9903-094 (RPL)LICENSED CONTRACTOR DECLARATION
U i I hereby affirm under penalty of perjury that I am Dense `iq der provisions of
F-- .Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
�,w Professionals Code, and my License is in full force and effect.
C M License # - Lic. Class Exp. Date
r` LU 690773 x;:53 C27 B t�t3i}!OG
~ Z ir�- • ate r;� �''1 Signature of Contractor, �! '� 2 •�.a = /
J OWNER -BUILDER DECLARATION
.W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
Z- ( ) 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).
LO () I am exempt under Section B&P.C. for this reason
N Date Signature of Owner
Qrn
U Q WORKER'S COMPENSATION DECLARATION
C:) Z I hereby affirm under penalty of perjury one of the following declarations:
U-) H Cc
.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
mJ Q performance of the work for which this permit is issued.
Q .0 (s,,) I have and will maintain workers' compensation insurance, as required by
O CJ Section 3700 of the Labor Code, for the performance of the work for which this
a rn H permit is issued. My workers' compensation insurance carrier & policy no. are:
?.; Z Cartier ' Policy No.
000 Q STATE F11ND i0t3f,<t:17.vy
g (This section need riot 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.
1 Date: / • r, Applicant tie ice.
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
.a• 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.] 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)}""J /� �� t. Date
PERMIT #
BUILDING. PERMIT
"(13.004
DATE VALUATION .�!^`l3,W0 (* LOT TRACT
JOB SITE
ADDRESS 78,9. BAYBERRY DRIVE
APN y
OWNER
CONTRACTOR/DESIGNER/ENGINEER
78-930.BA'3t'OPARY :OR:!~1!E
81-9vti N40rJ' IVAIN VIEW LANE,
'LA Q1.fINI-'A, CA 92253
LA. QU1NTA. CA, 9.225:1
(760)39!R-!766 CB1111 ISM
USE OF PERMIT
1'uCiL Ai►if IOR SPA
:E�.�i,.Jfii�,�t,.r>1.CL,i' « ti'i'.iiiZAt�'ft3.++1f2.�i.�l;fta i1%f.IJS'P i3�# IN1'T.A.C� ,tet'
1?;tik:-S'!•��"2'�12;lAtu�'f r�'1`iC.�l�'
POOL Ax1liN'OR SPA 121AW.00 LS
ESTIMATED C°O7ST OF inti°STS UC'1i ION
t3,000.40
VKR iT FEE, S'ElM.il9Ait2:1
P1. AN CHECK FER 101 -MG -439 -IM
��C?xS'i'Rt?C".°?"1n531�1 t�it.{)rpty_r�i��ld►(3 �Flddl3t►
1}3G'€1NN1C11 , FM -- I1100L 101,M-421.,000 5:�1.OcT
%'d'iZxC.11. FELE. _- POOL 101.-000.420-(i£it3
P1.f1,`4fi1IN0,FX* -1'001, 101 -(CA} -419 -OW 527.09
S[,1B.'1'OTA1'�. PLAN CHECK
..ESS 11TZ; - AID FE -1131S
$0.00
Y.MA i FE.R11' I f PCES 1)U pJ NLai FY
$3.73.60
RECEIPTDATE
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 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover >
Equipment Location
Underground Electric jA
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
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)
COMMENTS:
r
MAX
DEEP END RAMP
CONI
4 KILL MSCI
6• CONI BLK. W//3
O 4e'O.c VERT.
ST- SOLID GROUT
ALL CELLS
♦ pe BONS
BEAM
RAISED BOND BEAM
BRASS EU
PULL Box
ABOVE WA
10 IW .OMLEN�GTII 4' :mj i
Ise Ir ac
BOTH WAYS
AROUND NICHE
SECTION AT LIGHT BOX
RENF. GUMIE
130 Ir D.C.
BOTH WAYS
SCHEDULE - 1
RADIUS SCHEDULE
BBEAM STLOND
FOR NON-EXPARSIVE SOL POOLDEPTH
4 03 FOR EXPANSIVE S0.
