0206-289 (RPL)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
F- Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04 W Professionals Code, and my License is in full force and effect.
C = M License # Lic. Class Exp. Date
I LU 034 V
~ Z I-- /Date JCL -2 —Signature of Contractor
CSO 0
J U OWNER -BUILDER DECLARATION
HLU d I hereby affirm under penalty of perjury that I am exempt from the Contractor's
to License Law for the following reason:
Z_ ( ) 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).
LO () I am exempt under Section , B&P.C. for this reason
N Date Signature of Owner
ON
Q)
d Z WORKER'S COMPENSATION DECLARATION
o tr I hereby affirm under penalty of perjury one of the following declarations:
Lo H O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W compensation, as provided for by Section 3700 of the Labor Code, for the
? mQ performance of the work for which this permit is issued.
` Q C) ( )" I have and will maintain workers' compensation insurance, as required by
O U Q Section 3700 of the Labor Code, for the performance of the work for which this
u 4LOZ permit is issued. My workers' compensation insurance carrier & policy no. are:.
Z
Carrier STATE PUPID Policy No. IY164DR-ROR2
ob 5
C)
g (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
3 subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with,those provisions.
Date: 3� Applicant'
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 ana,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/Agent) %V Date9lVfe
` BUILDING PERMIT PERMIT#
DATE 09
. 12%, VALUATION M10W. 0 LOT TRACT
JOB SITE ADDRESS 1 7-637 Cr.e'�1�'t;Xs�`.; i�.Rx�iC�.i A
APN
OWNER
CONTRACTOR/DESIGNER/EN &NEER
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USE OF PERMIT
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PFtOR TO PWiLOUfi. W.PEC7CAL IaOOL JKQUI ""4T 'ENC:LOSk.iAR N6T
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CITY OF LA Q I TNU A
FINANCE DEPT
`3:`f YAL PIM.& ,SES DIM NOW
RECEIPT —
DATE
BY ^
DATE
INSPECTOR
Y
/)FINALED
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
BLOCKWALL APPROVALS
steel
POOLS - SPAS
Set Backs
Electric Bond,/07—,2 —Q
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
�� c
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
42 _
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
-Temp. Power Pole
Underground Conduit
.Rough Wiring
Lour Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
NEW 6HIGH BROWN
BLOCK WALL
SET
BACK
PROPERTY UNE 50.0' 1
IZ'
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE i ct B
i
-ENSENADA 3 -
F.F.:1'-0" ABOVE THE CURB
PAD: 0'-6" ABOVE CURB MEASURED @
CENTER OF LOT @ CALLE ARROBA
PROPANE TANK
1._a.
1
\NEW 5' HIGH BROWN
BLOCK WALL
r --
BACK
CURB
POOL PLAN
SCALE:1 B'= P4Y"
b
g
I
UNAUTHORIZED USE WARNING
E E -DEMdRU ARE THE PROPERTY O
LENCH DESIGN GROUP. REPRODUCTION
IN ANY FORM WITHOUT WRITTEN CONSENT
IS EXPRESSLY PROHIBITED. UNAUMR23)
USE EXTENDS TO ORIGINAL MID MODIFIED
DERIVATIVE PLANS AND IS APPLICABLE TO
INTENTIONAL AND LNNTENTIONAL
INFRINGEMENTS.
J
DRAM
A.R,
CHECKED
S.L.
DATE
08-22-02
SCALE
1/8"=1'-0"
SHEET
#1
A.P.N.: 774-171-013
ADDRESS: 77-837 CALLE ARROBA
LEGAL: LOT # 1, BLOCK # 247, UNIT # 23,
SANTA CARMELITA @ VALE LA QUINTA
PLANS PREPARED BY.
DEL VENTURES, INC.
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A.P. LENCH D
PRESIDENT
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DECK
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PFTtJPN
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DRAIN
5' TO 3' DEEP
4
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POOL
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RETURN
264'
IPOL
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6'HIGH
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ATER
LIGHT WATER' •+.' ��
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RETURN-. -b'
gRETURN
NEW 6' HIGH BRAWN
NEW 4' HIGH BROWN
1
BLOCK WALL
PROPERTY
UNE 50.9 ` l
BLOCK WALL
CURB
POOL PLAN
SCALE:1 B'= P4Y"
b
g
I
UNAUTHORIZED USE WARNING
E E -DEMdRU ARE THE PROPERTY O
LENCH DESIGN GROUP. REPRODUCTION
IN ANY FORM WITHOUT WRITTEN CONSENT
IS EXPRESSLY PROHIBITED. UNAUMR23)
USE EXTENDS TO ORIGINAL MID MODIFIED
DERIVATIVE PLANS AND IS APPLICABLE TO
INTENTIONAL AND LNNTENTIONAL
INFRINGEMENTS.
J
DRAM
A.R,
CHECKED
S.L.
DATE
08-22-02
SCALE
1/8"=1'-0"
SHEET
#1
A.P.N.: 774-171-013
ADDRESS: 77-837 CALLE ARROBA
LEGAL: LOT # 1, BLOCK # 247, UNIT # 23,
SANTA CARMELITA @ VALE LA QUINTA
PLANS PREPARED BY.
DEL VENTURES, INC.
aba /%
A.P. LENCH D
PRESIDENT
2 SECTION
SCALE: NONE
3-%"
18"
BENCH DETAIL
SCALE: NONE
A.P.N.: 774-171-013
ADDRESS: 77-837 CALLE ARROBA
LEGAL: LOT # 1, BLOCK # 247, UNIT #,23,
SANTA CARMELITA @ VALE LA QUINTA
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE BY
UNAUTHORIZED USE WARNING
THESE DESIGNS ARE THE PROPERTY OF
LENCH DESIGN GROUP. REPRODUCTION
IN ANY FORM WITHOUT MMEN CONSENT
IS EXPRESSLY PROHIBITED. WN1fHORIZED
USE EXTENDS TO ORIGINAL AND MODIFIED
DERIVATIVE PLANS AND IS APPLICABLE TO
INTENTIONAL AND WNTBJTIWAL
INFRINGEMENTS.
a
FINISH SALT
WATER LINE
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W
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W
07
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7'-0"
1
LONGITUDINAL SECTION
•�
SCALE: NONE
2 SECTION
SCALE: NONE
3-%"
18"
BENCH DETAIL
SCALE: NONE
A.P.N.: 774-171-013
ADDRESS: 77-837 CALLE ARROBA
LEGAL: LOT # 1, BLOCK # 247, UNIT #,23,
SANTA CARMELITA @ VALE LA QUINTA
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE BY
UNAUTHORIZED USE WARNING
THESE DESIGNS ARE THE PROPERTY OF
LENCH DESIGN GROUP. REPRODUCTION
IN ANY FORM WITHOUT MMEN CONSENT
IS EXPRESSLY PROHIBITED. WN1fHORIZED
USE EXTENDS TO ORIGINAL AND MODIFIED
DERIVATIVE PLANS AND IS APPLICABLE TO
INTENTIONAL AND WNTBJTIWAL
INFRINGEMENTS.
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W
A
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W
07
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DRANK
A.R
CHECKED
S.L.
DATE
Os -22-02
SCALE
its"=r-0"
SHEET
#2
IL
PLANS PREPARED BY:
BEL VENTURES, INC.
aea
CH DESIG O
. LENCA D
PRESIDENT
W
A
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W
o
DRANK
A.R
CHECKED
S.L.
DATE
Os -22-02
SCALE
its"=r-0"
SHEET
#2
IL
PLANS PREPARED BY:
BEL VENTURES, INC.
aea
CH DESIG O
. LENCA D
PRESIDENT