0004-068 (RPL)It
LICENSED CONTRACTOR DECLARATIOTN-,,
I hereby afflr fm,smder penalty of.perturyth I am hcegnsed'under provisions of
Chapter 9 (commencing with Section F001 .of Dlvision.3 of the Business and'
Professionals Code, and -my License &spm full force and effect
License # 16c. Class -Exp. Date
74127 Ate: "1813112C
Date r Signature of Contractor-_---•--^�=�°°��
OWNER -BUILDER DECL RATION Y.
I hereby affirm under perialty 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 ownerof 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 STATE FUND Policy No. 046.00-0007934 .
(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: �i;� %"%� Applicantxt�'
Warning: Failure to secure Workers' Comp sation 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
fora permit subject to the conditions and restrictions set forth on his•:,
application.?
i
1. Each person upon whose behalf this application is made & each person af..
whose request and for whose benefit work is: performed under or pursuant. to'
any permit issued as a result of this applicafon 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 180days 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 toenter upon
the above-mentioned property for inspection purposes",
Signature (Owner/Agent)-Z�-••_—.. Date •
t
.._.
tiB.UILDING PERMIT -- PERMIT# L'
DATE VALUATION�q LOT (4^68 TRACT
JOB SITE "
ADDRESS AQ¢ �j �j�� �{[� ( /�q �ye�
• :` 43- i�PwT :J7=4b�.Q1.\.A. 41111.[ I
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APN
•. r .i'
- OWNER - -
CONTRACTOR / DESIGNER / EN &NEER. ,ny
STEVE DODSON OONSTRUCrION s
4.3.583 VER.ONA.COM.
73011 COUgP_1X CLL 1 R., SUnT- 4 �^� �•
i,A QUINTA CA 92233
PAI: D SF:f:?.�' CA 9220 . _ f - i I �
s
C ta0)346=4032 CsLt`
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USE OF PERMIT
POOL AMWOR ,SPA
POOL & SPP. 0NL.Y-.A.LJkR1 M,8.A ZPJF LS SH.FJ L SE IN PLAGE AT
PRE-PLAOST9k IMISPECTION,1NWSTIGATION 1?FZ HAS BEEN AMUSED
PER L'-kC,FOR WORIK COMPLzTED W/o otfILDTA7Ci k'Lr1ma
1
VALUATION 30,000.00 LS•
fi
ESTCMrli'1*3t-D COST OF C(al'4',S".1 ..UCT11[ON
�aCa�.Od➢ .
PLAN CHECK PER 101.000.439-318 $1803
CONSTRUCTION FE -9 101-000-418-000
MECIiWHICAL FIT -- POOL 101-000.421.000 $40D
PILO CTRICAL FRE - POOL 101-000-420-000 $90.00
PLUMBING F'E%? -- POOL 101.000-419.000 $27.00
WES'1'tOATIOM FEB 101-000-423-000 $284,50
suB-,rorm,. COATmT.X mON AND PLAN MEM
$91�93
LESS PRE -PAW 1:'`.x`1
woo
TOTAX, PMW FTA'S DUE NOW
RECEIPT
DATE
BYi
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
e BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
�, Iorms & 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
fbplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Bond Beam
Main Drain
Approval to Cover
_
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
01
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:
,
RAISED BOND BEAM CROSS-SECTION REVISION �. ALERT CONTRACTOR cannot assume responsibility for GENERAL SPECIFICATIONS
OUTSIDE EDGE FINISH damage to curbs, sidewalks, driveways, cement SIZE 20 X40'6"
WATERPROOF BOND BEAM t Slabs- sewers lawns trees, fences, retaining
AIRPIPE DECHIwalls. spr
NG (RELOCATE POOL) AREA 732 PERIMETER 1 17
inklers, telephone lines or shrubs. �� � ��
GRADE When access is made through a neighbor's D P 3� 6��X5� 6X3 6
3' HIGH 6 TO 7 FEET IZ�� it is understood thatyou, the owner. TILE CHOICE GROUP 3 145
hbo s ermission and assume full 2'@+6" 46'@+12"2'@+18"12'@+24"'
have that ne' r
tg p
IN LENGHT
nsibilitv..
GUNITE resoo COPING CANTILEVER
P/L DATEsignature
POOL CAPACITY 21960 GALS
PUMP CAPACITY 103 GPM
.ti
3 OFFSET r PALM SPRINGS BOULDERS MOTOR HP 1.5
35 MIN 24".
�� FILTER STA RITE 300 SQ FT.
P/L 22 BACK TW SPRAYHEADS /
7'-0,. � 3 6 ,� GPM -
+12" . I r� rti - HATER LAARS E 400 BT
- —;, TURNOVER 2 HRS
N LI 2
RETURN LINES 2 "
516". BASINI MER MODEL AMERICAN
7'-0
.e► VOLLEY BALL SLEEVE 3 16 YES
40'-6" POOL I LIGHT 00 W CLOCK NE BY SDC FT. 160
RS 6
3 EQUALIZER LINE ELECTRICAL BY. SDC FT,250
X;8'� I , 1 " OFFSET
Q
X , 6 r'
6.OFFSETI PLASTER COLOR . WHITE
2 -9
DECK BY SDC SQ. 1447
DECK TYPESLT FNSH COLOR TBS
17 20'=9
5'-6" = STEP FT.
�— • � �
3'6" OFFSET � V _t SPA D 24" SPECS.
6 12'-6 of
OFFSET DESIGNER SIZE 7
LITE 100 WATTS
C� QF LA QUINTA - RICHARD/E RI LEVEL SEATS 22" 24" 27"
• DATE DAMWALL STACKED
BUIL ING & SAFETY DEPT. DAMWALL TOP GOLD QUARTZITE
PROVED 3-8-00 SPILLWAY SIZE "X WIDE
JAN DY
A R G/E REVISED SPILLWAY PCLOSED
FOR C NSTRUCTION = 'RES I D E N C E # JETS UPER 1 LOWER
GATE �" BY STACKED WA RFA LVame:- BILL LEITCH
W/ Mourrraw QUARTZ WATERFALL CROSSECTION (no
" I WATERLINE & CAP FOR CASCADE scale) Address: 43-583 VERONA CRT
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