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RPL (9705-148)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of.pepury`that I am licensed under provlsions'of Chapter 9 (commencing with Section -7000) of Division 3 of the Business and Professi&tals Code, and my License Is in full force and effect. License # * Lic. Class Exp. Date 574 Jli� i • J r! Date _ � ` Signature,of.Contracfor l OWNER -BUILDER DECLARATION' ' 1 hereby affirm under penalty of.perjury that f 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 w,ork,'and the structure is not intended or offered for sale (Sec. 7044, Business'& Professiorials Code). ( ) I, as owner of -the property, am exclusively contracting with licensed contractors to construct the project -(Sec. 7044,' Business & Professionals Code).. O �l 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. ` A. 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: Cartier Policy No.',, SCA' 6-FfMr) 1:3`(i'IF!SfG (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,1 should, become subject to the workers' compensation,provislons'of Section 3700 of the'Labor I6ode, I sha I fort, ith comply Dply with those prov�7lsi"o,ns.' Date: , Applicant �{ . ��r�,r3a Warning: Failure to secure Workers' Compensation verage•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 I any permit -issued as a result of this applicaton agrees to; & shall, indemnify i & hold harmless the City of La Quinta, its officers, agents and employees; 1 2. Any permit issued as a result of this application becomes null and void if I 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 co7ect. I agree to comply with all City, and State laws relating -to the building In trution,and hereby.authorize representatives of thisCity to enter upon above-mentioned property,46 inspection purposes: ,c?- ignature (Owner/Agent) `: 1I, _, �' -ter Date` •PERMIT# CONTROLN• BUILDING PERMIT 5235 DATE VALUATION' LOT TRACT rz r�r si poo,m) JOB SITE APN ADDRESS•-b'Z� OWNER CONTRACTOR / DESIGNER / ENGINEER fi�If i .t1F\NC:fif'I &ft`V 'DOiJSC>tcl t;t fR�'"flt.UC'.'Ctf:N, 4-162o IN41.i'Ado lift 73-01:1 COLIN'TkY C110B LiRIVE., SIT-. .V44 i,A.f, l li'N"T'A. r�: , ' i2s3' i>„ [IM 4r1Esl.'l :r - : CA �►2.z6fl 0131.,#. :1044 :USE OF PERMIT Al 'r1CJ, L AFM3l: R SPA 1S;_�ti}.w i. r.,ST MA ' !:D CQAST � 4. C��1�3�'r:fi:1JC�'D�I� 1.5,300.00 'PILAN CHECK Fk:E ' 10 t -(*0-42W-31.9 $131-0 C'I1g113 t'Ri.TC"1'ION, PT, t.f1.l 4(l{t �4 � i3 •©ti(3 31171.00 M110"li h!ICAL 1TSd•,l'tr{3L 10.1 -OGO igqCyy",,'!'''{i�.sf'L 42in3�[t}��i'){f�i • •;101-000-4119-000 . ' {i:Y. )()tI0 @$�ryr1:"�.fk3 qy-1TC)J�"J. . S; IAJ2�'.4i,�INe1FfJfn..i'X.A.. 101-000^ 1q -47V 21 11G*1ANi1,1'i ANC[I1'CK &378_15 1. LESSIS k&PAID FEES $0 ,00 Ar .. 