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0101-162 (RPL)LICENSED CONTRACTOR. DECLARATION' 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 Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date 510 27 A C53 Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the C:,_ntractor'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. have and will maintain workers' compensation insurance, as required by Sectiiin 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. Baas TF 1i'.4?dr) df 4 fS� r7JEf1� ! (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 provisipns of ection 3700 of the Labor Code, I shall forthwith comply with t/ios p ovislo Defection Date: Applicant r.;r✓� ,l ,/ �.�f Warning: Failure to secure Workers' -Com , ensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, inJ 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 forinspectio Verposes. Signature (Owner/Agent)y��e Date BUILDING PERMIT PERMIT" DATE f VALUATION LOT TRACT JOB SITE APN ' 57-46.1 SPANISH THUS OWNER CONTRACTOR / DESIGNER / EN (NEER ' WA4I' 191 0i3D MVE DIDDIRIO +i ('014STRUC110M INC. .57'•461 BP,P,NYM;£ IUZ IME 73011 (:OUNT.I,'i' MUD DR, RME.R I AQIJMTAjs: CA 92253 RAL14+1I7I.Y.'�'1- T CA 922648 (760)346-4042 CRUO 1044 USE OF PERMIT , POOL A SPA SHA 1.1 0Z IN Ia1,A- . F, AT PRE FILA T U. 619PP4:`i'.tONIF001< ( QUIPM'EW 990LOSUPW 18 NOT DIC➢.,UDED W THIS PERMIT 32,941.00 M Ea;' ITMA ['.1L13 COST OF C:C NSFIRUMMON 32,Ji m PIMUff KIM �6'1'.Mt M'`.ay MAN CHECK ME 101-000-439-318 $197,60 C°ONST,,R10I ,TlM FEE 101-000-4184M $104.00 14 RC:HAWIC9,AL M •- POCX 101 -000-4.V -000 $24,00 ,�.WCTW..0 41, ME, .- POC?l.. 10-1-000-426-000 313.07 YIN1 UNG FRE -- POOL 01.,000-41.9.000 ; � ®�1 4 JAN :100 6 2001 FIN� �CX— no SUb-TTAL COMM ':1C,1 ON AND PLAN C:`1 "K $597.60 ' M93 FIRRI-MOPMU :L'OTM. F.1=�';2: CT FEE DME NOW �7 RECEIPT;"r.:;, DATE % / BY DATE FINALED INSPECTOR 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- irewallExterior ExteriorLath 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 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 f 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) i OWNER TO PROVIDE ,TA ALL UNIT COMPONETS --L-PT. SDC/ SHELL AND TOP ONLY/ NOT A PART OF I CONTRACT" UNTIL ON OWNER SELECTS UNIT 6-0" AND SIGNS APPROV D P/L GOLF COURSE SPILLWAY& COPING TO BE PREDOMINATELY GOLD QUARTZITE ' 40'-0"� r R10-0 LOVESEAT lfi"Mmwq�i� 151, IItv/.� R6' -O" 1. A 1, Olt • u. ..1 �1• u i LOVESEAT D __ 7. m51. r' t I � \ fir/ � •1 ADDENDUM I' GAS/ELEC STUB FOR BBQ — — — 0'-0" NOTE TO ELECTRICIAN INSTALL ONE LIGHT WITH SWITCH ATTACHED TO EXISTING POST TO USE AS LIGHT FOR BBQ AREA POST LOCATION IS NOTED BY ARROW CITY OF LA CIL! ,TA BUILDING & SAFETY --L-PT. P U R 0I14 I O W FOR CONSTRUCT ON PALM DESERT TEMECULA 6-0" DATE BY APPROV D AREA 680 PERIMETER 112 DEPTH 3' 6" x 8' BOBCAT BY OWNER OR OWNER' A NT' ACCESS R& R hit Ilk - 11 KIMMER/AUTOFILL N44 11. ►I.'4 , jESP 491 of 59 1 �iPLANTER AREA Eau PATIO i 3 EMO RERQUIRED FOR CONCRETE THIS AREA ONLY P/A G/E 50' A AQUASWITCH 1 INSTALL INDOORS IN NIASTER / NEXT EQUIP TO SLIDER AS PICTURED LOCATION IS NiARKED ADD VENT STACK REMOVE EXISTING GATE TO HEATER SAVE TO REHANG CBECx.V.ALVE STRIP FORMS FOR FINISH STUCCO TO MATCH HOUSE PLASTER COLOR PEBL COAT TAH BLUE DECK BY SDC SQ. 750 DECK TYPE SALT - OMAHA TAN LA QUINTA HOMES DESTE3I R:. ::::........':SY? YL(:5::::::::;>::>:?:: ..