0108-205 (RPL)LICENSED CONTRACTOR DECLARATION
U)_.. 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
c1I W Professionals Code, and my License is in full force and effect.
C) c7 License # Lic. Class ,' '^� Exp. Date
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LLJ
Z `Date -?• tk Signature of Contractor f
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J U OWNER -BUILDER DECLATI N
W W I hereby affirm under penalty of perjury that I aria exempt from the Contractor's
~ U) 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).
M () I am exempt under Section , B&P.C. for this reason
LID
N Date Signature of Owner
N
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WORKES COMPENSATION DECLAMATION
o W I hereby affirm under penalty of perjury one ofithe following declarations.
Lo la— O () 1 have and will maintain a certificate of consent to self -insure for worker=s'
X w �: compensation, as provided for by Section 3700 O•f the Labor Code, for the
O J Q performance of the work for which this permit is issued.
C0 Q () ( ) I have and will maintain workers' compensation insurance, as regiiired.by
O UQ Section 3700 of the Labor Code, for',the performance of the work for which this
Z permit- is issued. My workers' compensation insurance carrier & policy no. are:
Cartier Policy No.
r O 1• sI Q1'd7' Lt�9t°w ,f 1 C:`1d '31.1,%03-"1
J (This section nged not be completed if the permiY*uation is for $100.00 or less).
., () I certify that in the performance of the work forwhich 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-1pe"workers, compensation provisions of *Section 3700 of the _abor
Code, Irshall fo�w'th compty' with those p -ovi,si ns. r
Date:* + i %T APPlicant
Warning: Failure to secure Workers 'Compensation coverage is unlawful and
shall subject an employer to criminal penalties ana.civil fines up ta:$1,00,09 in'' r
addPion to the cost of compensation ,�amages as`provided for in Se6tidn'3706
1 of the Labor Code, interest and attopney's fees;
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,IMPORTANT Ap.Rlication is hereby made to the Director of Building and Safety
for a p't mitrsubjcbrd
eCt to the itions and re9trictions set forth .on his
applicatiorx -
z
1. J=a person upon whose behalf this application is made & each person at
w*4'request and for whose benefit work fs performed under or pursuant to
any permit i3rued 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
"16prmit, or cessation of work for 180 days wih subject permit to cancellation.
r"Cy that I have read this application and state that the above information is
i .correct.' I agree to comply with all City, and State laws relating to the building •,:;
` %ruction, arld;•4r y authorizE resentatives of this City to enter upon
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Signature'(Owner/Agent)t`✓ Date J/
BUILDING PERMIT PERMT#
DATE VALUATION LOT i�� ° TRACT
`
JOB SITE
APN
ADDRESS.18-116 CORAL- NE
OWNERS -
CONTRACTOR/DESIGNER/EN (NEER 1,
`,`W 0)q C1° UB m �C.5C.1Ans; i -Le
ROAWf AWSWORTH POOL C0*fRtlCF10
7V505 AWITUUR, 52
74852 MWON MAMAS S
t1� J� C°3�2�5
Fr�,F. 1r1t�%21 CA42211
5115
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USE OF PERMIT
PacYL ANDd0R SPA. ,
ttff.cc�^��er•v YY �h�srtt a�sa AA� w.v,,c���� ,,y gg••��y� i� v win ff 7�' �u �e 9
P0iii!f�Y.Y.ti::' gni.. .1wIrJ�[1dS.i ..+F>Ja �1.rii.Lpi �!..��.li .�i,�L lfV�%i�1la�Sik�F�Aiil ''�ti; tf;mss
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{'LaciL.CBRYdl OR OPA driyViW,VW W
l& �;A vo ddwr op cons'I'Iti7ant)n
PI" CHECKFEE . ' 103_000439.318 $163.30
CeONST1;IBM0141 101-00"19-000 $232.0)
KIFICKANICA11 ME, ". POOL 101-ODO-421-CM 524,00
n..; C,rPut.AL PEE - 'P0. 61: 101-000-4MODO 545.00
PLU1 DTP40 FER -'ZaWL 101.1000--419-000 $27.00
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AUG 21 2001. E SNOW
'y
CITY OF LA'igUINTA
INANCE DEPT. t= rya
RFCEI�F r= u .DA,�E�
L
BY
FINA INSPECTO
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
POOLS - SPAS
BLOCKWALL APPROVALS
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
oto,
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
/
/
`—
COMMENTS:
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)
JUL-31-2001 14:08 TRADITION GOLF CLUB 760 564 2356 P.01i01
q ra diffo
ARCHITECTURAL DESIGN REVIEW
July 31, 2001
Ms. Niclde Gormley
Building and Safety
CITY OF LA QUINTA
78-495 Calle Tampico
La Quinta, CA 92253
Re: Tradition 7� j
Old California Village, Swimming Pools
Dear Nickie,
Via Pacs&nile
760-777-7011
This letter will serve as ADRC approval to obtain a building permit for the swimming pools
at the Old California Village at Tradtion. If you have any questions, please do not hesitate
to call.
Thank you.
Sincerely,
Christina J. Dores
Architectural Review Coordinator
cc: Jody Jones, APC (via fust class mail)
78505 Ow Av&-Am 52 — LA Qu►NTA — CA 92253-1120 -- PHONE 760/564.3355 — FAx 760/564-2356
TOTAL P.01