RPL (9910-076)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that Iam 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
574127
Date 1,04 Signature of Contr-bi6t
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that.l am exempt from>the Contractor's
License Law for the following reason:'_,
(.) 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, Business & Professionals Code).
( ") I,'as owner of the.property, -arn exclusively contracting with licensed
contractors to construct the project (Sec..7044,' Business. & Professionals
Code).
O 1 am exempt under Section B&P.C. for this'' reason
Date 'Signature of Owner
WORKER'S COMPENSATION, DECLARATION f.",
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 ofAhe, Labor Code,• for the
performance of the work for which this permit is issued.
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:
Lamer . 46 � Policy No.
. �74`AAs�'.rL'V1l'IJ i!`itl Yy tilWd�.71
(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;3.700 of the Labor
Code, I•shall forthwith comply'with.those 1p ovisionss Awa
Date r'i � ��
Warning: Failure to`'secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines'up to $100,000;'in
addition to the cost of compensation, damages as provided'for in Section 3706
of the Labor Code, interest and attorney's fees...
IMPORTANT .Application is hereby made to the Director.of Building and Safety
for a permit subject to the • conditions and restrictions set forth ,on his
application.
A'. Each person upon whosebehalf this application is mane & each person at
' whose request,and for whose benefit work is performed under. or pursuant to
any permit issued as a result of this applicaton agrees to, shall, indemnify
&' hold. harmless the City of La Quin&ta, its officers, agents and employees.
2. Any permit issued as a result.of. this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days Will- subject permit to cancellation.
I certify that I have read -this application and state that the above information is
correct. I agree to comply with all City, and -State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspe tion purposes :.
ar
Signature (Owner gent) Date./A/f .a-
BUILDING PERMIT PERMIT"
't�1iEA..4D`Tte
DATE VALUATION ,.. LOT TRACT
JOB SITE
ADD RES W230 rVIEI.H.O
OWNER' •
CONTRACTOR / DESIGNER / ENGINEER
�l:.,fi'r`,b .i C'i. i� T.1" IC -•
�.Y18-0Yt.I)V.+..9.JpY�JN. CI9:1J 1TAidM/lrllON
Fsa3-�3d? ,��.Ll�:bs:3�,r °, . •
! s��t #"ICt'�1��'k�%' ��.�! tai., KC.tl'T� f'�i
LrkQlAfuTA. CA, 92253
FALL DESS I: :. CA. 922W
4,�c�t1,o. Qfi•utf C',BLN .1.1044
• 'i
USE OF PERMIT
POOL YOILVORSSPA
7.
110 01. zi-.SP,h'.ONi; Y -A.F9 RMISOI-k13.!'Z.W6, S-i-M.I. W ill I LAKE xv "
P0 011 Al''�"f,+110P.. 'Y.i�f. } SU,�i lj. 9 ;�:.ar
r
ur� is e a D "G r oec c o� aec'sy ��vro�q�
,�6 1,�. 4VD- 46ff' i A/1 U?, A. 6! :d'.l'4Y/
ao> �e�+ i
J'47$ LI
.I T'JiMM FEESUMMARY
PLAN CHECK PEE '101-000x439-318
MEGI ANNIC AL Fos • M01, t 101-90042t-000 rffA.W
i.I.ECTzC1.CA,TA;>t:'Iai., .W17qQ0 42t3-". l�a�.tt0
KLt?vi'BtNG FRE -110 X, 101,-6t3J .q;i9 0(K i:270)
SUB ?:Ci ' 1, C2� N 'RUCTIf�7 �1�7:f) A! �1't1t fes; �;1:!",i�.
$�>f;1.9>
$0.00
= ' TO� 3 a :. "' . tzl i iA"bf� ii�'�� JE Kow.
$661,95
1
RECEIPT
DATE
BY' •
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 Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
steel
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
, >14 14
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
'
-
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)
GOLF COURSE... Two r8" CUSTOM CASCADES °4r.• '. 1;,� 3 •; CONTRACTOR cannot assume responsibili y for GENERAL SPECIFICATIONS
"' p /L damage.to curbs1 sidewalks driveways. cement .
2'X2'! SIZE' 16X 32
+24"' HI H 3/4" ERS STUB' slabs, sewers, lawnssrees, fences, retaining -
r 1 , , AREA 397 PERIMETER 46
_ 5 :' walls. sprinklers; telephone lines or shrubs.,
' LEAVE DIRT' _ T 0•i s o DEPTH ,
n • * ! { . x t�. � 3X5
property it is understood that you, the owner, TILE CHOICE 'TSO -607 SQ, 74
1.2 + + ' -- RI' 6":•t have that neighbor's�ermission and assume full Rgg?i' @+6" i'@+12" 12'@+18" 4'@+24"
" t P/L
/ BENCHresponsibility. COPING CANTILEVER j.
