0202-209 (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
1 StJ C.;5 R Mr- e
Signature of Contractor.—
OWNER-BUILDER
ontractor
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 vyorkers'
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
Ir
permit is issued. My workers' compensation insurance carrier & policy no. are:
Cartier Policy No.
MAU Fil'ND 224-1302.29R9
(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:., Applicant � _ a �,r•'^�-, �s
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
for a permit subject to the conditions and restrictions set forth on his
application. 0�
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 for inspection purposes.
'Signature (Owner/Agent. �' '����%as Date
BUILD1,NG PERMIT
�PfERMIT#
DATE VALUATION LOT ' TRACT
YFf7IA21MeyP
JOB SITE
APN
ADDRESS
OWNER
CONTRACTOR/DESIGNER/EN INEER
,j% ,R0.f1fi JAQ
aumlg rjr; Pi-JOLS &, sx�%-o
81..61 IZER(AT
39-268 .1,1AVAJO aiY?,.t'•UUL
LA QZ7,1!>3 rA CA 922,53
Y7 JC Cr A, VAX .7.»3 V` CA 92264
t
(-760)369.2940 043it
USE OF PERMIT "
11-n/L AWWOR STA
:Pt: OIL V41) SPAIMT10AX APPROVED' 11TREM..Ai. Ai 0-'/.8A"J2f .; Ski., L
DF; IN PLACE ,PIRIOR. TO PREPIASWR IA SPECT' 101- . KAN, EQUIPMYN'T
n1C1.CWS,. RE 140T INCLUDED IN l'i_[LMXT.
POOLA ID/Ot'3..SRA is
RRU49f9D 00.45T OF CONS'TRU+tTrI014
J:".Rrni„'V.id.�.fti 11&15. R)CJ,�� 1
1t Jil -.IV 741? I _ 1 X 1 MU(l�l 39�� A i+ $193,38
C 014$' RISC't' 10N 11V.9 i 01.00("118.4700 $2971.9
M]ECi ANIC;.+A1., kZZ -, POOL 101.000.421.000 SX00
EA&C'C'.fRIC.Aa.M,4 POOL 101, 000.420••000 $45.00
rPx.,U113lii)Ntf; FEE .. BOOL 101-1=419.000
r ailAND r1l CITZ 1111K
6,W5.
rf
,
FEB 25 2( � ass :s DVA& low
CITY®FLAQUIRTA
RECEIPT
DATE
°'BY,C,`.'�-y
D/yT� �A � ^
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
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
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
.Sewer
Pool Cover
Connection
Encapsulation Qy
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:
C/Py®p /-
QU"NTA
FAIRWAYS ASSOCIATION B�/L�r� RECQ
� Arvo SAP
December 26, 2001 r Ty
Mr. Aaron Adame
81-685 Tiburon
La Quinta CA 92253
Re: 81-685 Tiburon
J
Dear Mr. Adame,
At the December 17, 2001 meeting of the Architectural/Landscape Committee, your pool,
ti spa and drainage plans have been approved. However the following conditions are to be
followed:
A. The equipment room needs to be enclosed.
B. An irrigation plan needs to be submitted.
C. Some of the plants/trees are not on the approved plant palette,
D. No permanent structure of hardscape is allowed within five feet of the
property line without a variance from KSL. (Thus is an association
requirement.)
E. Deposits will be required for landscaping, pool and spa at close of escrow.
If you have any questions, you may contact me at 760-564-3858.
Sincerely,
I / ! .,I�
Manager
P.O. BOX 13710 • PALM DESERT, CALIFORNIA 92255 - Tel. (760) 776-5100 • Fax (760) 776-5111
email: pga�vest@monaircbgrp.com
CI OF LA QUINTA I
BUILDING & SAFEfY DI=P ; .
APPROVED
FC R CONSTRUCTION
DATE
29-1/8 ft
south
I .
14 ft
38 ft
3- 24" RAISED PILLARS
/ - I - WITH 18" SHEARS
M.
m
m
m
N
w
N
W
71
M
0
3
E
- 90
s
O
3
CL
QP
east 19ft. `9ft
8ft 12 ft
Eft
3 f
14 ft 18" RAISED 4
SPA ion West o
12" RAISED
FIREPIT
. 0
4 f
�4 new home north
,. NOV-18-2002 02:23P FROM: 70:7777011 P:1'1
i
5 —CITY OF LA QUINTA
UIL• DING & SAFETY DEPARTME VT
1 777-7012
o I NNSPECTION REQUEST LINE
777 7153
Ow ADAME Y
Cont r- jUjfjjE UP POOLS & SPAS
Permit u r I 202-209
JO IN CONSPICUOUS PLA,.E
INS
P SIGN ALL APPLICABLE SPACES
JOB ADDRESS 81.685 TWERON
POOL AND SPA ONLY. ALARMSIBARRIERS SHALL BE IN PLACE
PRIOR TO PREPLASTER INSPECTION. POOL EQUIPM) WT
ENCLOSURE NOT LNCLUDED IN PERMIT.
TYPE.OF INSPECTION DATE INSP.
FOUNDATION 8 $ETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
I PRE-GUNITE J2 I
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN&(;D
CONCRETE SLAB
JOISTS 8 GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING 8 VENT • A/C'
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT 0 a' 08,
FRAMING
INSULATION
- ---PRE-ROOF n _ _
COVER NOW RK UNTIL ABOVE HAS BEEN SIGN
DRYWALL INTERIOR
EXTERIOR LATH ;.
POOL PRE PLASTER
POOL FENCE 8 GATE
SEWER SEPTIC TANK
FINALS
ELECTRICAL
PLUMBING
HEATING - A/C
I HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ALL CONCRETE FLAT WORK SHALL BE PLA ED A
�' MINIMUM OF 2" BELOW WEEP SCREEDS.