RPL (0311-217)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9,(cornmehcing with Section 7000) of Division 3 of the Business and
Professionals Code, a'hd my License is in full force and effect.
License # `. ,G Lic. Class Exp. Date
,7751165 AD BIC , ,,�*��3104
Date Signature of Contractor
OWN ER-BUILDER,DECLARATION
I hereby affirm under penalty of perjury that I 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, 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 STATE FUND Policy No. 1689467.21103
(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 Sectiotp,3700.of the Labor
Code, I shall forthwith comply with those. provisions.
Date: �%% ='�%t- Applicant—
Warning:
pplicant 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) �'`� %"r Date
BUILDING PERMIT PERMIT#
DATE VALUATION LOT OMI -2!7 TRACT
42,{3ElCDM `
JOB SITE
ADDRESS 49-400 , ISS.10N R—YVE WAST
APN
_ »
OWNER
CONTRACTOR / DESIGNER / ENGINEER
MARK BYMS, S,
CAA3`3 "iIQ VIEW P Imo.,
49-400 MMMON 1Y M'4r?F.. T
2295 E, V. RD
LES Qi411 mk Cly 92233
MW - " ; i3'7(IS CA 92262
k j/78-21 N) MIX 2951
S c C
USE OF PERMIT J
POOL.AMORMPA`'--�.- �
� og6l - 3 (a l
POOL, 5f'h,2j1`.Z. �. 41 liLO6K 1-!'R.L1, CITY STIU' ARD
AL.ARi&4i.A13Ft1LRO SHALL DIP 114�'L� �"L ��k')4�-P1.,AR7'LR !'t SPIXTION.
- 4 FT. WALL 4.00 fpr
POOL AN SPA 2:1,936.03 3.,
PLAN CHECK PEE 301-000.439-313 $145.2$
CO3dSS�7'♦yhyyrgq3frx:t(�33N FEE
1t by//���tt00-416-�I00 t2is,000
g�py
ll�ilZ�i.T�'�NICAL a~'i E,-- POOL 101-000-4 1'000 n9640
ELYZT111CAL T+`, E — POOL 101-00014120-010 $45.00
PLU1tai3 O FRE -, POOL 1 q'i $27.00
SUB -TOTAL CONETiMUC"17.OR A1�I3 ?STA' CH K;
X61.25
130 k IRL,-PAM 1�7t `iTOT'A181°10MI'T'�;1''S
11a`ST.�' NOW
$467.25
004
EFINAONCE
_..JJ
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
Stem
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 - IM. Lath
Final
Final
BLOCKWALL APPROVALS
steel
POOLS - SPAS
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
_
2 ..
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
11/21/2003 `.09:.18. 760-320-3667 SAUNDERS ENG PAGE 03
eicisting W/I fence 3611 GOLF "CO .' n 5 E
PA PA I ~�~
72 /
5'0 "•
-611
VV +OII
TANNING LEDGE
-5' .5,
seal.. 6'6 a i� pool
bock 42
side I 8'6
PA
,Spa set @ +18"
Six Back Jets
-7'0 )J• Stucco Ext.
6'quartzite. illway
16'0—
EXISTING 5'
BLOCK WAIL.
EXISTING 5' A \\
BLOCK WAIL decking I I % \
! J' � oto existing
I / PA's drain
P313-
P/L �/ I 1 34'8 \ 357
r rl 2413/i EXIS 24 w Ped TIb,
to existing existing
I I / \ I � \ \ P
drain
II \ \
r /
OPOOL
WAND 016 " EQ
EPI GIE
AC
AC
GATE
light switch sleeve all planters
BYERS
RESIDENCE
kEVISED 9/23/03.
Lai
A 2205 -East 'tamarisk Road - Palm Springs, CA 92262 Licehse No. 179165
11/21/2003.-09:18 760-320-3667 SAUNDERS ENG. PAGE 02
11/18/2003 .12:34 760346991.8 DESERT RESORT MGMT PAGE 01/01
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1
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November 14, 2003
Mr. Mark Byers
49-400 Mission.Drrive West
La Quinta, CA 92253
R,e: Addition of pool, spa and BBQ
Dear Mr Bxexs:
The Architemtu'ai Committee #br the mastex Associatxa><t of coot adds 9a has
-400
reviewed tuTplPs foie the_ additian.of a.pool, spa and BBC Y -."-.----�
ie 'The Conn tCe 3ppmved the plans as
C-- MissioWDfiid Westin Rancho -La QuiAta
• submitted. _
When this is courtlate, please rret= a Notice of COMPWiol I form and rets m It to Desert
Resort a ant so we can begin the process of having Your oonstructriati deposit
returnee
Sine ,
r
Assist COmsrlwuty Association Maier
M Associatio>x of Pa><ucho I,a Quiztta
Cc: Canrp View Pools fax: 760520-3667 -
P.O. Box 4772 ' Palm Desert, CA 92161.4772
73.560 Alessandra, SURD 6 • PBIm Duagd. Callfarnla • 761 ,346,1161 FAX 760.348,9918
Email: drm@drmint0mQt"oom • www•dr�nlrriernRtcam