0110-306 (RPL)LICENSED CONTRACTOR DECLARATION-'
I hereby affirm under penalty of perjury thati am licensed under provisions of
hapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License
`#pay y Lic. Cllass�^7 p Exp. Date
p
IV
Date Signature of Contractor's
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 S F,A TEM, Policy No, iltdir•�f.-O'JI� 7�i;�$
(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 provision's^)
Date: i, /M. , Z Applicant ^z. Z = ;� �-
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 .ssuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this applicaticn 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). t ./ Date-, -
BUILDING PERMIT PERMIT#
% VALUATION, LOT TRACT
DATEJ77
JOB SITE
+•223om i nTo
APN -
ADDRESS AW7,4v
OWNER
CONTRACTOR/DESIGNER/EN (NEER
MAUL
IX AKDETFXMIURS
IA QYJ114TA VIP. 9225.11
AALM MYRDAGS CGA 9'L2i�2
C760yris-9070 CR -1.4f 5326
USE OF PERMIT
POOL AXiafOr"i.� , 3PA.
14 RXPLACE-11L4f,
liA]SED PLANTER AipY.0JDOk.31ICYJC rNCLUOR kt,QUIPA9,T:NT 0,L1WD1ALk[d4: S
1'43f1L ANDIO1 SIFIA 1};1A.D0 Ls'
EUMAT'D COST CIF 'O.NYMM17014 MVKWO
K qqM3r 9. 81TAp4M
PLAN CHECK, FUR 101-000-439-3 18 $Sf'i',60
C;O1aSTRUC" ION FEE 101.000-418-000 $304.00
M.t;'.Grl`S,AMC;.11`F, l E i' -. POOL 101.000.421.000 $24,00
rt:1.UR:'.M:.r'S3
i
I'F..t1:m13 mo h" - 'Cri l.r 101 -000-4194000 r ..� ?$27'.AO
I
tr
001
' ClITYOFLAQUINTA
r• • FICF
-' -1 Gt .�i4l4t�'3� 1 :'I,fl1� Fkt+,C:ia $597.64
RECEIPT
DATE
un/ i
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
Patty Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
Set Backs
Footings
steel
Electric Bond
Main Drain
POOLS - SPAS
(f/�
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
_
r
Final
PLUMBING APPROVALS
Underground Plbg. Test
Gas Piping
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
Low`Voftage Wiring
Fixtures
Maii9 Service
Sub- Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
L' cz 2 C:L4LtM. GoX& E7-
CommuiL4ty AzzocZat.%ort
P-.. 0. Box 162
La Quinta Ca.92253
Telephone:. 760/564-2177 FAX: 760/564-4882
October 30, 2001
The Planning Department
CITY OF LA QUINTA
P. 0. Box 1504
La Quinta CA 92253
RE: POOL REFURBISHMENT
78-230 San Timoteo
Ladies and Gentlemen:
The Architectural Committee has reviewed plans submitted by Leak Detectors for
refurbishment of pool at the Sterling Ball residence.
We find these plans in compliance with the CC&Rs and are, therefore, 'approving
them.
If you have any questions, please contact the office.
Yours truly,
Jimmie D. Woods _
Chairman/Architectural Committee
G FTA/;- LA QU I STA,
_,,u���D1N!G & S,� F E Y EM T.
LE
AP;��:O01�9 iOR CRUCTfON
��
i
{ Job Scope- Remove Replace-Tile, plaster, two pool
skimmers, plumbing, two pool.lights,all
honer-' Sterling Ball equipment,Build 8'x8' Spa in elevated
Address- 78230 san Timoteo planter.
zontractor- The Leak Detectors pool- EXISTING-23'x50', with 12" raised bond.beam
license- 618116 C-53
spa= PROPOSED- 8'X8', i n .existing raised planter.'
address- P-.0. Box 8674
Palm Springs, Ca. 92263 f Equipment
t
phone- 773-9070 heater- Teledyne Laars 40OLLDN
/ 400,000 BTU -
�+•r-►w-LIQ,
€ pump- Purex 1 1/2 Hp Whisper Flow
Energy Efficient
nt
_ [Purex p Whi sper Flow Pump
- fntn pump-Fnt. Pump-Purex 2
L, - , .,
:r te_ S€ --_ y it r- reCartridgelean e
• -• r1 _
•
' to Purex C N Cl ar
4r �.•: , . . ..
-
gas run 5slze 1 12"
lights- 2 American products 400 WTT.
controls- Jandy RS/ with subpanel
_ c j
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s
- � � -� I _ �;l.3 SLAG .L li �7Q��'�^`n 0�'�'•�.�..
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CITY OF LA QUNTA
DING & SAFETY DEPT.
.7• Mr
INED
- ^ T UCTiON
I' a 30 0� r•
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70
s
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PC L
TtYO LA UUIN IA
2.j
SVILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION