0109-104 (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 # Lic. Class Exp. Date 4
5-7412,7 AV, 33 ;y,,,:;.rf W3aif):t
Date- �' j Signature of Contracto ti.,. �''✓!�
OWNER -BUILDER DEC LA" ATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 1, 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 sof 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:
mer Policy No.
ISTATE aTUI+D 0460-00"34
(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 r _•
Date a �r. Applicant "rr✓-.✓` "' "" .
i``V V7 ing: Failure, to secure Workers'wl ompensation coverage is unlawful and
shall subject an, employer to criminal penalties and civil fines up to $100,000, in
addition to the cost -of compensation, damages as provided for in Section 3706
of the Labor Code, .interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person'at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work isnot commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have. read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) _ - Date.
BUILDING
PERMIT PERMIT /t
.Q
DATE VALUATION
LOT 0109-104 TRACT
JOB SITE
APN
ADDRESS
ry ♦ BBy p
OWNER
CONTRACTOR / DESIGNER / EN (NEER
sIrk V111.1:d4:yDSONo°'Ifiv,
192:3ODSON COMSCRiiC:i 1,03 MC.
(766)346-40;2 0,BL O 4044
USE OF PERMIT
i
POOL AMY OR Wn
P001BPA ALARMSMAR.RIERS SHALL HZ IN K.A.CF;AT PT.�?� AS'Z'M
,INSPECTION, PIsR3>,+Si i' 009S NOT IN0WDE 1QUIP ENT E'd(wWStlR
VALUAIrl",
LS
MMUf '['�}j� �j�f�'$j�,@Q/��p p�.�.��a'�,�
.!."3Ye dr4tlU A��w:,*,* i31Si.lW.{:Y.�9$..Y.GS.
PIM ","ECK ME, ::
1.014*0E 4 39.33'18 $9%09
CONVRUCTION FES
101 _000-4 1 8_1000
MF414;f UKALE F.IZE -- 100a
101 dw_.:421-000
ELECTRICAL tFEV e, POO.Z
101.�Ot —420-000 � �l5.aII0
f --p-004.19.00 3 WOO
SEP 13 2001
CITY OF
FINANCE ),PITTA
J :iSi�sC1 cimmLJC TIION-Akm P.Pt.,,wt; t! 9« v
M160
u -'so 1 `'R vPAD Irmo
$0.00
RECEIPT
DATE
BY •
DATE FINALED
INSPECTOR
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 Wali Insulation
Condensate Lines
Party Wali Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
Set Backs
-
Steel
Electric Bond
POOLS - SPAS
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping'
7C
G
PLUMBING APPROVALS
Gas 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-
G- G
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Law Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
I + 12 FIRE PIT ANSI # 496 I
„ MFR.HEAT & GLO
BLOCK WALL 33'X24"H
W/ DECK CAP
+24"
c
GOLF COURSE
2-3' C
+ 18"
R1'-611 1 1 + 2%�
2'-6"A I '
81-011 11'-0" f,r•
i
2'-811 ( I
� SBS36" HIGH PA
V I
1
I
3'-0"
I
. 1
-011 m
23
f
-8
29 I
1 11
' _011
17
1-12" CUSTOM CASCADES arch fall
'OM CASCADES \ 1,;
21-011
I +30"
R1' 611
vi
24"
SPA SIDE SWIT
611
TILE
NOTE; PL
BAR TILE I t
40 SQ. 1 JANDY RS 6 WITH SPA
SIDE SWITCH
RESIDENCE CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
b A RE -INSPECTION FEE OF $30 1 11
DATE { Y
1 1/2" GAS LINE WILL BE CHARGED IF THE APPROVED - B
PLANS AND JOB CARD ARE NOT ON
THE SITE FOR A
INSPECTION. SCHEDULED
GAS NO EXCEPTIONS!
ELECT PAG E 1
MA
PL
151-011
am
SIZE 13 x 29
AREA 358 PERIMETER 88
DEPTH 316" 51.31611
TILE CHOICE TAN SQ. 146
RBB. 39'X24" 9'X18"
COPING CANTILEVER
POOL CAPACITY 101740 GALS
PUMP CAPACITY 102 GPM
2 PUMP #1 STA RITE HP 1
PUMP #2 STA RITE HP1,5
FILTER STA RITE 300 SQ FT
FILTER RATE 102 GPM
HEATER LAARS SIZE 400 BTU
TURNOVER HRS
SUCTION LINES 2 "
RETURN LINES 2 It
SKIMMER MODEL AMERICAN
CHECK VALVE YES
GASLINE BY SDC FT.
POOL LIGHT 400 W CLOCK T 104
ELECTRICAL BY. SDC FT.
PLASTER COLOR WHITE
j DECK BY SDC SQ. 130
DECK TYPE SANDIEGO BUFF
1/8"=1' SCALE I.
STER PY
ACCESS
BOB CAT
R&R WALL N
1 � O
SIZE / RAISED b
LITE 100 WATTS
A`fERI LEVEL SEATS 22" 24" 27"
/21 /O1 DAMWALL 1 " X 4 FT.
DAMWALL TOP TILE tv
:REYESED : SPILLWAY SIZE
3 " X 18 WIDE
CLOSED
/6/01 # JETS AY 4X UPPE L LOWER
lie STEVE & DONNA DODSON
Address: 79253 LIGA ST.