8 p. `;.�. •. Ft -` •_, • �.' 1st- 1 � ,��; a 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 SI b 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 Wali 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 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) - 9 7 W E D 1.0.: 1 2 D O S P P.O. COX 1504 B�i101nyt / / ! M 1 78,105 CALLS CSTADO .._. •/ V _7 /1 / '/'. / A.� n NP LA Ot IINTA. CALIFORNIA 32225 Oer nOr f3 E = Mallif+G i Ar ld1e33 - ri y ZtP Tel, :il,;. - -a ` Con factor nn i Addreza A)72� t416 J�k• - ZI Te)• State Lc. C ' & Cte3all. 7 '%y/a? 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TN C -1 -AWS Use a. 6- 0,2 0n.s •a W" r) .• O.Ref of a.V.:r. •rV W- r %-Wo u...e. ra .n. r ,r v Ae swft n.%.= VRI +r" -"I Aa Mc.e oaa'.W a nu r•M,K 3 ucv10 u•J 1 Awl uernut Inyai .7vt­------0. t1 D.C. fol me. r"Ann _. Oae^-- • -0.cx .. oe lk1ER3_GOI3/Ln3AT0N OCCLA/MT10M WI Itw•Mart.oey"polnalnlM rnmrw" �a1C;Mhoo 0007 I1.lcoeft"I00•. Kiel^ 800. L-ewlAltlafa w pofty 110. c**c4Ay �] Woy .I Illrrd �1E IM Giry. 1: CwoMa mpJ m f'PaC►r.mlatlaG ' Ci11f1i1CAT[Ol pcpl/ffp i110r woltx�e oorrotaATON IN9uM1rCE' "� lIM Hata Aa.O .am e. etienow I If. 0.(.w to Alr w A..d.e da- is," .sear.. a) .;.nlry gw.�• IT• m .11-W . w li elvc (e. s.tgo l 1. �rmlt N t IT 6.co I a•AR not • af•olvr A•Y p.ItM In arty mel'11x w r Iv UacOwee eI.DIe/1 to N. WwMw Ci..nVnnuueaet l A.e of Cee. vW`;, .ChCa r0 /PlVCA.r ;i y der '11.ef0 ltlh CO .A a Cs.0er .Y e•1wR e.or. lud19 ftae. ttbin•rt' 'rAROay.W' Yoir.a's x w sa lCoe.. 1q'1 wa roRn.Rn . te'•nq..en 7u0+orvo•Wl. o• Rro O.rr s•I0. Oe..W iMea.l. C0119fOUCT1011 Lv.W M 10 AGENCY 1a.ronr tltlrm Ind Moro Is a eetmvoem Ieealnq .q." to rhe oatonew-ve J V. "A IN 'NO Iha Do~ ;I Iruea• G$Ar. Mw. 00 Co0..1 Leneert- LoAdorf "nest Tb.. II 0loutfurt0 0a:"•c .Har. OreTrlr inlea -1. e1q•e0 a•re valklAla(L aria %a tutea:l to b0ua'•a11l .rOre th....49-i. tv I" 0ayx 1 wil/ U..11 MN row 1P,.& 3opllorlM Ana Ime.1lNl um bine lreomVna'. 70 06OWL 1 1p rat to ean0ty tntn all dty VN Csl.n, aOtnARtaO aW .1fu 10.+1 Nf.Itro b %I W1111a rMxnKlllr 010 !a." a. v4s. rooroes.gn..e 41 an ally to enter Uro .Olt•b m.•Itceae 009•ny or agw,wt our0oaes 4.nafu'e el Avpeeenl .. _ 0eao uytu0 houclIe. '• Gty. 91.fk Zia _ ... FINANCE APPL16AIlON ONLY IUILDINC: TYPECUNSI: '.P. Number_, _ .egat Dgv:riyti0n_- _... Itujett Dexriolion 5q. fl. N13 viZB stones Unita New ' Add C Aller O 1looair, Donu.wion r etuation 1 Rreby afewn ntal 1 am a3arr91 1.0m me oo h• tap, Vw"a. W M W IMI no60. 