0101-221 (BLDG)..LICENSED CONTRACTOR DECLARATION `
I hereby affirm under penalty'of perjury that'I am licensed underprovisions 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
r<#11d A Lic..Class, . Exp. Dai�ttqe
9
Date . ��1§ignature 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).
() I am exempt under Section B&P.C. fcr 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 agre that om
If I should bece
subject to the workers' compensation .p ovisions lection 3700 of the Labor
Code, I shall to hwith comply wit h't os - roVisip r'
�i
Date: 1 Applicant f.. t._.'- - ✓
Warning: Faflure 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 ate ,
whose request and for whose benefit work is performed under or pursuant
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 fo i spec fol urposes.
Signature (Owner/Agent) r" _ Date b,
+ PERMIT#
B_UILDING•P,ERMIT
DATE VALUATION LOT TRACT
JOB SITE
APN
ADDRESS
'I'7•-�k� �:A:g�%fir �'��A.'
� -
OWNER _ _
CONTRACTOR /DESIGNER/
RP PH OMZA
f
ROOF nLE IPE (.''�A9w ;11y
V-ty00 C,P"X i,a, A`1E
74v"4 ixa AW AY BA.Y.; R
LA 199'A. CA 4'V'2 13
BERMUDA DUN .S �''A. 92211
060)200-0811 CRUZ 1420
USE OF PERMIT
t
��R�;vp p, y � pry yyp�y
s�LG;�it+Y.L�i.L7Gll.Ts���4iCi^�3
IrZ11001PTYER 1IT ONLY -'MUST ilXPAm&CE8:t7OYNG.iSAATIMIA1, Ed?tTH CLASS
IMOOF 000.00 ,ice
�I�'.�` Aurk{i coer or HuCa,lidl*XR�.e.'[,smon
9 Wv"t FEE 101 mEK110-41 B-000 VAN
N
JAN 18 2001'
)IT lue
�
'
r
4Cif.Vraft& CC?NOWMMO)T AND PLAN C53;:?=
$30.00
,c
I =3 PRE - PAI DIEF4,9
$0,00
'KCrWo PMOM'YM DTT. NOW
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
4 f
46
INSPECTION RECORD
OPERATION
DATE '
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
i Compressor
Insulation
I Vents
Fireplace P.L.
Grills
Fireplace T.O.
t Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath.
Drywall - Int. Lath
F
Final
Final
BLOCKWALL APPROVALS
steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
'
Appliances i
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage WiringcD
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
;
1
,
1
1
Q-742.
CONT-RACr.ORS--ATE T •T�'F�L�Ls 636394 P.O. BOX 11257
l Palm Desert CA 92255
760-341-6073
A proposal.wed.to'-RA12H-GARZA
Mailing Address:— P:O. BOX 1874 LA-QHINTA, CA 92253.
rZAddress: 77600- CALLE TECATE _ A QUI - A, CA 92Z53-
564-7074
[Description- of Work to Bel'erformed: •
REMOVE EXISTING BUILT UP ROOF -ARID DISPOSE. NAIL ONE LAYER 40# TILE
LINER. REPLACE GALVAN1= 1ASHINGFOR MVAC: AND -PLUMBING. INSTALL
NEW.SHEET METAL.AT ALL ROOFTO WALL TR ANSTTTONS. INSTALL TWENTY-
FIVE SINGLES AROUN A/C U14TT'ROP4IyACIA TO -BACK OF DUCT WORK FOR
SERNgUA ORR. QTS.TAI,L-L-IGHT-)#EWAU-R-OOF TLE T$�'ACTURES SPECI-
FICATIONS. $8250.00 -
PATIO --SHEET PATIO COVER ` rFH PLYWOOD- $,5m Go-
NAIL'OM-LAYIER
,500:09-
NAIL•OM-LAYER GL -ASS -BASE TOPREPARED SURFACE: INSTALL NEW EDGE
METAL ANUPRIMER. TORCH ONE LAYER'GBSP-4-MODIFIEIJ_ $750.00
Notes -In Kee;)i gwith Tndnetrv.gtan ardr--L-This gparatttee-does anyd mage.to-the interior or we t
rior on which the roof.is applied or damage to any contents therein This guarantee does not cover damage to.
