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0302-216 (PAT)LICENSED CONTRACTOR DECLARATION r I hereby affirm under penalty of perjury that I am licensed under provisions of �c wt&q (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 26 A C:33 ` I213lIT}'' Dated (;' Signature of Contractor;- } )J. OWNER -BUILDER DEC_`ARATION 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. 0 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 IiWE FUND Policy No. 229,5404W (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 prov'sions of Sectio 3700 of the Labor Code, I shall forthwith comply with those povisiions. Date:�1.�,j�."d Applica%oe Warning: Failure to secure rs' 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 -f06 -inspection tion purposes. Signature (Owner/Agent) ] �"� Date 3 }ju ,z,BUL PERMIT PERMIT# ,�DING DATE VALUATION LOT#o �� TRACT JOB SITE APN ADDRESSybu��i3%lw� .. , OWNER CONTRACTOR /EN 1NEEER 12J014 BTPKr ,/DEDESIGNER PELLCidER C`yYDrRTJC7109 79.391 U1lZkRA VW.A 74691 J,AQTJW'rA C,i'o. 9 2253 THO' 3SPND'?1. LMZS CA -922,76 (76(0275-6017 COLO 3 1 W USE OF PERMIT 396 RF, .AI.UMAWaD LATC ICI Pt..110 COVER, P.ER A:! RIxOVED K AWS PORt;H(PAT TCS 19 RAST M, '07) CC',31a°7." OF CC NFIRJi3C'T`I0N PL,W CHECK PEE 101 -000-439-318 02.03 C:CJAISTR.UCTTON FEE' 101-000-419-000 S&LOO Miff© S"ITtCaNQ MOTION FEE - RJESlb 101-00-241-000 Q D D FEB 2 "7 2UG3 CITY OF LA G U44 TA 1' F, FINANCES 'DEPT. LESS Rl i`?Lpe4z77 .IIRYU $07 00 RECEIPT DATE ri r, 4 i BY DlEJ71NALE INSPECTOR n� / r.%: 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 I BLOCKINA A PROVALS 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: 02/26/2003 14:15 7603173278 SPEERBUSSVCS PAGE 02 ALISO LA QUINT.A, HOMEOV'VNERS ASSOCIATION � C/O SPEER BUSINESS SERVICES 200 E. Racquet Club Road, Suite H-38 �\ Palm Springs, Ca 92262 (760) 327-3278 Phone and Fax Matthew Diefenbach Allison Knight Kelly Grimes Robert Schein Allison Boikovs.ky President Vice President Treasure. cre �' . , ... for February 21, 2003 Don & Denae Barowsky 79-391 Sierra Vista La Quin,ta, CA 92253 RE: 79-391 Sierra Vista Account #145 Dear Mr. & Mrs. Barowsly: Your Architectural Improvement Application dated February 10, 2003, requesting. approval for the installation of an Alumawood'Patio Cover in your back yard was reviewed and approved as submitted by the Architectural Committee. We understand that the color will be Desert Sand to match your house. 'Ale are glad to see that you have hired a licensed and insured contractor to perform the work and expect that all applicable City re the work: quired permits will be' pulled prior to the commencement of We thank you for your cooperation in following the guidelines set forth in the CC&Ws. If at any time, a portion of the plans or related documents submitted to the _ Architectural Ret*iew Committee is later determined to require significant modifications, the Association reserves the right to require you to submit additional plans for review. In such an event, the Association may withhold approval for that portion of the modifications until they have been determined :to ` conform to the Association's requirements. We rely on the participation of all residents within Aliso La Quinta to maintain uniformity within the neighborhood so that the visual experience is appealing, property values increase and the community remains a desirable place to live. Your cooperation in this matter is very much appreciated. If -you should have any questions, please feel free to contact me. Sincerely, Speer Business Services FOR ALLSO LA QUINTA HOA Nancy Speer Community Association Manager Cc: Pelletier Patio . 02/2E/2003. 14:15 . 7603273278 SPEERBUSSVCS PAGE 03 PEB-11-.3 10:18 HIGH TECH IRRI5ATION 75� 347 5248 P,�,„GJ2 vci W61 cvu� ��- : � r ova4f 4,4 r o: 7PGCI�AV��V4: , AUSO I,A QUINTA. MOMEOWNEfM A 3MIATION APPLICATION FOR ARCHITECTURAL IMPIROOVEMOM .� RETURN FORM TO: AUS 0 LA QUINTA MOA Ar+chftcu rat Review Cvmmift” CIO SPOOr 6mmem Swvkm r 200 esaft m Chaftat Suft N.W [L, PWM she. CA KM' J LKI ,qENJ ¢ (T13Z7.8�78 phot NAIMtE ipieoue prtflldea�} � . p v l-suU1yt�.ti�, MAlUNm AOORM AWOMTM A CPM Ch.. STAB, ap TELEPHONE N{go GlTI'. efok-'E. 7 T'6lSF1i0Nf NUt�OI�t a�enelea N+s�ns I w� pddia ap �� � q�+Nt Avm tAe per aR Ca lauinb �tde� oMer gareRnn�! tl" . Nina I am mown ae1BW ! � �- � o�r>Qe � wA ao (m woo VW we a vnw d�nges nglr � fn �eat.atat�le a, �� t orbs mq or %r s&VMleetl m `rte• �° Qd W W"We t asst ^ry► pmt r� er eror;�lot. drts « �oNe�t. � �sr IgP1��w r+�aen� of N at any &V, s poftAon d Ills plans a e�atnd down dolm !a I yft Cebt n� I "a V aM1 LAOYIIw"q is WW eesb m"W" Vft VW nowwaeom t W,*,AjtVW4 N..■ab �, !O"'e' alt oe on et me wry mei etatariatned to DATE RtsCEtVtEp DATE REVtENfED m Naj J OF LA QUINTA,... '.J-JIL ING & SAFETY DEPT. R R CONSTRUCTION yz. 7139) Vistr, C4 A RE- NSPECTION FEE OF $30 WILL BI'CHARGED IF THE APPROVED PLANSNO JOB CARE ARE NOT ON THE TE FOR A SCHEDULED INSPE C"t NO EXCEPTIONS! c to 2AP TGTRL P.01