9605-157 (RPL)LICENSED-CONTRACT(iti-DECL'A'RATION''
I h!2reby affirm underrperialty of perjury that I am licensed under provisions of
Ci5'apter 9,�,ommencing 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
55ti:d u i 53''"
212807
/ '7`t '1
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
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
Perfor ance 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 iissue�d� M,yijhrorkers' compensation insurance carrieri;&fpolicy no: are:
Canner 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
subjeet to the workers' compensation provisions ofjSection 3700 of the Labor
Code, I shall forthwith comply.With those provisions.
e:1 Applicant
Vt
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. '4-
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 representative?& this.City to enter upon
the above- mentioned. property for inspection,purposes.
"gnature (Owner/Agent) "3"" "" Date
BUILDING PERMIT PERMIT# CONTROL#
��/�IV�1 rY ILEI �,�a.. -� 3393
DATE 019 ALUATION $14,100.00LOT TRACT
JOB SITEqpN
ADDRESS�8-710.SAN.1 A
�1$�$-.��D �1�'
OWNER
CONTRACTOR / DESIGNER / ENGINEER
DAVID & Yvv,,'.rE ViC.E:ld4:;1 ,
SUNRISE PWLS
7s770 SA11Y1'A ra.
44028 ELKHORN TR.
LA.IQL1'.(AI'1'A. CA 92.2.53
PALM DESERT CA 92260
(61`040-5521 - Chi%44 1-444
USE OF PERMIT
150 .1. A:t* DiOlk SPA
P001. &T SPA
P06.1A i4NDiOk SPA 14, 50,00 1..5
MIMMED COST OF CONYMUCT 10N
PCRTVI F t- !i ft.UAW MN1At,RV
("oNsT€2f crYc:>td FEE 101 -000 -419 -OW $1,62.00
PI, A N C EMCK FEE 101-000-4.39-31$ $1(15.30
NfEC HA1 ICAL 1:CT-, -- POOL 101-00{2421-000 524.00
F_4.9C!.VR CA1:: Fal — Pool. 101-000-420-000 $0,00
PLUMBING ING EEE —MX .. 1.01-000.1119,49X) $V.120
- wi?T3-Tt YrAL {~ONS'T1%.1)(� 1'[<?�1 AND PLAN CHECK
%n�USS 1>R►r-i�Al)] FEES
Y�ci.;;(1
-1'(J1"' .J.. @'B�lE MI'l` 1�'i�:�,S f)ll►;T+iOW
X34;3.3#►'-.::
J A'N 0. 1�9 0
i
BY
,
RECEIPT
DATE
BY
DAT I
I INSPECTOR
INSPECTION RECORD
e 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 Wali Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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
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 Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
P/L
1
P/L
GENERA Sr CATIONS
POOL S17E 15p:110
FCC>L nREA 360 S0. FT.
POOL PERIMETER 88 LINEAR FT,
DEPTH 3"%' TO 6"
COPING GANTIl EVEP
TILE CHOICE GPOUP 11
POOL CAPACITY A.PP. ;0,000 GALS.
P! IMP CAPACITY CIO GPM
POOL PUi IP 1,5 ULT KA FLO HP
FILTER QUANTUM 175. SOFT.
FILTER RATE 175 GPM
TURNOVER APPPDX. 4 HRS.
VAC/SKIMMER 1 i/2 ;' 2 IN.
RETURN LINE I IN.
MAID! DRAIN ANTI VOPTEX
SKIMMER MODEL DUAL FOP,T
FILL DEVICE MAf\IUAI.-
HE,°,TER TELEDYNE 250,000 BTU
GASLIf lE BY: SUNP.ISE LENGTH 100 FT._
LIGHTS -POOL 400 WT. SPA 100 WT.
TIME CLOCK INTEPMATIG Z4 HP.
ELECTRIC BY: SUNP.ISE BONDING SUNPIS
POOL CLEANER N/A
CHLORINATOR N/A
DIVING BOARD N/A
LADDER N/A
SLIDE N/A
ROPE RINGS N/A
ACCESS TRACTOR DODGAT
GRADING NONE STUB PLUMB NO
DECKING 5UNP15E SO. FT. 650+450
CONCRETE REMOVAL BY: NONE
RAISED BEAM -LENGTH N/A HEIGHT
SCALE 1 8' DRAWING #
DAVE AND EVETTE VIGENGIA
78-770 SANITA
LA QIJINTA, GA
(,619) 3A0-5521
SUNRISE POOLS PALM DESERT, CA.
CALIFORNIA LICENS
;opy
APPROVED BY:----_---_—�-- ---�
THIS DRAWING REMAINS THE PROPERTY OF SUNRISE POOLS.
REPRODUCTION OR UNAUTHORIZED USE WITHOUT WRITTEN
PERMISSION IS PROHIBITED.