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LICENSED CONTRACTOR DECLARATION
;I;ereby 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 Exp. Date
,%574127 A i1131i99
VDate 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:
( ) 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).
() 1 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:
Cartier 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
sui ect to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.» -
✓Date:.. v Applicant---- -2— ' _- o . �.-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 1 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.
Signature (Owner/Agent) Date
J BUILDING PERMIT PERMIT "03-087
DATE � 1 VALUATION $20,,0 ,00 LOT TRACT
JOB Sn't S +ILII-rQ� SONES'dAV4',r# Y APN
ADDRESS -
OWNER CONTRACTOR/DESIGNER/ENGINEER
SC.IM11' BLOUGH 5MVE DODSON CONI SIRTLIt" PION
7q-9.50 SONESTA WKY 73.011 COUNTRY CI.t113 .DW, SUITE F4
LA QUINTA. CA. 9225-4 PALM i'st1: SERT i.'•eA. 42200
• (760)346-4032 CitiN 10"
USE OF PERMIT
!'CX )L tA,N11t(. k SWA
i. �Oi'al,r'SPA, E►Uri2AdRGARrca (S 'SHALL RE W 4T PR&P ASTEXA
POOL MNWOR SPA
2C,C►(h?.001.S
';,S INATED x:010017,01F CONS RU(MON
2Q3,�1�9:a0
PERMIT FEW SUMMARY
PLAN CHECK FEE. 101-MAJ-139.318 $1134.55
COAtS`f IK r ON FFT 1014)10-4118.000 S^,07f i
1L9: CHAN''7CAL.FEE--POOL 101-000-42.1.000 SN.00
3 ECTRICAr..M -•. P001, 101 W(W420.000 545.00
KUMEfING FEE -- t'tXX 10.1-0(d1-419-000 327.00
,r
S11f.4-T l AL C: )NSI "fRU(."1'tON AND MAN CHFCK.
?437.?1,
LESS r_PAID ES
i'I':FE
410 (; 0
TOTAL t? ERAl f f FE S 01W, NOW'
S437.5;
BY / I DATE FINALED I INSPECTOR
INSPECTION RECORD
9 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
j1Z
PLUMBING APPROVALS
t
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
CK for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
If
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)
SPA 0+12" CONTRACTOR cannot assume responsibility for GENERAL SPECIFICATIONS
damage to curbs, sidewalks, driveways, Cement
- SIZE 13 X 30
slabs. sewers, lawns,trees. fences, retaining A
walls, sprinklers, telephone lines or shrubs E 36
When access is made through a neighbor's
property it is understood that you, the owner. TILE CHOICE GROUP 3 SQ, 83
TWO SPRAYHEAD have that neighbor's permission and assume full RBB. 2'.@+6" 12'@+12"
responsibility. COPING CANTILEVER
DATE signature PO L CAPACITY 10,000 GAL
PUMP CAPACITY 103 GPh
16'-6" MOTOR HP SIA g[TF HP
r— LEAVE DIRT
AIRPIPE
R6'
RS'
BENCH 20'
POSITION SPRAYHEADS IN LOWER STEPS
1 R7'-6"
45'-6n
5 3 \
R31
I / I
t \
R3, 38'-6 "
. • EVES
13'-6"
2 P-6
RAISED DECK CROSS-SECTION
OUTSIDE EDGE FINISH
P/L
1T-6
R6'-9"
ci
aV�
f �' �/
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26' C �,P,ca i ,;S
C, Ili
SF OF\DECK �[kLL APDL
GODRICHA
MOTOR Ppm==mmm="F=l
FILTER STA RITE 300 SQ FT
FILTER RATE 102 GPM
HEATER LAARS SIZE 400 BTU
TURNOVER 2 HRS
SUCTION LINES 2 "
RETURN LINES 2 "
cieimmrR mnnri AMERICAN
GASLINF BY SDC FT. 50 1
ELECTRICAL BY. SDC Fr. 200
AUTO CLEANER GREAT WHITE
CHEM.FEEDER
Pi ASTFR mi nR WHITE
DECK BY SDC SQ. 935
DECK TYPE SLT FNSH NTRL GRY
STEP FT.