MATER SURFACE Y-6' V-0'
4'-0' 1•-0•
E T S 5'-O' 1'-6'
w_r r -o•
`ORAS REDID r-0• 3-6'
�•
4m ETT CrTr_
1 y r-6' 4'-0'
C YL OTE: 146 SECTION F_D• 4•_6•
CAN BE
END
FOR
UP TO S'IN DEPTH
11• 7n SE 4 /4 BAR BOND Ise Ir act GTA
BE
AND EXTEND DIVE r ei POOL BOTTOM.
r EA. TEN 1
9' OF RAMP MALL TMCCNESS IN CENMTELL
TO CHANGE
UNIFORMLY
n
STD. REINFORCEMENT & DIMENSION
EXPANSIVE
1
PLASTER
pe BIND BM.
BOND BEAM
STANDARD COPING & TILE
co'.. :XL
4 NO
BOND BEAM
/30 12-0.c M0R,2„
STL THROU..
Ise trac�•�
VERT STL
NAT. GR.
1=-2
SHALLOW END
FILL ADJACENT TO POOL
Camc LEVEL BOND BLL W/ GROUT
OECK BEFORE POURING DECK
POC.
3 1/2' LONG MASTIC FINISH MADE 7. REDO
MIN. OR
=AR Br CITY
13 LEL FELT TIE HASTE
OR 4 MILL MSOLM ^:" PLASTER
I
BOND BEAM
CANT. CONC. DECKING
oEac OR GPS py.
2 03 BARS
BEND BOND
4• BM. SIL.
AROUND NICHE
ELEVATION
1
o
,e 2 /3 BARS
2m
SKIMMER NICHE DETAIL
`MAINSW DRAIN
AT LOW POINT
TYPICAL LONGITUDINAL SECTION
4' MIRE
03 VERT S
O Ir D.C.
"P" TRAP DETAIL
2 03 BOND BM.
PRE -CAST COPING
WATER SURFACE
DECKING
MATER SURFACE
^ Iso ,r CIC
~E
, 4 /JO BOND
M
vAPSK BEAM
X /30 5'06Q VERT
10 SPA M_
o rELASTL
� b
DAY 2000 P.S.I. COMP.
6' b
9. STEEL SHALL CONFORM TO AST.M. A 615 GR. 40.
APPROVEENCLOSURE
ID
LAPPED 40 OLA.
ALTERNATE TO
5 PUBLIC PODS REGUIRE COUNTY HEALTH DEP .
MAX
DEEP END RAMP
CONI
4 KILL MSCI
6• CONI BLK. W//3
O 4e'O.c VERT.
ST- SOLID GROUT
ALL CELLS
♦ pe BONS
BEAM
RAISED BOND BEAM
BRASS EU
PULL Box
ABOVE WA
10 IW .OMLEN�GTII 4' :mj i
Ise Ir ac
BOTH WAYS
AROUND NICHE
SECTION AT LIGHT BOX
RENF. GUMIE
130 Ir D.C.
BOTH WAYS
SCHEDULE - 1
RADIUS SCHEDULE
BBEAM STLOND
FOR NON-EXPARSIVE SOL POOLDEPTH
4 03 FOR EXPANSIVE S0.
MATER SURFACE Y-6' V-0'
4'-0' 1•-0•
E T S 5'-O' 1'-6'
w_r r -o•
`ORAS REDID r-0• 3-6'
�•
4m ETT CrTr_
1 y r-6' 4'-0'
C YL OTE: 146 SECTION F_D• 4•_6•
CAN BE
END
FOR
UP TO S'IN DEPTH
11• 7n SE 4 /4 BAR BOND Ise Ir act GTA
BE
AND EXTEND DIVE r ei POOL BOTTOM.
r EA. TEN 1
9' OF RAMP MALL TMCCNESS IN CENMTELL
TO CHANGE
UNIFORMLY
n
STD. REINFORCEMENT & DIMENSION
EXPANSIVE
1
PLASTER
pe BIND BM.
BOND BEAM
STANDARD COPING & TILE
co'.. :XL
4 NO
BOND BEAM
/30 12-0.c M0R,2„
STL THROU..
Ise trac�•�
VERT STL
NAT. GR.
1=-2
SHALLOW END
FILL ADJACENT TO POOL
Camc LEVEL BOND BLL W/ GROUT
OECK BEFORE POURING DECK
POC.
