9908-101 (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
640377 C53 C27 ,^--tqW, W20(
�r` r
Date Signature of Contractor
OWNER -BUILDER DECLA ATION
I hereby affirm under penalty of perjury that I am exempt fro he 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.
(,) 1 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.
(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"f should; become
subject to the workers' compensation provisions kof Section 3700 of the Labor
Code, I shall forthwith comply with those�prov_isiogs. 4�
Date: 9/ '` 4Applicant C� � r
f Warning: Failure to secure Workers' CompensatioQn cdvptrayge N ur7lawfulland
shall subject an employer to criminal penalties andtoivil fines up •jd! $100,000, in
addition to the cost of compensation, damages as p�roy ded 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 authorile represents ves.of this City to enter upon
the above-mentioned pro erty for nspectio urposes. t
`Signature (Owner/Age tt. �� Date �1
BUILDING PERMIT PERMIT"
DATE ( -, i"VALUATION.S 7.N&ft LOT TRACT
JOB SITE
ADDRESS 49-IC51 RJO ARWaSO
OWNER CONTRACTOR / DESIGNER / ENGINEER
r%(NkI A 4 T1 %ArvivT Tr A -m n9 A r TSC"l`G"f+'�''k^
12'U,I! Yo 4.1..1 L 7 -LL i •J.a \.!U-. CA L L.l-� -1
X 9-145 WO 10W '..:SFJ Atz? t� ��,j c s ': - 73-960 HILI AWAY ! 1 !, :i�>Ji� S
LA (YJIKf'A• CA 927M VALM DESERT CA 92260
(760)%'"726 C:81 5220
USE OF PERMIT
PI,A✓L Ji SPA. ONL x` - 1N A i a4CE
111,&fI'F:R lisi,S!'fi4 II! 1N
4t(R)JI. ti.INw4rFc :v)k
I_,.W.i'30 US
it'F~;RM(T FEE SEll4 MAItY
i!'i.AN !'141s+_`[ti, F05H to 13 4)00.439-318 114 t7 01)
CV )W t'rRV K'stt 3N 1, V 1014 A f R-tdt<3(4 $190,06
1blC..V 11ANWAL. I"C:lt P(W_)J.j (Jl =-•#21 a 5241 X1
i Esc "3'iiit �Yta I :Ll ih .� �t,
101 -00 -420 -ON 345.OU
MAIW INO FHE __ II X.M. !U1-(K0.41VAW SV.00
';t it3..`RYrA1, ffNSTRI K"n0N kW) PLAN 04FCK V0300
LF104S PRFTAID F US $0.00
RECEIPT DATE BY 71 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
0. 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
Set Backs
Electric Bond 4
Footings 1
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
`(j_
Underground Plbg. Test
!v_ R �/
Final
Gas Piping
10— $ C�A `Z-�
PLUMBING APPROVALS
Gas Test
Electric Final
CV w _e-tr_
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
0
Gas Piping
Gas Test
Appliances
Final
- Gf
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
i
F�,_ 1
Utility Notice (Perm)
COMMENTS:
September 3, 1999
Mr. and Mrs. Donald West
49145 Rio-Arenoso
La Quinta, CA 92253
Dear Mr. and Mrs. West,
The Ventanas Architectural Committee has reviewed and approved your submittal of pool, spa
and landscape plans subject to the following comments:
1. You will need to install area drains and drywell with bubbler adjacent -to the street.
2. � . The rear yard contains existing landscaping; which shall remain. This is. not shown on the
plan.
We are in receipt of the signed grading and drainage form along with the signed construction
regulations. We have received the construction deposit for this project. Thank you -for your
submittal and patience in our review of your plans.::..:.
'i
Sincerely,-.
Mindy Gutierrez, Property Manager
The Master Association for Rancho La Quinta
1
Professional Community Management / Desert Resort Management
Post Office Box 4772 • Palm Desert, CA 92261-4772
73-550 Alessandro, Suite 5 • Palm Desert, California • (760) 346-1161 • FAX (760) 346-9918