0302-214 (BLCK)CD
N W
O � M
I W
Z ti
O O
V
�
LU
CO
Z•
ct)
L0
N
r)0)
Uit Q
�
Qcc
rH0
0 J J
m<
a: In
co5
N C)
LICENSED CONTRACTOR DECLARATION. ,
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000),f,Vvlsion 3 of the Business and
Professionals Code, and my License is in full tofce and effect.
License # Lia Class Exp. Date
2498:3 C-5;4 H1c
ate - Signature of Contractor'
1
=`OWNER -BUILDER. DECLARATION
I hereby affirm under penalty -of perjury that.l am exemptfrom 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&RC. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
O 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 Iregpired 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:
Cance INS CORP OF 14Y 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, a'pd agree thai if I should become
subject to the workers' compensation, prr 1p1vlsl,pns of echo' 3700 of the Labor
Code, I shall forthwith comply with tho e�provisi nS.`� 4
,/'bate: Applicant—
Warning:
pplicant Warning: Failure to secure Workers' Compensation cov rage is unlawful and
shall subject an employer to criminal penaltiesand 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.
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, indemnity
& 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 [rdpresentativea of this City to enter upon
the above-mentioned property for inspection p rpo ees.
i , `` 1 i 1
./Signature (Owner/Agent) Date
PERMIT#
BUILDING PERMIT W.'
.
v
DATE f! VALUATION LOT bl'31.1� TRACT
_
J �xxS,�1Cti.t�
JOB ItE_
APN
ADDRESS 52-440 PIrM, C'::•�!T0 D...R.1Y'�
OWNER.
CONTRACTOR/.DESIGNER/EN (NEER
mall. san—a.
52.440;t ELI GA;f0D- .IVB
75080 ZT. CHAkIX-0 FII OF
LA Q0TN TA CA, 92253
?'.AL1 IYERSA..RT ","A. 9221'
(7W,56M852 LlMif `71
USE OF PERMIT
G&NEER'el, L1QaL`DNC3
POOL R.QlJIPtV11+'!.TVAULT I ER APPROVYD.13TRUC': C:+li_:f`S/11t.h.N3
VAI.,U.SA,TION Fb0 o,okl us
RY1'.rK.4'J :D COO OF CONS'TR1;1MOF+?
PIAN CHECK, FEE 101,000(1-• 39-418 $64,35
CMIST UCTION rL?E 101-000-419-000 $'09,09
STk1ONO MOTION FFE• RESID 101-000.241.000 $•$0
3tP, i•-� '�.�.a1.r C(Nk1,7fRTJCT1014 AND EL}' tT .y... .sVX
64, 151
:f 1.5.0 r�tR-:PAr1a ,Y1;.%.9
r' nn
U III �'�`A:L ' :1L1>�li t' �';:1+:u 13 1 ' NOW
MAR :20:2:00
Circ OF Uk OWNTA l
IPT^`
DATr.. e
�i
DAT FINALED yj
INSPE
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
Icy Wall Firewall
EPerior Lath
DrywaDv Int. Lath
Final
Final I I
BLOCIXWALL APPROVALS
Steel
P®®LS - SPAS
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
? C�
Final
tility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbotures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
03/18/03 14::18 FAX 7603415161 imul
s
Mareb IE3 2003 FAX (760) 360-5719
ur- NC-- u49Y5
75080 8t. C6A% FI=.�Suitc A
P" Dwwe, C,nlifurnia. 92211
760-5( 8.0852
FAX 760.341-5161
To; Plan Review
Ann; Eric A- Frenzel
Re; Plan ,Check .# 0307-214
T3tility vault.located at'52-MO Del -G lo, La Via, CA
From; Dick Laimkuhler
Eric, Relative to our phone conversation of this date, we used b soil bearing pressure of
1 SOO PSI..It will be situxW,on.approximately 25 fleet of compacted,fll (blow sand)_
Please call meifyou have any ether questions..
Z0 39tid
3S' 9NId33NI!)N3 9NnO,A
6IL'S09E09L 9E*01 E00Z/81/E0
R U 1 � ` b �J A
45'BEND
; f ' 60.02INV 8 i
` OF jai "-a .
y
FF-64.00
lb
O �O Lr) k:
62.90F5 Go`�' cu
P.A. o M
i 6'2.5FG
POOL 1
v� WS=63:40.
CI-`1( QF 6.3.40FS b cn
` �
FF=63.00 gU11)'NG & c �y
uh�c A� RUGt O-
OR
g 65.40FS
P.A. 1 }
ON-2R 65.OFG
64.90TG I :
°q SPA 63.90FS
1 T
'� RM 63.90FS -�
63.90F5
G5.40FS 63.54FS % 1
2 6306T 63.2FG
61.261NV
0.87 _ 0.57Ell
,I
63.5FG 3' HAROSCAPE SET BACK___
(63.QFG)9.SOT63.11 T
6YV 6; 2 61.61INV I t
63.5FG
62.00TF�, f
1
R ,q n