F T -loll DATE —
signature • POOL CAPACITY14,000 GALS
+ - . 5' PUMP CAPACITY 103 GPM
..... 9' MOTOR HP STA grTF
HP2
+18" -=--- - — 3��-- },-_— r- ~i4,' 13'' - OUTSIDE EDGE FINISH P� �.. rtl�►
AIRPIPE a ^ - FILTER
+ STA RITE 300 SQ FT
161 \ / Lar, 'k
.:`' ' 1 3 — z - a 102 GPM.
RI' -611 t '
VERTICAL t h BENCH € - �, DECKING HEATER LAARS SIZE 400 BTU
`.`::•
-JFINISH DECK —�
r
-
TURNOVER 2
HRSRi'6"
31ni•2
11
q4
\%
11
SUCTION LINES
1
2
6CK RETURN LINE
R L -6
.t _
!I=
L:
'.1 !rr-
�� p
Y1' 8
,1` 0f
<' ��� AMERICAN -
•: ERI
- -6
:. SKIMMER M E
1
R I (�
.:l;%; ° / • ........:.............::..:.: +... ti':,`.fig{%k:^.`:<`y:;t.E�:$'}:;:'i2:Si::3�32..r`.�•: -
<^ YES
a G E - (UNITE 160
GASLINE BY SDC FT.
PIA 191-3 " P/A .`, *" POOL LIGHT 400 W CLOCKJANDY
A- RE -INSPECTION -FEE OF $30 ELECTRICAL BY. SDC too
r 16 -(S
P/L ' + ?4 MLL BE`CHARGED IFJHE APPROVED AUTO CLEANER
\ ��
T z. ' `r-ef h6f iva r1 u. D ARE NOT ON
F ' F HEM. FEEDER .W ERB TE
SLEEVE ALL P/A s ' 18`-6" - .. Ep vIPNi1 N ISVVING0 A SCHEDULED PEBBLE FINISH TAHOE BLUEI
AL1���(��(61.. - � _^` r DECK BY SDC SQ. 33 Z'
NO IXCEPTIONS!' DECK TYPE DUNE '
STEP FT.
�,r - • p • _ .: , .. , ... � moon �nini�' � � � � •�.-� �
SPA SPECS.
a', s
PIA � - y�i» X01 �{ �•" , "` •
' ,a: ' + ,• r -n µ' ^ r �" 1, "REVISED SIZE 7' RAISED YES +18"
JANDY RS 8 . : ;. .A WATERBRITE 4 LITE 100 WATTS
,1 a _ 3 " �� 10-8--99
.; t. RI LEVEL SEATS 22" 241127"
+�� ( ,j ` DESIGNER DAMWALL STAIRSTEP
G/E!!riOC: .. . 1 DAMWALL TOP TILE ,1
<' r ALLOW FOR SIDEWALL = JOHN/EV SPILLWAY SIZE ';.X WIDE .
- DISTANCES 'E DATE LW Y XX N D
# JETS 4 UPER LOWER
' •E _ r Q A Ir 5-5-99,ob
.'. ` `' + +' ' • $ r , - - Name: WALKER HOMES/ LAWRENCEIOLSEN
,t BACK HOE
- ISION.ALERT
��� 80-230 MERTON
' $FIRST D� '-,
ACCESS �� x 3"TIL { (COLOR OFTILEIDECK,PEBBLE) ,' ,
* NO WALLS YET WATERLINE CAP FOR CASCADE- LA QUINTA
X18'•9 z 16
- - ,.ea.><a:.: ;,.,>. +;.:..> ..;.:yS$`a ♦1{"TOP OPDA.N 9 — QUINTA TRACT RYDER LOT#
WALL `/�,I� O
aif�32.3.,Q+.t�"t
.i2.: ,�.: - DEPT;•-
• '>T:z .1 ILDING & SA
�5":':'..: '�Y.;^r • RtS9 AND � -
n�oo�+bga > WATERLINE
, V E D
c;i�::. ::✓t a:s:;:t%z?'
FOR...
E . r .. RO .5
APP sop-
. %%.''f`:€':,,.:a�:. ;R�. :Si'BP$: y{•1
aX. CONSTRUCTION
F
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w
ALL
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ri• �tYti
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N
7 11 COUNTRY 30 0
RANCHO
CHO
3.
0
:�:.:»r. .` B DR. F-4 CALIFORNIA RD.
� �? :.3: CLU STE
¢ «' = STE 206
— PALM DESERT CA.
..:t TEMECULA CA.
NOTE: LA 92260
LANDSCAPE AND FURNITURE NI URE
92590•
- ARE SHOWN FOR ILLUSTRATION 176 346-4032 -
_ (209)676 -SWIM
., ONLY ANDARE NOT INCLUDED.
LIC # A-574127 .
_ - - a