0005-218 (RPL)N
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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 4EAp. Date
7i 2)00s C-5 � 04/30/2(
Date f—Signature of Contr
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 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 fOtKX111T Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
(L;;l 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' compensatio�,provisions, �rSeciion 3700 of the Labor
Code s I fort, with comply witf� rgvislo sem'
Date'" �rY G%dpplicann
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 su�ject 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 Cliy, a State laws relating to the building
construction, and herebyeuthoK repr�ssentatives of this City to enter upon
the above-mentioned �irope�� �ection purposes. ��.
Signature (Owner/Ag9"', Date
u BUILDING PERMIT PERMIT#
DATE VALUATION LOT 0OW112 TRACT
JOB SITE
APN
ADDRESS 48-M GA_1'ZMMANO
OWNER
CONTRACTOR / DESIGNER / EN (NEER
HAYFS
VALLEY a PUL & SPA
48.580 CA0KTr111 0
4741 C L I'ALM CANYON DX x#115
LA Q1�'.IN"1"A Lit. 92233
PALM SP7IN 7S CA 92264
(160)778.3939 CB14 2565
USE OF PERMIT
.P001a ANIDJOR SPA °
POOL & SPA O`NL- ' - Af AR.MISMARRILI:.S SHALL HE I:1 PLACE
PRE-PL&STER IN3PF MON, PERMIT Y ORa N01 IKCIAM. KO'r'1w'WA.LL
EQUIPMENT ENC1.A3t3RK
`ALU.f HON L3.
E5115"MD COST OF CONSMUC:1.1011
2010D0.00
MMM FEE S(TAOIARY
PLAN MF,(:IC''-M,GR 707-000-439-316 $I341.55
CONSTRUCTION I+RIi 101-000-419-000 $20.00
MECHANICAL FEE -- POOL 101.000.4.21.000 $24.00
Ei,. CTRJCALFE..E-•FOOL 101-000-420-000 $45.00
PLUM.BINO FBE, -- POOL 101.000 -4,19 -NO
,
5 4
Klli- MAL CONS Z�CGN AND PLAN CF.Ih.M
$43i , 3 s
1.1a'w33 PR19-PADa 1—MiS
$0.00
RECEIPT
DATEBY�
DATEFINAL_ED
INSPECT -OR
lam/
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
ops
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
-
Final
Gas Piping
4226V
PLUMBING APPROVALS
Gas Test
Electric Final
22 ,cz, cz-
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:
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12.00'
8.50'
3.00'
NORTH 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.
P/L .NO mv NSI
SPA JETS 9" - 15"
1.50' BENCH 21 "
SPA RAISED 12"
STACKED "QUARTZITE" SPILLWAY
EXTERIOR TILED W/ VM20
"PEBBLETEC" PLASTER INTERIOR
..............
MAIL
MATCH
BENCH EXISTING
SKIMMER 3.00' 4.50'-
11.
JACK HAYES LIGHT 26'88
E�0�(\
48580 CAPISTRANO J-IIJJ
LAQUINTA
564-6425 JANDY
SWITCH EXISTING
VALLEY POOL & SPA CONCRETE
SCALE 1/8'= 1'
NOTES RELATING TO APRIL 27 LETTER
5) COLORS & MATERIALS ARE LISTED IN BBQ NOTES BBQ GAS LINE STUB
6) BROOM FINISH CONCRETE, TYPICALLY SAN DIEGO BUFF
7) CERAMIC TILE AS NOTED - SAMPLE ATTACHED
8) SEE NEW NOTATION POOL EQUIPMENT PER CODE
SPA AIR LINE TERMINATION
-4- 7.00-0- HOSE BIB
A UNOBSTRUCTED)
3.00' CIN OF LA OL TA
BUILDING & SAFETY DEPT.
BBQ ELEVATION APPROVED
FOR CONSTRUCTION
BY
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MAY -16-00 02:07 PM NHF CASTORENA 760 772 5860
P.01
�" •
Cityof La Quanta
Building 41 Safety fltWsion
P,O. Box 1504
Permit R
76-49S.00i. Turtplco
La Qulew,'CA 92253
&hiding Permit Application and Tracking Sheet
I'to nr Aii,l�ess. 4$580 CAPISTRANO
Ckvne s Name; HAVES
_ P. Nutl,b.-t'
AddwssA, t4858Q#C 'z- I-
t.i}ai i)rurtfilx�n.
City,ST:ItP: LAQUINTA,
!;lutL;jtc.K' VALLEY POOL & SPA
TpI ,
euNITEPoo
ia,irr�, 4741C E. PALM CANYON DR #116
Ptnjs�itkecrilniva: EN -T
lip PALM SPRINGS, CA
778-3939
,.
C53-721005
City t:ir.0` 2565.
inch �•npr 17rsiyner
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atldtr� �
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04). 'c.7ir:
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Cauoiratii T7Pr:. may:
i ►eirtt q!Oe.lsttde oacl::N+'. Add'n Alta Repau
!Jena
tilpte Loc. ti.d';:s:,:;
Nnnrtiit'm,tit't Per on: JOE. DEISENROTH
Scj. Ft: s t;rutb:
rd tic µ.u(Cuaw a wi: 778-3939:
''
Estimmal IVAwof
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14`AF'�- 16-00 02:09 PM NHF CASTORENA 760 772 5860 P.02
CITY OF LA QUINTA
SUB -LIST
VALLEY POOL rL SPA 4741C E. PALM CANYON DR
..,. ., CONTRACTOR ADDRESS
OWNER NAYF JOB ADDRESS 48580
It is the responsibility of the General Contractor or the Owner/Builder to monitor the sub -contractors thpt
are on this list are the same persons performing the work. Any changes to this list must be approved the
City of Le Quints Department of Building 6 Safety prior to work being performed by a changed sub-
contractor. Failure to comply will result in a stoppage of work end/or the voidance of building permit.
TRADE
SUB -CONTRACTOR'S
NAME
TYPE OF
LICENSE
STATE
CONTRACTOR'S
LICENSE
NUMBER ..
WORkiR'S
COMP. NAME/
NUMBER ON FILE
Ct1'Y
BUSINESS
LICENSE
WARDER/
EXP. DATE
GRADE!
EXCAVATE
POOL
AIC -12
672850
6/30/01
6/30/01
ZENITH
44986 64
200;4901401
816
1/12/01
PIPELINES
C-34
CONCRETE)
FOUNDATtON3
N/A
C-8
ASPHALT
A
FRAMING
B
STEEL!
STRUCTURAL
C-51
MASONRY
C-29
PLUMBING
GATTUSO POOL
C-36
67285
816A
LATHING
C-26
DRYWALL
C-9
PLASTERING
CROWN POOL PLnsrERNc
C-36
427606
9/30/00
11 9 -9
184
8/7/00
NVAC
C-20
ELECTRICAL
GATTUSO POOL
C-10
67285
816
ROOFING
C-39
SHEET METAL
C-43
FLOORING
C-16
GLASS)
GLAZING
C-17
INSULATION
C-2
SEWAGE DISP.
C-42
PAINTING/
DECORATING
C-33
TILE
C-64
CABINETS)
INSTALLATION
C-6
FENCING
C-13
LANDSCAPING
C-27
POOLS
C-83
OTHER
J 6 L GUNITE
472187
FREMONTINS CC)
7/994A
9/19/00