9607-097 (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
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 3740 of• th,%Labor Code, for the performance of the .work for which this
permit is Issue.' My workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
(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.
Date: Applicant
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 days from date of issuance of such
4ermit, or cessation of work for 180 days will subject permit to cancellation.
I
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 W#074W 3769
PERMIT# CONTROL#
DATE 7/25/96 VALUATION S14 -511M.00 LOT TRACT
JOB SITE
ADDRESS 79-26S C:AMINO A.11 IRIli L0 I APN
OWNER ICONTRACTOR / DESIGNER /
C1 NPLTR1t CkOLV}iJ:.[. CpttR;i1N %i1?: :"'€7 ` 8 ODSON CONSTI UCMIO
1535 SOL ".D" S'i ltk.i�"!, 9117E. #100 .. nf3ic05A.1'E1�i.Z %D. VE9
SAN RERN.A1 :134N, CA 92408 CATHEDRAL t:'di'Y` CA 922.34
(009)381-6007 (0 VC )324-1212 C'RLO 1.0,14
USE OF PERMIT
P00.1.. AND/`k 81'x'1
P00f. AND SPA. (:?MLS,'. • 4 -�-7
E ST tN"fED C:t ST OF i:-C;I'VS`.I'tfI HON
u,5ewljo
T�1.i�:t+iflli�L:K.1�a?k
101.00(�•43� 31:8
$ttfS.zO
c�fac�r;31t�uc-zz�:�r�.1
101-000.418.000
MECUA:N1,(,"AL ['Ess - • POOL
$24.00
1 f,.UX'FR iCAL FRY-, -- 1100L
10140420•000
100i t.00
t?JA1111INGITP. -- POOL
1010W-40-000
$21.110
SUO-1WA.L C'QN. 7RU(nT0N AND PLANT CRECK $363.30
TO '.i't1�.�'i'C�2:)t91'C i�'��.1'� !l?�Ji" t4�4'N �r3(►�3.:4fl ..
RECEIPT DATE BY DATE 11INALEDI _ / 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
POOLS - SPAS
BLOCK.WALL 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
ra
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)
r
Tt'ht.
78-495 CALLE ' TAMPICO — LA QUINTA, CALIFORNIA 92253 - (619) 777-7000
FAX (619) 777-7101
July 29, 1996
Steve Dodson
Dodson Pools
73-011 Country Club Drive, Suite F-4
Palm Desert, CA 92260
SUBJECT: SETBACK ADJUSTMENT 96-427
LOCATION: 79-265 CAMINO AMARILLO
Dear Mr. Dodson:.
This letter is to report approval of the setback adjustment application pursuant to Chapter
9.188 of the City of La.Quinta Planning and Zoning regulations, subject to Conditions and
according to. the attached exhibits.
SETBACK ADJUSTMENT REQUEST: To reduce the rear yard setback from 5' to 3' for
a new kidney shaped swimming pool.
CONDITION: Obtain a building permit from the Building & Safety Department.
After review it was determined that:
1. This adjustment is consistent with the intent and purpose of the Zoning
Ordinance to allow development of accessory. swimming pools in an R-1
District.
2. There are special circumstances applicable to the property, .including such
factors as size, shape,. topography, location or surroundings that justify
approval of the adjustment are: (1) that the private rear yard area is small, and
(2) greater separation is needed between the swimming pool and the patio
cover for the occupants and/or guests.
sba96.427-p
MAILING ADDRESS - P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253
3. Thisadjustment will not be detrimental to the health, safety, and general
welfare of the community because an existing 6'-0" high masonry wall is next
f to the future swimming pool and spa facilities. The existing wall will provide
adequate security for the property owner and/oradjacent neighbors.
If you have any questions, please contact me at 619-777-7067.
