9706-107 (RPL)nin
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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
Profess°fbnals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
374127 A 1
/Date, � 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:
Carver Policy No.
'1AI'13VL;1+1t
(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 shat forthwith comply with;rose provisions.
Date: 0* Applicant /r
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 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 da s from date of issuance of such
BUILDING PERMIT
DATE 6116M7 VALUATION $14,87.5 d11i LOT
JOB SITE
ADDRESS 44-335 CAFi INO AM,
OWNER
V} ?IMN y;NAA ICYUk.M
X,
44-335 C .M INO AWL'
,ta,fL QlJi;NfA. CA 9725:3
USE OF PERMIT
1atJC:f.1.,
lfW,L AND SIP A.ONIA
VALUXIFIGN
PERMIT #
97"1 -*107
APN
CONTRACTOR/DESIGNER/
CONTROL#
TRACT 5370
J.1TIV i.. %,�W
J1J�9�JiV i, ONS.4.1 IJIIT +i..+fr)%,
7 -0.11 Z::OIJTV'i'& Y CLUB 131t11/E, !�17F. F4
PALM EASRUIT OA 92260
{70U1346-4032 CHL # 1044
14,8 775.00 LS
14,137:,410 "
PLAN 0.*4X FRt()'1-f}fes-�9l�:,11R $105--w
XE 'Cl:LANI;
INSPECTION RECORD
OPERATION
DATE 7
INSPECTOR
OPERATION
DATE INSPECTOR
4 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
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equi
_----Underground
Electric
Underground Plbg. Test
Final
Gas Piping Kv
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
H er
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover 17
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)
7'
1
SPA
( +6"
ADAMS STREET
air induction
pipe
I--- 7-
11'-3"
I I
PI +23'
26'-0" 4'�
16'
P/L
1
spray heads 6"
30'
15'
41
4'
14'
® S If
W
�oF
POOL
p, b equip to ® & SPA
�'WaJ.I LIGHT
�o SWITCHES
4-5'
40'
GM+ENI
bobcat access thru
r.v. garage with
door to rear yard
12'
16'-7 1/2"
W
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CITY OF LA OU INTA
._GENERAL SPECIFICATIONS
;E 15' X 30'
AREA 370 PERIMETER 82
DEPTH 3x5
TILE CHOICE group3 So. 56
to
BUILDING & SAFETY DEPART EK
CONDITIONALLY
ACCEPTED FOR CONSTRUCTION
SUBJECT TO INSTALLATION AS PER
"
D ALL APPLICABLE CODES j
BY lhy"�5"
RBB. 6 t nnish
COPING cantilever verer
POOL CAPACITY 13140 GALS
PUMP CAPACITY 100 GPM
MOTOR HP STA RITE HP 1 .5
MOTOR HP n/a HP
FILTER STA RITE 300 SQ FT
FILTER RATE 103 GPM
HEATER LAARS SIZE 250 • BTU
TURNOVER' 4 HRS
SUCTION LINES 2 "
RETURN LINES 2-1.5
cVIKAKAro nnnnn nRA
GASLINE BY sdc FT. 40
POOL LIGHT 400 CLOCK t104r
ELECTRICAL BY. sdc 145
34'-6" AUTO CLEANER none
rHF:m FFFni:P none
STEP 6' FT.
SPA SPECS.
P/L SIZE 7 RAISED Yes
LITE 1 WATTS 100
RI LEVEL SEATS 22" 24" 27"
DAMWALL 6 " X 6 FT.
DESIGNER DAMWALL TOP tile
SPILLWAY SIZE 3 "X 12 "WIDE
randy SPILLWAY x OPEN CLOSED
DATE # JETS 4 UPER LOWER
5-20.-97
W 17'-6" Name: Shawn and Dena Durelle
Address: 44335 Camino Azul
City: La Quinta
TRACT Ran. Oct. LOT# 37
Do sol,
POO/41
�`''S"r V2z PALM DESERT TEMECULA
infimnCOPY 73-011 COUNTRY 28910 RANCHO
Scal 1/H',=1'O', CLUB DR. STE F-4 CALIFORNIA RD.
PALM DESERT CA. STE 206
NOTE: LANDSCAPE AND FURNITURE 92260 TEMECULA CA.
ARE SHOWN FOR ILLUSTRATION (619) 346-4032 90
90
ONLY AND ARE NOT INCLUDED. (79)676 -SWIM
LIC # A-574127