0105-192 (RPL)1:� LICENSED CONTRACTOR DECLARATION
I herby 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
Date - 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
corppensation, 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 Y
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.
(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 p.rovis'ions o%Seetion 3700 of the Labor
Code, I shall forthwith comply with those provisionsiV
Date: . 7-01 Applicant—
,,Warning:
pplicant ,?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 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 repreesp4tatives of this City to enter upon
the above-mentioned property for, ir,4e` tion pu��ses.
Signature (Owner/Agent)
BUILDING PERMIT _ PERMITN
DATE VALUATION LOT ()IW 19!9 "TRACT
JOB SITE
APN
ADDRESS
OWNER
CONTRACTOR / DESIGNER / EN INFER
fPi/XEDC3DSON, ~c►iITTR CTI.1031010,
1.A,QOD3"I°A alk ;92233
LykLMi3MTHR1 CA 92260
USE OF PERMIT
P001,.t ND/OR ;sPIX
1u�t�y �
POOL,I3:F?i�,..?.�,,61�11+1 i£SJtiRRVER4' HALL 82"IN PLACE) f PRE PLASTER.
WSPECT104, PChO.6 FQUIPMENT F- 1,':14SURE NOT INCLUDED.
s'
POOLAqMR VA �.fil:50,1#0.1J
. MSAI cosy ' OF C>r)NS1:RUC"1;IOIV
PIAN 03D'ECK FE 101"000-439-318 $$140,25
C°043'D.'il.FlCTION VYX 103-000-418-1000 $1121.00
MLG'°HAMIML Re _.. Po. 013 101. -13M47.1.000 $24.00
EL.IrL TRIC;.AL FUZ -, POOL, 101-000.420-000 $45,00
P1eL3MS1'RO FUFI -- ?00 11 $27.00
p �
SME AY, U"34 A-ND_,1:1tAN'CJAr11C1K
$467.2,1
M Py 1 1103 PR1•~-F.at TD 1ML.
01 C:)
F,NpNCE
RECEIPT
DATE Q
DATE FINALED
INSPECTOR
1i
/BAY (
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
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
Set Backs '
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
`G/
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
Sewer Connection
Pool Cover
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
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
+-
~
COURTYARD
POOL
STRIP FORMS FOR
FINISH
STUCCO TO MATCH
HOUSE
NOTE: SPA HAS ENLARGED
BENCH FOR TANNING SET
AT -6" / CUT REMAINDER
AT SPLIT BENCH DEPTHS
R3'-6"
P/L
5' 7
BOBCAT ACCESS
R&R BLOCK WALL
5.S
'i
I7'
AIRPIPE
S
T
R
E
E
T
ENTRY
P/L
P/A
,-A
3'
7 /r
R7'-6"
29'-3"
R7'-6"
a
15.5'
15.5'
/ \ 2.5'
R7'-6"
SLEEVE ALL P/A'S
ADD VENT u
STACK —
TO HEATER 8 d 40
AQU I (STA
BUILDING & A ETY DEPT.
A P P OV E D MASTER
FOR CONSTRUCTION BEDROOM
iDATE 5 I BY
A RE-INSPE
CTION FEE OF $30
Will BE CHARGED IF THE APPROVED
PIANS AND JOB CARD ARE NOT ON
THE SITE FOR A SCHEDULED
INSPECTION.
NO EXCEPTIONS!
LA QUINTA HOMES
MUDSILL CROSSECTII
HOUSE
}F MUD SILL
2" BELOW MUDSILL
R7'-6"
BLOCK WALL
P/L
P/A
SLEEVE ALL P/A'S
t
r
51�
AQUA SWITCH
P/A
SLEEVE ALL P/A'S
GREAT ROOM
STAGKFD WAT RFA �
W /ROCKY MOLNTAIN AI A! R72
WATERLIN A CAR FOR CASCADE
E
X18 BB
♦IS'1'OP OF DAM
WALL
P:.
WATERLIN
D
i 91 i WlDt .
6»Y?`
SPA DAM
a
'WALL
::RET:URN
T
NI= wI..E?
:CV. '
:Y1B(... A.. E
GENERAL SPECIFICATIONS
SIZE 12'6" X 34'
AREA 330 PERIMETER 74
DEPTH 3X7
TILE CHOICE GROUP3 64
RBB, SPA+18"
COPING CANTILEVER
POOL CAPACITY -11,OOOGALS
PUMP CAPACITY 103 GPM
MOTOR HP STA RITE HP 1.5
MO
FILTER STA RITE 300 SO FT
HEATERI 400 BTU
TURNOVER 2 HRS
SUCTIONI
2 it
RETURN LINES 2 fl
MODELSKIMMER
AMERICAN
CHECK VALVE YES
GASLINE BY
SDC
FT. ALL
POOL LIGHT 400 W CLOCK AQUA
ELECTRICAL BY. SDC FT ALL
PLASTER COLOR 3M QUARTZ
DECK BY SDC SQ. 1205
DECK TYPE SLT FNSH SD BUFF
STEP FT.
SPA SPECS.
DESIGNER
SIZE '7 RAISED / +18" LITE 100 WATTS
RANDY/RP TRI LEVEL SEATS 22" 24" 27"
DATE DAMWALL STACKED
P/A DAMWALL TOP QUARTZITE
SLEEVE ALL P/A'S 1-11-01 SPILLWAY SIZE QUARTZITE WIDE
I REVISED SPILLWAY XX OPEN CLOSED
# JETS 4 UPER LOWER
Name: PERSSON RESIDENCE
Address: 49-380 RIO ARENOSO
LA QUINTA
TRACT RANCHO LOT# 50
gj_A'�QyINTA
Do son
MASTER COPY POO/S
PALM DESERT TEMECULA
N 73-011 COUNTRY 28910 RANCHO
1/8"=1' SCALE CLUB DR. STE F-4 STE CALIFORNIA RD.
PALM DESERT CA. TEMECULA CA.
206
NOTE: LANDSCAPE AND FURNITURE 92260
ARE SHOWN FOR ILLUSTRATION (760) 346-4032 90 90
ONLY AND ARE NOT INCLUDED. I Ir � A C7A 1 (909 92590)676 -SWIM
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