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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 Busines;,and
Professionals Code, and my License is in full force and effect.
License #Lic.Classs ` 9 Exp. Date
574,11 A -r�3 1111: t jr
r...W,
Date Sigri'at re of C ntractor
_T/. _' r,a,_ ~M OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt 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 Soction , 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 STAT1OUND Policy No. 046-00-01109
(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.
Date: f0^^+ -e f Applicant'," r /`J.aunsctvr�t"•
�Warning:'"Faildii, to secure kers' Compensation coverage is unlawful and
shall subject an employer td"criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Age,irf-1: IPAa�rT, " ' r Date
BUILDING PERMIT PERM T#
C11 if7-:i1,3,
DATE VALUATION LOT \� TRACT
JOB SITE
ADDRESS^'�*r �SI�dw�
APN M1
OWNER
CONTRACTOR/ DESIGNER/ EN [NEER
OPW 047(,: IDT
STUV . l OINSOR c.,OMMLiG'"i1014 TAC.
79.77$ CK101140 '
73011 C°OI.TN` RY 4,",'%M3 DIC. :ztrS 0 F4
CA 92253
PA.Ur,"I'MUT CA 92260
(760)3,1 405132 C_T" 1044
USE OF PERMIT
��10���e4���
POOL. PA. ALAI2M.r*f..BAliRlglLS'$}a,AL,4, BE JM PLACE :kT P RE•Pr.ASTERIL
N419111ECT1ON, PINA,,.L<U,lPKEN1 F34CLOfATARNOT MC1,.U'DED
POC31.r,aaND1012 SP.k A1010108 1.6
1Nw1r'. 'I 'A:I+ ) C'Ck+.1`i Ole C"ON'S'n;E,TariC:sN
24,OW.00
PERMT ff Us, SUMMARY
PIAN CHECK REX 101-000-439-31 R
CONS'1`T U&TOl`i AXE 101.000,418-000
1~QBMWIC AL Yrm, -- poibL 101,000-421--000
kyk�..y�:C:''p�RI}�t�".A�i�,.g��}',�':...,��P�?{�!'ry.a 511 8 -jC�?mCf0-4q'k2l[a�wfi00 ,l(�tt/D
0011
�$.y
,1 �,f41 9114`8 !76'.19 " 1+W"'• 11 _ 10 L -000-A1 9.: ( �. �} • �A(a 1 of
, 1
NUV 01 2001
Cly 0r- �Lt' ['W1:
c
TY P.LAN t.°:j^: EbK .
$496.95
V LYE:. k RF, ,PA0 �.Y1s�
TO, 00
RECEIPT
DATE
BY
DATE INALED
INSPECTO
r p.
INSPECTION RECORD
OPERATION
DATE
INSPEPTOR
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
�/ r O
t
S. Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
•
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
Gas Test
�J _
PLUMBING APPROVALS
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)
MON
R�sert
sort
M nagement
October 29, 2001
Greg Golden
79-775 Cetdno
La Quinta, CA 92253
RE: Citrus Course Homeowners Association
79-775 Cetrino
Dear Mr. Golden:
This letter is to confirm, in accordance with the Architectural Guidelines; the Architectural
Committee has approved your architectural approval request for the installation of the pool spa,
barbeque, decking and landscaping as submitted.
When all work on the project has been completed, please notify this office in writing so that the
improvement can be inspected and signed off by the Architectural Committee and your deposit
can be returned to you.
Please contact me if you have any questions about your architectural application.
Sincerely,
:i
F. an lcahy
AMussociation Manager
on behalf of the Architectu I Review Committee
Citrus Course Homeowners Association
CITE' ®F LA C)UINTA
t,l +'LDING & SAFETY DEPT.
wED
CTION
1Q10 0 L
Professional Community Management / Desert Resort Management
Post Office Box 4772 • Palm Desert, CA 92261-4772
73-550 Alessandro, Suite 5 Palm Desert, California • (760) 346-1161 • FAX (760) 346-9913
SPILLWAY & DAMWALL TOP
TO BE
PREDOMINATELY GOLD
QUARTZITE
STRIP FORMS FOR FINISH
STUCCO TO MATCH HOUSE
I DOUBLE CANTILEVER CAP I
FA
AIR PIPE
QUARTZITE SPILLWAY
R3'-6"
DECK
P
/L
SOD REMOVAL
APPROX 280 S.F
STACKED WATERFALL
W /ROCKY MOUNTAIN QUARTZ & CAP FOR CASCADE
'
+IS"TOP OF DAM
TF
WALL
7E
SPA SPECS.
