RPL (0108-301)LICENSED CONTRACTOR DECLARATION.,
I hereby,affirrn under penalty of perjury that I am licensed under provisions of
Chapter .9 (commencing. with Section 7000) of Division 3 of the Business and
C14 Lu Professionals Code, and my License is in full force a - nd'effect.
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C) =) -i License # Lic. Class Exp. Date -
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OWNER -BUILDER
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4TION
LLJ 1 hereby affirm under penalty,of perjury t4at I a exempt from the Contractor's
License Law for the following reason:
Z 1, 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,*Busi,ness & Professionals Code).
( ) 1, as owner of the property, am exclusively contracting with licensed
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contractors. to construct the project (Sec. 7044, Business & Professionals.
Code).
C0 I am exempt under Secti6n B&P.C. for this reason
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(\I Da te Signature of Owner
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< WORKER'S COMPENSATION DECLARATION
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CD 2 1 hereby affirm under penalty of perjury one of the following declarations:
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0 1 have and will maintain a certificate of consent to self -insure for workers'
X U.J. L—L compensation,, as provided for by Section 3700 of, the Labor Code, for the
.'.m_J < _J performance of the Work for which this permit is issued.
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1 have and will maintain workers' compensation insurance, as required by
d (-) u) F- < Section 3700 of the Labor Code, for the performance of the work for which this
I'll: permit is issued. My workers"6ompensation insurance carrier & policy no. are:
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. Z Carrier Policy No. I
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< (This section need not be completed if the permit valuation is for $100.00 or less).
I certify that in the p6rformance'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' cbmpensatiojpro wisior�:cf Section 3700 of the Labor
Code, �§h�1 shall hwit
h comply with those ons
Date.
1e
Applic nt
BUILDING PERMIT PERMIT#
Varriing: Failure to secu re(7VV6TrRers',Com pen sation coverage is unlawful and
AMA a
shall subject an employer to crimina I perialties'and civil fines up to $100,000, in
A PN
ke.co" provided for in Section 3706
addition to t st of compensation, damages as
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of the Labor dode, interest and attorney's fees.
CONTRACTOR DESIGNER / EN (NEER
IMPORTANT Application is hereby made to the Director of Building and.,Safety
for a permit subject .to the conditions and restrictions set Jorth on his
M EYEAR C"0117MIOCA-11034
application.'
3413 KM PAUnd DVTVH
1. Each person upon whose behalf this applic6tion is made & each person' -a
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CkTHIKDRAL MY CA 922?5
whose request and for whose benefl�', work is performed under or pursuant.tb
any ny permit issued as a result of this applicaton agrees to, & shall, indemnify
-& hold harmless the City of La Quinta, its officers, agents and employees.
.1 X001, AMk),R SY'A
2. Any permit issued as a result of this application becomes null and void if
4
.,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
-menti property for inspec urposes.
the above mentioned p tien,6
Signature- (Own )dte Anpnfi.,1'7�
BUILDING PERMIT PERMIT#
DATE ALUATION LOT 0IM301 TRACT'
AMA a
JOB SITE+
A PN
ADDRESS
R
OWNER
CONTRACTOR DESIGNER / EN (NEER
M EYEAR C"0117MIOCA-11034
13r 15.4( MEMOY7 DPL
3413 KM PAUnd DVTVH
CA 92253
CkTHIKDRAL MY CA 922?5
USE OF PERMIT,.
.1 X001, AMk),R SY'A
4
POOL EQUIPMENT
FIMIAND-JOR SPA 1171
aour 0171 cONTMUCIMN
WRIM&W17 ME, MUMMY
pik"AN 0"MICK YEE
MECHANICAL TME - POOL 101.000-42,1-000
R!"t , TRICAL FEE POOL 101-000-420-00a $0.00
PLU:M9,1140 FIRE MOL 103-000-419-000
t OTAL.'CC)krdXqXTC7)'!'ON',AYff.) MAN CIMCK
a M -T
$597.66
LESS PRE"I"AU), RMS
isom�_
UE Now
PERINM ITTERD
AUG 29 2001
CITY F LA QUINTA
T.
Ea
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
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wail Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
n� _
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 TestElectric
Final
Waste Lines i
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:
't
-
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)
I
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FROM MONARCH PHONE N0.'.. 760 776 5112 Aug. 24 2001 02:54PM P1
PGA WEST II RESIDENTIAL, ASSOCIATION, INC.
P.O. BOAC 1282, L.A QUINTA, CA 92253
• E _ (760)-776-5100 FAX(760)776-5111
PGAUDW
August 24,'2001 I
Franceen Park `
Blue Seas Investments '
9701 Wilshire Blvd., #11 l
Beverly I ills, CA 90212
Reference: Lederman - x0-155 Merion. La Quinta, CA 92253
Architectural Change Request — Pool & Spa, BBQ and Patio Decking
Dear Ms. park:
The Architectural Committee and the Landscape Committee have reviewed your plans for the addition of a
barbem, patio decking extension, pool, spa and additional landscaping. The Architectural Committee
approved your plans as re -submitted.
Review by the Conanittee is only for general conformance with the architectural guidelines. It is the .
responsibility of the owner to fully understand and conform to the architectural guidelines criteria whetber
or not all deficiencies are noted during review, It is also the owner's full responsibility to field verify all .
existing conditions. The Committee's decision with regard to project design will be final. Please refer to
the Architectural Rules for all required submittals.
Please contact Raphael Villareal, supervisar for Valley Gardening Service at 7601399-1844 and Carol
Fuller, the Association Manager, prior,to any irrigation modifications associated with this change. Damage
to the landscaping, i.e,, shrubs, trees, flowers and turf is the reiponsibility of the contractor. The
landscaping must be brought back to its original condition when the project is complefed. •
Approvals given by the Architectural Committee are good for only six months from the date on the
approval letter. After that time a new application must be submitted.
As of this date, we have not received your landscape plans. We must have these plans so they can be
reviewed by the landscape committee in conjunction with your architectural application approval.
F
Upon completion of your project, please complete and return The Notice of Completion of Architectural
Change
In the meantime if -you have any additional questions or concerns, please do not hesitate to. contact Carol
Fuller, Association Manager, at 7601776-5100, Ext, 20.
Sincerely, l
PGA WEST II RESIDENTIAL ASSOCIATION - -
For the Architectural Committee f
' Carol Fuller „t
Association Manager
CC Board of Directors r'
Unit File -
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