0312-238 (RPL)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
WProfessionals Code, and my License is in full force and effect.
C) License # Lic. Class Exp. Date
Lu 65612Iq C53'Mcf,2^�s a ���0✓
r- Z Date ! '' Signature of Contractor �.4a:, er.
(O D r
J U OWNER -BUILDER DECLARATION
WaW I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following reason:
Z_ ( ) 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).
C'') () I am exempt under Section , B&P.C. for this reason
LO
N Date Signature of Owner
ON
rn
d Q WORKER'S COMPENSATION DECLARATION
p cc I hereby affirm under penalty of perjury one of the following declarations:
LO O ( ) I have and will maintain a certificate of consent to self -insure for workers'
X W Y= compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
m Q C) 1(�,r%)—I'have and will maintain workers' compensation insurance, as required by
O C) Q Section 3700 of the Labor Code, for, the performance of the work for which this
a rn H permit is issued. My workers' compensation insurance carrier & policy no. are:
Z Carrier STATE COt111'ERSATI Policy No. N6,16168-2003
ao --)
�O
(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
1 subject to the workers' compensation provisions of Section 3700 of the Labor
•`•7J Code, I shall forthwith comply with those provisions. g4
Date: {ft%r%� 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
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.
i. 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
purposes. /
Signature (Owner/Agent)(�� Date✓
r WILDING PERMIT PERMIT#
DATE VALUATIONLOT TRACT
1 $17A00.011
JOB SITE APN
ADDRESS 7 rgb2 1?ALSSI�C3� �tOt:F~ °F'dJiZl� - -
OWNER CONTRACTOR/DESIGNER/EN INEER
WHOP CALMMA POOLS & 81)Ag CMP :lb AX CiC
76-622 TALKNG ROCK 1IM4 86.100 AbEN. E 54
1AQDDr1;'A CA. 9225.3 4OAC:s?�'.�x.A CA 92236
(76O 398-9222 Cid 00355
USE OF PERMIT
PCX,1L AIM/tai? SP-
POWSPA.ALARMSIBARRIERS SHALL HE IN PLACE AT PR&PLA5',fER
INSPECTION. I QUIPMEW c )3Nt`.l.fOSURE NOT DgCLIS33FD
POOL ANT -110A SPA
17,000,110 LS
1 STIVAI D CWT Ori CONIRMUCTION
17,OMW
PK'Mif 1+ OE S1lle?LMIky
PLAN Cl-1L+CK FEE,
101.000-439.318
$117.09
CONS'b RUCTIOW F&T
101.000-418-000
$190.00
MU'idA'tri1C.A.LFEE - POOL
101-000.421.000
$24,00
ELECTRICAL 17FZ? --'POOL
101-000-420.000
So, cc
PLUM P40 WE -- POOL,
101-000.419-000
$77.00
- C0X8T1ZUCP 0)ST./+3+TiJ PLAN c SCK $393.00
DEC 31 1003 T-A.L Pm -c�°:��w>�� ��r : Ovar AX)
CITY OF QUINTA
FINANCE DEPT.
RECEIPT DATE ,1 BY D FIN ED INSPEC 0
'/ ° E� r�
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
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
—0
Set Backs
Electric Bond
al
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
'
PLUMBING APPROVALS
Gas Test
Q
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
9_z
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
0
.e.", -
1
ti
V
FAC]
CV i
M
LO
b5
A-
.1000,
1000'
CONSTRUCTION AUTHORIZATION'
S.ALF S 141 LD
DIG
PRE-GLTNITI-
1-N,,,DERGROUND
MASONRY
DECK
PRE-PEBBI-E
SPECIFICATIONS
I- 4;
TYPE SZE
SURFACE AREA OF POOL
PERIMETER DEPTHS MIN. MAX.
SPA SPECIFICATIONS
TILE
Sim — x — SO. FT.
ULE TYPE
SPA DAM VAU WIDTR
WATER LINE
Na OF JETS
TILE TRIM
LIGHT — 0% -ft
QUARTER ROUND
RAISED SPA AT +Ito
R.B.B. Tu N
SPILLWAY TYPE
SPECIAL TIOIES
D CKING
CKING
EXCAVATION /'(�EL
TYPE
ACCESS FROM
EVER
CANTILEVER
nMM
DEEP END RAMP
DECK ECK DRAINS
LOW SEAT
DPECCO
ommm REMOVAL• LOADS
CM CORE
SOD PDAOVAL LOADS
'no
STEPS,
VM REMOVAL By
M FACE
IR16GATM REMOVAL BY
TITLE BASE
IRWGATVt REPAIR
SAND AND VISOLIEEN
Ir ft
Reams
12- 0.11 &
voi S"
18' R.S.S. Sf�
24" R.B.B.
