9605-075 (RPL)LICENSED CONTRACTOR DECLARATION
U) I 1 -hereby affirm under penalty of perjury that I am licensed under provisions of
Chap�gr 9 (commencing with Section 7000) of Division 3 of the Business and
CV W •- Professionals Code, and my License is in full force and effect.
p Z) ch License #' Lic. Class Exp. Date
() 51417.7 A 881/97
U //
1�_21/96
� Z � Date Signature of Contractop
O)
r0�
CO F- M OWNER -BUILDER DECLARATION
--I U
Hd I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following reason:
Z_ ( ) 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).
C0 () I am exempt under Section B&P.C. for this reason
L
N Date Signature of Owner
ON
O>
Q WORKER'S COMPENSATION DECLARATION
o 2 Z I hereby affirm under penalty of perjury one of the following declarations:
Lo �cc
O () 1 have and will maintain a certificate of consent to self -insure for workers'
X U L= compensation, as provided for by Section 3700 of the Labor Code, for the
m� Q performance of the work for which this permit is issued.
Q C) ( ) I have and will maintain workers' compensation insurance, as required by
O U Section 3700 of .the, Labor Code, for the performance of the work ,for which this
d ul H permit is'issuedl- I ty workers' compensation insurance carrier &'policy no. are:
It Z Carrier Policy No.
06 d
J (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 rove ions of_Section 3700 of the Labor
Code, I hell,forxhy"v'th comply with �ad�roy stens.
Date: /"�`"` �4`Applicant,` W '"�}
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
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 f �si;Id on purposes.
Signature (Owner/Agent Dater'
BUILDING PERMIT PERMIT# :. C°NTR°`#
"�' 3327
DATE '511.:5196 VALUATION SM01)tl N LOT TRACT -
JOB SITE 79-350 CA,ii'IING AMARILLO x
APN
ADDRESS
OWNER
CONTRACTOR/DESIGNER/ENGINEER
()N CONr ,TltUCnol 4
1555 S. 'U S"T13.1,.l.1' .
68805A PEU&M #F0
SAN SERN.ADINO CA 92408
C"NFRi~DRA.1, CITY CA, 92234
(909)381•-CM7
(619)324-1232 r.i1t.# 1044
USE OF PERMIT
P00.t, ANDfok S'PA.
P(+KX ANL) SPA ONLY
E.S'"i.' NOWiM COST .O CONSTRUCT ION
IS,€i63�.i113
PERMIT WE tii3,NIMARV
PLAN (3- CX.lol 1, 10.1 -WO -439,31;( $10530
�LI.,14, TfRUC TION FFY. 1.n; I -OW -4 ! 8_000 $162,00
iviEMAN.ICA%, FFE—PLl1YL vi 000-112 14*0 V&;k t
R1X(_', 12tCAL FE—M0 101am)-4'20-000 $45.00
i't.1f,MBINo, FRE --Pool.., 1U1 -(W-419-000 $37.00
S1,1C3•t'o'1'At. Mi4� 7Lt3MDN ANIS PLAN ctlwcK.
5363.30
LESS PRE -PAID VES —S
$0.00
fAt., Pl+�ttl'WJW!+'FRS IME NOW
S363.31)
i996
RECEIPTr)
DAA i
BY /
E AL
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 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
Underground Plbg. Test '
Final I I
Gas Piping t
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Neater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer Connection
Pool Cover
Encapsulation
Gas Piping
Gas Test
Appliances
Final 1-7 LF
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:
P.L.
BOBCAT
ACCESS
(remove &
replace 2'
of wall &
W.I. gate)
t i
STEP
j, .
+011
011 SPA
,RAISE
+6"
.61611R
+
-3' O 17'6"
19'6"
C. 91D
4'6"R '
718"R
KC -93 +off. --*--STEP
I
61911 5 ide—(2) 3/4" PVC
STUB PIPES
3'R 6'R
W W I UoorlW 518 'R
GAS STUB
\ FOR BBQ HB PLANT AREA S
GM581
EM 62' W W
pool & spa W
light switches
-O7F0111
Ell
�1=1 7M 67 To U 2J ��E I
W
R&R TWO A/C UNITS
BY CENTURY HOMES
y
• i
• i
SPA SPECS. GENERAL, SPECIFICATIONS
SIZE 73UA_ 23'PX39SQFT SIZE 14'X 31' AREA 360
RAISED +6" , DEPTH -3' TO -5'
LITE 100 WATTS SHAPE PERIMETER 93
TRI LEVEL SEATS TILE SIZE GROUP 3
22„ 24„ 27„ IES TILE COLOR NV -499
DAMWALL WIDTH 6"X 7' RAISE BEAM 12' OF +6"
SPILLWAY SIZE 12" X COPING CANT. 93'
OPEN XX CLOSED POOL CAPACITY 12330 GALS
PUMP CAPACITY 90 GPM
JETS.#_ 4 _ MOTOR HP STA MAX 2 HP 1.5
FILTER SYSTEM 3 300 SQ FT
GREAT WHITE FILTER RATE 100 GPM
AUTO CLEANER TURNOVER 2.5 HRS
RETURN LINES. YES.,. "
KREEPY .IKLEAR MAIN DRAIN YES
CHLORINATOR
SKIMMER MODEL DUAL PORT
CHECK VALVE FOR SPA
HEATER' LAARS SIZE 250 000 BTU
GASLINE BY S.D.0 137' W/BB
POOL LIGHT40OW
SPA LIGHT 10OW
L. CLOCK 24HR 220V
ELECTRIC BY S.D.C. 224'
ELECTRICAL BONDING BY: S.D.C.
TILE AND COPING S.D.C.
7' OF +6" STEPS DECKING BY S.D.C. 634S FT
STANDARD KOOL DECK KC -93
CONTRACTOR cannot assume
responsibility for damage to
curbs, sidewalks, driveways,
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,
DATE have that neighbor's permission
5-20-96 and assume full responsibility.
NamiCENTURY HOMES lot#49
Address79350 CAMINO AMARILLO
Quy-LA QUINTA, CA. „RANCHO
Tract. O TILLO"
POO/S
SHOW ROOM
73011 COUNTRY CLUB DR.#F-4,
PALM DESERT, CA. 92260
PHONE (619) 346-4032
LIC # A=574127 ' jeff Lamb
CITY OF LA QUINT��
A
BUILDING
& SAFETY DEPARTMENT
CONDMONALLY
ACCEPTED FOR 'CONSTRUCTION
SUI3JECT TO INSTALLATION AS PER
AND ALL APPLICABLE C DE
DATE
DY