0402-177 (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
I Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
828284 C53
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
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.
S T. a 1? FUN.0 174499.03
(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 provisions.
Date: 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.
I Signature (Owner/Agent) Date
BUILDING PERMIT PERMIT# ;
DATE VALUATION LOT C3f1Cxm^3 �r" 7 TRACT
2l13Q4 i2 .tj[tC;.l'it7'
JOB SITE
APN
ADDRESS
44-515 FA :d -t 0RC LE
-
OWNER
CONTRACTOR / DESIGNER / EIJ (NEER
ROTS B.A.M.
ALZXERKINE POOLS U, :NC
.44-575 P T 's'li �`.fAE
4) 625 ( E C: �71�� MUM
1,A qUZI Mk CA :92.233
PA3'. WNESt ,'f CA: 92260
f760Y173-32.93 C,-BLO 5307.
USE OF PERMIT
PC201, nr7DAM WA.
P00)L/3PA,. ALAR.MSIS.&RR;°'!,'.S;`.it1t3LL HI IN PL&CE..t3.T PRI,?,,PL.A,r:T17:R
(`��;��5;'lfE7%l, C��i/Ids?di'1+;i3�'t!:eft:G.C1;LIItE`?ZOTI'AIC:1.,€FDE.t7
POOL. ANWOR SPA dU,CiQSI,Op L»-
El! 1��MST (IF :�0N,` V?�I7c{,�'r1Q1V
11010M.00l
yy���
PMUT s9'A:.ElMMARY
PLAN Cd -IE: K PRC 101-000-439-318 $134.53
CGINS'1`RUC TION FEE 101.000 -418 -(IOC) $307.00
MECHANIC.AL FEE -• POOL 101-000-421.000 M.00
ELECTRICAL FEE —POOL 101.000-420-000$45.00
.
i 700
PLUBINC , TE -- POOH., 101-000-41S `C� [AV
EFEB 8 2004
CITY OF LA QUINTA
FINANCE DEPT
SUB -TOTAL C°CI T i UiICT(Old PRE) PLM C:NECK
�/3115
.`te a:
r "P+�0, 00,
'y //w�ryry ,��� ,,rr //��yy ypl.XeeaEt'3 ((T�[.F2�"+-xP�tM
Sed. AIK, F1=9 s' IPTU0 S7 VIDE, NOW
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
Final
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
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
Pool Cover
Sewer Connection
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)
CO
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{or }L1L51'ECIJ7GTIONf
damage to curbs sidewalks drivevan <ernerD
N \' evrers lawns tress fences, rimircnp SIZE'
shbz s3 • ..
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.W l� walLi sDriddas, tdeDlsor�e fiDes or sfm�s. �� �
,� ' \:.•\. (p/ le, /ry When access is snide through a n6phbor's TSO,
-
GC q amnesty it is understood that you the o�.nc � F Z
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have du neiftor s Datnkdm and assume bEl j Rsa Q 0
resp
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KibiCmCOPING •
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APPROVED
I-OF CONSTRUCTION
DATL.off BY S7
a
o�
F
s " CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
FM of rte° 777-7012
INSPECTION REQUEST LINE
777-7153
Owner BOB BATES
Contractor'AL-DERE
TE POOLS II
Permit.Number 0402-177
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 44-575 PALA CIRCLE
POOL/SPA. ALARMS/BARRIERS SHALL BE IN
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
TYPE OF INSPECTION DATE INSP.
TEMPORARY POWER
SETBACKS
U/G PLUMBING / WASTE
U/G ELECTRICAL/ GROUNDING
FOOTINGS / STEEL
CONCRETE SLAB
DO NOT POUR CONCRETE UNTIL ABOVE SIGNED
ROOF NAIL / PRE -ROOF
OKAY TO WRAP
FRAMING COMBINATION
ROUGH ELECTRIC
ROUGH PLUMBING
.ROUGH MECHANICAL
INSULATION
COVER NO WORK UNTIL ABOVE SIGNED
INTERIOR GYP. BD. DRYWALL
EXTERIOR LATH
GAS TEST
SEPTIC ABANDONMENT
SEWER CONNECTION
SEPTIC / GREASE INTERCEPTOR
MASONRY INSPECTIONS
FOOTINGS / STEEL
BOND BEAM
POOL / SPA / WATER FEATURE I S IONS
PRE-GUNITE / SETBACKS
U/G PLUMBING "
U/G GAS
U/G ELECTRICAL ZZ
PRE -PLASTER (ALARMS/ BARRIERS
FINAL INSPECTIONS
TEMP. USE OF PERMANENT POWER
-ELECTRICAL
PLUMBING
MECHANICAL
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT
FINAL / JOB COMPLETED
�AyLL CONCRETE FLAT WORK SHALL BE PLACED A
IVIINIMUM OF 2" BELOW WEEP SCREEDS.
4/22/04 s
City of La Quinta pq S �'
78-495 Calle Tampico
La Quinta, CA 92253
Attention : Building Department
Reference: Permit Number 0402-177
Bates Resaidence
44-575 Pala Cir
La Quinta, CA 92253
To Whom It'May Concern-
I have run into a situation where the homeowner is in default of our contract at 44-575 Pala Cir, La
Quinta Ca 92253. I am requesting a stop work order for permit number 0402-177 for the above
mentioned address. I believe the homeowner has contracted outside of Alderete Pools 2, Inc., under this
permit. Please do not allow any more inspections under this permit number.
CITY OF LAS. OUINTA
Thank' You,
APR 2 3 RECD
BUILDING, AND SAFETY,
Loretta Alderete, CEO
Alderete Pools 2, Inc.
41625 Eclectic Way Suite B-2— Pahu Desert, Ca 92260
(760) 773-3293 -office— (760) 341 -2275 -fax— State Lic.# 331412