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LICENSED CONTRACTOR DECLARATION
I heresy affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Divisjon 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp.. Date
018996 C:5-+1, 1/30/2fX
Date -D�Signature of Contractor 1
OWNER -BUILDER
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
Sectibn 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 c" • •vv• iii n tt� Policy No. ) ., nnyn Ila
ISjfw ♦i.14!l,l.f 1'.
(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 ° ection 3700 of the Labor
Code, I hall f�rthwith complywitti0hose provisions.
te:� ! � � t Applicant jvi
Warning: Fail re to secure Workers' Co� pens tion 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 authori�re esentatives of this City to enter upon
the above-mentioned propert' or inspection purposes.
-d 0
iig ature (Owner Date
a
BUILDING PERMIT PERMIi'1)02_ 114
DATE /J0 VALUATION iI/22,000,00 LOT TRACT
JOB SITE (c7$770 CLL b4,1s ",'9 NVA-' APN _
ADDRESS
Cake 11n
OWNER
CONTRACTOR/DESIGNER/ENGINEER
u, A`rc %,n) rip t: T)''r 4."T) A trc-syn- f. A A 4 i f 'V iN1t'1T C' ! CV0C"rO t TrVT 1C116T
I L\ 1, 41I!♦\�I lJ., 11.1 It til 11t\4. 1 1 [ Vit Itit .. 1 V\.Jf •�I .-.\/1.4/1.1'\.Vv l l.. i�
79770 Cl BRILLO W.PLY' 53300 ti.VEFiMA 11AAf.I)U'Z
{,A 01Jli+i'i'A CA 92253 LA Qt.)IN'1'A CA 92141
(760)56+-3655 CTUX 2893
USE OF PERMIT
POOL ANUOR SPA
k >`>0b SNA & iiFIQ ONIL li - i�L. ,RMSZAi`tR URS S1W.1 BE iN FILAC .-ii i0
t'tLt•:f'.Lf1uJ,'f:lf iN:>f��;l:'f,'1Uid.
V i\l, UXi il;' X
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}s•DDra N"'r,
J,%"rFn,4,1AAii_aIn iL.'% tXi,
PLAN t:;`ilwCK..I-1*, 1014X)0 -439-:31X
r`d)WSTRI 11"T1014 i, rq1 ) I'I(g,oflin
212110041M"
It iXltJ I1V]t. Al. l•l'.i. /ho An F �•i1/"'t611
VA
V\Il}
I'll.ON61INki FEE _. "P001. 101-WG_413-00U s2'1.titf ;
!
RECEIPT I DATE
LESS PRE-PAIDPE'TS
TlYfAt. VERMIT MRS OUP, NOW
W7 25
$0.00
$467.15
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
Steel
POOLS - SPAS
44
Set Backs
Electric Bond
e-111
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
C<)
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
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:
02/07/00 20:55 FAX 7607719863 PATSI IMAI{OFF t
0001
a?i07/oo VON 13:43 FAX leo 348 8918 D R I � Q002
February 3, 2000
Mr. and Mrs. Robert Krakoff
Re: 78770 Cabrillo way
Dear Mr. and Mn. Krakoft
The R cho La Quinta Architectural Committee has reviewed your second submittal of plans
for the installation of a pool, spa and barbecue at your Rancho La Quinta bome. Based on these
plans, the construction of the pool and spa can begin now.
Additional information is needed on the barbecue. You have provided the height of the
barbecue, but we will need to know the proposed color of the tile. Construction ofthe barbecue
cannot begin until this information is submitted. The landscape items deudlefl in our letter dated
January 24, 2000 have not been responded to as of this daze. l look forward to working with you
on these items.
Please call me at 346-1161 if you have any questions on this information.
Sincerely,
I
Mindy GutlerzC7, Property Manager
The Master Association for Rancho La Quints
Prof-!!uional Community Manageiucnt i Desert Resort Management
Post Office Box 4772 • Palm L*sert, CA 92 6 -k -4:77z
73-550 Alessandro. Suite 5 ■ Pz1m Des tt, California * (760) 346-1151 * FAX(760)3464918
r
{
PE3
KRAKO ,FF HOME
O 78770 Cabrillo Way
I Rancho La Quinta
C
y.
A RE -INSPECTION FEE OF $30
WILL BE CHARGED IF THE APPROVED
PLANS AND JOB CARD ARE NOT ON
THE SITE FOR A SCHEDULED
INSPECTION.
.NO EXCEPTIONSf
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR,CQNSTRUCTION /
DA'
BY
1/8 "=1 I
N
Construction
Pools Spas Fountains
(760)564-3655
Lic. #658996