9906-170 (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
Professionals Code, and my License is in full force and effect:'
License # Lic. Class /r Exp., Date
1 02/29/201
/ate ��- • `� �� S gnature of Contractor �"
OWNER -BUILDER DECLARATION A. I-�
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:
Carrier 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, and agree that if I should become
subject to the workers' compensation provisions o1%Section 3700 of the Labor
Code, I shall forthwith comply with those proui,;s(o ��-+� s �{ , a "•` — .-.
�-R,4�.:,..,.
,date: L:.-'Z:A e yApplicarit
Warning: Failure to secure Workers' Com pensatiomcoverage is unlawful and
shall. subject an employer to criminal penalties and civil fines up to $100,0 0� in
addition to the cost of compensation, damages as.provided for in Sectio 3706
of the Labor Code, interest and:attorney's fees.,
IMPORTANT Application is herebi made to the Director of Buildingnd Safety
for a permit subject to the conditions and restrictions set forth orr' his
application. ' _A' / i-
1. Each person upon whose behalf this application is made &Z ach 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.
Sfgnature (Owner/Agent) Date
PERMIT #
BUILDING PERMIT.
:. 4906-170
DATE VALUATION 512,000,.00 LOT TRACT B -199'i118
JOB SITE
ADDRESS 53•-7" AVET4I.i AJUA14,Z
APN
!% -� ,>ie1:�
774-151-003
OWNER. _J - • -
CONTRACTOR / DESIGNER / ENGINEERS
--1 i_ bEL w-NTURES
LES; D 1. Vi:NFRfH'S
.836 i v..0CuP s St St lraI, 30
8:401 V tt: KE.11s 81', S19 118 _V .
SAN`>AEGO QA 92111
SSA.N DIEGO Gr1 92111
r_SIA"r 859
USE OF PERMIT
1)00L ,�t- 'SPA OWL:Y 1.11 AR"I. rDtlltisTM S.tiALL BE IN PLACE AT
1y13 i�'<:k�i.A.:i`3:1:i#2.1N8I'�G".0 I ti�I+l
POOL ANDAM SPA 12„ 000.00 LS
.n?s� --tpf�9g,y f � e ,�I•+v,f^�aa•� f n f• s e' �T f*� s
iS.ITIATi .,b; r.47'
, � n !u2
PERMIT PCE SUAIA`RA,sW
'PLAN CHECK EFE 101 row -0. 9.318 S87.95
4i►�;c' t rC s'iON I' 1 �i t-004} a18 •i� fili $1135.00
f NNMCMANICi1L ar--.POOL 101.000.421-000 a2r.0
WE-C�'I`.E�ICAL Frill -,.Pool. J01-0001-420 0001 S45A
PI,A1Py AINfQ Fes: POOL. 101 000,419-000 $27.00
1 +
a F.
ti
A esft �
ONra"1RUC'ITO AND FLAN C EC.K
,ESS PRE -PAM FFPS
$0,04
JUN 2 41999
+ /1 ®F LAUYJi'IYi�i � 7
RECEIPT
DATE BY3`
DATE FINALED
INSPECTOR
"r
z ;t 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 Wail 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 Pibg. Test
LC
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 Piaster
Sewer Lateral s.
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
z6z
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
GF.I. J_ ._ h - -
Smoke Detectors
Temp. -Use of Power
Final
Utility Notice (Perm)
'BLOCK WALL
MACE POOL
• /-53-190_ AVENIDA J ' A EZ
TA
17 --12" RAISED +BEAM
APPROVED'A RE -INSPECTION FEE Of $3(r_FpCpNSTR 1
WILL BE CHARGED IF THE APPROVED c
PLANS AND JOB CARD ARE NOT ON
THE SITE FOR A SCHEDULED
' 13 to �7 � est
1NSIPECTION.
NO EXCEPTIONS!
I'T
POOL PLANL`,
:SCALE:
. - ---_ - 1 of 2
3'-0"
(41 JETS
SEAT
DECK
RETURN
if
DRAIN o
LIP'
3
16" ih
N
LK"'T
J
J i Z -
�
_O.Q r 5'; TO 3:' o
'
-�•
...DEEP � o
SEAT STEP'
P 0 0 L
s P a
o
FIG
LIGHT
a�
13
.
-OF LA QUI
c
:BUILDING & SAFETY DEI'TE K
0• / -IJTO' �
r I
APPROVED'A RE -INSPECTION FEE Of $3(r_FpCpNSTR 1
WILL BE CHARGED IF THE APPROVED c
PLANS AND JOB CARD ARE NOT ON
THE SITE FOR A SCHEDULED
' 13 to �7 � est
1NSIPECTION.
NO EXCEPTIONS!
I'T
POOL PLANL`,
:SCALE:
. - ---_ - 1 of 2
3'-0"
81-011
l
LONGITUDINAL SECTION,
SCALE:' 4"=1'-0"
6-15-99
4'-0" _ - •.91_011
30'-0"
---'--- 91-011
MACE POOL
53-790 AVENIDA JUAREZ
LA QUINTA
RAISED
_i
BOND BEAM .
All J1Ps'-0"
L
1211
10
22'-011
211 LIPS
-�
DAM
DEC
K
--
-�. N SEAT
-
uj
SPA
DR IN
DRAIN
81-011
l
LONGITUDINAL SECTION,
SCALE:' 4"=1'-0"
6-15-99
4'-0" _ - •.91_011
30'-0"
---'--- 91-011
MACE POOL
53-790 AVENIDA JUAREZ
LA QUINTA
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