9611-039 (PLBG)' LICENSED CONTRACTOR DECLARATION BUILDING PERMIT
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 DATE 11/14/96 'VALUATION 0 . Lor
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date JOB SITE
ADDRESS '19-745 NO.6 I.IiWOOD
Date 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:
Q() I, as owner of the property, or my employees with wages as their sole
co pensation, 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&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 of Section 3700 of the Labor
Code, I shall forthwith comply with -those provisions.
(Date: Applicant—
Warning:
pplicant 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, &rshall, 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
theeabove-mentioned property for inspection purposes.
4ignature (Owner/Agent) �� �sz�' �,,P Date/ J ,,5—_-7e
OWNER
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I.A QU(NI A CA
USE OF PERMIT
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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 APPROV LS
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:
OF LA �, �'a�J �`=`` i
PGA WEST II RESIDENTItaul'
LASSOCIATION, INC,=f �/
Iv<Errti t�H.y� flr el ( �h U�r�
P.O. Box 1282 • La mtaCCA 92253- Sly � L-, £�
R rxib
October 28, 1996 Ee E P A .. i
Terry Allen
79 745 Northwood
La Quinta, CA 92253
RE: PGA WEST 11 Residential Association
79 745 Northwood / Architectural Variance/Fireplace, Bench & Wall
Dear Mr. Allen:
I am pleased to report that the Board of Directors for PGA WEST 11 Residential Association, at
the recommendation of the Architectural Committee, has approved your plans for installation of
the fireplace, bench and wallin the rear -yard of the above referenced address, with the following
conditions:
I ) Wall height not to exceed 20"
2) Bench height not to exceed 32"
3) Barbecue height not to exceed 5'
4) Color of the barbecue bench and wall will be finished in stucco to match the color of
your residence, and
5) Installation of the barbecue will comply with all City building codes and/or ordinances.
Please let me know when. the barbecue is complete, so that we may do a final inspection. if you
have any questions, please do not hesitate to contact me at (619) 776-5100.
Sincerely,
.PGA WEST 11 RESIDENTIAL ASSOCIATION
John H. Handel ,
Association Manager
cc: Board of Directors
Architectural Committee Chair
\tmonarchtuserstsuzytpga2lallen-arch 10-28=96.dm.
11/04/1996 03:55 6197761640 ROBERT TAYLOR'MSNRY PAGE 02
R ERT OB
MASONRY CON'T'RA " R
42-200 BEACON FILL, SUITE .A
PALM DESERT. CA 92211
BUS.: (619) 773-0012. * FAX: (619) 7713-1640
STATE UC. •629176
STATE LIC. •629176 -
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