0001-106 (RPL)aA
ICENSED CONTRACTOR DECLARATION
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
69077 C53 C27 C219 06/30t20t
y �ate "2X"746'_ j,%
Signature of Contractor -- !�=;''� Ar:.l : v� v jyI�
+ / / 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 r
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.
aTA. 1• Uri?T'i3 u f •^vit +i4''aT 31tJ s3
(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: Applicant (/--'� .�.Z ✓ /.¢ �� _ ,
V TtT- f �,
Warning: Failure to secure Workers' Compensation coverage is unla ul and
shall subject an employer to criminal penalties and civil fines up to $1'00; 00, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to .the conditions and restrictions set forth . on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a, result of this applicaton agrees to, & shall, indemnity
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit Issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent)Date %�/ A-1
BUILDING, PERMIT.: PERMITk
1il3ilk-3.(�6
DATE �i VALUATION 4��(j��t,ka$� LOT TRACT
�/
JOB SITE
ADDRESS 7S -.%O .'RIO SEGO
•.
APN _ - r• ,
♦ .. r '
OWNER
CONTRACTOR / DESIGNER / ENGINEER
iViRMRS f RAr.Y",,TAN
A: z�':i.'.t?,x^.3. ,z t�CC'".�+ ,
78-960 RIO SECO
J
73-960 Fil QHAVAY 1.11 3. ScTj "M 3
LA QUIN':dYk CA 19:2253
P.fli:,M DESBRT CA 922;M
(7Est? f+Et'C72 GAL4 5220' .
USE OF PERMIT
.i' jOl, ANli Ok SPA,
{
POOL, & SPA c�M =AL tc/�11�IS18ARIUt U S LL BE iN PLAC"`t� A, a RE —
1'R AS'i`fut I.NSl'�L:'T1V2� •
:4'Cyt'Y'A'pM A'a'Aj'A1 MG7'Y' O!''as'` i.'si `+Iw1_)Y��1'Aj
s. a 5.ao►.r3 a.a.at �, a>a Cvin' 1 a.a cc a. e. ✓/
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a �uVu.g�vr
k°.EMUT E, E SUMMARY, �
PLAIJE k1E4 FEE t J01-000-Q3',-3P£f l'I .�jt►
(,,Y1p KI91?'1 r,; rfO-N trF;F i 0I -i300 -.d I, 15•.090 s t3f9.
tMECTi7�:�°�,C AL't?;Lls • t`001, 1,01-M-421-000 o� 3.f14
fc.iWrWCAi.. F POOL 1Gi rltJti- 2t�-i� iG yi5.t»)
YLVINIBlNG, VE Y, .• POOL 101-000-419-0€30 527.00
RM: TOMAI, CON1,1 M'M CTION' _ N'T141-AN CHFCX
�z!�3.t}�`►
1,l_'',.'SS PRE -1 MD .';".;FS
101'f0.E.PERMIT FUS 011J tN'OW
S393.0
RECEIPT
DATE
BY( /� l E�f
DATE FINALED
INSPECTOR
/
i
FA
INSPECTION RECORD
OPERATION
DATE
I. INSPECTOR
OPERATION
DATE
INSPECTOR
J 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.Q.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
GC%
Underground Electric
I
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
Law Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
.. ,.
$ 16023919011 Pot; „
January 28, 2000
Mr. and Mrs. Frank F raeyman
78960 Rio Seco
La Quinta, CA 92253
Dear Mr. and Mrs. Fraeyman, .
The Ventanas Community Association Architectural Committee our submittal of
pool, spa and landscaping plans for your home in the Ventanas The plans were approve
subject to the following comments:
I . A construction deposit of $2,500.00 is required prior to the onset of construction.
.2. Landscape lighting is not specified and will need to conform to the "lighting"
requirements in the Architectural Review Guidelines:
3. The. drainage for this project will need to include core drilling,to the front curb.
4. It is recommended that you review closely the use of the Acacia trees next to your pool,
they drop a lot of leaves and may be a problem fvr you later.
Thank you for your submittal and patience in our review of the plans. i look forward to working
with yuu further. on these improvements to your.home.
Sincerely,
Mindy Gutierrez, Pro, anager
The Master Assoc' �' La Quints
Professional Community Management / Desert Resort Management
Dost Office Box 4772 • Palm Dcscrt, CA 92261-4772
73-55Q AIC85andro, Suite 5 • -Palm Desert, California • (760) ,146-1161 • FAX (760) 346-9918