RPL (9811-089)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
'dRapter 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 ;
:314127 Ar� 4d-
OWNER-BUILDER
L47",
Date A 41 Signature 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:
( ), 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). ' a ' '
( ) I am exempt under Section B&P.C. for this reason
Date Signature of Owner
"W10RKER'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.
SI have and will maintain workers' compensation insurance, as required by
ion 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 Policy No.
(This section nee 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
�de, I shall forthwith comply.with those proyisions i
e: °gApplicant—/;
Warning: Failure to secure Workers' Compens tion 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 ofLa Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes•null and void if
f 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 �• /f*
BUILDING PERMIT PERMIT#
DATE VALUATION LOT .01-0:49 TRACT
JOB SITE
APN
ADDRESS
}}y }} p a q Q Q�fp
524 9 .A ��ENIPA NA V'�A.'SIIil.RO
OWNER
CONTRACTOR / DESIGNER / ENGINEER
5,24 79A Jt eVf01V.Nr VARRO
nio11 cC?U'urity CwB m.:, Sour.
i.�A: t�jUilJ7: CA 42253
P.ALM DES.ER17 CA, 91260
1U44
USE OF PERMIT
'POOL s"WLV, NOItTA'XIM, AALAit'i tASARVL EAS 41ALL iso rN AT
POOL A14_1110K SPA 13,900.00 LS
4
FZ7I1lIXfMM COST 01s Q:'ONSI'i.AUCTION
J. 1.4,904).00
IL -AN CHECK`t E 1.01-000-439-3N
1t-'+t+s lMK,11014 FUR 01-000.418-000
Mr. C.T.RICAL V0 -OIL 101-2100-•420-901D 510
PURNICi1NG1=',EM-••Pool. 101-{}00419-000
SUB-110TA-1, ICO.NS",lRf- G110N AND PLAN CKCK
$324 45
LESS PRF-P.A.101 FEES
' TMAI:.PERMIT VUS DMENOW
$324.45
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
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 741
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping N.,
PLUMBING APPROVALS
N
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)
1
Z)VILLMW
QFtN t
Y.l
# J
UPER LOVVP
y
oi
►
CONTRACTOR •a not ass .m responsDi� for
dam e' drrvew cp
GENERAL- SPECIFICATIONS
• :.,_ � ..,.
-�
_ , _.: e� - . ..:..-. � : _
:._.. '�, ....
-
,—.. � .` ,: -
1,
- ^/'
ilahs Iawmp.hees fgnSes- r�uv
S!�ilii�t�eCS tClPnllOn lInes Of ehf Ib5 �I7 n � c'fs
f'
.
- ,
SIZE 15 X 24
,. ..._ _.
! .. -
= .:
.....� «...
., :: :-; •:.' - - ; '.. :: -: r.y
,., s. _ _ W
_ -
-
_
.. r, _ t,r - -� _.
-
-
_
41ade toter "a n..lahG0�5 D it is inderstood
fhat X�ij. thenwee[- Aave that n�iQhhore
_
AREA 264- PERIMETER 64
;. .'.
- . .. ., .�.:.. - •c • '.• J�- '-.:.,
_
TEMECULA CA.
—
- - ...
- z -r
-
��mis<ion and a«„rrie full retnonei6�Ti tX
•
.3X6
3
ga.TE.
TILE CHOICE • GROUP3 37
.. signature.
NAVA
`-
CANTILEVER.RD-0-ST
1\
:
10,800
-POOLCAPACITY L
PUMP CAPACITY 103 GPM
MOTOR' HP 1
r
- —
-
MOTOR HP� ................ HP
-
TE
l.. •-
�
-
FILTER STA RITE 300 SQ FT
-
FILIER RATE 102 GPM
HEATER LAARSSIZE ............• BT
mi
BOBCAT ACCESS
3'
GATE
P/L
12'-6"
P/L
R 15'-0"
\ •1
k TURNOVER 2 HRS
10'-6"ILINES. 2
RETURN LINES 2sKimmER "
MATCH NEW DECK TO EXISTING DECK MODELAMERICAN
�. YES
\`
1 c— R4'-6"
6
14'-6"
15'
— R6'-6" '
r�
P/A
J DOOR
7'-9"
E 60' �- LIGHT SWITCH
RESIDENCE
NOTE
C OURTYARD POOL
P/L POOL LIGHT 400 W CLOCK T104R
CITY O F LA WIN t A ELECTRICAL BY. 140
AUTO CLEANER •••••••••••-••••••••-
CHEM. FEEDER .................