xoof due to any rause ba!gond .lam inAmfing hit-ttot limited windstorm, hailstorm, an-'
ms
terof other equipment, foot traffic on roof, structural fault or settlement, cracking' or other failure of the roof
Aecl,.�. o Aundatinnxfthe hail dmg ate. which thm r�ei: 2- -�-bBpme necessary for the roof-
ing contractor 'to remove and/or reinstall any antennas, cooling or heating appliances or other equipment, whether
..ormot an additional, I g isnmcg SaC tw tt
®ttherRopf Tile -Specialty -nor
;
the installer assumes any responsibility for the performance of said equipment. 3. `R�000ff Tile Specialty does not
assilMe anySPCMfarnrforA" r of any existing defects un-
less specified in estimate and proposal.-
,Total£osE- -$-,SEE AB4VIE- T a-complition unless the contract. If riot accep-
tance in thirty days this proposal is invalid Pxtra. $35.00 per sheet of plywood if needed
Arrp ore YoxaLH y in il»Ao complete work mentioned
in the proposal contract for which Uwe agree to pay the amount mentioned, in said proposal, and according to
erms thereof, nitiall . Tfa leaka g- cai�Pri by 1 fiyyjthin TEN yeah from
date of application, we will repair it free of charge. ,
installation• itir,ti=b�-tbe-acceptm=ofthis- y= Tile Specialty to make the
installation; to issue work order with specifications shown herein and to pay our charge for such installation-
You-agree
nstallationYou-agree to pajc the amount lire specified hereiff cove, --the mire. ref said�materials and labor charge.
This estimate is based on a complete job and any surplus material remains property of Roof Tile Specialty. Verbal
imcfPr;tmdin —'AT with not be -bin u� "li herein There shall be no
liabilities or
for delays in, failure to complete, deliver or installation of all or any of the herein mentioned mer-
rha'� if due to rem a 'kms . pr �dIIr l�artnA �a„r �pntrart :Any.ChangeS
made by you in specifications herein, necessitating additional materials or labo"r"shalll not be included or covered
by. thi&.propns*,�utsh*be prOided-formider separak—and-addition orderfromyou. ( Initial).
Arbitration of disputes: Any controversy or claim arising out of or 'relating to this contract, or the breach thereof,
.sha111&C by -a torin accordance grith -the appii mble ' tn� Arbitrator Rules of the
.American Arbitration Association which are in effect at the time the demand for arbitration is filed A judgement
upon.ft award rendered ..bp thz arbihaor(s) may: be-entered`itt court havingjllr"*'on thereof. Any arbitration
award shall be subject to correction and/or vacation for the reasons stated in the code of civil Procedure. The ar-
L:a.-..�:......r...ft ......tea «...........Ll....µ..«......, Ir— --A ..........--- �.. at.....«.....:1:.... «..a.. RA.... h..:...- .......« x... «..a:....
ROPOSAL:
DGe_L SPECIALTY
NiAlvffi:
-NIA=G ADDRESS:
'MB ADDRESS:
PHONE#:-
Rii !RPJM BY:
74075 ASTER DR. PALM DESERT CA 92260 75 )0-341-6073
VESCR=ON OF WORK TO BE COMPLETED:
I 1 )01 L L 14. f � I 1�,, CJ ;777717
L 4
V,a N,
_JOE
77). 7-
LIU
(SPECIAL INSTRUCTIONS FOR WORK TOB E COMPLETED:
-PIM 7r' 4=11 71% 1 t
P-)
WARRANTY?. MANY YEARS? O WARRANTY
INO EXISTING LANDSCAPE LIGHTING IN REAR YARD ,
• NO EXISTING OVERHEAD UTILITY LINES IN REAR YARD
• PATIO FURNITURE FOR ILLUSTRATION PURPOSES ONLY
2- TILE ACCENT CROSS DESIGN MARKERS
AT EACH END OF POOL (MARINE FIELD DIAMOND BLUE)
POOL SPLIT MAIN DRAIN SUCTION MINIMUM 3' APART.
