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9805-146 (RPL)U) 04 W` Ouch d r` W rZ x oZT� Zo OO �� J W W I �a U) Z M LO N ON U (3) It �a Cr Z r< 0 LL 0 J J mUU O rn �t Z_ co 5) �O Q J LICENSED CONTRACTOR DECLARATION I.,hereby affirm under penalty of perjury that I am licensed under provisions of '''Mapter 9 (com fencing tfyth 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 /&1e6-2-56 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. 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 Policy No. is t T'12t30Tst?� 1 (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 forth ith comply with,lhose provisto E. t Date: Applicants-- rn r.� �2 f_'A-..- 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 hist, application. d 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 to above-mentioned property for inspection purposes. Signature (Owner/Agent)_ Ga Date6 f BUILDINGPERMIT PERMIT# CONTROL# DATE VALUATION ,,I,�fllltt �!1 LOT TRACT7823 JOB SITE ADDRESS 7944'10 r�Stl{a EW 11t, APN OWNER CONTRACTOR/DESIGNER/ENGINEER BRIAN & LAURA LEG, Rt,.E, E t:AWENT POOLS 79-210 ASHLET OL 2318S. %rMI N'tlRll 1i.VENU.#' LA QUIN`1'A, C:A, 92253 ONTARIO CA 9176 t USE OF PERMIT POOL )\,NV $;P A. i.1.N1 t►; V000 APdD'09, GPA i5.0U0.Gi111;: E5'11MA." EX) C08`A.' Oki' CVNS-1'ft1r`S:`'�'gON 15,1N1'9Dxo r FEE SUMMARY � PLAN (J1F(X FLEE 101.-000-437-518 �!t►5.?;3 CC.9AfWRV(.171014I�TA 1101-t1W-318-0100 S162.00 NFECTL AMICAL FIX __ P0011 1.011-OW-1121-11MI V'ICA A) .81 IRICrli..0 UE »- t<+t:.OL 10j.-000-420-000 915.01) N[ UMIMNO 10EF ['00[. 101-WIJ-419-ID lt1 S27'.00 a �;tJ�-`ley''1`�a�`®NS""#"�iEJ�"•#`1t�N,�1,N1:� �"!../11Nt^,1�F;C':€�. `'1111'►.3111 PAID LESS PRE -1 AID IT'REsS $0.00 1 `1'UrAl, #'RAMIT F E1,EN 'tail E NC9W S1idOJO JUN 0 2=- 1998 . . t,JITY OF a, 110 R,,E CEIPT DA E } q L BYy� .# t 'M^4 DA FINA INSPECTOR ti 11113 x;�{ i( 1 INSPECTION RECORD 4 OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air I,Roof Deck Exhaust Fans 6;.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wail insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS - SPAS Steel 1-10 Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test i 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 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 i Final Utility Notice (Perm) COMMENTS: Light PARTS LIST. MOTOR - BEATER 20 AMP 2-71I'IROW BREAKER 1 /2" CONDUIT (ADD -4F12 GROUND WIRE IF P.V.C.) 2- 012 BLACK AND 1- R 12 WHITE WIRE 220 V WATERPROOF T1ME CLOCK 1 /2" WATERPROOF FLEX. CONDUIT WtTfI CONNECTORS urm u 15 AMP BREAKER 1- # 14 RED AND N 14 WHITE WIRE G.F.I. AND WATERPROOF "J"BOX (ADD 9-12 GROUND WIRE) SW1TCf1 AND WA I'ERPROOF "J"BOX BRASS "J" BOX 0 Time Clock Heater G.P.I. Panel witch Braes Motor J, 18" Dee �1Z 4o►S LINE i RE.s► t��tcE S15Z All-Awr H ED SRGe -Fbiz SLEC, . Rook up—, �}� i �J-.1P 1 �CIPO PoolBudosrs • e�c�e 1954 -I D14• SPq ��SisP I ta� Pw =1 11 3 STFFSII �v (909) 947-6474 (800) 479-5560 Fax (909) 947-4393 2318 S. Vinevard Ave.. Ste. A Lk- No. 618892-C-53 Ontario. Calttomta 91761 CuOM� C,v I UE , Gl S G ARRIE L ->J �l 'fZ�parZ P �' 5� SP4 = 3o F6OL I G-=NEPA, *= SPSCIFt ::TIONS EXCAVATION `�AAI?P^c Amts ® X Boo Cat ShU=6 CK Remove Out Remove S wnots, Remove Fume Reowe Fence Remove C*Xrw • S. STEL Exoansae Sod Stec Pa=m— PLUMBING F*W Run F.;, Ronan Unes Baaarasn Lro 0 Trac Gas lirr T (n FGD ELECTRICAL Rte+ By Ftq.4_ GUNITE Love Seat swim Out Edi 2nd SUP YES Rbo k% X FL Rbb h X FL COPING Type STD TILE Type Soa Darn Acct rile OECXING Tyt» -cC :aaartston .Town Focangs wt&M Oram EQUIPMENT Hear Type CAgZ&=44= Pump _2`ho is-. Smartsox Yes &ED AcuaMagta Yes Nt Smar ugm C!�!:) No SCO w uq^t <5D No Smwwac Yes (Sq: F --w y Vac Yes QED Neater LMOPzU ® Pr. Slide Steer Descent Sao PLASTER C-Aor,_ SPA Size ZpA. In Out Plimoinq Run cam wag Lamm Nuenow Of .fats LF Blower N.P. Yee No Rarncw_Modsl• Soa Side Swfth Yes SrnanugM Yes co at Watt L q Yes • . Nil — avYati :..: tr,raats • I�orvy anon :... .:. -...:.: ---_ • Apprvv. ttgtriomant!ocaoott .. - ____— • Urtcars-,r,d that aecking srvvm is for &=-anon oaroase: x+y ar4 undersand mat Bey ars'z receive =?-Me feet of aecc. Prepared Especially For: ['BRIAN MIRK LEET sit -19-21D As"L PL Cay LA Quim- A Z,o cl7- Horne.Phor, � oo - `349 WOlK Pt�pne Oeslcrw Lat Blocx Tot= AFI N- V40. .Joc No .