3 1/2' LONG MASTIC FINISH MADE 7. REDO
MIN. OR
=AR Br CITY
13 LEL FELT TIE HASTE
OR 4 MILL MSOLM ^:" PLASTER
I
BOND BEAM
CANT. CONC. DECKING
oEac OR GPS py.
2 03 BARS
BEND BOND
4• BM. SIL.
AROUND NICHE
ELEVATION
1
o
,e 2 /3 BARS
2m
SKIMMER NICHE DETAIL
`MAINSW DRAIN
AT LOW POINT
TYPICAL LONGITUDINAL SECTION
4' MIRE
03 VERT S
O Ir D.C.
"P" TRAP DETAIL
2 03 BOND BM.
4'-0• MIN.
WATER SURFACE
MORU2 STLO 12' ac
T
•T�
^ Iso ,r CIC
~E
J VERT ST !
_
STRAIGHT MALL
1
WEEP NOI,E$
10 SPA M_
RAL
>
4' MKI
>
1
4' cnTMoN P. BOTTW/OM 4
sE
/70 12' D.C. B.M._
SEE TYP. POOL
SECTION
SPA ADJACENT TO POOL
TYPICAL SPA SECTION
�
CITY F- LF �: �
NOTES BUIL - Z
ALI
A
�PAHWENTI
4'-0• MIN.
BUILDING SURCHARGE
O %"� "" "•�
MASONARY VENEER
•FENCE. FENCE SMALL DE MDL S' -G' MGM ABOVIC
GROUNIX GATES SMALL BE'SELF CASING AND SECSCONSTRUCT
MTM LATCH 4'-6• MIN. ABOVE THE
7. CREAT SMALL CONFORM TO UBC STM 26-1. A.S.T.10
DECK
As
AS PER L
As PER 1ACJIL tItOINANLi•S
WEEP NOI,E$
S
MAX
2. POOL SMALL NOT BE FILLED WIN MATER UNTIL THE
FENCE NEE» CONSTRUCTED ""°
DAY 2000 P.S.I. COMP.
MIR
9. STEEL SHALL CONFORM TO AST.M. A 615 GR. 40.
APPROVEENCLOSURE
6200
V6200i
LAPPED 40 OLA.
ALTERNATE TO
5 PUBLIC PODS REGUIRE COUNTY HEALTH DEP .
P00.
BARMIER PUT
ADD /3 1r C.C.
APPROVAL.
IN GING BOTTOM
H.ONCITUO AL 0
.0
4. POOL EQUIPMENT IS NOT PERMITTED IN FRONT YARD
TRANSITION WHEN
EARTH. NO GROUND WATER
CONI Fr!:
REO'0 BY BLOC DEPT.
I2. GUNITE TO BE PLACED AGNNST UNOSTUF41M EARTH
MOISTURE BARRIER
SHAPE
BUILDING
PROVIDE PLAN A CALL'S
LINER
RAISED PLANTER
FOR RET. WALL
EXPANSIVE SOIL ONLY
rRDnaN
pq�AIN.SI'"L`
14. KEEP CONCRETE CONSTANTLY DAMP FOR 14 DAYS
�
CITY F- LF �: �
NOTES BUIL - Z
ALI
A
�PAHWENTI
S ELECTRICAL AND PLUMBING PERMITS TO BE TAKEN 01 T
1. POOL SMALL BE COMPLETELY ENCLOSED BYtAND!
BUILDING SURCHARGE
O %"� "" "•�
sLXaAIE
•FENCE. FENCE SMALL DE MDL S' -G' MGM ABOVIC
GROUNIX GATES SMALL BE'SELF CASING AND SECSCONSTRUCT
MTM LATCH 4'-6• MIN. ABOVE THE
7. CREAT SMALL CONFORM TO UBC STM 26-1. A.S.T.10
X D- Los 0-5'lo D- to
1200
AS PER L
As PER 1ACJIL tItOINANLi•S
•flat
- MIDI p fwrnc p nfae 3.
S
4 GUMTE SHALL NOT BE LESS THAN 1 TO 4 11/2. 26
2. POOL SMALL NOT BE FILLED WIN MATER UNTIL THE
FENCE NEE» CONSTRUCTED ""°
DAY 2000 P.S.I. COMP.
LL ATION A
9. STEEL SHALL CONFORM TO AST.M. A 615 GR. 40.
APPROVEENCLOSURE
6200
V6200i
LAPPED 40 OLA.
