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0008-258 (RPL)LICENSED CONTRACTOR DECLARATION 'irm under penalty of perjury that I am licensed under provisions of C er 9 (comnTencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. •'License# Lic. Class Exp. Date . i 1503 B C27 _ ,'07/31/2( Dated Signature of Contractor & OWNER -BUILDER DECLARATION 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. (Ir) 1 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. MID-CENTURY AOI08-64-57 (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 of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: k r �.> ' Applicant. :: /.. �• ,� �/ T 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 for inspection purposes. f Signature (Owner/AgenDated BUILDING PERMIT PERMIT# DATE VALUATION LOT -2239 TRACT 08/15.17.0C $�3,EIL;t3.C10 JOB SITE APN ADDRESS € 50 :l ISPKILO - - OWNER CONTRACTOR/DESIGNER/EN (NEER ° DAVE & DITANE AUL' T 17E� . T C11TES 50.8:50 NMRO 41535 YUCCA LAATE LAQLTN-fA CA 92253 1311';x. LIDADUNES CA 92201 (760)360-44013 C B14i 2046 USE OF PERMIT POOL A._ C A)R _9,PA POOL &SPA ONLY -ALA NISMARRIX0 SHALL HE IN ISI. AC? AT PRE P1 AI1TFR rNSPECTION,P001, EQUIPMENT P—NCLOSURE 1q, i+ OT !NCLUDED IN niis PERMS, POOL Ah L'IOR SPA i3,AflD,Dff I'S ESIMNfED C09x OPCONSTRUCTION 131W0100 PMAti'a" FEE SUMMARY PLAN CHECK FEE 10) -009-439-318 $93,60 CONSTRUCTION FEE 101-000.41E-000 $144.00 1 PLUMBING FEE .. POOL k 1 QI-©00.4143.00U AUG 15 2020 SIT ' i` LA Q U111 9 t -TOTAL., s~;a]+TMU'C*l: ON AND FLAB 03EC e $267,60 Lid :3 .taRR-PATD FEES $0.00 TOTA-L FE-710MIX 1,11 EC DARN POW RECEIPT DATE BY 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 Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: ` (� V /� trch - Eng Supply Co. 3574W1 MASTER BEDROO]V BREAKFAST ROOM EXISTING RESIDENCE oo.. o0oo` oc C PnnL AREA TO BE ULOS En i,,.t DATE U I N A '17— -f TO --- — ------ o 14 POOL.OUf>SMENT SPECIFICATION 1;rtace Area Pool ertmeter .rths Min Max SPA SPECIFICATIONS Ft ELECTRIrL F, A) &-- K -77'w-Sa, - 06 , ,!)a Dam ivfit� , Wall Wtdfr q T r,(- (,If)Ck b Panel of Jets Lights in ,qh, Booster 0,fikG F GF! OtlVet k/ �I�o alit Aqua A+r-Bar &Blower Extra'_ -,Witch for Sim :.,cf-t f �owp, Only Blar4 Fl,jgS 11-iisedspa IV necial Notes Bl()"o- Cleaner leaner F XCAVATION - �111 i, -,cess From COPING 9 TILE C,);)i,,o White er.FrARamp Spacial ante Pernoved By __ T Typf, I'ttoCe Type !P Trim mas'l(- -ash Romovai- 2 B B 18 P B B )nCrete Removal Lnad- V e(, Removal By ,jmr Removal BV - 7 "t Pail f r. R, 6 B 12 R R 8 1 F R 8 DECKING elf. - 01 B By So, Ft alkout V!sc ick Pack, mab"Ic Footing "JEEL ',,>(• I Kpan,!ve Soil ('arfileve, R.6 B 12 R 8'' R F F Deck Dra, nS Curb Core rcharge 0111-e, nd RarrivDecco Dra r Dtvino Roam.J,q -veseat Inside Wall Width Other Pat,,) Straps & F or:lta;q No Slide Installation, Vial! Dowel'Misc MASONRY Coring Tyr Piantpr Wall PLUMBING - F ;!er CH Bark 'Up VVa!' "01 Pump Fco!irgs RBF P Farin" .4 I nater 4 Tvvo poster Pump L` f? - -tk; c, Type Wall Type x F ri �!-mer tz, P n q i!e!aker Nq ctNifad,. w +er Cleaner I It 1-ine Lirt, PLAST ER 7 olralt�, Poo,ec, ear5o),x . ...... V "-1711AI! F GUNITE int, o -epEnd Rimp FENCING R R P 12 R B P 1 F1 R F1 H c All !_Vcai Crvfe Reuirp-ents RE' Ruyer Prior f(, ca o /espal 17f,"i Ste ''('piaster �tch Bond Reary) OTHER ping Canti!,,ver ?Chad Spa Dam Wall a Dam Wall Width IC' OWNER RESPONSIBILITIES C vrip, To I! Determine !V 1'1 arrfoTm-fte f_ or sf)�3 at lavo,.1 on Day of Lxcav-itww rake !?,a! P,0ql a,,t, (,:)fPf'r1j l'y :i,q a,,,c.-ptarc-, of local 0ijikli,c; Dec;,, - merit at time. of IGSuprico of 10'a, I ty", e tfr 0;1,, s,ioii insta;lf?, ,4Take Not ti,at Gaiifor,i.a L IS NOT •7onrj,!,ons 0' ()Lre�'!� ariel any Damage 1r) 'urt),;, 51deK 4S i�tvpw iawns or ether 1, 'f,rn, "'"I Well See that all ,,id 1 �-rs .et 1( al cndr�s 1,,:, , pcoi nn( icisiiro prinr tc orenlast('r If l!'), 16 F,II pod. imrnf9d -'llt?j, rite tl '7 Take Not -,e that !1,,s w1d w, 1;sf, witi,out Vriftp, r0r1T1jSSjC,Ft of Caiifornia Pools ;r,,: c pri-)!, hfteo by law C Pjai PO')l acrd Equipment t ocat on,. ia ' ha , read tnf,. Res;,,)nsit, fit(S N�:-1'7iCE S above SWIMMING POOL PLAN FOR: NAME AULT RESIDENCE STPEET JOIr ADDRESS THE CITRUS COURSE ESTATES CITY LA QUINTA PHONE OFFICE RES LO" TRACT PAGE BOOK MAP BOOK PAGE NO, MAIL ADDRESS CITY CONSTRUCTION OFFICE PHONE NO. SCALE DATE r DRAWN BY CRAIG SOLD IT T BY JIM CHECKED BY lie -27 (619) 340-9000 F-7`77 P77"7""wom'" CALIFORNIA CONTRACTOR'S LIC NO. 185102