9610-014 (RPL)U)
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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
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
w�f4d 1 A
Date 1/)•1%-. l 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:
( ) 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).
( ) 1, 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'37 ' 00 of the Labor Code, for the
performance of the work for which this permit'isissued.
( ) 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
f' q'4'ii �.._.r^ t,+y.i rQi
permit is •Is�uedrM�••w'orkers' compensation insurance carrier•f& •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: +. i .<` Applicant,- 7 ,
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 onhis
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 r inspection purposes. r
Signature U ner/Agent) ! _ �.. "" Date A61411 p�
BUILDINGPERMIT PERMIT# °°NTRDLk
417
DATE VALUATIONS $141""*. LOT TRACT'
JOB SITE 7- V2"- CA. %1140 H.OSt!l )A
APN
ADDRESS
OWNER
/DESIGNER / ENGINEER
. ..CONTRACTOR
1g141¢.t .N.1 i
tte
SOVC
W5 5 +3 t3 *;`p'
tiS Ua.tl P.44 RE Z R.D. YINI
+� 313f-GQ41y
019)324-1230. [044
USE OF PERMIT
POOL XNOICM, SPA
1100L AND SPA ONLY
. _ wZ r l..r-7 M 70. n•o. vv. ..a
kIS.C.'I&IAll" 0 (10- `t or C:9NMIX { IO
s+S..7iDiif.11li
P -LAN Ck(RCK. fTF
C OMST12UCIr[O { FEE 101-000-418-000
st rlt�d>a1G/li. dTi is ...,)�Oiii I011-000-1Ldd30e
E1,.'� C 1T4fC,AL k'FT. -- YCa.)L 1101-000-•42ti••�l 00 $4.50)
suft-T(YrAL,C,Of4�Q� AND PLAN CRECK
$363—V
LESS M�'�•�1 AK) PRES
$0.00
OE31,♦ De�Tsl'2li'i.,i. .d.• T:ii�r 11:w1 aJ l,+i Ai'F./�Fr.i18..7..,/�7
OCT'1 G 1996
By
RECEIPT
DATE
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
Root 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 o
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
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
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
4f
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)
R7'-7"
PL
R2'-0" I TILE DAM WALL.
. 16'I 0" • r R6'-6" /WITH SPILLWAY
'DECK 7 ' DIA. SPA
---� R +6"RAISED
j
PL 12'+ 14'
Ix
3'7R
27- 0
22'-5 i
i
PIL
■
W S _
W
j box
MASTER
LIGHTSWITCH
DDDDDD.'MC7 - y.
i
s QAEETY DEPAR`� AE'.: "
W O6ADITIONALLY
AC4'1'#'Er# ED FOR CONSTRUCTION w
SUBJECT TO INSTALLATION AS PER
W
AND ALL APPLICABLE CODES
I
DATE D 6 BY
---
5' -f
AIR LINE
15'+
SPA SPECS.
GENERAL SPECIFICATIONS
SIZE 7
SIZE 14 X 28 AREA 350
RAISED 6'T
DEPTH 3:6"x5x3.6"
LITE ZOO WATTS
SHAPE PERIMETER 81
TRI LEVEL SEATS
TILE SIZE 3X3
22" 24" 27" 6-
TILE COLOR tbs
DAMWALL WIDTH
COPING cant
SPILLWAY SIZE 3" X 12
COPING COLOR tbs
SPILLWAY
x
POOL CAPACITY 9450 GALS
OPEN CLOSED
PUMP CAPACITY 90 GPM
# JETS 4
MOTOR HP starite HP1.5
FILTER starite 300 SQ FT
FILTER RATE 100 GPM
TURNOVER' 2 HRS
SUCTION LINES 1 "
RETURN LINES 2 "
MAIN DRAIN 2 "
SKIMMER MODEL DUAL PORT
PL
CHECK VALVE YES
HEATER LAARS SIZE 250.00QTU
GASLINE BY sdc
POOL LIGHT 400 watt
SPA LIGHT 100 watt
CLOCK 24 HR 220V.
ELECTRIC BY sdc
ELECTRICAL BONDING BY: sdc
TILE AND COPING sdc
DECKING BY sdC 555 sq ft
SDBUFF COLOR SALT
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
DESIGN
understood that you, the owner,
have that neighbor's permission
and assume full responsibility.
Name: CENTURY
Address:
79-295 Camino rasada
City: LAQUINTA
TRACT RANCHO OCOTILLO LOT# 71
SHOW ROOM
73-011 COUNTRY CLUB DR. STE. F-4
PALM DESERT CA. 92260
PHONE (619) 346-4032
LIC # A-574127 -