0011-172 (RPL)LICENSED CONTRACTOR DECLARATION
khereby affirm under penalty of perjury that Vam 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
�. A C53
Date !; ?';�� Signature of Contractor K "' ✓' _�
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).
O I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
f 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 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 provisions of Section 3700 of the Labor
Code, I shall fort with comply with.th'o a pro isions.
Date: �' .� / '' la Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest.and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.r
Signature (Owner/Agent) Dae.�
BUILDING PERMIT PERMIT"
DATEf VALUATION LOT TRACT
TRACT' jY
111
.460$r�
JOB SITE f
APN
ADDRESS
OWNER
CONTRACTOR/DESIGNER/ENGINEER
DOUG M:FMIS
:%TIK'M 17C3DSOk1 DIC:.
44.6160 C.AUX? V?AAi°IABAKRARA
73 0 11 COMT.E.H. T CLUD M, OWE F4
L.A Q1•l W1'A CA 92253
PALM Ti.�M�iER CA, 92260
(160)346-4032 CRTA, 1044
USE OF PERMIT
k°OC111, ANIXOR M -k
POL}f., d4: SPA. 0NLY-A1,, ARM.V1iA'RAf.ZRS MALL BF IN PLACE A`1' PRE,
PLASTER, INGMTJOR POOL kA. UIPMFWT 314ATIL BF i'M4 FLAC'E AT PR
PL..ASTER .INSEPCTION.
POOL ANUOR SPA 16,44,00 W,
Nr�9, MmED Cosa or. CONSI' mCnon
16,423A)iD
PLAN CHECK FES 101-000439.3113 ltll"l.�
C(nIST .UCTTUNI FEE 101-000--118-000 $180.60
1AFC:'11A'13TC.AL FEE - POOL 101.000.421.000 $24.00
F KC TRICAL F _. POOL 101-600-420-600 $45.00
PLUWi3M0 FEE -- POOL, 101000.419-000 $27,00
g
p 4=1'"TAL CON'UrI2'iDi.-MOM ARD PLAN fA13EC:k+°.
$3.93.00
�
NOV 2 8 2000
1'Cyy All :PWIRM F FW.S DUB avow
S393M
IT Y hp LA %AUNA
a
z
RECEIPT-
DATE /
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
I DATE
I 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
POOLS
- SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Final
Underground Electric
Underground Plbg. Test
Gas Piping
_ 0
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
COMMENTS:
No pts
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)
POUR IN PLACE
12" CONCRETE CURB ]
FOR PLANTER
}
2 12" CASCADES
O
--126-\4'— ,
P/L
P/A P/A o
5
30'-3"
(DECK) P/A
�. +12" +18" _
UMBRELLA SLEEVE
>O 8'-7° 5' 3'6" 7
\ II
8'-7"
7,-0"
TAN I
5' , 5'-11
C LEDGE
r � r.
< 8'-6"
� 0 P \� " .j
/ 10 -8 ;
'F 5' GSE UMBRELASLEEVEA 14'-3" 211-3"
mc, LAARS LX P/A
ELECTRONIC HTR MODEL
STACKLESS TYPELv i 1
5'
FNcolr�l
OVE' I
C.STOOP AREA
RESIDENCE
BOBCAT NOTE:
ACCESS PROVIDE TEMPORARY BARRIER
R& R DURING CONSTRUCTION
A RE -INSPECTION
WILL BE CHARGED IF IRIOPR4VE�
PI SANS AND JOB CARD ARL NOV US
HE SITE FOR A SCHEDULED
INSPECTION.
NO EXCEPTIONS!
STRIP FORMS FOR FINISH
STUCCO TO MATCH HOUSE
NOTE:
SPA SPILLWAY IS CLOSED TOP
WITH CANTILEVER CAP
& DOUBLE 12" SPILLWAYS
Ut- LA UUINTA
UILDING & SAFETY DEPT.
APPROVED
FOR -CONSTRUCTION
signature
LA QUINTA HOMES
.MUDSILL CROSSECTIO]
HOUSE
IF— MUD SILL
2" BELOW MUDSILL
E
BY
L
DESIGNER
RANDY
9/05/00
REVISED
10/1TV
GENERAL SPECIFICATIONS
SIZE 14' X 26'
AREA 310 PERIMETER 97
DEPTH 3 1/2 X 6'
TILE CHOICE GROUP 4 SO 60
f1@B.— .
COPING CANTILEVER
POOL CAPACITY 11,000 GALS
PUMP CAPACITY 102 GPM
MOTOR HP STA RITE HP 1.5
-mffaR")--— — — — - mp— —
FILTER STA RITE 300 SQ FT
FILTER RATE 102 GPM
HEATER LAARS LX SIZE 400 BTU
TURNOVER 4 HRS
SUCTION LINES 2 "
RETURN LINES 2 "
SKIMMER MODEL AMERICAN "
CHECK VALVE YES
GASLINE BY SDC FT. 50'
POOL LIGHT 400 W CLOCK T104R
ELECTRICAL BY. SDC FT_ 200
7CTr ZERNER-. — — — - - — —
PLASTER COLOR WHITE
DECK BY SDC SQ. 690
DECK: TYPE . 'SALT CLR. TBS
7' .X 771 FZAISED +18"
100:. WATTS
.EVEL SEATS 22:' 24". 2711
WALL 12 " X 12 FT.
WALL TOP CONC.MLE
LWAY SIZE 3:"X 18" WIDE
Mme: DOUG / PATRICIA SHEETS
Address44860 CALLE SANTA BARBARA
�CdY: LA QUINTA
S AL A ERS TRACT SONRISA LQT#
PdSORP�o/s
�l PALM DESERT TEMECULA
N 73-011 COUNTRY 28910 RANCHO
CLUB DR. STE F-4 CALIFORNIA RD.
1/8"_ —1 SCALE PALM DESERT CA. STE 203
NOTE: LANDSCAPE AND FURNITURE 92260 925LA CA.
90
ARE SHOWN FOR ILLUSTRATION (�� 90 90
346-4032
ONLY AND ARE NOT INCLUDED. (909)676 -SWIM