•.•...... MUDSILL CROSSECTION . . . . . RANDY SIZE 8' RAISED +18" — R6-0" LITE 100 WATTS HOUSE:::::DAT>✓::: RI LEVEL SEATS 22" 24" 27" P/L MUD SILL 11/27/00 DAMWALL QUARTZITEFF. DAMWALL TOP QUARTZITE DECK:REVISED:: SPILLWAY SIZE QUARTZITENIDE P/A 2" BELOW MUDSILL imin12-20-00. � �0 SPILLWAY XX OPEN' CLOSED # JETS 4 UPPER LOWER C AIR INDUCTION PIPE 7'-6" OWNER TO PAY BY PROVIDE ONE LIGHT HOOKUP IN FRONT YARD FOR OWNERS EXISTING FOUNTAIN ALSO HOOKUP PUMP FROM SAME FOUNT. TO GFI IN FRONT COURTYARD SEE OWENR FOR EXACT LOCATION Names STEVE & SUSAN INWOOD Address: 57-461 SPANISH HILLS LANE JOB# LA QUINTA, CA TRACT PGA WEST LOT# 7 Dodson P CQNTRACTOR cannot curbs, sidewalks. driveways. assume res oneibilly cement slabs. for d^mane to �et�Prs, lawn ''''''..... T''''''': ......................... ..:::'GENERA—l0NS '-"*. SIZE 20' X 40 -trees. fences retainina walls. sprinklers. tel Phone lines or shrubs PALM DESERT TEMECULA LAYOUT, DESIGN & ELEVATION APPROV D AREA 680 PERIMETER 112 DEPTH 3' 6" x 8' SUITE F-4 CALIFORNIA RD. SUITE 203 PALM DESERT CA. 92260 TEMECULA CA. 92590 BY OWNER OR OWNER' A NT' NOTE: LANDSCAPE AND FURNITURE ARE SHOWN FOR ILLUSTRATION (760) 346-4032 (909)676-7946 TILE CHOICE F OCEAN SQ. RBB. SPA AT +18" LIC # A-C53-HIC-574127. DATE signature COPING QUARTZITE STEPTRIM POOL CAPACITY 24000 GALS RFP -RAIN PUMP CAPACITY 102 GPM PUMP #1 STA RITE HP 2 ILTER STA RITE 300 SQ FF STACKED WATERFALL W /ROCKY MOUNTAIN QUARTZ &CAP FOR CASCADE ILTER RATE 102 GPM_ _ EATER L.AARS SIZE 400 BTU A L B8 15"TOP OF VI D.1s URNOVER HRS 6 y. . o... wALL . UCTION LINES 2 ET RN LINES 2 U KIMMER MODEL AMERICAN f: .Ia wA f BB YES VA V E 'HECK LE w>D' E:: SPADAhf WAIL" INE': 3'.'>TII.E .SDC ASLINE BY FT. 70 ..... L LIGHT 400 W HT CLOCK AQUA G e�aTE RETUtfN: lx`IE WITH>>>><<`>'`>� SDC FF. LECTRICAL BY. 250 CBECx.V.ALVE STRIP FORMS FOR FINISH STUCCO TO MATCH HOUSE PLASTER COLOR PEBL COAT TAH BLUE DECK BY SDC SQ. 750 DECK TYPE SALT - OMAHA TAN LA QUINTA HOMES DESTE3I R:. ::::........':SY? YL(:5::::::::;>::>:?:: ..•.•...... MUDSILL CROSSECTION . . . . . RANDY SIZE 8' RAISED +18" — R6-0" LITE 100 WATTS HOUSE:::::DAT>✓::: RI LEVEL SEATS 22" 24" 27" P/L MUD SILL 11/27/00 DAMWALL QUARTZITEFF. DAMWALL TOP QUARTZITE DECK:REVISED:: SPILLWAY SIZE QUARTZITENIDE P/A 2" BELOW MUDSILL imin12-20-00. � �0 SPILLWAY XX OPEN' CLOSED # JETS 4 UPPER LOWER C AIR INDUCTION PIPE 7'-6" OWNER TO PAY BY PROVIDE ONE LIGHT HOOKUP IN FRONT YARD FOR OWNERS EXISTING FOUNTAIN ALSO HOOKUP PUMP FROM SAME FOUNT. TO GFI IN FRONT COURTYARD SEE OWENR FOR EXACT LOCATION Names STEVE & SUSAN INWOOD Address: 57-461 SPANISH HILLS LANE JOB# LA QUINTA, CA TRACT PGA WEST LOT# 7 Dodson P ADDENDUM OO FOR E -WALLS 42"H X 4'L PALM DESERT TEMECULA s'o,� I / N 73-011 COUNTRY CLUB DR. 28910 RANCHO 1/8"=1' SCALE SUITE F-4 CALIFORNIA RD. SUITE 203 PALM DESERT CA. 92260 TEMECULA CA. 92590 NOTE: LANDSCAPE AND FURNITURE ARE SHOWN FOR ILLUSTRATION (760) 346-4032 (909)676-7946 ONLY AND ARE NOT INCLUDED. LIC # A-C53-HIC-574127.