0106-173 (RPL)to
H
N LU
W
�v�
r.- LU
r-
o Z r—
ccoo O, c
H to
F-
N
Z
M
N
ON
U(3)
CL
Q
Z
Cr
r ¢ O
Xw �:
O -'Q
m � U
O
a a,
't Z
ado O
Q
J
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 # Llc. Class _ Exp. Date
Date f ^ I Signature of
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 ItU141-11.r
_ Policy No.
11 RE &I C &I U1 .rI 11 81)
(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��w.ith those provisions.
Date:& Applicants
P
Warriing: t'ailu a to secure Worke"rs'-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 p operty for inspection purposes.
Signature (Owner/Agent)�.... t.M ."" Date+ '
BUILDING PERMI PERMIT#'
DATE ! VALUATION LOT . TRACT
/
JOB SITE/ '
APN MIN
ADDRESS
70-9151 CAMM MCI&
�
-
OWNER
CONTRACTOR/ DESIGNER/ EN (NEER F�)
(.':R AD MURF'1`cM
1At" aYR1.1:'OOLU :A SFAS
78.933 CARWIM C'li'tatS
PA). -PDX 2791
LA Q%T'i�+1�'A (.:°A. 92253
1A QmIT.& CPI 92M
« C4i 93i3S (MLk, 1943.
USE OF PERMIT
Pfv70dJ'.,"P..A.,.A.1:.f1;`LM:;v"OA?k12.1E;i S SILAL , BE IN PL ACC AT PR.i P61,A5TFA
1N:tPEC3'i(iW.Of�� 14?1ti�la!f`3�'xi,(�iY ad'€3I' �4�Ic11<t� �1r,
1100L.AlUXOR. SPAL Won LO
XIMM?aTKID COST OF WHOMUMON
18,sopd. cv
PWI CHiibrJ4 YZE 301.000-439-318 t1219.'Yi1
SS'1;t3w°;i;C3t�PMe
R,ti1W1WQ0'A-1. F: •- POOL 101-00a-421-000 $d4:►°t0
101-000.420-040 fs.Gi1
PLUMP'No FRE P0014 101-000-419-000 $x'7.04
Dr'. BUB -TOTAL "DP1.".4ME=
$22.70
1- JUS 1 ail :� 1M P!RE-.PA1DT47BS
50.00
1 _ TOTAL U2P,A'KE,. lDIDE M11i
RECEIPT
DATES ! Ii
BY
DATE FINALED
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 Wall Insulation
Condensate Lines
Party Wall 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 Plbg..Test
Gas Piping
Gas Test
Electric Final
_
'_
Final ..
PLUMBING APPROVALS
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
_—
Shower Pans
O.K. for Finish Plaster -
Sewer Lateral
Sewer Connection
Gas Piping
Pool Cover
Encapsulation
_
Gas Test
Appliances
Final
COMMENTS:
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 i tice (PTrm)
UG!lz/U1 AIE Ub;40 t'AA 70U J4U Nylb L x Ai
Mr. Chad Kreuter
78-955 Carmel Circle
La Quinta, CA 9223
Dear Mr. Kreuter:
The Rancho La Quinta Architectural Committee has reviewed and approved your submittal, of
plans for pool, spa, and firepit at your home at 78-955 Carmel Circle, with the following
conditions:
All work is to be done in accordance with all applicable requirements of
governmental entities, including the City of La Quinta, and in accordance with all
Homeowners Association architectural guidelines and governing documents.
The owner drains to a properly installed drywell or properly installed drain line and
bubbler box located on their property..
That the 1`trepit is Saki and ornamental in nature, rather than woodburning.
When the above conditions have been met, and the work begun is finished, please fill out and
return to me the enclosed Notice of Completion The consultant will perform a final inspection
after receipt of that notice to verify installation according to the approved plan, and then your
deposit caa be processed fior a refimd.
Serely,
.O
Crary I Troy, Property Manager
R.alicho La Quinta Master Association
Cc : McIntyre Pools via fax at 360-3435
Professional Community Management / Desert Resort Management
Post Office Box 4772 * Palrn Desert, CA 92261-4772
73-550 Alessandro, Suite 5 • Palm Desert, Caltfomla • (760) 346-1161 • PAX(760)346-9918
:i