ANTI -COVERS 10" ASME /ANSI APPROVED
SPA SPLIT MAIN DRAIN SUCTION MINIMUM T APART.
ANTI -COVERS 1D" ASME /ANSI APPROVED
PL
,1
SPA AT -0- ELEVATION
WITH TILE DAM WALL
DEMO AND REMOVE
THIS WALL
O
-
w
DEMO AND REMOVE THIS
CONCRETE PATIO AND REPLACE
WITH DECOMPOSED GRANITE
WD
ELECTRIC CONDUIT
1'
2'
6"
SCALE
TILE DROSS MARKER DETAIL
c
SCAT L.E'
1/4=1
TILE ORDrr MARKER AT EAC. END OF POOL
LIGHT BROOM FINISH NATURAL GRAY
CONCRETE COPING
MAIN HOUSE 200 AMP ELECTRICAL PANEL
SAWCUT / REMOVE AND REPAIR
EXISTING CONCRETE FOR NEW
GAS AND ELECTRIC RUNS
POOL EQUIPMENT. 250,000 BTU HEATER
'ALL EQUIPMENT SHALL BE SEISMICALLY ANCHORED
SPECIFICATIONS
TYPE GIINRE SIZE w4r )I
SURFACE AREA OF POOL ONLY 225 SO. IT
PERIMETER DEPTHS MIN._
POOL 8 SPA COMBINED TSI SO. Fr. I T 17 LM FT.
ow
RRIGATION RIS"AL
RNOATION REPAIR_
S' RA.S
SO. FT.
F"m LT.I
0WANEION JOS
CANREVER
Om DRANK_
DECW MM-
OURSOORE_
STEPS—
STEP FACE—
TSESASE_
SPl1Y
PLUMBING BIER
FLTBI HAYWARD SM 725 SG. FT. PROP
POOL mw-d&W mBE T5 HP VARIABLI PLANT
SODOM PULP Sm RETM
ADDL FUW SIZESEms'
FTRFPI
AWL NRrP KM
NEATER HAYWARD ■m 2500D0 BTU
GAB LINE.
FOUNTAIN
SNEER DE
LIGHTS N
STL! SET
PLUMSM
01 1 I IMK. 21reS
POOL / SPA LIGHT ON GROUND FAULT CIRCUIT INTERRMI PER
22'- It POLYETHYLENE GAS PIPE
IEQUIPMENT NOTE:
POOL HEATER ROPANEI
Gi-rY OF LA QUINTA
ItG & SAFETY DEPT.
FENCING
1?RETURN FENCETYPE -
HEIGHT—
GATE
GATE REVIEW
REMOVE S REH
RTIT. T,TATR�
OWNER REBPONSIIBILITIE6
OWNER TO:WI1
M RETMAPPItUXMMILMr N:OMMOREMATUYOUr ONMYOFD(GVATM
M=MROlIq TOBMIARE
YENfAND AT OF rMNROE OF PER1EfTOAOCFDMNCEOF
IN NSTDORgXMCr MSMELLATLLUSTTVAMOALYFOa EE %Y,*AFTRI/BLr NNALLO.
R= TMMIEKifi TO 0UM4�IOEV/LLR4ORVEYMY OrAIR 1=001 HEMEN AREA,
(1) NIETHF,MTP FEBINQMATEftGA FS-AMOGAMKDOOMMENTLOCALMOFORAPOOLEILTDEIIE
M.