DESON POOL FOR EARTH PRESSURE
5 PUBLIC PODS REGUIRE COUNTY HEALTH DEP .
IOL POOL SHALL BE MDL 5'=Cr FROM BUILDINGS, TREES,
REINi. REQUIRED
REQUIRTHICKNEED
SPECIFICATIONS
APPROVAL.
v 301 14. M1 PRESSURE +M- N7 3/6
25700
.0
4. POOL EQUIPMENT IS NOT PERMITTED IN FRONT YARD
K- _"4 J -.6e
EARTH. NO GROUND WATER
. m1 - 360 P.SIR 900 ALLOW
OR A REQUIRED SIDE YARD AD4ACENT TO MAIN
I2. GUNITE TO BE PLACED AGNNST UNOSTUF41M EARTH
SHAPE
BUILDING
M. + 0.]o - 21
LINER
TYPICAL POOL
BE P`°'A0E0 WITH "�"°'E° FILTER
'
CABLE CODES
rRDnaN
pq�AIN.SI'"L`
14. KEEP CONCRETE CONSTANTLY DAMP FOR 14 DAYS
S ELECTRICAL AND PLUMBING PERMITS TO BE TAKEN 01 T
CIA SCHEDULE 2
BUILDING SURCHARGE
AT THE SAME TIME AS POOL BURRING PERMIT.
RCHARGE ADDIT. VERT.'51L.
04
7. CREAT SMALL CONFORM TO UBC STM 26-1. A.S.T.10
X D- Los 0-5'lo D- to
1200
C 1sa62. 17560.
•flat
- MIDI p fwrnc p nfae 3.
S
4 GUMTE SHALL NOT BE LESS THAN 1 TO 4 11/2. 26
4 -0' YIN p Wftac p Or=
DAY 2000 P.S.I. COMP.
09
9. STEEL SHALL CONFORM TO AST.M. A 615 GR. 40.
15000
6200
V6200i
LAPPED 40 OLA.
DESON POOL FOR EARTH PRESSURE
DANK MEANS NO
SPECAL OR
IOL POOL SHALL BE MDL 5'=Cr FROM BUILDINGS, TREES,
REINi. REQUIRED
REQUIRTHICKNEED
SPECIFICATIONS
OR PROPERTY LINES.
v 301 14. M1 PRESSURE +M- N7 3/6
25700
11. SOL SHALL HAVE BEARING 1000 I1 FT. UNDISTURBED
.
K- _"4 J -.6e
EARTH. NO GROUND WATER
. m1 - 360 P.SIR 900 ALLOW
WE x AREA 0 DOM TO
I2. GUNITE TO BE PLACED AGNNST UNOSTUF41M EARTH
SHAPE
EXCEPT FILL A RAMP.
M. + 0.]o - 21
LINER
11 PLUMBING ! ELECTRICAL INSTALLATION TO CONFORM
T7 LOCAL CODES,
POOL CAPACITY GILL:
14. KEEP CONCRETE CONSTANTLY DAMP FOR 14 DAYS
PUMP
15 MINIMUM CLEARANCE BETWEEN EARTH AND STEEL TO
MOYER M.P.
BE r,
FILTER SIL FT.
VACiNM LINE t d" -EN '
R[NRN UNC
TYPICAL BOND X
'BEAM
W/4 /3 E SCHEDULE 21
LNAN ORNTN
=
BON° BEAM STL�
M000_
WATER
ONE STORY HOUSE I CASUME 13" VENTED MI
OR GARAGE FOUNO-
ATION. 1000 LIL/FT.' CAOf
OR FENCE
RACE ADOIT.
VERT.STL IN WALL
IN ACCORDANCE NTH
SCHEDULE 2.
•�J�2
CIA SCHEDULE 2
BUILDING SURCHARGE
sw 1100 1
RCHARGE ADDIT. VERT.'51L.
04
X D- Los 0-5'lo D- to
1200
•flat
- MIDI p fwrnc p nfae 3.
