9906-107 (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
348708 i; 3 1.2i31/19s
Dto t, _10 Signature of Contractor 44y, 'W -'rt'�•
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.
( Xr 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 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 agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Af
C &Ee, I shall forthwith comply with those pro fisionsf r" r
ate: ! % ^ Applicant—
Warning:
'
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.
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. 1: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.
Zature (Owner/Agent) �'� '` " ! Date
BUILDING PERMIT PERMIT�l3
DATE "VALUATION $27,#00.00 LOT TRACT
JOB SITE
71i- 31 �l. "KING �tf➢Z"f'�'1'6�%iN
APN
ADDRESS
OWNER
CONTRACTOR/ DESIGNER / ENGINEER
y�
�Dtp
WE"ST
73-€11 TA L.'KENG ROCK. TCJftN
43375 MAOISON ST
LA QI.,11NTA. CA W2T3
'!I D10 Cid 92202
(70)347.59:9 CAi14 1151
USE OF PERMIT
PWL ANDi0k SPA
1}0& I-)A,�i NI,Y, i1LAIIkOd ANi-ii0it BA.RR.IE i 11.QTA. gami
�L01,
POOL V4D/OR SPA 22,000.00 LS
ESIMILV 1 V COSH' OF CONSTRUM.If,1N
24000.00
PLAN C?!ECK FEE 101-000-439-318 S146-2-5
f)N3TRIIC"rI()N fITF 1111-i►f}0_4W_(V0 Se2`1.tII)
T.11;061/1;aZC%11.]rM, -- POOL 101 -000•421 -ON Z1.0
I.,.i4;"'MUCAL T`L;E — POOL 101-Wi -1-000 $43,00
N.Uh1.61NO 1'Is — P0011 1.014)00-419-000 127.00
SUB-"F'ciTA.IX, ClNS"i'Ri.", 'TON :ANIS PLAN CRECK,
c�7 2ti
,y LESS ME -PAID FEES
$0,00
Q l A!,1'CKNIfr FCF.V DUE. NOW
$467,25
PNP
N �,1
CA
V
I t v -AJ L;: .'
C h
DATE a
C
BY'
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION DATE INSPECTOR
BUILDING APPROVALS
Set Backs
Forms & Footings
Slab Grade
Steel
Roof Deck
O.K to Wrap
Framing
Insulation
Fireplace P.L.
Fireplace T.O. ,
Party Wali Insulation
Party Wall Firewall
Exterior Lath
Drvwall - Int. Lath
OPERATION DATE INSPECTOR
MECHANICAL APPROVALS
Underground Ducts
Ducts
Return Air
Combustion Air
Exhaust Fans
F.A.U.
Compressor
Vents
Grills
FansA Controls
Condensate Lines
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.
SmgY! Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
3
COMMENTS:
Final
Final
BLOCKWALL APPROVALS
steel .
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
z
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
3771/
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 Piaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
i
Gas Piping
Gas Test
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.
SmgY! Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
3
COMMENTS:
TRADITION GOLF CLUB 6 760 564 2356 06/17/99, 13:34 (9.:01/01 NO:727
a
Won
ARCHITECTURAL DESIGN REVIEW
June 17,1999 VM r'a�Jtmi7e
Mr. Greg Butler
CTTY' OF LA QUINTA
post Office Box
La Quinta, CA 92253. ,
Re: Kellerher Residence, Lot 47, pwq 28470-2
78-631 Talking Rock Turn
Dear Greg►
Please ecce t this letter for approval of the swimming pool on the above referenced lot. If
p * lease do not hesitate to call•
you have any questions or need additional information, p
Thank you.. 1
Sincerely, 7
Christina J. Dores -
Architectural Review Coordinator
/cjd
78505 OLD AvDm 52 - LA QUINTA CA 92253-1120 -- PHoNE 760/564-3355 -- FAx 760/564-2356
TYP
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CENTER EDGE . OF PECK
ON COLUMN \ N PA
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ON WALL 14'-6'5,40
ON
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POOL
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-SNADEI3TR1JCTURE ___1,, CITY OF LA QUINT
BUILDING & SAFETY DEP .
PA APPROVED
FOR CONSTRUCTION I
FIRE PLACE DATE 2i BY�
'EIRR IOR 3'
r
A-1
• CTan� fEt Of $30
NU K CHAKED IF TK APPROVED
PLANS AND JOB CARD ARE NOT ON
ME SITE FOR A SCHEDULED
INSPECTION.
.NO EXCEPTIONS!
western wools
CUSTOM POOL/SPA BUILDER
serving the desert area since 1977
Allen Elkins owner
Ph 347-5959 Fax 775-7709
P.O. BOX 1047 - INDIO LIC. #348768
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From: Kin) Dahl 760-773-`_.�,15 R(--,A/PD(-VLA. To: ('Tiristina Dor?s iBLJsin?Gs Fa.--"' Date: 111 Tim IDAE+:38A(vl P*— of 1
To:
Chdstina, The Tradition
From:
Rob Parker
IF=
Pages:
1
Fc:
Ron, Stoker Construction
Date:
November 19, 1999
Re:
Kelleher Residence
Project:
9854-1
0 Urgent 0 For Review El Please Comment El Please Reply 0 Original will follow
• Comments:
Christina,
Per a phone conversation with Ron from Stoker Construction, Mr. & Mrs. Kelleher have
decided to return to the original pool and spa layout that we designed. The spa that is
currently attached to the pool will be removed and a new separate spa will be constructed
per Our original plans.
Rob Parker
RP/kd 9854--f heik-jie,-Fax
CITY 0;7
� { , bradiuon LA 01j!jV7A
ARCHITECTURAL DESIGN REVIEW 2 2
BUILDING AjV0
November 19, 1999
Via Facsimile
760-777-7011
Mr. Greg Butler
Building'and- Safety
CITY OF - LA QUINTA
78-495 Calle Tampico
La Quinta, CA 92253
Re: Kelleher Residence
Lot 46, 'Tract 28470-2, 78-631 Talking Rock Turn
Swimming Pool Review
Dear Greg,
This letter will serve as. ADRC approval for the above referenced owner to obtain a pen -nit
for thej,��,imMiing pqol�.at- t:.the,,abc!ve_,referenced address. The approved pool plan is
attached.
If you have any questions, please do not hesitate to call.
Thank you.
Sincerely,
"'y
Christina J. Dores
Architectural Review Coordinator
/cjd
0 mail) ji.-P )�, 1--i I � -1— - 7 7",
,.Lass�e-St ker, (via fust class -m
VAL "2�6"C
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78505 OLD AvENu 52 — LAQunrrA -- CA 92253-1120 -- PHONE 760/564-3355 -- FAx 760/564-2356
C
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ITY OF
HONG & SAFETY T. :I
APPROVES - a
N� 10�a Af ,3,N)V SNVId
FOR CONSTRUCTION 03I10dddV 3Hi 3; u30dVH3 39111,1
I OE$ 30 333 N0110 MI-38 V
DATE Il Y BY Q�
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