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0109-172 (RPL)f— N_ rn W O =) M (L r W o Z c(DOo W W I— a Z co L0 N ON U rn CL Q U')QO' xWLL co d rn It Z_ co 5 t- CY �L 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 = I '� 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 19;ction 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 Policy No. STAT F FU14f) OW812541.. (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:../"- ADDlicant i.j' %I 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 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 for inspection -purposes. Signature (Owner/Agentf !�. ! +'r .� • Date% BUILDING PERMIT PERMIT// DATE VALUATION LOTP '� �� « TRACT JOB SITE APN ADDRESS 52-61.1 CA MI7..: A Cts? 7117 OWNER CONTRACTOR / DfiSIGNER / EN (NEER 52-611 CIAIMMMIArr 'x'5090 M', t_'`.'f•1 `r ' S PL, 0- PALIA IMM71' CAS, M11 USE OF PERMIT P0011AND.10p, STIA RJOIDt. SPA, AI ANY.SIB ARRIERS SPL&LL RAE Dd PLACE .A'f PRE-PLASTf. R. INSPECTION, 1's7ts>,.Ptt;!1.fif�4ch�Pi� .i1�fti',1t�1�tFh.E�3t�i' iRv�"LiIUL�f .'' VALUATION 31A19.00 LS EMM'i' D COS" ' OF CCA.it 'TKU(.'d off 31tM)AH) .1:'RPc�.M.Tr YKE SUMMARY KOW CHFICK FEE 101.00.439.318 S161910 f: ONSTRUCTiox t'EZ 1 01-00041. 8--000 U91.00 MECHANICAL FER -- POOL 101 -•Lt --x,21.000 $224.00 WXCTRUCAL YEE „A PC90L 101 -100"210-000 $45.00 "WMINO FEE _ POOL 101-000419-000 W.00 SUB-10°.tAL CY)M tRUc'.";1 OR ANF ��Ty`�yyiA'[1`im(q��j'4/�"(1jC: MIKES y S`'A.4.K'3�.A .R"yts3-93'.T�S.f Llt.&tA:�S 1)7,1 f.' kl()W i94s 74t�Sa� . i RECEIPT DATE 1 +1 BY DAVE EVD 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 Wail Insulation Condensate Lines Party Wail 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 Equipment Location Underground Electric Underground Pibg. Test Final 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 _ COMMENTS: Epinal 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) I POOL SPECIFICATIONS ITFI / WIDTH �- FILTE %2 0 DdFl i�ATER �1 a d, o dy BTU SPA SPECIFICATIONS SIZE 9' FILTER V HEATER BTU LIGHT IME i. V jk� Ii�S POOL CONTRACTOR MIRAGE WATER FEATEMES 75090 ST. CHARLES PL., SUITE B PAIM DESERT, CALIFOMU 192211 LIC. # C53 524983 UC. NO. 524983 75080 St. Charles Place, Suite B Palm Desert, Califotnia 92211 760-568-0852 PAX 760.341-5161 DEPTH 3 6 TO PUMP H.P. LIGHT w DEPTH ✓� TO PUMP FY -A L H.P. JET PUMP ::3 H.P. CITY OF LA 00 TA BUILDING & SAFETY DEPT. ,APPROVED FOR CONSTRUCTION DATE S 1-//w BY 9' 4.1160A 1: . qav r' imam C W �loo� Plawti -sz U1- C llq G+- - T�JJ'0,, C. C CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTI DATE � BY gft"py 0600- ovaS 901 v!3 (Fifter 3 —� 400K BTU a Heater 'ioo srR •R�r ct , iE PUMP_ o_ 4'—Fi' 420 Cart. a pool filter Filter 2 Pumps stacked on shelves @ ea. location. (Total of 5 pumps) S �i_ ' & � y — AW jDec-05-01 04t23P SECTION TWO — Heater installation Heater Placement, Clearances, and Venfing Indoor (U.S.) and Outdoor Smelter (Canada) Installation Instructions The heater is design certified by AGA for installation on combustible flocering; in ;alcoves; in basements; in dros- ets or utility rooms. In Canada, this pool heatk�r cin only be inste leJ cnit- doors or in an enclosure ("outdoor shelter") that is not normalty occupied and dares not directly communicate with occupied areas. For installation on carpet ng, the heater must be mount- ed on a metal or wood p:.nel that extends at least three inches (1.0 cm) beyond th 2 base of the heater. If the heater is Installed iii a closet or alcove, the entire floor must be covered by the p•incl. AWARN 3 Explosion hazard with Propane gas heaters. Propane gas is heavier than air and will settle to the ground or floor. Do not install a heater using Propane gas in pits or other locations where gels rtaight collect. Fotfow the requiremerds for heater location as specified by the Standard for Storage and si Handling of Liquifed PetroJeum Gases, ANSNNFPA 58 (latest edition) so that the heater is installed a safe dis- tance from Propane gas storage and filling equipment. 