOCK T104R
s -
4
• . _ y�•'-
- 3
r ELE
CTRI A
C L BY. S
DC
t
- 2
f
1
50
�42
1" • .
A!�I� I'1� ,
r
L f G '
•
9 + ,
34„tet PLASTER COLOR WHITE «
A �x DECK BY SDC SQ 1135)
” CANTILEVER EDGE • ' - �- - ,, I x =a ar .1�
• DECK TYPE SLT FLASH SD BUFF
STUCCO TO MATCH HOUSE M T I - y, _ STEP FT.
U' I ' SPA SPECS.
a_ `a�_- SIZE - 7 RAISED
F- +_ ESIGNER YES+18"
.. ,DIAMOND UT DECK 13"X13" , : ' .^ B LDIN T� �E�eT� LITE 100 WATTS
L `
NDY/EV I LEVEL SEATS 22" 24" 27"
LIGHT SWIT f 4 CONDITibNA
n 1T-6" AC�.eEr-T� LY! DATE DAMWALL STACKED
15-0 1#_ , �� FOR CONS"�Uc �.10� 4 2a� DAMWALL TOP QUARTZITE "
• _ - ' .' . _ - 5 .. .-, UE�JECT T 6 - I e SPILLWAY SIZE 11 X . WIDE -
` E - • O INSTALLAT N AS PER D
'` • REVISED SPILLWAY XXOPEN N
5-5-99 #JETS 4 _ UPER LOWER`
E: AND ALL APPLICABLE CODESr �� STEVEN WALKER HOMES
a x '' :® i 1 • x / SNEIDER
A t%', I [ 80-000 MARION
a ,
` ; f _ C;iW LA QUINT
A
--NOTE.-SEE-SEPARATE
. •Mester Bedroom � . __ � Dining Roorri " �
-- PLAN FOR TR�TEVEN WALKER �� 2
= Living Roorrl f0� Celli COURTYARD WATER FEti.
DO sof
51.6;
POO S
!.'�:�,♦ ` PALM DESERT TEMECULA
�c-!n BACKHOE ACCESS --- . N 73-011 COUNTRY 28910 RANCHO
dw .
®. NO WALLS YET ` . ^ �1_` .I CLUB DR. STE F-4 CALIFORNIA RD. ,
- _ 1/8 —1, SCALE STE 206
PALM DESERT CA. `
TEMECULA CA.-
�r - �� OTE: LANDSCAPE AND FURNITURE 92260
Master 8o#h J� t t ARE SH 92590
- Ii I T Ti aaS_a�
ONLY AND ARE NOT INCLUDED.
F. imITAL