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9908-098 (RPL)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 #••,Li ,Class Exp. D e. x'! 377 t c53 t:37 C29 al ilr3f)12tN ate � . f �� 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: ( ) 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. Q6 1 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 SA' aTE tiFIjI, 4 .. .j Policy No. 229-98 T W2,0130 (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 worke 'compensation laws of California, and agree that if I should become sub ct to the workers' compensation provisions of,Section 3700'of the Labor C de, I shall forthwith comply with those provisions;. I ate: Applicant fl br ��. - • -, 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 Zture bove-mentioned property for Inspection purposes. (Owner/Agen()/Date BUILDING PERMIT PERMIT S1 7,0N.00 DATE VALUATION LOT TRACT JO3Ak CHCST APN w ADDRESS OWNER CONTRACTOR / DESIGNER / ENGINEER M,'?A MASON' NATURAL F. F'EC'l;S $ 803 CEDARC' ST 7-1-960H'014WA'Y .l11, SITE 5 LA QUiN-M C,A 92253 PALAT DESERT CA 92.24M '760).W-6726 W-67,26 CBLf# 5220 USE OF PERMIT POOL ANI.1OR SPA. • '�..r..rw • a ,.�: t �v . i - r'►L.t ''x x.9 . ��..�v,.. �.' i' i . t ,PLASTER INVECiION. POOL ANVOR, S A 17,(011.0 LS YISTINIt1`ff',E D ['girl' Ore CONSTRUCTION I7,1W.00 W:ERNIFf F ME S1i MMA.R N' NIEt"'F1'AXICAL F'17, ---POOL 101-0004:21-000 $24,00 Ei..L•:r, TR-ICAL FFE .- POOL 1014W -4120-10W $;45.00 P9.,L'M(:3RITOr FEE — POOL 901.000 -419 -(WO %2'1. P � PLAN C.Eltdt;i"6.FU 1014itO-4-19-•3fS I17,(}) CONSTIttt4"'I ON FW`I{31-0I3t3�41�s-00n $1 t0.(lfi r• PlAgL 11 AUG 19 1999 . OF L.ik QUI D° ,fry - %M -TC DAL CONSTRUCTIaN ANDPLAN ClikjK $1393.00 LESS 6 RE.. -PAID FUS x+0.00 TOY M.,11"ERIN+IYT FJt ES DUE NOW S393.0 RECEIPT DATE BY DATE FINALED INSPECTOR d: INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Balks 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 Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric U bg. Test Final Gas Piping PLUMBING APPROVALS Gas Test 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 Encapsulation9K! 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) August 18, 1999 Mr. Don Mason 80-825 Cedar Crest La Quinta, CA 92253 Reference: Architectural Change Request to Add Swimming Pool and Spa Dear Mr. Mason: The Planned Unit Development Architectural Committee has reviewed your plans to add a spa and swimming pool. The committee has approved your. request as submitted with the following conditions: • The wall cannot be more than 20" high from the existing grade • The drainage will be such that there will be no drainage to neighboring properties, inclu6ng the golf course Please contact Miguel Valenzuela, supervisor for Valley Gardening Service at 760/399-1844 and Carol Fuller, the Association Manager, prior to any irrigation modifications associated with this ;.hange. Upon completion of changes, please contact Carol Fuller. Damage to the landscaping, i.e., shrubs, trees, flowers and turf is the responsibility of the contractor. The landscaping must be brought back to its original condition when the project is completed. Approvals given by the Architectural Committee are good for only six months from the date on the approval letter. After that time a new application must be submitted. If you have any additional questions or concerns, please do not hesitate to contact Carol. Fuller, Association Manager, at 760/776-5100, Ext. 20. Sincerely, PGA WEST II RESIDENTIAL ASSOCIATION For the PUD Architectural Committee Carol Fuller Association Manager cc: Board of Directors Unit File Mason — Approval Swimming Pool/Spa 't August 18, 1999 Mr. Don Mason 80-825 Cedar Crest La Quinta, CA 92253 Reference: Architectural Change Request to Add Swimming Pool and Spa Dear Mr. Mason: The Planned Unit Development Architectural Committee has reviewed your plans to add a spa and swimming pool. The committee has approved your. request as submitted with the following conditions: • The wall cannot be more than 20" high from the existing grade • The drainage will be such that there will be no drainage to neighboring properties, inclu6ng the golf course Please contact Miguel Valenzuela, supervisor for Valley Gardening Service at 760/399-1844 and Carol Fuller, the Association Manager, prior to any irrigation modifications associated with this ;.hange. Upon completion of changes, please contact Carol Fuller. Damage to the landscaping, i.e., shrubs, trees, flowers and turf is the responsibility of the contractor. The landscaping must be brought back to its original condition when the project is completed. Approvals given by the Architectural Committee are good for only six months from the date on the approval letter. After that time a new application must be submitted. If you have any additional questions or concerns, please do not hesitate to contact Carol. Fuller, Association Manager, at 760/776-5100, Ext. 20. Sincerely, PGA WEST II RESIDENTIAL ASSOCIATION For the PUD Architectural Committee Carol Fuller Association Manager cc: Board of Directors Unit File Mason — Approval Swimming Pool/Spa