0211-182 (RPL)LICENSED CONTRACTOR DECLARATION `
I hereby affirm under penalty of perjury that I am licensed under provisions of
,,Chapter 9 (commencing with Section 7,300) of Division 3 of the Business and
Professionals Code, and my License is?in full force and effect. _
License # 6c. Class Exp. 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 towner of the property, am exclusively contracting with licensed
contractors Ito construct the project (Sec. 7044, Business & Professionals
Code).
O 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: .
Carver ,HATE, FIND Policy No. 15429,'17-01
(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: 14 •. Applicant - `a;:.,..-�.n,; 1 w f
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 ln�S�aafety,' •
for a permit subject to the conditions and restrictions set fortY oW'his'
application. r -1 /.-, I`
1. Each person upon whose behalf this application is made & each'e son 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, iplemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null ago void if
work is, not commenced within, 180 days from date of issuance/ f such .
permit, or pessation of work for 180 days will subject permit to car?&k4tion.
I certify that) 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.
1
Signature (Owner/Agan j�* Date
' �'y'''d'•;:ria"
t a'BUILDING
PERMIT PERMIT #
•
DATE VALUATION
{LOT TRACT
JOB SITE A�?
ADDRESS
APN `
OWNER
CONTRACTOR/DESIGNER/EN (NEER
a}G =1 s89
18-7 0 CAM- TAVI PTC0 SC't:i'fiE9230a
, �.Q�PYk+i
Cha 92253
Q1Th . CA 9225'
I
USE OF PERMIT
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9 01-0 L-424-1.i3C
Pl,tiM9^f1NG FEE - POOL
101-000-419-000 SAO
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PAT, CC
MUCII 109 AND T?T�Ktl at -M -K
0 ME -FAM 17M
$0.00—
DEC 91001 ' ;T
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REIPT °
CE
DATE
BY
DATE FINALED
INSPECTOR
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f�
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
OX to Wrap
F.A.U.
Fuming
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
2 ,�
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
f 1
Gas Piping
PLUMBING APPROVALS
aste Lines
Gas Test
Electric Final
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
�—�y
(O' /i -G3_
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
. . ELECTRICAL APPROVALS
Temp. Power Pole ®/L
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) f "
COMMENTS:
r------
--- ------ EXIST'G_•6' 8_LOC_K_ _W LL 95.QQ` -
I OL EQUIP. -�
i
POOL 2T X 12' W/1 H.P.PUMP I
11
I SPA W/HEATER �I
I r
I� I f��l • .i � �I
1 y .
14' I 1
1
1,00 PT
I� S.B.
i 1 I 1-01
10' a J
4 -D- Q� r` S.B. IJ
AVT FILL
' - �X13
I 1
160.• 1
1�
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I r —
I
I.LOT 174 wow 1 u-
39,70-1 _ FF i
PAD i es Iz
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S. oR — 0 1 Mc PAD 36%& �1
3 I I I
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L j %91
%2i0 1 L---�
,I N
0, X11u-
3/D-4
xx1 Zl
WI .
li LANDSCAPE.
I (NATURAL OR PALM SPRINGS _ 6 =-41
1 1 GOLD GROUND COVER OR EMAL S.C.DOOR 1
1 �-VE'RIFY- � 0 — — — 1
1 cw
•0 0
1 L-------- --- — ---
LINE OF SETBACK SIDEW" � i
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1
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28'-6" t� LANDSCAPE 1I
I A-2 LANDSCAPE NATURAL OR PALM 5MING5 I
I� (NATURAL OR PALM SPRINGS GOLD GROUND COVER OR
GOLD GROUND COVER OR MAL) -VERIFY-
I-VERIFY-4 � - _ �.,... • ••�� • ""�" WATER METER
1 --• VERIFY LOCATION
•--- 40mo-
g5.20' DRIVE ENTRANCE
42
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11
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5 GALLE QUITCS -li-
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A
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LANDSCAPE PLANT SCNEDULLE
SYMBOL
SIZE
COMMON NAME
LATiN NAME
A-1
1-14' CALIPER
BOTTLE Tmm
DRAC1404WON POMuLNMO
A-2
1-14' CALIPER
MEBG>eJiTE TIlm
PRO60108:6 CHL9NeE6
0-1
V-3' FEET
MEXICAN FAN PALM
WA 4MGTCNIA FILFERA
15-2
15 GAL
COCO PALM
APSCA6
5-3
15 GAL
FIRUiT TREE'
iT4Jr4N
C-1
4 OAL
RICU6 NITiDA
FICUS NITRA
0-1
b GAL.
