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0308-155 (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 Prcafessionals Code, and my License is in full force and effect. - . • License ec#6 C.53Class �f Exp. Date t3 qq 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. ,l.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 STATE CO3MPFINSA,TI Policy No. 04" 169-200 (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' compensatioI"ovisions of Section 3700 of the Labor Code, I soall fo with comply with those provi'sions.! Date: r 5 Applicant— Warning: pplicant 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 foj�inspection ppurposed'. Signature (Owner/Agent) +=1.ip� Date ✓' BUILDING PERMIT PERMIT# ,ll DATE V%tLUATION O LOT TRACTJOB SITE ADDRESS I�'�..O.IZ, APN OWNER CONTRACTOR/DESIGNER/EN INEER : mM. AK)/aR.-NM8. XAI:XOSKP4 . CALT, POOLS A SPM MAW OO 79-095 00O27 O iYRIVE' 86-11 00 AVVIME Sfr,.- �a�`.�'�3P LA Q' MV, CA,. 92253 C'OA MLLA (:k 92236 Q60)398-9222 C'Bi; , 00355 ,USE OF PERMIT POOL ,r?NVOIR, SPA if�C30.t�SPA,. Ai.Ar .IMMAR91FAM SHALL BE TN.PL AC F &T PRE -PLASTER , iNSPECTIOX EQUIPMENT hfiiCI.Lh9URENOT.INCLUDED POOL ANLtIORVA VZO001001 LS F►�'r"�".C11(..tV C09, .' OF CONS" RUCLION PIAN CHECK & 1(31�Clt�i} 9M,al,� $'117,00 COWSTRUC"TIO'N i e '(27•(300- 18�1�iS0 S'1f3Ct.�10 MECHANICAL MF, ,. POOL 101-000-421-000, S24,,00 ELEC`I'14;[G1+Lt?R -POOL PLUMBRIO FZ9'-- POOL .1.01.000419.000 ° MEOW f Agar%C5ICCKIC $393.00 3i31°t1C�O1, !� PLAW 1Z.9S PRE -PAID S $0.00 AUG18 a i.1. MTE ~ Fr NOW CITY OFLA CiUINTA Flf'a:�f•Ir� DEPT.,. RECEIPT DATE- BY T F A IN ECTO 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 711 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 Numbing Topr.Out Equipment Encfpsure Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation ✓ Gas Piping Gas Test 1/7 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) PA�I'°RELL ENGINEERING, GROUP, INC. 651 E. Northridge Ave. Glendora, CA 91741 PH: (626) 335-4362 FAX: (626) 963-4812 i ENGINEERING CALCULATIONS AND DETAILS FOR SURCHARGED POOL WALL KALKOSKE RESIDENCE 79-095 OCOTILLO DR. LA QUINTA, CA CITY OF LA QUINTA:. BUILDING & SAFETY'DEPT. P oFESs APPROVED fOR CONSTRUCTION 1KY- Qq 8 a-1 BY Exp 6/GS - C� v 1�,�cC� -a DATE: August 6, 2003 ENGINEER: J DOUGLAS R. FERRELL RCE # 32994, CALIFORNIA 651 E. NORTHRIDGE AVE. GLENDORA, CA 91741 (626) 335-4362 Project:0 - Gl -v9 Ocottt.t_o V)w CA QJtJTA PACMELL ENGINEERING Client: C" JAL GROUP, INC. Engineer: (D 651 E. Northridge Ave. PH: (818) 335-4362 f Glendora, CA 91740 FAX: (818) 963-4812 Date: 911 ty3 Sheet IZ— of 'FOOL �' j p.t` — jUtl.�l►�4 Suri-G4� E "DF -f- _ t� MSN I1 / GON� —#+GONT. 'ooL1�7ET7145 HORIZ. R=INF, lz 'rt #5012" 0/—.IU w L�.� -7u�_C- - • r(p, J J� Y' RMIN—r. p Q uJ 1 N Dir - 4 ez 1-1-7 R� 5 TABLE w �O� ST t11ZE'� TYR IN POOL TriIGKNr..�5 T' c�� i FLOOR 5 T A5:= 5" LR. G I b GLR. TRANSITION f. / 'ooL1�7ET7145 1-011 L�.� -7u�_C- Project: ��-ALkw%kcG 1"UC—S<<A 10E PATRELL ENGINEERINGtvtNw�- ,C GROUP, INC. Engineer 651 E. Northridge Ave PH: (626) 335-4362 Date: _ `�-> I � `U'� Sheet l of Glendora, CA 91741 FAX: (626) 963-4812 00L � 4pP, Lp,-( jT TO- �a - E T, -:c--- -5ca"Go To � � J P«rsr � �� � �o ST �O�N ✓IF�Qn15 Project:IN I w PA�I'RELL � � �� u��• � c � �-- Q.� . ENGINEERING Client: GROUP, INC. Engineer:'�`— 651 E.- Northridge Ave. PH: (818) 335-4362 Sheet 3 of Glendora, CA 91741 FAX: (818) 963-4812 Date: BU�t,Q���tN 2t ofooc, w.o���n1E $vt� V?tN`Xrofxi . G©r\I47z-UCTt0f'A J.. 0 1-Y6 1 �. 203 1b X i- ...._. All. x 1 .. �- �c�lo'� o�G• a. OQ oFES ��" ��9 �` �2 _. • IPS � � �- 20 00o X Project: I�Lp�(�St�E c CstviC-rJC PAtTRELL ENGINEERING Client: C GROUP, INC. Engineer: 'Q 651 E. Northridge Ave. PH: (818) 335-4362 Glendora, CA 91741 FAX: (818) 963-4812 Date: 020Sh'-et of r �3� CSM. ����MN•T• -. p�j ► bio 10.3' T. LO T (o L 0" t M' Ql� 110• toy 12, LC--4Li • [o�"i��-_ - 13. P�N1 _ I i � ` I.lo _ .... '. tiT W# -LL - 4 '2-3. 1b to C) ` 1 h QR ESS/Q�/��'° t . W !` p.C,�•LL4P Project: l,C1, l! -E Ac*iCc PATRELL ENGINEERING Client: GROUP, INC. Engineer: 651 E. Northridge Ave. PH: (818) 335-4362 Glendora, CA 91740 FAX: (818) 963-4812 Date: J V 3 Sheet of C(DoR'01''A o. -r -C=- C)(=- oo���T Z MOMENT DUE TO 5011_ PRESr;;U2E; SUMMED AOoO-r CR\Z' \GAL_ F%t NT < 0�1 (ZA-DIU5, C.OUn1TE9.N`OMENT Off, ST(ZA16HT WALL N- SONO) CjEAM QLSG- m e Q TAKEN AeouT TH 15 PC) 1 rQT N P4 %6 LuaE T Goo�znl�p.�Es •- D R x Z+ R - 3•_p,. 2,-p„ .54 3'-O" I' -p" 455 83q 3.a4 .64 ZSa 4 •�C� • 82 1.134, 2.Oq-7 5.(o0 1.3Cn T- 0 3•_(o" 3°_Co" V.5g4 2.q'35 b,44 1.c1 i 0 " 3' - 0" 4'-(9" 2.04 a 3.-114 -7 • 2-7 2.45 9 --0 3'-&' 15'- Cd' 2.504 4, Coy 3 8.11 3.00 10'-p„ 3._�,. 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