Qiw La Quinta
JOB# 150-01
TRACT TESORO LOT# 56
CITRUS
&dsoff
Poo/s
PALM DESERT TEMECULA
73-011 COUNTRY CLUB DR. 28910 RANCHO
SUITE F-4 CALIFORNIA RD. SUITE 203
PALM DESERT CA. 92260 TEMECULA CA. 92590
(760) 346-4032 (909)676-7946
LIC # A-C53-HIC-574127
MFR,HEAT & GLOrV I
BLOCK WALL 33'X24"H
W/ DECK CAP
stursQ.fmish.m Inatth_ho-=e
24�
\ I
IIL
NOT TO EXCEEIxO
A
A
A
Y _ �
1
BBQ36" HIGH
A
1
i
3'-O" 1
1
NOTE; L
GAS
ELECT
PA
PA
vvir c.vurFJt
29'-B"
. _...._. 17'7-01" --►
Z-3' CUSTOM CASCADES"„ CUSTOM CASCADES arch fall
/+24' . ' +30"
RV -6"
24"
A SIDE
: 6"
PA
■
112" GAS LINE
JANDY RS 6 WITH SPA
SIDE SWITCH
�'_ ---�►J
GENERAL SMCIFICATIONS
--�
SIZE 13 x 29
AREA 358. PERIMETER
�_. 88
+ 3'6'_5' 3'6"_
W
}
_
TILE
m
CHOICE TAN _ SQ 146
R 39'X24"
�U.C_ _O/ ON np
COPN(' CA1TlLEYER
vooL CnPAorY
102
..-ST.t
2 !!Lf q I RITE HP 1
srAnlre Hp, c
m
R TER STA—RITE 3010 5Q F;
-
FiTER RATE t0_' GPM . -
"
_
HEATER L.AARS SIZE 400 EITlI
—_---HRD
�D
—
Tl.'RNONER
.
2 • --
3
RETURN LINES—
3
SKYAMERMOCIEL AYIERICAX-_d
i
CHECK VALVE_ YES _- ._-
-
GASL PSE BY SO_C FT.
C
PL
F LIGHT—TpKCLOCK _TIU1—
!n
0
'
ELECTRICAL BY_ SDC Ff_
2
?CASTER -vi
0
0
r
A
- _ _
6ELK eY _ soc sQ. 1300
r
DEOC TYPE SANDIE`
N
nl;+IO-ZER SPA SPECS.
—
;'_6-
LTTE 100 WarrS
DATE KNELL, AyS ZZ— 24' 27'
DA3IWALL 9 2 x 4 —Fi —
DA1tVYALLTDP .IU.E—
----
REVISED SPLLWAYSIZE 3 'x is wil
/6/01 5P0.lWAY XC OPpd CLOSED
a JETS s
tIDPER LOWER
� STEVE & DOAUVA DODSON
8mmm 79253 L1GA ST.Ox
m
X;
La Quinta
a
'
STER PY
JIM ISO -01
m
,,Ey
Igg SORO LOIN 56
CD
N
CITRUS
ACCESS
BOB CAT
R&R WALL N
PALM DESERT TEMECULA
73 -CII C]VR9Y Cum 00. 28910 WANCHO
L O
61YS,7.S CaWlr1u 00. 9A'�E 2na
iAUtCESfYi Gl 9226D I:WZLAGI 9259-C.
(7W) 346-403Z (909)676-7946
LIC a A-CS341IC_574127
'
m
(A
SEP -13-01\10:21 AM DODSON POOLS 7603410895 P.02
OS: tlb, O1 WED 11:45 Ft.0 760 349 9018 D R is 9FJo�Z
Ott
na + 'meat
August B. 2001
Steve & 0onna Dodson
70253 UP titieet
La Quitlle. CA 92253
AmhlL-d l W Approval Request
79253 Liga Street
Dear Mr. & Mrs, Godson:
T h.ie {slier Is to canflrrn, In aaordance with the Architectural Guidelines; the eat for the nseellation
Architecturl
Cemrnittee hits aDPrcved your arChliectural as sbmitW Por 019 P�'c requirements you
cif the pool, $Pa. parbeque and Iends�Pin9
have agreed to In accordance tb the terms stated In your app�� bn dated August B, 2001,
The Landscaping c ornmittC@ vlWsato exprem ess thea COMM cf the roipellh, 011th m.y
susceptmle to sunburn due to tfi
project has been WmplOtsd please nati y this office inewa� pour deposit
thud the
When all work on the a Archltedural t✓omrn� Y
Improvement ran be inspeetvd snd signed off try �
,fin be returned to you.
questions about your anctti ecturaal application.
Pisses+ contact me if you have anY
slncare�y,
��Pran Mullahy
A006 tion Manages Committee
on behalf of the: Archkeetursl Review
Citrus Course 110maow^ers Aseoeletion
rmf,W!, nAt Comrt+wdty Ma>maemene l NOW RE sort Maeagemert
Pmt o9kaBpm 4772 • PalmDeet, CA 9x::61 4772
73-5 50 A.leUQU&o, Sidito 3 • Pim brssrrt.0alifanu+ • (760) 34 r 1161 •FAX (760) M6 9913