��l�I-L,•DII'�IG & SAFETY DEPARTMENT
PLASTER COLOR WHITE
CONDITIONALLY DECK BY DOD SQ.470.
ACCEPTED FOR CONSTRUCTION DECK TYPE 3LT FNSH NTRL GRY
SUBJECT TO WSTALLATION• AS PER STEP Fr.
SPA SPECS.
SSE RAISED 40
LIT ♦ WATTS -
_ :..... RI LEVE TS 22" 24,r W
AND A6L APPLICA - Gp
I _
DE SIGNER DAMWALL
DAMWALL TOP ,,#***,
B N RIC RD/E SPILLWAY ")C** WIDE
CITY OF LA UUNN, !A
BUILDING & SAFETY DEPARTMENT
CONDITIONALLY
ACCEPTED FOR CONS T RUCTION
SUBJECT TO INSTALLATION AS PER
AND ALL APPLICABLE CODES
BY
SCAI
NOTE:
LANDSCAPE AND FURNI'
ARE SHOWN FOR ILLUSTRA
ONLY AND ARE NOT INCLI
-_,BATE
Z)VILLMW
QFtN t
# J
UPER LOVVP
Z
'1 d
►
Address: 52-279 A V ENI DA NA VA RRO
QjW LA QUINTA
TRACT
LOT#
~ .
f'
16'-6"
I
PALM. DESERT TEMECULA
73-011 COUNTRY.
28910 RANCHO
CLUB DR. STE F-4
I.
PALM DESERT CA.
STE 206
W
TEMECULA CA.
(760) 346-4032
RESIDENCE
NOTE
C OURTYARD POOL
P/L POOL LIGHT 400 W CLOCK T104R
CITY O F LA WIN t A ELECTRICAL BY. 140
AUTO CLEANER •••••••••••-••••••••-
CHEM. FEEDER .................
��l�I-L,•DII'�IG & SAFETY DEPARTMENT
PLASTER COLOR WHITE
CONDITIONALLY DECK BY DOD SQ.470.
ACCEPTED FOR CONSTRUCTION DECK TYPE 3LT FNSH NTRL GRY
SUBJECT TO WSTALLATION• AS PER STEP Fr.
SPA SPECS.
SSE RAISED 40
LIT ♦ WATTS -
_ :..... RI LEVE TS 22" 24,r W
AND A6L APPLICA - Gp
I _
DE SIGNER DAMWALL
DAMWALL TOP ,,#***,
B N RIC RD/E SPILLWAY ")C** WIDE
CITY OF LA UUNN, !A
BUILDING & SAFETY DEPARTMENT
CONDITIONALLY
ACCEPTED FOR CONS T RUCTION
SUBJECT TO INSTALLATION AS PER
AND ALL APPLICABLE CODES
BY
SCAI
NOTE:
LANDSCAPE AND FURNI'
ARE SHOWN FOR ILLUSTRA
ONLY AND ARE NOT INCLI
-_,BATE
Z)VILLMW
QFtN t
# J
UPER LOVVP
RIO -20-98
NamePARKER RESIDENCE
Address: 52-279 A V ENI DA NA VA RRO
QjW LA QUINTA
TRACT
LOT#
~ .
4YEK.•
R
® P/S
PALM. DESERT TEMECULA
73-011 COUNTRY.
28910 RANCHO
CLUB DR. STE F-4
CALIFORNIA RD.
PALM DESERT CA.
STE 206
92260
TEMECULA CA.
(760) 346-4032
92590 .
(909)676 -SWIM
I IP 44 A
c-7AI'1-7
ti
G..