Loading...
0212-186 (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 ,M✓r Date Signature of Contraeto ~,§/L 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. 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 SATE YU14D Policy No. 16805$3-02 (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 tha-Vif I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with,,those provisions:- Date: - w' ' ✓ Applicant" 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;x, 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 workis 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 for inspection pyoses +�,� C f' r Signature (Owner/Agent) _ '"•!` �-/-•-r"•Date,'�'�" .• BUILDING PERMIT PERMITT#�� DATE VALUATION LOT TRACT 12^0= 1181M AM JOB SITE APN ADDRESS s j,.. &* wrram of OWNER CONTRACTOR/DESIGNER/ENGINEER X1 13© Ii .0 tC?N 41515 YUCCA LAN J1 L& Q'ti M A CA 92.2153 BIMMUraAX7M;S CA 92201 (760)MO.44041 Lt 3C)9 USE OF PERMIT F•'4 01, AHk' OR MPA POOL & SPA ONLY, .Fk3,t,RMSMARRIERS :;HALL SZ YIN RACE MUM TO PRULAOTER INSP1?CTION, POOL CQUtPMi,'i T EsT•1+:' .a<rg4TRENOT THCLi M"D 10MWIT. POOL ANDJOR VA 1000.00 1-9 ftp'IMrr FEE 517MUMZY PLAN C1 ECK'FEE 101-000.4439-318 C014STRUC ION YM 101-000-418-000 $189.00 E►RECH"ICAL KX — POOL 101-0004,21-000 S200 9,=fR1G.AL P70, -,, P CIL 101-000-420-000. MOO PLU.MSM0 14119 -• POOL 101-000--419-000 lax�.oa 81,R_T%_JTf 1.g0NM1RZ .1CMK,i1+l AND MAN t',:`:CNCIC �10"d.SS ' TMS PRE. PAID M3 �U.UiD Q 0 OTAX, FE IRT EBBS ,Di1NOW D1113 S US VIRU 2 4 :2003 CITY OF'LA QUINTA FINANCE prPT A RECEIPT DATE "' :J • BY;-' , DATE FI ALE �L 3 INSPE R f. ___ 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 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 Sewer Connection Gas Piping Pool Cover Encapsulation Gas Test Appliances Final _ Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fodures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: INDIAN GOLD BOULDER WATERFALL +1t6" TO +5 SPA +18" STUCCO AND PAINT FACE BEACH ENTRANCE TANING LEDGE EQUIPMENT WALL 5' 14T STUCCO AND PAINT POOL EQUIPMENT 660 8, X 3' X3'HI COBALTO 71LE COUNTERTOP 42" VINTAGE UNIT 5.5 WrFH 42" 5.5. DOORS 571JCCO AND PAINT SIDES \1_0 3 C'1_0 p � CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION '5vzoBY t- DATE�.I�! A IM-IMISMnON FEE OF $30 ALL BE CMED IF THE APPROVED PLANS AND 108 CARE ARE NOT ON THE SITE FOR A SCHEDULED INSPECTION. .NO EXCEPTIONS! DESERT CITIES CONSTRUCTION LIC 4�B-651503 KELI-Y RESIDENCE ADDRESS: 8J-630 71RURON DR CITY: LA QUINTA LOT #: 10 TRAC2293118-2 REVISIONS: (1) DATE: (2) DATE: (3)_ DATE: Date Printed 1/8 .11 =1' Scale 9:15 AM 12/23/02 FM EVU-M Drawing by: eric valdivio POOL SPECS z SIZE: 16'X33' 0 AREA: -486 PERIMETER: 97 m DEPTH: 5PA SPECS n_ SIZE: 7'X 13' IOU AREA: 92 SF PER: 39' a z DA/\AWALL: 18" WIDE LL RAISED 0: +18' SPILL TYPE: TWO 18" TIED #OF JETS: 6 LIGHTS: 1-100 WATT...I xa- Imu CU) FACE FINISH: STUCCO AND PAINT " U) D q) >- DIG/ EL 0 17_'_ TYPE: BOBCAT Z u C) ACCESS: "SIDEYARD ELEVATION: DEEP RAMP: m BENCH/TAN-LEDGE: Z 0 CONC/501) REMOVAL: u U - TREE REMOVAL: u IRRIGATION REPAIR - RBB LENGHTS: JL Lu ROCK POCKETS: u PLUMBING < FILTER: 300 SF HAYWARD POOL PUMP: 2 HP HAYWARD BOOSTER PUMP: 1.6 HP HAYWARD <1 EXTRA PUMPS: HEATER: K M HEATER .400 TIME CLOCK: < SUB PANEL: HAYWARD AQUASWITC14 'L< EXTRA OUTLETS:" SKIMAAER.z INCLUDED 0 AUTO -FILL: INCLUDED LU z :::> D_ GAS LINE: 57UR OUTS: CASCADES: < SPRAYHEADS: 0 u -4 D ') D_ C) -A r -J POOL LIGHTS: I-Iqoo WATT LL :Fq) z SPA LIGHTS: WATT cri PLUMBING SIZE: STUB SET EQ: GUNITE Z O < DEEP END RAMP: F-1 q) 3 Cx) 2nd STEP: Z ui < LOVE SEAT SPILLWAY TYPE: CANTILEVER: COPING: u'u w< Ree:sEE STEEL 0 ui Z ui :D LLE 'Do: TILE 7YIzE-. COBALTO WATERLINE:'TILE uj u 4) TILE TRIM: lu Z M D RBB TILE: Lu 40 0 w DECKINGF- oix u'rj LL < -r 11 COLOR: YOSEMITE BROWN � I < SQ FT 1jq7 SF uj w FINISH: BROOM x Z 0 Z < Z EXTRA JOINTS: < 0 3: Z CAN711-EVER: u�< xj < 4 DECK DRAINS: IDECCO DRAIN: CURB CORE: STEPS: Lu STEPS FACE SUB BASE: VIsQUEEN: BANDING: Lu STAMPED: RELEASE V -i ja- --I STRIP: Co H CoMOW MASONRY COPING TYPE: z RBB FACE: < Lu SPILLWAY: STEPS: Lu P/L EXT WALLS: PLANTER WALLS: zx RETNG WALLS:V Lu EQ WALLS: 20' x 5' HI 3: 0 0 GATE TYPE: R&R GATE: BBQ zq) SIZE: 8' X3' X3' HI <u 66Q MODEL: q2" VINTAGE TOP FINISH: TILE z u -i SIDE BURNER: C FACE FINISH: STUCCO AND PAINT < PE N LIGHT PLUG OUTLET z LIGHTS SWITCH: < --A PLA51'ER 0 z a PLASTER COLOR: DL z PEBBLE COLOR: MINI TAHOE BLUE w POOL LIGHTS: 1-400 WATT SPA LIGHTS: 1-100 WATT ROLLED BOND BEAM: wj X Lu < EYEBALLS: x < OTHER ui z z Q 0 KELI-Y RESIDENCE ADDRESS: 8J-630 71RURON DR CITY: LA QUINTA LOT #: 10 TRAC2293118-2 REVISIONS: (1) DATE: (2) DATE: (3)_ DATE: Date Printed 1/8 .11 =1' Scale 9:15 AM 12/23/02 FM EVU-M Drawing by: eric valdivio