0005-357 (RPL)LICENSED CONTRACTOR DECLARATION
UA'- "
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
N W Professionals bode, and my License is in full force and effect.
O M License # Lic. Class Exp. Date
Lu' 728796 C53
oZ I-- Date- -; Signature of Contractor
ZD O f
J U C:) OWNER -BUILDER DECLARATION
W Lu r- I hereby affirm under penalty of perjury that I am exempt Irom the Contractor's
~ a License Law for the following reason:
Z( ) 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).
cr) () I am exempt under Section B&P.C. for this reason
LO
N Date Signature of Owner
ON
Q WORKER'S COMPENSATION DECLARATION
C:) :2 Z I hereby affirm under penalty of perjury one of the following declarations:
U-) O () 1 have and will maintain a certificate of consent to self -insure for workers'
X Lu �= compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
m Q U (,�,)," have and will maintain workers' compensation insurance, as required by
OU Q Section 3700 of the Labor Code, for the performance of the work for which this
2 rn H permit is issued. My workers' compensation insurance carrier & policy no. are:
,It Z Carrier Policy No.
w5 REDLAt D INSURAN- FWP9981938
r` C3
J (This section need not be completed if the permit valuation is for $100.00 or less).
( ) I certify that in the performance of the work for which this permit is issued,
1 shall not employ any person in any manner so as to become subject to the
workers' compensation laws of California, and agree that if.l should become
3 subject to the workers' compensation provisions of,$ection 3700 of the Labor
Code, I shall forthwith comply with tl ose�provisions.
Date: " Applicant _JAZ J
Warning: Failure to secure Workers' Compensatiqn coverage is unlawful and
shall subject an employer to criminal penalties ancf 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.
sr
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 fer)inspection purposes.
Signature (Owner/Agent) Date
BUILDING PERMIT PERMIT#
DATE5// VALUATION LOT OQOS.'4S7' TRACT
/� Sr/s2,50Q,0df 64 28367
JOB SITE
APN
ADDRESS 531.20 l3EL GATO DIMP.
763 1.020
OWNER
CONTRACTOR/DESIGNER/EN (NEER
TOM GARTNM
BUBBLE SPRINGS
6520 GLF.A00N IRD
71509 S.AN 00ROON10
ED114A MN 55439
NAWCHO NMWE CA 52270
(160)341-2336 CB14t 5486
USE OF PERMIT
POO:L.. ANVOR SPA
POOL & S:PA. ONLY ALE3RMSA ARRWii°�.5 S1-1AII BF IN PLACE AT
PRE-PLAP3'j'ER i'NSPECTIOAI. THIS PEWIT DOES NOT INCLUDE B[,OCK
WALL. FNCLOSULRE V01; POOL EQUIPNII'JN'f
POOL AND/OR SPA 32500.00 L9
1,CS'J4ASA.F.. D COW (Y.0' CONI;",i`RUC'.0 O N
32H s00
PEJUM TRX St M -VI ,.1 Y
"KAN CHECK FEE 101.000-439.318 51x:,60
CONSTRUCTION PEE 101-000-418-000 $304.00
MECHANICAL ",E -- POOL 101.000.421.000 S24.0
ELW TRIC;ALVIK w -- POOL 101-000420-000 $45.00
J w
PLUMBING FELE -- POOL 101.000-419.000 $27.00
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Y--
1
r 0
XUB-TCIT.AL. COI TRU MON AM PI" CHECK
�ri9i.ES:1
LESS PRE—PATD `k". -&S
$11100
TOTAL PMW IPHE31)(YE NOW
X7.60
RECEIPT
DATE
BY r.1
I 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
BLOCKWALL APPROVALS
POOLS - SPAS
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
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbctures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
MAY -09-2000 16:33
May 9, 2000
Mr. Joe Portolesi
A.J. PORTOLESI
Post Office Box 1802
Palm Desert, CA 92260
TRADITION GOLF CLUB
'Tradift'011
ARCHITECTURAL DESION REVIEW
Re, Gartner Residence
Lot 64, Tract 28867,--53-120 Del Gato Drive
Swimming Pool Approval
Dear Joe,
760 564 2356
via First Class Mail
P. 01/02
This letter will serve as ARRC approval for the above referenced swimming pool (copy
attached). If you have any questions or need additional information, please do not hesitate
to call.
Thank you.
Sincerely,
Christina J. Dores
Architectural Review Coordinator
/cjd
Pc: Greg Butler, City of La Quinta (via fax)
cMb oaan�•a�a.�omu fwd
78505 OLD AvENuE 52 --- LA QurgrA — CA 912534120 --- PHoNE 760/564-3355 — FAx 760/564-2356
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