MFMLPOOL TMEDATELYAFTBI PLANTER (FOLLOWWTRLM M-DONOTIIKRIO6I ROK)
M T. NOTICETIMTTME DMrMAi rRESOlB PNOPlNTV OF 7EIFAMAM TIMTANYIE WRIDUf
VMf REN PER.RspONI OF TE8lRRA r PTIOHRII®RY LA W.
SWIMMING POOL PLAN FOR:
E CHOVAN RESIDENCE
R U L
/I�D� I I
GUNITE
1
PL
ors"ol
DEEPEW RANN
CO NSTRUCTION OFFICE PHONE NO.
SCALE
J' -J.
DATE DESIGNED BY
05-14-14 JH
EXTEND2WSTE
F
JOB"
R E V I S I O N S nATE:
LOVESEAT_
'
POOL EQUIPMENT 50 AMP SUBPANEL
B: euITIOIr RANOFTM AMENJW
atTKALIEANiweocETrOFMEtHAWCALUXOM MO ME)
DATE %ELECTRI;I�E.r
SPLUNAY TYPE
.�
-
WITH 3S" CLEARANCE AT FRONT AND SIDE
-
EOUIPOTENfUL BONDSq RE0UpE1Blf88W1LL BE NBTALLED TO EUMINATE VOLTAGE
oRADENTr WIFE PGOL AREAA. PER DEG ARf. EOD.2L
201 3 CALIFORNIA BUILDING CODE (SASEDON2006I11C)
201 3 CALIFORNIA MECHANICAL CODE (BMW ON 200E UMC)51
2013 CALIFORNIA PLUMBING CODE (BASED ON 2005 UPC),....
201 3 CALIFORNIA ELECTRICAL COOK(SMEDON200SNEC)
2013 CALIFORNIA ENERGY EFFICIENCY BTANDARDB
GDAE�rENTDDDEEEDTIDNI.2,71
� pI FXDBRNANBB10BlDY,ANYPER8ON
NOPOTIF AT+IOO CENTER AT T N
DRYS, PRIOR COMMENCNO THMTIXGVATION,FIFIEIXGVATN)N WR? SECONAl1CfE0
NNpAREA7MT18INOWVKDR REMONASLr S1pUDKN/IOML TOCONTAN 811BBIMFACE
INSTALLATIONS OTHER THAN THE NEIERORgIND FACLITE6 OWNED OR OPBIATED BY THE
IXGVATLMAND p THE IXOAVATOR SHILL DMWATE W11R V*M PANT OR
oT11BL 8111TABLE MAF"R M TIIE ARE TO K IXGVAIED
CANTLEVER—
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41
COPRIO PIP
a
'
POOL / SPA LIGHT JUNCTION BOX
INSTALLATION OF POOL SYSTEMS AND EQUIPMENT WILL COMPLY WITH
R' II.2EE2TE1
POOL / SPA LIGHT ON GROUND FAULT CIRCUIT INTERRMI PER
22'- It POLYETHYLENE GAS PIPE
IEQUIPMENT NOTE:
POOL HEATER ROPANEI
Gi-rY OF LA QUINTA
ItG & SAFETY DEPT.
FENCING
1?RETURN FENCETYPE -
HEIGHT—
GATE
GATE REVIEW
REMOVE S REH
RTIT. T,TATR�
OWNER REBPONSIIBILITIE6
OWNER TO:WI1
M RETMAPPItUXMMILMr N:OMMOREMATUYOUr ONMYOFD(GVATM
M=MROlIq TOBMIARE
YENfAND AT OF rMNROE OF PER1EfTOAOCFDMNCEOF
IN NSTDORgXMCr MSMELLATLLUSTTVAMOALYFOa EE %Y,*AFTRI/BLr NNALLO.
