0110-244 (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. ClassDate
C 113., 04430/24
Date Signature of Contractor-" 75
OWNER -BUILDER nECLARATION
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:
Cartier ifs£@'JPtyad Policy No. 19404"41
(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•thos5�9,r&isions,
Date: Applicant --'P
" 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 representatives of this City to enter upon
the above-mentioned`property for inspect n purposes.
✓Date,,,;'
Si nature (Owned :& en'tf
BUILDING PERMIT PERMIITnT#
DATE XeVALUATiON` 31.8180.0 LOT TRACT
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OWNER
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OCT 2 2 2001
CITY OF LAQUINTA
-FINANCE DEPT.
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RECEIPT
DATE '
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
Fin I
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
_
_c
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
Sewer Connection
Pool Cover
Encapsulation
Gas Piping
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 Notice (Perm)
MERRITT -POOL CONSTRUCTION
41-995 Boardwalk Palm Desert 760-568-9200
�vINTA 1 Mo CIT OF LA
UIl- ING & SAFETY DEPT.
13 _
FO CO, STRUC
I
[4 p a\' _-- --
IPATE "-
Garage
Demo all decking, plaster and the
Remove and replace surface skimmer
Install auto fill device
,Demo corner of pool to expose steel rebar
Construct a 7' round +18" spa w/18" wall
Install all new plumbing for existing pool
Install 6 jets In spa and fountain return
Install new pool and spa light niche
Replace circulation Pump & Motor
Install Jet pump and motor
Replace filter
Install Aquaswitch
Gunite as per plan
Replace decking with Colored Concrete
Construct a Quartzite spillway
Tile water line In pool and spa
Pebble Coat and fill with fresh water
APRILI2, 2001
20D: M.
SPECIFICATIONS
Pool Size ... 15'6" X 30'6"
Spa Size..7' ROUND
Pool Area..455 sq.ft.
Spa Area.... 50sq.ft.
Pool perimeter..94ft.
Spa Perimeter .... 28.ft.
Pool Depth 3'6"X5'0"
Spa Eleva...+18"
Spa Jets .... 4 UPPER 2 LOWER
Lights..1 /400 1/100
Autof ill ...M . P.Products
EQUIPMENT
pump.stoRite Maxi 1.5H.P.
Sta-Rite Maxi. 2HP Jet
Filter ... StoRite Modular300
-Timer ... Aquaswitch
Decking color... TBS
Square feet....
Tile Choice ... GROUP 3
T.B.S.
Mr. Steve Oates
yg- 701 SAN &'rn 4-s
Ce .
LA QVINlTA
SCALE: 1/8" -1'-0"