SPA SPECS.
SIZE 7 RAISED YES+12"
LITE 100 WATTS
RI LEVEL SEATS 22" 24" 27"
DAMWALL 6" X 7 FT.
.DAM ALL TOP TILE
SPILLWAY SIZE 3 "X 12" WIDE
Name: BLOUGH RESIDENCE
_S _ J AddresS: 78-950 SONESTA
G/ i 511-6" SAW CUT 10 SF & REMOVE Qft�L LA QUINTA
Y `�,,/< FOR EQUIPMENT TRACT LOT#
A/C. WALL
LIGHT
LIGHT SWITCH.
BY SDC L�IIII
-
.
RESIDENCE
- _ 110 SF OF CONCRETE TO
RE1v10VEFOR•BOBCATACCESS -
-_ - - ,
' -
-
-
"oTIiEP%a PALM:DESERT _:TEMECULA
- '; - -• � '��`289
•-, __ _ •BOBCAT ACCESS .=
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_
tiTEMECULA
TE: LANDSCAPE AND FURNITURE
PALM DESERT. CA.
-
ILLUSTRATIONARE SHOWN FOR
22
- - s -4032'"'J
ONLY AND ARE NOT INCLUDED(760)'346
fi w
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I
2i'-6"
... „
1-6" 5'-3"
3
R6'
RS'
BENCH 20'
POSITION SPRAYHEADS IN LOWER STEPS
1 R7'-6"
45'-6n
5 3 \
R31
I / I
t \
R3, 38'-6 "
. • EVES
13'-6"
2 P-6
RAISED DECK CROSS-SECTION
OUTSIDE EDGE FINISH
P/L
1T-6
R6'-9"
ci
aV�
f �' �/
�
26' C �,P,ca i ,;S
C, Ili
SF OF\DECK �[kLL APDL
GODRICHA
MOTOR Ppm==mmm="F=l
FILTER STA RITE 300 SQ FT
FILTER RATE 102 GPM
HEATER LAARS SIZE 400 BTU
TURNOVER 2 HRS
SUCTION LINES 2 "
RETURN LINES 2 "
cieimmrR mnnri AMERICAN
GASLINF BY SDC FT. 50 1
ELECTRICAL BY. SDC Fr. 200
AUTO CLEANER GREAT WHITE
CHEM.FEEDER
Pi ASTFR mi nR WHITE
DECK BY SDC SQ. 935
DECK TYPE SLT FNSH NTRL GRY
STEP FT.
SPA SPECS.
SIZE 7 RAISED YES+12"
LITE 100 WATTS
RI LEVEL SEATS 22" 24" 27"
DAMWALL 6" X 7 FT.
.DAM ALL TOP TILE
SPILLWAY SIZE 3 "X 12" WIDE
Name: BLOUGH RESIDENCE
_S _ J AddresS: 78-950 SONESTA
G/ i 511-6" SAW CUT 10 SF & REMOVE Qft�L LA QUINTA
Y `�,,/< FOR EQUIPMENT TRACT LOT#
A/C. WALL
LIGHT
LIGHT SWITCH.
BY SDC L�IIII
-
.
RESIDENCE
- _ 110 SF OF CONCRETE TO
RE1v10VEFOR•BOBCATACCESS -
-_ - - ,
' -
-
-
"oTIiEP%a PALM:DESERT _:TEMECULA
- '; - -• � '��`289
•-, __ _ •BOBCAT ACCESS .=
��_..� N � �� .CAL
C 1
-
R&R WOOD FENCE - 118 - SCALE• � -
D:
- - , - y.i.}
... -,
,...-.-
_
tiTEMECULA
TE: LANDSCAPE AND FURNITURE
PALM DESERT. CA.
-
ILLUSTRATIONARE SHOWN FOR
22
- - s -4032'"'J
ONLY AND ARE NOT INCLUDED(760)'346
fi w
X760) 346