0103-102 (COMB)FU)-
N_ U -
W
O M
' W
o Z
coo OO
H(D
LLI F--a�
U)
Z
CO
LO
N
ON
U °)
Q_
Q
o.2Z
U')► --0
lL
co J Q
QU
OU
���
It Z
00
d
Q
J
CENSED"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 # Lic. Classt 0Exp. Date
37, cilill C27
Date F" 1 ;1Signature of Contractor""ZI.
d r �
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. ,
(.)r 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:
Cartier Policy No.
SMATH FOND 25-01 UNIT 0,26130
(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 700 of the Labor
CocJe; I shall forthwith comply with those provisions s:
D e: 'x� f— ` ✓ Applicant ^.-- Af. d �)+�f
Warning: Failure to secure Workers' Compensation coverage is ufilawfuP%and
shall subject an employer to criminal penalties and civil fines up to $`00,000;, In
addition to the cost of compensation, damages as provided for in Section,3�06
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safe);11
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 prope rtyjfor;inspection;purposes.
,�f
Si9fiature (Owner/Agent)�`~lyc`- �'r Date
'
BUILDING PERMIT PERMIT#
DATE VALUATION _ LOT TRACT
M/14/211:33~ IY3i1.4EiD
JOB SITE
APN
ADDRESS
OU -40 CKDAR C.r�.�ivTi f
t ..
OWNER
CONTRACTOR/DESIGNER/ENGINEER
JIM & KARENRIWO.LP'.
NA =PAL EFFEM It
00-80 CEDAR M, Wr
*13 -9W 1-1101rWAY 13 MUMT.'r)
L& Q)TAMA. CA 92 253
PAM DFAWr KLA 92260
(760)568-6726 3220
USE OF5 PERMIT
�L.reT.�SaES�!✓ s�Rd:idaSlS].'1�7
V.SC1`PUCALirU'TJ..FT �IOR Wrgi'CE3LfrAU, lPt'+yy�yy�C�'t� OT TO M,001,431 IS'
DEPTH 4 144RX 93 FT -I OI, T ,�:. 1..9 Lola. dt Y C{.4xi.DE
CS.4 I o (a
VALUATION %Om Do Lail
PATbIYN29 SUMMARY"
(11011►" RIV110N AM '�8�3�gY){)-�! I t3 •t7iyA �9�.��
Zi',I.rrt TPlC L I' ?_ i a 1 • C��k ^ 21? -Q(10 $�y.3
K,tMM FF& 101-000-419-000 SMO
`
u
MAR 14
ii��A v�t3��yy2010w1 }�j�
Y Qi- ui
LESS PRU.- = IT��
RECEIPT
DATE
ABY r
DATE FINALED
INSPECTOR
M
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
Footings
_
Electric Bond
Main Drain
Bond Beam
_� 60/
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
Gas Piping
Gas Test
Appliances
Final
COMMENTS:/
Final!L
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)
FROM : MONARCH-RCCOUNTING
Mardi 7, 2001
Mr, and Mrs. Jim Rundle
84-865 Cedar Crest
La Quinta, CA 92253
PHONE NO, : 760 776 5112 Mar. 07 2001 06:12PM P1
PGA'WF.,ST II RESIDENTIAI, ASSOCIATION, INC.
P.O. BOX 1282, LA QUINTA, CA 92253
(16Q) 776-5100 FAX (760) 776-5f 11
Reference: Architectural and Landscape Request
Patio Deddng Extension, Fireplace, Water Feature and Landscaping
Dear Mr. & Mrs. Rundle:
The Architectural Committee and the landscape Committee have reviewed. your plans for the
addition of a spa, patio decking and additional landscaping at their meetings on February 20th
and February 22nd respectivrJy. The Architectural Committee unanimously approved your plans
as submitted.
Review by the Committee is, only for general conformance with the architectural guidelines. Itis
the responsibility of the owner to fully understand and conform to the architectural guidelines
criteria whether or not all deficiencies are noted during review. It is also the owner's hull
responsibility to field verify all existing conditions. The Committee's decision with regard to
project design will be final. Please refer to the Architectural Rules for all required submittals.
The landscape committee has received and reviewed the revised drawing and is also in receipt of
the one-year guarantee from Natural Effects on all of your shrubs. and trees installed by them,
Yaur applita�on ha5i,erEby been approued`and,•you may bepin.ronstructon .
Please contact Raphael Villareal, supervisor for Valley Gardening Service at 760/399-1844 and .
Card Fuller, the Association Manager, prior to any irrigation modifications associated with this
change. 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 oondition 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 7601776.5100, Ext. 20.
Sincerely,
PCA WEST II RESIDENTIAL ASSOCIATION
For the Architectural Committee
For the Landscape Committee
Carol Fuller
Association Manager
cc: Ward of Directors
Unit File