71� Sin. (is cm) , .tear space above Raise at least i L:L L 5 M) abov& thavoid ttamma vapors leave s in. (Is cm) of clear space belweer, unit and (1 combustible surfaces TOP VJEW Figure 2-5: Minimum inc!oor Clearances P.01 Installation in a Garage or Utility Boom AwA )_ Jf c; Risk imt fire and explosion it installed at floor level in an automotive garage or near gasoline or flammable liquid storage. Gasoline fumes are 'heavier than air and will settle to floor level in closed spaces. Gasoline fumes and spilled gasoline or other volatile liquids (such as some paints and varnishes) will travel across the floor and can be ignited by a gas appliance. In a utility room or residential garage instal- lation, install the heater with the base at least 18 inches above the floor, so that the burner and ignition device will be at least 20 inches above the floor (see Figure 2-5). In a garage, install a rail or wail to protect the heater from physical damage by a moving vehicle. Heater Clearances Indoor (U.S.) or Outdoor Shelter (Canada) The foflovvitag clearances must be maintained from combustible surfaces: TOP b INCHES ALL SIDES 6 INCHES VENT 6 1 NCHES Venting Indoor and Outdoor Shelter Installations a,vrsrtl I pick of asphyxiation it ext►aust is not correctly vented. Follow venting Instructions exact- ly when instalUng heated: Do not use a draft hood. with this heater, as the exhaust is under pressure from the burner blower and a draft hood will allow exhaust fumes to blow into the room housing the heater. Exhaust venting to the outdoors is required for all indoor and outdoor shelter ("enclosed") installations. DD NUI' common vent this beater with another appliance. DO NOT substitute or modify parts in the venting system. Enclosed installation n requires tenting to the outside. On an enclosed installation, the exhaust discharges from the Vent Body into a vent pipe. I ocate the heater so the vent run is as short and straight as possible. ' Orient the boater so teat the vent pipe does not inter- fere with adjustment of the operating controls. The operating control panel Located ott top of the jacket can be rotated for easy access. Safety Precautions: AwAArainiu Risk of carbon monoxide poisoning. 00 NOT iterate treater it vera faults are detected. Correct any vent faults before operating heater. f - ;�w Dec -05-0I 04_24P SECTION TWO - Heater Installation Heater Venting Venting indoor and Outdoor Shelter Installations - Continued The heater requires sufficient air for combustion and ventilation. Choose a location that will avoid contami- nation by chemical fumes. NOTICE: Combustion air contaminated by corrosive chemical fumes can damage the heater and. will void the warranty. tame z-%.;: %mrrosive vapors ano rossioie,*ources Likely Contaminants Area Chlodnatsd swknrning Pool or spa cleaning pools and spas chemicals. Acids, such as Combustion hydrochloric or muriatic acid New construction and Glues and cements, remodeling areas construction adhesives, so ifs' std in - paints, varnishes, and 1,291 cm' paint and varnish strippers. 