R= TMMIEKifi TO 0UM4�IOEV/LLR4ORVEYMY OrAIR 1=001 HEMEN AREA,
(1) NIETHF,MTP FEBINQMATEftGA FS-AMOGAMKDOOMMENTLOCALMOFORAPOOLEILTDEIIE
M.
MFMLPOOL TMEDATELYAFTBI PLANTER (FOLLOWWTRLM M-DONOTIIKRIO6I ROK)
M T. NOTICETIMTTME DMrMAi rRESOlB PNOPlNTV OF 7EIFAMAM TIMTANYIE WRIDUf
VMf REN PER.RspONI OF TE8lRRA r PTIOHRII®RY LA W.
SWIMMING POOL PLAN FOR:
E CHOVAN RESIDENCE
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FOR ('j�NSTRU ION
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CO NSTRUCTION OFFICE PHONE NO.
SCALE
J' -J.
DATE DESIGNED BY
05-14-14 JH
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JOB"
R E V I S I O N S nATE:
'
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B: euITIOIr RANOFTM AMENJW
atTKALIEANiweocETrOFMEtHAWCALUXOM MO ME)
DATE %ELECTRI;I�E.r
2
.�
-
A
4
F811 DIG ALERT - BEFORE DIGGING
-
EOUIPOTENfUL BONDSq RE0UpE1Blf88W1LL BE NBTALLED TO EUMINATE VOLTAGE
oRADENTr WIFE PGOL AREAA. PER DEG ARf. EOD.2L
201 3 CALIFORNIA BUILDING CODE (SASEDON2006I11C)
201 3 CALIFORNIA MECHANICAL CODE (BMW ON 200E UMC)51
2013 CALIFORNIA PLUMBING CODE (BASED ON 2005 UPC),....
201 3 CALIFORNIA ELECTRICAL COOK(SMEDON200SNEC)
2013 CALIFORNIA ENERGY EFFICIENCY BTANDARDB
GDAE�rENTDDDEEEDTIDNI.2,71
� pI FXDBRNANBB10BlDY,ANYPER8ON
NOPOTIF AT+IOO CENTER AT T N
DRYS, PRIOR COMMENCNO THMTIXGVATION,FIFIEIXGVATN)N WR? SECONAl1CfE0
NNpAREA7MT18INOWVKDR REMONASLr S1pUDKN/IOML TOCONTAN 811BBIMFACE
INSTALLATIONS OTHER THAN THE NEIERORgIND FACLITE6 OWNED OR OPBIATED BY THE
IXGVATLMAND p THE IXOAVATOR SHILL DMWATE W11R V*M PANT OR
oT11BL 8111TABLE MAF"R M TIIE ARE TO K IXGVAIED
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_ SELECT 1 O N S
INSTALLATION OF POOL SYSTEMS AND EQUIPMENT WILL COMPLY WITH
CONSTRUCTION AUTHORIZATION
STONE
-
SECTION 114 MANDATORY REQUIREMENTS
EXIT ALARMS TO BE INSTALLED ON ALL DOORS WITH DIRECT ACCESS
TO THE POOL
SALES FIELD
DIG
.
TILL a TILE wti Oft -SAND IDSIIT�jtINE FEUD
BOULDERS
DECK COLOR BROOM FINISH NATURAL GRAY
POOL HEATERS / PUMP EQUIPMENT SHALL BE INSTALLED PER MANU FACTURER'S
RECOMMENDATIONS AND IN ACCORDANCE WITH LOCAL REGULATIONS
PRE-GUNITE
UNDERGROUND
CONTROL IIAYWARD PROLOGIc 4
PEBB/PLAS PEBBLE FNA CAT I'CLAMCO•DECK
ALL DECKING EXPANSION JOINTS FOR REPRESENTAK)N ONLY,
FIELD LAYOUT WILL VARY
MASONRY
SIGNATURE
II
DRAINAGE NOTE: D* -P Ond �a+paME�oftme.
unlen
PRE -PEBBLE
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