9702-026 (RPL)U)
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LICENSED CONTRACTOR DECLARATION '
I herby affirm under penalty of perjury. that I am licensed under provisions of
SChapter 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
3 7tS"2 C:53 213103
D� ate 2 '/�1/ G�✓ Signature of Contractor �° {
OWNER -BUILDS 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.
311 XTS ITT 94D 0517'116-97.
(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, anVgree/hat if) should become
subject to the workers' compensati oIf pro slqns � eo�tiom'3700 of the Labor
,Code, I shaJI� rthwit�ycomply with those prow sio se's
Date:" / / /Applicant''+
Warning: Failure to secur orkers' Compensation coverage Gs unl� nd
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of -Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application. E"
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this applicatioon. and state that the above information is
correct. I, agree to comply with all City,%and'State laws relating to the building
const action, and hereby authorize/representatives�f7this City to enter upon�y°
th bove-mentioned property'for/inspection pGr� ses. V .
Signature (Owner/A e t
9
Datez r�
PERMIT # CONTROL #
BUILDING PERMIT 9707IR6 4745
DATE 2114/07 VALUATION 1441 I) 00 LOT TRACT
JOB SITE
ADDRESS' 45-160 Ii IDC.ET11411 WMI
APN
OWNER
CONTRACTOR / DESIGNER / ENGINEER
Ch! V,Al.APlU.S
SUNAIR POOLS
'0160 .kiitl%ac:;lr'(." E WAY. ' .
P.O. "Box 1045
IA QUIN 1A CA 92253
PA LIM DEMM1 CA, 92261
(1�1)Sti-40.1.4 C.ft,k 529
USE OF PERMIT
P00L 0Nl. s'
V taLIJATId rN I,'_^ 13it 1
.1�.��'3xi'��A'$'�i;� t.".'�' �Ai" �::��iN;�+'��t'•,:1�'1'�i��
� �.,3(;54.��3
S 1.I,�9tWA �Y
i"s�d±IE
PLANCH'.K)" 1t i,- +1ia-433-3➢Fr $97,75
r,0N,STR(Yr''I`10N2-.liY 101 -000 -418 -ON) $135.00
MEC11,1 LAICAL FEE -1 ool, 10.140-4121-00 $24,00
'f'R!(: A -L I' fill -- P0 L 161 -000-4241-000 $45.00
PLMIN9)3ki; G .1:E -F. w- P00L I Ol.-OOO-rl:I9-tW $27.00
I J11-M.1".�1L Cf4a!'��'I'l�1:lC710 ANl') Pt..AN C:I CK
PAD LSS PRE-TAID 1T.ES
Irl DO
FEB 1 1997 �><-►�1.Nt PIPIRo��rj3 FFIV, DIia.�,�re,�►
TY OF LAQUINTA � t
1
RECEIPT
DATE. _
BY
DA
INSPECTOR
)INALE0
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
POOLS - SPAS
BLOCKWIALL APPROVALS
Steel
Set Backs
Electric Bond
Footings •
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric_
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
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)
1531
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MIN,� y G' r
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AND ALL APPLICABLE CODES 3
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1 DEEP
END j
SHALLOW
1 END
SCALE 1 /i" - IV'
PLOT PLAN
GENERAL SPECIFICATIONS
sin p x 3-S Code g,v - 3 s
Shape ►�. c-4 A.
Depth to 5 to
rile Color 64 a -17-
Coping 12'? Cantilever !/1
Pool Capacity ! Z % `e 0 d Gals.
Pump Capacity _72- G.P.M.
Filter OV g,4!- ! C /-' V ,� � 0 Sq. Ft.
Pump 4 &V,+- �—f o H.P. /
Filter Rate % j G.P.M.
Turnover a Hm
Vacuum Line & Skimmer 1
Return Line 2 —
Main Drain
Skimmer }� ,.,. �j )r4 V: �...1 �_,-V•i• J '
Backwash to
Affl,-& P Me" 40+1.;,
Heater L !4 ✓L S size 2 J 0, B.T.U.
Gasline by /N l le Electric by S 01;4 a
Light j-- 41 0
Time Clock -r/ C e -e -
Decking v? �e-� L s t✓
Board color
-
Slide == Color
M. o h S 69,U-1, J/,4 -,S Le,
f..i'7a-
Iq 44,-
I -A," ^-I- W 1}i1,1, 4, _ S 1 `f I- - �'`L
1A,Ya-t1t , ,
C / - i {' (_ leo ,u ex ,
Name T
Address
CRY Ll�
Crow Strom in S A +/ .e -
Phone 7 7 2- S a
Date - ; r- L' 7 Drawn by.
0 SUNAIR
POOLS
SINCE 1974
Pa am M5
P" DESERTM, G 9M1
PHONE (d/9) 5694M
swe uce4m C43, r
Desert Sands Unified School District
Notice: 82-879 Highway 111
Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
CERTIFICATE OF COMPLIANCE
Date 4/18/96 APN # 604-342-009
No. 14343 Jurisdiction La Quinta
Owner Name Century Crowell Communities Permit #
No. 45160 Street Bridgette Way Log #
City La Quinta Zip 92253 Study Area 230
Tract # 25363-1 Lot # 16 Square Footage 1663
Type of Development Single Family Residence No. of Units 1
Comments
By
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports,
covered patios/walkways, residential additions under 500 square feet, detached accessory structures or
replacement mobilehomes. It has been determined the above-named owner is exempt from paying
school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.72 x 1,663 or $2,860.36
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now be issued.
Fees Paid By cc/Foothill Independent Bank/Topaz Associates Telerlhone',�.
Name on the check �- -
Dolores A. Ballesteros
Superintendent
Fee collected /exempted by Pauline Pearson Payment Received $2,860.36
Check No. 24015
Signature a ",Z,,a �Q �A>Q W�.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
e.
Embossed Original- Building-Dept./Applicant Copy - Applicant/Receipt Copy - Accounting