NATAL PLUM
CAMtI'SA G. BOX 11000 BEAUTY
0-2
6 GAL..
W-ILELER OWAM
1" l l R"ORRtM WHLER Ot1AMB
0-3
D GAL
C#t=i LEAP EUAyO"
ZuRYOPb PECTINATUb
0-4
b GAL
IDOUSAMVfL.LEA
00 ANVILLEA 6"XAM6
O -S
3 GAL
TAC"
TAC"
0-6
5 GAL.
OWAFIF OLDER
N RW OLEANM
0-1
D OAL
GiRMEN rgtmT
LnwTRUM =mm
E-1
1 GAL,
PURL" LANTANA
LANTANA
I"
I"
HYOM SDA 0 32880D
ADDITIONAL NOTES:
ALL VMEe TO Da W"M TO WALL
iNCOR3t' All VM 6 AL 010 ALL 11141 `
rr-ON= LOW COLOR MA"Md ALOtdr3 F14" STREET
VICINITY MAP
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.AVE I DA La FO DA
-- --- --- ---
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RJ 1J RJ
AVENIDA NUESTRA
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I
La QUINTA/ CA. NORTH
m
FIR0J.ECT DATA
OWNER: CORONEL ENTERPRiSES INC.
P.O. BOX 389
La QUINTA, CA. 92253
PROJECT ADDRESS:
51395 CALLS QUITO
La QUiNTA, CA. 92253
LEGAL DESCRIPTION:
LOT 114 MB 021/0h1 DESERT CLUB TR. UNIT 5
ASSESSORS PARCEL NO:
110-113-®10
LOT COVERAGE TABULATIONS
R- L - 3 OCCUPANCY
TYPE 'V -N' CONSTRUCTION
APPLICABLE CODE:i991 U.S.C., U.P.G., U. i.C.41996 NEC
ALL WORK SHALL COMPLY WITH CURRENTLY ADOPTED USC,
UPC, UMC, NEC, OF THE C I ` T OF RANCHO M I RACE, CA.
LOT COVERAGE TAS U LAT I ON S
ENCLOSED AREAS
LIVING SPACE: 2, 2q0 SQ. FT.
GARAGE SPACE: 7% SO. FT.
SUS TOTAL SPACE: 31086 SO. FT.
COVERED/PORCH: 175 SO. FT.
TOTAL SPACE: 31260 SO. FT.
TOTAL COVERAGE
LOT SIZE: 12,088 SQ. FT. 100%
TOTAL SPACE: 31260 SQ. FT. 26.g6%
NOTES, STATEMENTS a CGNDITIONSt
1. SITE PLAN HAS BEEN PREPARED FOR PRESENTATION
PURPOSES ONLY - CIVIL ENGINEER MUST VERIFY
ANY/ALL LOT DIMENSIONS, MEASUREMENTS -IF REQUIRED
2. FIN1514 FLOOR SMALL. BE 12' ABOVE DATUM POINT AT
TOP OF CURB AT CENTER LINE OF LOT.
3. DRIVEWAY APPROACH REQUIRES A SEPARATE PERMIT
AND INSPECTION FROM CITY OF LO QUINTA
A
1-i 2' CALIPER
LANDSCAPE NOTES - FRONT YARD
PROVIDE= (3) TWO 1-1/2• CALIPER SHADE TREES
(10) TEN (MIM.) - 5 GAL. 514RUBS
PROVIDE: IRRIGATION SYSTEM FOR ABOVE
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