323 cm' 323 cmz Wades and Ceaners 333 in' containing calcium or 84 in' 84 in' sodium cNodde Beauty parlors Permanent wave solutions, 542 cm' 1 542 cmz bleaches, aarosol cam 400 inz containing chiorocarbons 100 in' 100 in' 1 or fluorocarbons Refrigeration plants or Refrigerants, acids, glues various industrial and cements, construction finishing and adhesives processing plants Dry cleaning and Bleaches, detergents, or laundry areas laundry soaps containing chlorine. Waxes and cleaners containing chic One, calcium or sodium chloride Combustion and V4ntilation Air Supply For indoorinstallabon, the heater regi res.airsupp)y openings for ventilation and combustion. The mini- mum requirements are for two (2) openings: one 12 inches from the ceiling for ventilation air and one 12 inches from the floor for combustion air, in accordance with the latest edition of the National Fuel Gas Code, ANSI Z223.1., and any local codes that nuty apply. P-02 The minimum net free area in square inches shall be as follows: Table 2-6: Combustion and Ventilation Air Requirements Indoor Vent Instaliation ...1. Always vent the heater to tlw outdoors, • Vent it horizontally or vertically using Special Gas Vent, (see Table 2-G, Pagr 2-1Q, or • Vent h vertically usjng'lype "B" double wall vent connector pipe. Locate the heater so as to minimize the length of hori- zontal vent pipe and the number of vent elbows required. Horizontal vent runs must slope up 1/4" per foot from the heater to allow exhaust condensate to drain and inust have a condensate drain as described in the venting installation instructions. Outdoor Vent Cover Removal The heater is supplied from the factory with a built-in stackless outdoor vent for outdoor installation. Remove the outdoor Vent Cover for enclosed installation. To reinstall the outdoor Vcnt Cove ~, hold it fig place against the Vent Body,push together, and fasted with two screws. 2-b 1-1 a All Air From All Air From tnside Suitding Outside SuildMq Model Combustion dent Combustion Vent 200 2W iry 200 rat' so ifs' std in - 1,291 cm' 1,291 cm' 323 cm' 323 cmz 333 in' 333 in' 84 in' 84 in' 333 2,149 cm� 1 2,149 cmi 542 cm' 1 542 cmz 400 400 inz 400 in' 100 in' 100 in' 1 2,591 Crile 2.581 em` 645 cm' 645 C1W Indoor Vent Instaliation ...1. Always vent the heater to tlw outdoors, • Vent it horizontally or vertically using Special Gas Vent, (see Table 2-G, Pagr 2-1Q, or • Vent h vertically usjng'lype "B" double wall vent connector pipe. Locate the heater so as to minimize the length of hori- zontal vent pipe and the number of vent elbows required. Horizontal vent runs must slope up 1/4" per foot from the heater to allow exhaust condensate to drain and inust have a condensate drain as described in the venting installation instructions. Outdoor Vent Cover Removal The heater is supplied from the factory with a built-in stackless outdoor vent for outdoor installation. Remove the outdoor Vent Cover for enclosed installation. To reinstall the outdoor Vcnt Cove ~, hold it fig place against the Vent Body,push together, and fasted with two screws. 2-b 1-1 a is 0 IN 0 0 N a) a LU t q Y OF LA OUINTA SUB -CONTRACTOR LIST n� JOB ADDRESS - i 1 'I Lt ! ! I t>`. C -. �fi T NUMBER OWNERYhY • t, M,1_ . i u,�r, R�DSt� BUILDER lJa-I'�tUA Q64"Pm� tDY . This form shall be posted on the job with the Building Inspection Card at all times in- a copSR _Qlcus place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved liyAhe Building Division prior to commencement of works Failure to comply will result in a stoppage of work and/or the voidance N etc_