30'R.B.B.
IAN SHELF DEPTH
MASONRY
RM
COPING TYPE
CENTERS �"
R.S.B. FACING
SPILLWAY TYPE SM
STEPS
PLUMBING
CA%— 60e)
PROP. M. WALLS
MTS - :tIix
PM PUMPckr,— SM -3•
"TER WALL
RETAINING WALLS
MOM PkW SZE
EO 1P. WALLS
AWL PUMP SZE rh
FIREPIT
AED'L PVMP 92E s
TIME CLOCK
SUB PANEL
9eIMW9? TYPE
FILL LINE .
PEBBLE PLASTER
GAS W srues
LIGHTS POOL
L 2--:5-
UGHTS SPA I
MWTA MI/NPRAVHEAVS
POM BOND BEAM
94EER
ODM
SPAEYTBALL
LIGHTS IN POOL Z IN SPA
FENCING
STJO SET EOLJ1PVC%T
VL'jvP_w SSEwVwT
ream TYPE
GATE
GJNITE
GATE REIVEPSAL
DSP PC PAW
E)M-MVE,^ 2,-d STEP
cAxrLEvs E C
EST. CC-*ftF"0'4i
OTHER
R,8.8. - SET STM
WN ER RESPONS191LITIn
OW47t 10- (1) DETERNNE THE APPRMATE ELEVA" OF PM CR SPA AT LAYOUT ON DAY OF EXCAVATION
(2) TAKE WXTE THAT POOL AND MWW-NT LOCATIONS AE WKIECT TO ACCEPTANCE OF
LOCAL BV01140: DEPARTMENT AT TIME OF ISSUANCE OF PERM?
(3) WET DO" CONCRETE SHELL AT LEAST TWICE DAILY FOR W^ DAYS ALTER SHELL IS WTAL11D
(4) AGREE MAT CALFOMA POOLS IS TINCT RESP"BLE FOR UNDERG"" 0"TICINS CR CIMCTS,
AND ANY DAMAGE TO CURES, SVEWXK& WAVAM LAWS, OR OTHER TTEMS IN THE ACCESS AREA
(5) SEE THAT ALL FENCING, GATES, AND GARAGE DOORS VMT LOCAL 0mcs FOR A POOL ENO"AE
PRJOR TO PFCOLASTER WSPECTIm
(6) f POOL IMMEDIATELY AFTER PLASTER. (FOLLOW INSTRUCTIONS -- DO NOT USE RUDER HM
(7) TAKE NOTICE THAT TM DRAVINO IS THE SOLE PROPEIRTY OF CALIFORNIA POOLS AV THAT ANY
USE WITHOUT WRITTEN PERMISSION OF CALIr"A POOLS, INC. IS PR3HVTED BY LAW.
OWNER APPROVES KM. POOL AND EWPWE4T LOCATIONS AND HAS READ THE RES"MffEs AND NOTICES ABOVE.
SIGNATURE DATE
SWIMMING POOL PLAN FOR:
NAME
BISHOP RESIDENCE
STREET -7 1. Z-0
JOB ADDRESS ICITY
PHONE OFFICE RES
LOT 30) TRACT PAGE BOOK
MAP BOOK PAGE NO. ICITY
MAIL ADDRESS
CONSTRUCTION OFFICE PHONE NO.
SCALE
DATE
DRAWN BY
SOLD BY
JCHECKEDw,BY
WYS
JOB#
REVISIONSDATE
2
CITY OF Qu I NIT
1
RI-liLDING & SAFETY DEPT.
3
APPROVED
r,1110110
GONST-R
4
FOR -
DATE
SELECTIONS
STONE
TILE
BOULDERS
DECK COLOR
JANDY
PEBB./PLAS
SIGNATURE
Drainage cmd irrigation for planters and pots, by
DRAINAGE NOTE:
others, unless otherwise noted. .