'POP
LITE 100 WATTS
RI LEVEL SEATS 22" 24" 27"
s>
:I::..
WA
is WIDE
:d"OF�WAT8RLI2\
SPA DAM WALL:::':;<>%:zTp.E
SPILLWAY SIZE "X WIDE
7/03/01
SPILLWAY XX OPEN CLOSED
# JETS 4 UPPER LOWER
Name* GREG GOLDEN
Address: 79-775 CENTRINO
- LA QUINTA
SEPERATE::<
x5'T.URN:
w
18"
R6-0"
LAKE VIEW
331-0-
'I R9'-0"
451
26.5'
1zs 15S
I\
a-6'_5.5'
-9N UMBRELLA
/SLEEVE
BOBCAT ACCESS
RIR BLOCK WALL AND
REMOVE GATE FOR DIG
ID
CONTRACTOR cannot assume responsibility for damage to GENERAL SPECIFICATIONS
orbs sidewalks driveways cement slabs. sewers. lawns.trees.
fences retaining waIIs sprinklers, telephone lines or shrubs. SIZE 15 X 33
LAYOUT. DESIGN & ELEVATION APPROVED AREA 320 PERIMETER 86
SET BOULDERS BY OWNER OR OWNER'S AGENT: DEPTH 3'0" x S
IN DECK PRIOR TILE CHOICE GROUP 3 SQ.
2- 12n TO POUR DATE RBB. SPA9+18" 22'@+12"
CASCAD OM DESERT GOLD signature COPING CANTILEVER
NOT TO POOL CAPACITY GALS
EXCEED 36" LA QUINTA HOMES
I MUDSILL CROSSECTION PUMP CAPACITY 102 GPM
P2 PUMP #1 STA RITE HP 1.5
PUMP #2
R9'-9" I HOUSE FILTER STA RITE 300 SQ FT
MUD SILL FILTER RATE 102 GPM
HEATER STA RITE SIZE 400 BTU
'atV" DECK
2" BELOW MUDSILL TURNOVER 4 HRS
51 { SUCTION LINES 2 "
` ,a RETURN LINES 2 "
BBQ SKIMMER MODEL AMERICAN
6.s CENTER CHECK VALVE YES
6" STUBOUT GASLINE BY SDC FT.
G/E ONLY POOL LIGHT 400 W CLOCK T104
UNIT BY OWNER ELECTRICAL BY. SDC FT.
P/1
R6-0 TANNING LEDGE.\
N
IS 7A'
DECK
PATIO
EXISTING
LIGHT SWITCH
DECK
I
SAWCUT HERE
--------------
P/A�
. I
PATIO
EXISTING
I
I
SLEEVE ALL PLANTERS G/E 5-3"
I
1
RESIDENCE 45'
1213R
i siGiR
...............
...............
RANDY
...............
PLASTER COLOR WHITE
DECK BY SDC SQ. 1400
DECK TYPE SALT - COLOR TBS
SPA SPECS.
SIZE' 7 RAISED +18"
LITE 100 WATTS
RI LEVEL SEATS 22" 24" 27"
11/27/00
DAMWALL QUARTZITE
DAMWALL TOP QUARTZITE
:RBYI:SEID:
SPILLWAY SIZE "X WIDE
7/03/01
SPILLWAY XX OPEN CLOSED
# JETS 4 UPPER LOWER
Name* GREG GOLDEN
Address: 79-775 CENTRINO
- LA QUINTA
JOB#
jp'/
TRACT
CITY OF LA QUINM
BUILDING 8 SAFETY DEPT.
I
® (P
9
9 C19
a
OVED
♦` FOR CCINSTRUCTION
♦I
DATE
LANDSCAPE AND FURNITURE
ARE SHOWN FOR ILLUSTRATION
ONLY AND ARE NOT INCLUDED.
MANDARINA LoT# 20
v
PALM DESERT -TEMECULA
73-011 COUNTRY CLUB DR. 28910 RANCHO
SUITE F-4 CALIFORNIA RD. SURE 203
PALM DESERT CA. 92260 TEMECULA CA. 92590
(760)346-4032 (909)676-7946
LIC # A-C53-HIC-574127
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