RPL (0008-308)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapte , 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."`
owl
DateSignature 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 a's:.l ir: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).
O 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 STATE FUND Policy No. 046-00-0007034
(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 t9at if I should become
subject to the workers' compensatiopprovlslons of Section 3700 of the Labor
Code ++CC"I"�shall forthwith comply with those prowe�ions.'
Date:L �� ,, ?-t 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 represenfa°tives of this City to enter upon
he above-mentioned property fo`r inspectn/purposes.
Signature (Owner/Agent); ,,i'e�••w.G- Date •
,. ., �• .gam.
BUILDING PERMIT PERMITN`-' '.
DATE VALUATION LOT_ - ��' TRACT -
JOB SITE
ADDRESS so•-292on
:PS mm
APN
OWNER
CONTRACTOR/DESIGNER/EN (NEER
!'t3M hy.AZWR
STEVE DODS09 CONMRUC170Y.4, INC.
80.282 M MON
73011 MUMMY CLUB UIL, 81:1112 F4
LA QILTM` A 92253
;,Atm DES1r r CA 92260
' (760)34&4032 CK4 1044
:
USE OF PERMIT
POOL MWOR E. PA
PfkWL. 4.�SPA f71dl.T— Ltt`'kMSMr1T2WERS SHALL BE M PLACEATPRE
PLA '11,11. INSPECTIONYOOL EQUIPMENT 09CLC SU 19 NOT INCLUDE -D ,
M °1' HIS PERMIT
POOL ANWOR SRA 22,33D.00 LS'
ESTMAT IM C:C)SI' OF CONSMU - ON
22,.3.00.
:>PRRWFFFM 4 UMM't RY
PLAN CHECK k.' + ?01.000.439.318 $152,10
CONSTRUCTION KE 101-000-418-000 $234.00
;
MECHANICAL FEF. •• POOL 101-000-421.000 $24,00
'
ELECTRICAL M? - POOL 101-000-420-•000 $45.00
,
PLUMBING PER «- POOL' 101-000-419a0r�CI $27N
IW'IIp, >iAI,. C`G a " liC'17nI�F ANDI;%�!.t4 Cl�LiiCK
2.10
u3a PIE-7PAn.) nw
ZOO!
IVDAL y r. um FKES DUE
$482,10
t
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
OX 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
POOLS - SPAS
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
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:
CITY OF LA QUINT
BUILDING & SAFETY DEPT
APPROVED
Of �3fl
A RE-INSPEC110% FEE
E0 F -WE RPROVEO
vML BE CNARG RD ARE NOS OB
�kN.p 30B CA CNEOUEE�
(OWRACIOR amt P.'L �=sS!�S�E,51�lL�t f r GENERAL SPECIFICATIO\S
FOR CON�STRU ZNE Si
OOROSCAP�
T�OaLFTORAPERTY LINE
Sd' ---
IA RSWITCH
FOR JET PUMP
i
i
STRIP FORMS
FOR FLUSH STUCCO
MATCH HOUSE
EQUIPMENT WALL
BY SDC
BLOCIC'STvCCO `
I V A IA fCH
'-- STA -RITE
HEATER i
S!
t•
BOBCAT ACCESS
NO R&R
1nSPE��O�- RESTRCUCTU AROI�DNG wra is ylrrnuerz tdea�- ire or sb AREA. J66 �>;R 93
1Nhen axes is made thra;, a n jOhhnr << DEPTH 3C5
ItaPOOL DECK AREA !x�-c5r L s . dent a eh t yyuu e 3 igi�GReL'P: cD.60
bn— That neinhbce- Itprrni-;4: -ad assay full
[e5oor�ihiFty
Cps?M R ----
--- -- E '- —
RT -r / DATECAYI'LI.EV[-- signature POOLSAPACLLY-..- l0.CAI 9� ;
— BOULDER WATERFEATU PtjmpLCnrAQTM--. '9��
SEPARATE PLNtP ATERFALL CROSSECTION (tlo F10TOR HP STA RETE Hp I
6'
SCtscale)ur4as�a MOTOR HP BOOSTER /JETS HP LS
RK' -9 N' 5 19' - bas FILTER STA RETE 300 SQ FT_
BENCH '-� baso _ — _ WATERFALL PLM? 1 H.P
Ih'-u• - ]_',y. _ J_0. HEATER STA-AITE
IV -9- U-RNOV�ft _—
-
i�. 3 11' Rn' -Lr - - - .- - --
LO3' P.'A = BEYCH 'de !TILLNE5-_. _..
pool wnei 4C@944ER MODEL A%IM A\
.. Rb' -t- =- PALM SPRINGS GOLD BOULDERS -� CI1E(]LVALYE YES '—
\ PrL. — — ' --- --'-- CHECKS BY SDC FT. 65_--
+18' ► ^ LA OVI,\TA HOM ES
AN.VNQkEDGE }w DSELL COOSSICTLON POOL UGHT 40O W CLOCK AQUA
SLEEVE ALL PLANTERS ELECTFfi:QZY SDC FT.ALL -,
AU10-aZAK& GREAT WHITE
a. \� RoesE
WATERBD 7E
�� DECKsoc s 1078IH
LJfe[BREI a SLEEVE �� 2' BELOW RIUDSILL DECK TYPE SLT F\SHSD BUFF
REMOVE EXISTING � ----- --' -- SYEP fF. --
PATIO PADS_ SPA SPECS
► ♦ �.-`_ SIZE 7 RAISED +18'
E-MAIL TMAYNOR0 UTE 100 WATTS
-- ATTGLOBAL.NET TRI LEVEL SEATS 22' 24' 27'
DESIGNER DAMWALL STACK®
AQUA$ W ITC H DAMWALL TOP�ww R1ZfIE•
6"aaar axau [Isrrrr R4NDY/E SPILLWAY SIZE X WIDE
ZlYMIy RppFp CeI —7,4—TE .ILLYYAY �.- OPEN ❑ OCFa-
.Ateaaa..i a .�� 628-0 p JIB
$ TOM MAYNOR RESIDENCE
E e 80282 MERIOI WAY s
o I w - • _ S�If: LA OUINrA
} la *44 n I �QSTEV E\ W,AL KWR LOIS 21 4
18" WIDE Tux rtoani D���
MV mmw Both trot SPA
� i�Kf!!17 WALLL
l► k. f4wLC Giv _ leftSEPERATE
� �RETUR Poo/s
E TANT. WITH
CHECK VA! I PALM DESERT TEMECULA' -
1
73-011 COUNTRY 28910RANCHO
I y ,p CLUB OR. STE F-4 CALIFORNIA RD. 39
_ 1! .�. t. SCA PALM DESERT CA. STE 206 I
NOTE:: LANDSCAPE AND FURN TURF- 92260 TEMECULA CA.
m . ARE SHOVPN FOR ILLUSTRATION(7601 39.6.9032 92590
ONLY AND ARE NOT INCLUDED. (MD9)fi Eos