Very truly yours,
JERRY 4AMAN
yG
G e/PlarSDELL
cltae Planner
GT:cw
Attachments -
c: Kelly Tropple, Building & Safety Department
sba96-427-p
NOTE: 1 CALF JET
R3'-6"
81-0"
R4'-1 1 "
28'-0"
NOTE SAVE PALM TREE
CAP DAMWALL .
WI H OPEN SPILLWAY
R61- "
15'
1'-6"
M
�— R7'-0"
■ - - ■ --- AUTO 12'-6"
16'-2" FILL
12'-5 " r
I W W S
15'
J -BOX --�; S ., W b ... W
5'-4"
250
RANCHO OCOTILLO PLAN 3 MANZANITA
CITY ®F LA QU9NIA {
r BWING & SAFETY DEPA MENT
CONDITIONALLY H IDT -4
A EPTED FOR C- ONST.R NOTE: LANDSCAPE, FURNITURE,
:SUBJECT TO 11024 1AWION.A% R - WALL, CONCRETE DECKS,.
ACCESS'
AND BBQ ARE SHOWN FOR
ILLUSTRATION ONLY AND
AND L APP (CABLE COD ARE NOT INCLUDED.
I
h ;off v _ - : r--_-
:.moor - - _ --
5 gm garageem
W
II
SPA SPECS. GENERAL SPECIFICATIONS _
SIZE 7 SIZE 14 X 28 AREA -297
RAISED 6 " DEPTH 3'6" 5' 3'60
LITE 100 WATTS SHAPE PERIMETER
TRI LEVEL SEATS TILE SIZE
22" 24" 27" TILE COLOR
DAMWALL WIDTH 12 COPING cant.
SPILLWAY SIZE 3 X 12' COPING COLOR
SPILLWAY POOL CAPACITY 8,910 GALS
OPEN X CLOSED PUMP CAPACITY 76 GPM
# JETS 5/4UP&1-DOWN MOTOR HP STA RITE 1 HP
FILTER STA RITE 300 SQ FT
FILTER RATE 102 GPM
R '-10" TURNOVER 4 HRS
SUCTION LINES 2 "
RETURN LINES 2-1.5 "
MAIN DRAIN 2 "
SKIMMER MODEL S Q
21 CHECK VALVE YES
HEATER LAARS SIZE 250 BTU
GASLINE BY DP
POOL LIGHT 400
SPA LIGHT 100
CLOCK 220 V.
ELECTRIC BY DP
ELECTRICAL BONDING BY: DP
TILE AND COPING M368
DECKING BY DIP
751 S COLOR SALT
CONTRACTOR cannot assume
responsibility for damage to
curbs, sidewalks, driveways,
10.5' cement slabs, sewers, =
lawns,trees, fences, retaining
walls, sprinklers, telephone lines
or shrubs. When access is made
through a neighbor's property it is
understood that you, the owner,
DESIGNER have that neighbor's permission
n and assume full responsibility.
Name:. MR. & MRS. LA CROY
Address: 79265 CAMINO AMARILLO
S1Lu: LA QUINTA
TRACT L9 -T# 5.7
Ao0-1/4r
Do son
-_
SHOW ROOM
73-011 COUNTRY CLUB DR:.STE. F=4._ =
R PALM DESERT CA. 92260 =
PHONE (619) 346=4032: =
LIC # A-574127
Notice:
Document Cannot Be Duplicated
Date 12/22/95
No. 13983
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Owner Name Century Homes Communities
No. 79-265
City La Quinta
Tract #
Street Camino Amarillo
Lot #
Type of Development Single Family Residence
Comments
APN # 604-192-015
Jurisdiction La Quinta
zip 92253
Permit #
Log #
Study Area 233
Square Footage 2466
No. of Units 1
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 2,466 or $ 4,241.52
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 Century Homes
Name on the check
By Dolores A. Ballesteros
Superintendent
Fee collected /exempted by Ellen Patino
Signature
Telephone 619-360-7464
Payment Received $4,24.1_.52
Check No. 0924
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting