0006-270 (RPL)LICENSED CONTRACTOR DECLARATION
I here0'affirm under penalty of perjury that .l 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 f -_,.,..y -•—Exp. Date
1)/30/2(
Date.3 �Py� S(,Ignature of Contractor_
;l � ,. `� OWNER -BUILDER DEC
I hereby affirm under penalty of perjury that I amlexempt from the Contractor's
License Law for the following reason: - t
( ) I, 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
perforTf fiance 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 ST [,g VUND Policy No. 1394032-00
(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 Calif j+oand agree that if I should become
subject to the workers' compensation provitions of Section 3700 of the Labor
Code, I shall forthwith comply withthose provisions.
Vv N
Warning: Failure to secureWorkers' 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 applicatio�r and state that the above information is
correct. I agree to comply wit6. al,l,O�Ity, and State laws relating to t e building
construction, and hereby aut�i�Fize representatives of this City to �nte upon
the above-mentioned pro eMV/for.iin} pefction purposes.}/
'Signature' (Owner7Agent.1Date
BUILDING PERMIT PERMIT#
DATE V LUATION LOT 0006-210 TRACT
d
JOB SITE
APN
ADDRESS W$$,,(01q D
OWNER -"
CONTRACTOR/DESIGNER/EN (NEER
4940i{1MRSArONMWEWriff 53300A
-JZ 1DARA
:LAQUIWfA ! CA `92253
LA QUWTA CA 92253
��
CieyO)564�3r�5g C:87..� x�a�3
• s.
USE OF PERMIT f•
POOL AM/OR VA
fa00i, & SPA ONLYaAtAStiAg RI R ::f•IALL BE ITT PLACE AT PRV �
PLAST9RAWSi'ECTIORI POOL EQUIPMENT RMCLOSUC E IS NOT rNC;LUI)R . �
3
4
POOL AND/OR SPA 27,49a,00 LS
3ir> IATE. COST OF C:OA7S'I'#2t7MOV
27,0W.00
k''LtMr FM SUKAIARY +`
PLAN C.IIFVK FEE 101.000-439.318 $172.25
COMSTRU&I"ION IEEE 101-000-413-300 $265.00
MECIIANICJALFEE —POOL 101.000-421.000 $24,00
ELECTRICAL FEE — POOL 1,01-000-420-000 $45.00
PLUMBRIC FERE -- POOL 101.000-4'19.000 S2` OO
SLlh3-10TAL C°014 1RuCriomAMD pl_w CHECK
x;533.25
LESS PRE -PAID I=
$0,00
1,10111M Y Mway FEES IME VOW
RECEIPT
DATE
BY_LL�
D FINALE
INSPE R
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
BLOCKWALL APPROVALS
Set Backs
Steel
Electric Bond
POOLS - SPAS
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
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:
`
02
Tun -TSO t.e;_ 11 :47A -
June 20. 200(
Mr. and Mrs, W.F. Ezell
49-6$0 Mission Drive West
2513)
x -
La Quinti, Cr1 ).:�_
Dear Mr. and Mrs. Ezell.. -
The Rancho La Quinta architectural consultant has reviewed your submittal of landscape and
pool plans for your home in Rancho La Quintd. • Before submittal to the committee, the ^
following corrections need to be made:
l . Qn the golf course property line. only iawi to match the golf course or all" wide concrete _
uiovv band shall be allowed within a 12" setback from the property lune. No planters,
including trees; shrubs, or groundco-cr other than lawn shall be allowed in this 12" setback.,
2. Landscape ligYtttng is trot specified and most. conform to the "lighting" requirements in the
Architecturvi
al Reew Guidelines.
2. •The Queen Palms shall not block the neighbors' established view Itncs. „
4. No Palm Springs Gold fines. gravel of any type ; or cobble shall be installed where visible
from either the golf course or t'ront siTcct side.
3, (ween Palms shall have. a nunimum,tnunk height. of 9'-t) and shall have vaned heights when
grouped.
6. Submit csferior elevations at l/2" = 1' scale of BBQ indicating materials, colors, BBQ unit,
7. Phoenix Roebellcni shall be mitumun, .24" box size?
8. New equipment enclosures shall be a mirdnium 08" high. ;
Please accept my apologies for the length of this process. [ just received these comments from
the consultant this morning.. -I appreciate your immediate attention to the above, and ask That you
have corrections, etc. back to me by Friday June ''3, 2000 . Per item 6. submit barbecue
elevations and plan to include colors, materials of the barbecue unit, etc. Regarding items 1-5
and 7-8, a metro will suffice. My fax is 760--346-991 S ;
Sit�erely, • .
Gary L .t'rcy, Prok�rty Manager
Rancho La Quinta Master Association
Cc. V.auly Pools via fax at 564-3655
lo
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Ezee11 ,Home
49680 Mission (give Viest
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Construction �
Foals Spas Fountains
(760)564,,-36.55 ►`
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Lic. #658996 vI,.
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