S
7500
4 -0' YIN p Wftac p Or=
09
S- Y "a -ac
15000
6200
V6200i
6-0 Y
DESON POOL FOR EARTH PRESSURE
DANK MEANS NO
SPECAL OR
EMPTY; NO GROUND WATER PERMEABLE SOL
REINi. REQUIRED
REQUIRTHICKNEED
Ha- 2000 P.S.L. NI- 1600° P.S.I. n -I5
v 301 14. M1 PRESSURE +M- N7 3/6
25700
k a 7S PT2113 ".0661 "0.09
.
K- _"4 J -.6e
. m1 - 360 P.SIR 900 ALLOW
CC O 25' POOL RILL UWSUPPORIEO
625x2.sjn2
M. + 0.]o - 21
< . 0.09 11
W +M -Mf LEL NET MR I a AS A
3
16°0
sw 1100 1
2
04
3600
1200
05
S
7500
25M
09
6
15000
6200
V6200i
4
12
7
20.700
130001
7.5
25700
Igloo
14
POOL CALCULATIONS
1 MON. APPROVED
DECO T
Irsrid
NOTE: RELNNOER OF JOINT
IN NSION JOINTS —101—O-101— OR OTHER
EXPA
EVA IN OEOE AT EXP• MATERIAL
t0 -o• O.C.
EXPANSIVE JOINT
NOTES
NOT TO SCALE
DEEP
END
SHALLOW
END
UNLM OTHERWISE SPECIFIED:
POOL IS— SHALLOW Ta_ DEEP
1 NAVE RECIEVED A COPY OF
THIS PIAN AND HEREBY
APPROVE POOL AND
EQUIPMENT LDCJITIDN
SPA GENERAL
SPECIFICATIONS
OECMC
U SCaLmEOUS:
SOLAR GENERAL
SPECIFICATIONS
on
LOT NO.
TRACT NO.
BOOL _ PAGE_BLOGL_
ESCROW CLOSE
TENTATIVE DIG DATE
PERMIT OFFICE
OWNER:
TD INTERIM
APADWAAX n9Wff P v
I=an OV a QJMlO1
Fm MINA To IN FD100.
or
ojXX PO, OxDNY ON
an oOmACLOM:C GTO TO K
AM W1f
WM Nm LUN ON Pan Loa
WIO POOL a Dow
POOL OR SPA
JOHN H. HACKER
CIA Engineu
68255 CORIA RO (619) 324-2046
CATHEDRAL CITY. CA. 92234 (619) 324-0216
SWIMMING POOL CONSTRUCTION
1
7-p
AoM
3l P A.
cl cr'lzu S
-960 13AA gra
L---= OF LA Q'UlNi�
BUILDING & SAFETY BE rMENT
CONDITIONALLY
ACCEPTED FOR CONSTRUCTION
SUBJECT TO INSTALLATION AS PER
-7Z sv
AND ALL APPLICAB E CODES.
3 /7 BY '
POOL SIZE IS `tC DEPTH --L0 - PEA 2 SO. FT. ❑ INCLUDED
TEMPI. NO. FILTER NO. NOTE: ' SHALLOW END ..... ❑ LADDER ..... ❑
$11lWE NO. RETURN ONES +? I I (SE'fl R DEEP END DIG ...... ❑ SLIDE .... .
�lw 7 L!i' �� %�� �i{GAS ' aI� P -TRAP .... ❑ SPA (9R�
ACCESS�_FT. FENCE y BACKWASHUNE .... ❑ SPA .'. SZ.. ❑
MOTOR FviviF A!. _HP 7-In��4ZPi2ktT ld_ FILLLWE ......... 13 ^.'JORINATOA
LIGHT _ANTISYPHON VES A4� I' \ ( , , I.� EtT Tac ,ri. GRADING ❑ ROPE WNw .... ❑
HEATEA S��R4ci ❑ MAWT.xff . ❑
ELECTRICAL (� FT. BONDING YES �D �,t �D to AW: _ CUNITE INSP ....... ❑ TREES ....... ❑
GAS4iQFT.TILE COPiN N0. I7.�PN S ��I�c BOARO .......... ❑ Gi?ER ........
�
DA -PALM M IFNI R�'1�1�E$ LOT_ ►�toaR� "lam
POOL/SPA CONSTRUCTION/LANDSCAPING TRACT _� "' �• CrtY
(760) ,gBPF10NE Gia PMONE
CONTRACTOR NO. Is-1;C•53;C-27 690775 SALESMAN PLAN NO. �NO7ZQ