9705-096 (RPL)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
3912.152 C33,� 12r31i4r.3
\ifbate <—Z I-- Signature of Contracfo
Q U
OWNER-BUILPE 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 Policy No.
STA111 FOIND 05173 16-97
(This section need not be completedif 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°a ree that if I should become
subject to the workers'. compensate np)royi9ions�f S ction 3700 of the Labor
Code, I shall forthwith comply with those,pprovl Ions
\jDate: -% Applicant
Warning: Failure to secure orli
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 Wali Insulation
Condensate Lines
Party Wail 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
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
31 Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
PLOT PLAN
GENERAL SPECIFICATIONS
Size x Code 8,S- '/2S7
Shape u S
Depth y to to
Tile Cola
LA/
to Afn z
A
L/v z- -A
AdcImm'
CRY
Cross Sbom 6-7-
wti Phone 7 -72 — 9'-?
- Dnhvn by -
Data Z_
FAIR
DEEP
END eo POOLS
SINCE 1974
FKX SM 836
SHALLOW
ENO
CA 1 :M
PHONEY1Love %504M4
SCALE 1/e"- IV*
Coping 121
Cantilaww tl & _S
Pool Capacity
0 3 -!n Gals.
CITY OF LA QUINTA
Pump Ciaw"y
Fiftw I [-' U &,P_
>C
G.P.M.
C_ tr-- V I , P,,a Sq. Ft.
BUILDING & SAFETY DEPART
Pump
H.P.TM'EN,,-p,;�
-7 G.P.M.
Trp,-ft
Z
CONDITIONALLY
rnover
Hm
ACCEPTED FOR C ' ONSTRUCTION
.1
Nft�ym.,Une.& SkImrrw
SUBJECT TO INSTALLATION AS PER
Retuin Une
win,6rain
to
ANU ALL APPLICABLE CODES
ValveA-
BY
HM& bAAio__s sin
Gpifl' M* by 5 U A/11-
g 0
VA)
0
d"
'Decking
86wd
'Pow
i _------
�-
C. am -�-
LA/
to Afn z
A
L/v z- -A
AdcImm'
CRY
Cross Sbom 6-7-
wti Phone 7 -72 — 9'-?
- Dnhvn by -
Data Z_
FAIR
DEEP
END eo POOLS
SINCE 1974
FKX SM 836
SHALLOW
ENO
CA 1 :M
PHONEY1Love %504M4
SCALE 1/e"- IV*