06 PERMIT Plan Cnk. 0v1i P!an Chk. Bal. Electrical prlveway Emir: AMOUNT 8 IWAL REMARKS ZONE: -My.. -- Mlnhnum 381DIIC1t 013ta000M ' Front se(ttar.k 1r01n Canter Line Frear Satback (rum Rear Prop. Llrb _.. Side Stroll, Setback from Center Llfla � _Side SelbaCk Imam PflWAy I.i110_ . FINAL))ATE _ INSPE(:tGR , IseueO by: _ Oa10 PNnn{t_ V111daled by: -� 8 3L T. AOCEPTC-D ` j r, • w/3 glass SUBJE-Q-T TO NS At t block at spillway AND AL PPOCABLE. COCES SUCTION LINES 2 " _ RETURN LINES 2-1.5 " SKIMMER 24' Sheer deSent SKIMMER MODEL AM" air lineCHEC VALVE YES PL SPA+6" GASLINE BY S -D -C FT. 71' POOL LIGHT 400 CLOCK EQ/WALL/S.D.C.R4'-0 _ 5' E x ELECTRICAL BY. S.D.C. Fr. 148 R3'-6 15/1611 AUTO CLEANER n/a. CHEM. FEEDER n/a \\ t r PLASTER COLOR WHITE ® t; ; DECK BY SAC. SQ. 590 STEP 3' FT. SPA SPECS. . 14' f , PL stzE 7 RAISED + +32' P 29' 4 \ +141 LITE 1 WATTS 100 RI LEVEL SEATS 22" 24" 27 r \` back hoe DAMWALL If X 1 QT. 28' , DESIGNER DAMWALL TOP TILE/GLASS - t SPILLWAY SIZE RX to WIDE a �\ Jamie SPILLWAY x OPEN CLOSED DATE # JETS 4 UPER LOWER 15 8141 I' 17' 4-8-97 pa pa �` Name: rick hangcock Address: LOT 45/QUINTERA QLtL j/box lI� • TRACT LOT# light switch • f _ Apodmov POO/W PALM DESERT TEMECULA • S ect 2-R-9-73-011 COUNTRY 28910 RANCHO Scale: 1/8"=1'Q" CLUB DR. STE F-4 CALIFORNIA RRD. z PALM DESERT CA. TEMECULA CA. NOTE: LANDSCAPE AND FURNITURE.92 92260 ARE SHOWN FOR ILLUSTRATION (619) 346-4032 90 90 90 ONLY AND ARE NOT INCLUDED. 19)676 -SWIM t LIC # A-574127 GENERAL SPECIFICATIONS SIZE 14 x 28' AREA 419 PERIMETER 95 DEPTH 3-5-3 TILE CHOICE T.B.S. so. 65 RBB. 48' +6" COPING CANT POOL CAPACITY GALS_ PUMP CAPACITY 100 GPM MOTOR HP STA RITE HP 1 MOTOR HP HP+ FILTER STA RITE 300 SQ FT FILTER RATE 103 GPM HEATER LAARS SIZE 250 BTU TURNOVER HRS SUCTION LINES 2 " _ RETURN LINES 2-1.5 " SKIMMER 24' Sheer deSent SKIMMER MODEL AM" air lineCHEC VALVE YES PL SPA+6" GASLINE BY S -D -C FT. 71' POOL LIGHT 400 CLOCK EQ/WALL/S.D.C.R4'-0 _ 5' E x ELECTRICAL BY. S.D.C. Fr. 148 R3'-6 15/1611 AUTO CLEANER n/a. CHEM. FEEDER n/a \\ t r PLASTER COLOR WHITE ® t; ; DECK BY SAC. SQ. 590 STEP 3' FT. SPA SPECS. . 14' f , PL stzE 7 RAISED + +32' P 29' 4 \ +141 LITE 1 WATTS 100 RI LEVEL SEATS 22" 24" 27 r \` back hoe DAMWALL If X 1 QT. 28' , DESIGNER DAMWALL TOP TILE/GLASS - t SPILLWAY SIZE RX to WIDE a �\ Jamie SPILLWAY x OPEN CLOSED DATE # JETS 4 UPER LOWER 15 8141 I' 17' 4-8-97 pa pa �` Name: rick hangcock Address: LOT 45/QUINTERA QLtL j/box lI� • TRACT LOT# light switch • f _ Apodmov POO/W PALM DESERT TEMECULA • S ect 2-R-9-73-011 COUNTRY 28910 RANCHO Scale: 1/8"=1'Q" CLUB DR. STE F-4 CALIFORNIA RRD. z PALM DESERT CA. TEMECULA CA. NOTE: LANDSCAPE AND FURNITURE.92 92260 ARE SHOWN FOR ILLUSTRATION (619) 346-4032 90 90 90 ONLY AND ARE NOT INCLUDED. 19)676 -SWIM t LIC # A-574127