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RPL (0303-035)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am 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 e#G Lic. Class Exp. Date 053 kY,�Ii� C -0) t 0131W Datet} Signature of Contractor I�1t^� �� _. "lY- j, 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 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 ST.�Tt+;€ omP�73�Mai Policy No. �r1G-6lti�-�4t73 (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 3700 of the Labor Code, I shall forthwith comply with those provisions visions. 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 propertyjf�oginspje�ction purposees. Signature (Owner/Agent) fes" "h�4� t'r`r Date' f.t BUI.W NG PERMIT PERMIT# s VALUATION .. fi)�If "0X4 DATE , LOT TRACT JOB SITE� ADDRESS:.^3 _p11%1)VR.i�RAw�A:a APN _ OWNER CONTRACTOR/DESIGNER/EN (NEER MR. Ai /0R MRS. IMMMAW W .t' ORMA P001.E VAS (TOP MAN C01 $1 05.5- NIC1MMIX,"MIACM. 86.100 A,,V i 'YF, a4 1A,QjYfrrr`A , C�� 92253 0 0 CrM:LLA CA 92226 (760)398.92,22 Mul 00355 USE OF PERMIT POOLAND/OR MPA POOL, SPA,, B BQ(A:NS1 XIV.A, 81,11. $' BLOCK WAIL, CTT'' RTAa DA11 D, ALARMSMAlt➢ OW SHALL BE 1.1 PLACE AT PR&PLASTERMKIACf1ON. �� �.�. a �! On 3 yr. VA) T, U0 LF MAR POOL A WA'7 OR SPA 27r LM'I 2 4 22,7J3 CITY 7EF LA QUINTA FIRANCE F-`EPT 4ti 1113ZAM IRE StFMWIA "I PLAN CHWX = 101.9.0 -439-318 515;193 CONSTRUCTION PEE 101-000_418_000 $243.00 Mtf'.H!1NICA6FEE --POOL 101 -000 -421 -ON 1124,00 t*x..W:'i RICft,l,.ITUt - POOL 101-000-4.20.000 WX'S PL1,Nrr11HI G ME •, Pool, 703-000-419-0W $2710 SUB -:1170` 1tC°ClM1'J ::DC17iO3 AIM PLAN +CH+':f K $496,91 LESS T'.RWAN4:o:Fm $0,00 TMAX, .x""E10MF VE YiIf#E NOW $496.95 RECEIPT DATE i BY DA E INA INSP CT 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 _3I A91 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 !,Nater Piping Plumbing Final 1 lumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster ewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Q �/ � 'S7L�G% ie) 9e 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) 03/18/2003 17:12 9496314453 DAVE FREIMANN PAGE 01 03/:81 7UU3 13.4d tbb]b4«!LNJ rr-411G u:: oL 0.0 FAIRWAYS ASSOCIATION March l8, 2003 Mr, & Mrs. David Fre7imarm 81-055 Muirf-ield Village La Quints CA 92253 RE: Application for Pool, Spa, BBQ, and Boulders Ae� Iyir. & Mrs. Freiana: At the Marcia 17, 2003 Architectural/Landscape committee ameetizLg the plans your subnii,tted were .re"Viewed and approved with the following suggestion — use low growing shrubs instead of the hibiscus. If you have any questions, please contact me at (760) 564-3858. DM/ncp CC: California Pools Post QL-tic.c Box 1 C58 , La Quinta. California 92253 • Phor-e (760) 564-3859 Fax ('760) 561.2329 IJ oT e s I.-ALL PAINT' FOP- PLA5TEP- P . RE E LAST° MELIc- _ -2, VEH FY LocP►T I ° N OF GA5 'KEY' w/ L. A• 3. FIIzEPLAGE + (:56 IP9T#-LLE0 w/ L-g65 ar�.raA5 FLAME EHITTE� -VERIFY . w/ 0�•1 N E R . q.-tmF.i(a&p,cY 6A5' WPP. SHUT--OFF- �/ALv& {� Mb L'C^TE;o UPOLF. 45AS ONLL -It OuT�p- KITGNEHI. 6'-6• J t I - V-3' V-6-0 V-3' V-0• L V-6' OF CLAY FLUE ! TEX.EXTPLAS ER. 8' CONC.BL TYP. _ N i4: CONC. SLA B. Tl I ( + FIREBRICK I 4 fzAo. #4 BAR HORIZ. CONI. VES. I 4" RAD VEX. TEX.EX1. PLASTER. WBARS HORIZ. @1 O.C. TYP. ' 2' CONC BLOCK. T P COURSE ONLY. SAW IT AS RFot MY fi I 4'x4 STEEL #4 BARS @ 18' O.G. TYP. #4 BAR HORIZ.CO .TYP. - I. i i I BARS VERT.' @1 O.C. TYP. #4 BARS HORIZ. TYP. ( STONE HEARTH _#4 BARS HORIZ. T P. Vic. )•..y, f " 1 .. , '. -•�J,-'i -�+,�f I #4 BARS @ 18' O.0 TYP. .o TE .EXT. PLASTER. PATIO SLAB. NOTE: #4 BARS.@ 12' O.C. EA.WAY. SOLID GROUT.ALL CELLS WITH STL. REINFORCING. FIREPLACE DETAIL. SCALE 3/8"=V-0°