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0008-371 (RPL)LICENSED CONTRACTOR DECLARATION yi,herebv affirm under penalty of perjury that I am licensed under provisions of Chapier 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 xp. Date :574127 .A, j ow tf.2C Date `f '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 IIIe 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' lr'breby 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: CarrierST�.TE I'UND Policy No. a46-00400934 (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 Calif omi ,..and,agregthat if I should become subject to the workers' compensatiorYprovision Section 3700 of the Labor Code,d'shall forthwith comply with th se, provisions. _ `Date: bb "�-.bb s:C/ Applicant�`�X'7�=''. �'' 1?. (j 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 fesult 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 forinspectioon�purposes. Signature (Owner/Agent),/e. > ,_ l Date r` BUILDING PERMIT PERMIT# DATE VALUATION LOT Q � 571. TRACT 8+ ry'ry /may / R/Ci'%felil/ArVb 42�� 7.iiV Vv JOB SITE ADDRESS iii -745 C .W01`. WAY APN OWNER CONTRACTOR/DESIGNER/EN (NEER CP i-rtJRY C' ROiR11 M COMMONIi3iz,S STEVE DODS09 CONSYRUMION WC. 1535 SO, "D' MW S E 9200 73011 C OUMIRY CLUB DRQ SUBM' F4 SAN 89-RHARD)N0 CA. 92408 PALM ME'R'r CA 92260 (760)346-4032 C:131A 20144 USE OF PERMIT POOL AND/OR &'A, POOL & SPA 0:31,Y-ALARMSIBA RRIMS SHALL FIE IN PLACE AT PRE PLASTER INSPECTIAN.POOL. EQUIPMENT E CL OSURE IS NOT INCLUDED IN THIS 1'gTQI~fiT POO1. ANDIOR PA 2ZS07100 LS FST11'"TF:D COS`r Ole CONSTI UC 01f /i2�tU7.i9p PERMIT M sruhn&ARY PLAN CHECK FEE 101.000^431-318 $142.10 CONSTRUCTION i+-9 t01-040-418-000 $234.00 MECHANICAL ME -- POOL 1`01-000.421.000 $24,00 X1,ECTRICAL FFE1. PMOL 1Q1••000-44b.,00o $45,00 F'I U.MR TC1PER, _ POOL 101.000-4194000 � 4 + $27.00 x PA AUG 2 8 2000 SUB-'MTAL CONT RUMON .A,2a ID KLAN, 01�`.CK 492.10 s . , $L17ws _%Y3AW M-3 $0.00 M r 'i C`i"A AL PERM I?'sa S DIME t _ RECEIPT DATE f BY .: DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms 8 Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS Steel POOLS - SPAS Set Backs Electric Bond Footings Bond Beam Main Drain Approval to Cover 2(j Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Sewer Connection Pool Cover Encapsulation Gas Piping Gas Test Appliances Final 2 Cy Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: .:> n Z-- in c.�uIpw Ls_ r J cL Z w F— C) ¢ w s w s ¢ Z OpV(Y UX LLIW CO W N = W O Z ZLLJQF--1— c QONNc� � LJ O. Vx �J � V t G tyi .� H Oo o O w }. a O$' p m O N O p, w C y d •� ►3. ti bD 0 Q a% s a y a y A l7 V-0 y c �'oop-O ° a~ y .� Sd cd o •� ° Oy H vi i H Rppy ;a �A � .a i �] O bo C cd V h a '0 a •J cva on S'0"„ •`� i ° � w 0 q ° G° U o 3 `?� a s v A [�o ca y o u y aa vOi p. 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ST1l �l! .3/ �t 1 1 _G\VLE Y + SPA DAPI ' LE"T1fM75b=Y - - . D[C wALL CQVINS CA\TILEY'ER -_. N A1RP1➢E reELow sliDslu ssxxA 7' DATE signature CaPgCiIY_. 9.W ,GALS_ Oj - -- --' - i ,.E NOTE SWIRL FIVSH 4^TnR 1+P, m eL • - FILTER SPARFiE 300 _ jpT Op Y•>a EILWRRkIE.-.. _ 102 Gql .. m HEAIER..IMRS _S12E__ SUCTK)NUNFS . D 56SKIhIMEBBtOQEL _ .11 RICAN - } CHECK VciLVE_. YES .- -. i .- O tj 1 GASLINE BY SDC_ FT_ A' + d t Ic-3^ Rr•(" ,POOLLIG400'W CLOCKTI[MR N ' F1T P/L - f ElECTRICAt BY. SOC _ BALL _ O • IA'A' - BBQBV OWVER Prt AlJ±9 FiN� .. -- -- Z. GASSTUBBYSDC CH _ STRI P FORJIS FOR FI\LSH - .— — STUCCO TO MATCH "OUSE- • R COLOR TYNITH O O RTJ" %'-3- DECK TSMRL YPE N . STEP FT. - -_-SPA SPECS—.- • - DESIc�FA Siff 7- RAISED -Hs' JT•y.. U_ fE_1 0_0 WATTS -. - — RA_VDY/E RI LEVEL SEAT$ 22- 24" 27- 311' DATE DAMWALL STACICE _-- _ LIGHT SWITCH - 6{7-00 DAMWgLLTOP�AftT TE' - SVl1WaY WOE ADD VENT / REVISED 5EILLIYAY,iC (t]�L. _. STACK . i IBFR _ TO HPATBR DOOR , ' -- DUKE UTTER - d .. N _79-'79WAY PHASE2 W OW La 01'1\ZA A G/E lBACkTARLWF T DL:NES LOVE " .; 18 'Davalso�rID - Y RESIDENCE N Poo/s PALM DESERT TEMECULA BOBCAT ACCESS 73-011 COUNTRY 28910 RANCHO \O l[6R RFgUIR6D ���--'***���-'��� - CUIB DR. STE F4 CAUFORNIA RD, l' CALF pAW DESERT CA.. STE 206 UI SET EQP TO CLOSET MASTER NOTE: LANDSCAPE AMD FU - - 92260 TEWCULA CA, ARE SH lCLfiN n601346.40:2 9�j675-%m kR A RE=INSPECTION L,,NU"ETY DEnT i W WIIL BE CHARGED IF THEE OF aid p(gN5 ANQ JOB CARD ARE NROVE� ETHE SITE OT Ory __INSP FOR A SCNEOULED ECTITE RUCTIONNO D(CEp00NsBY