9908-059 (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
721d)(i5 C -53X,
�--:%-
�Dater Signature of Contractor
OWNER -BUILDER ECLARATION
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 Policy No.
(This section need not be. completed if the permit valuation is for $100.00. or less).
(se" 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�fb become subject to the
workers' compensation laws of California, and agree that if I should become
subject to the workers' compensation provisi ris''of Section 3700'of the Labor
Code, I.s 1 f rthwith comply Itfi twse p• too s n,, , -� :•'"" t
Date:��%Applicar"
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work. is performed under or pursuant to
any permit issued asa result of this applicaton agrees to, & shall, indemnify
_& hold harmless the City of La Quinta, its officers, agents, and employees.
2. Any permit issued,as a result of this application becomes null and void. if
work is not commenced within 180 days from ' date of issuance of such
permit,.or cessation of work for 180*days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with afllCity, an State laws'relating to the building
coynstruction, and hereby Buutho�rize representatives of this City to enter upon
the above-mentioned pro erty^forrinsiectio'n purposes..
JQi nature (Owner/AgenJtW� 't'"t""�v" "bate
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 45
TRACTJOB
SITE'
ADDRESS %�»�:�Er�+e�Jtsl�a, •f ��
APN %i�••.�Et�-�
OWNER
CONTRACTOR/DESIGNER/ENGINEER
Mg(:':HMI, KAPLAN
VAP,.LE`t:' f=izOL SEBA
48.260 V A. SOL-AN.0,.
4743C €;, PALM CtVNY64 DR. -Y,11 i
B.,AOPINTA Cly 4 72_%3
PALM `S'4'`:dt.N('rS CA 922CW,
?7�.t3)11�• �:° !? - CSLY T%_5
USE OF PERMIT
POOL .ANWt.. k SPA..
POOL -..&"A. TVCLUD(N i• PIX-O&W10 FOR e, .rPfifi:Ti'MgL—)11N,3 FO fW,=ru1HS,
"131 0, TI- R3 -SUB-L31' s1`f"t"61.( HEO
TICKA, d?Sxv7J7`. R ,3 A G.3r•,`lY wo u;
a-MMIOX.1110 ").111111T 0,31-11 CON13TRUM0111N,
PERMIT M117 SUMMARY
fS
PLAN O1 -OK FEE 101 -WO -439-318
'N.T. (�3Ac`d1L'AL 177 - POM 1014W4.2$- OW,fi7Al,TU
X iit s!RXi+:h »Otk204W E3.CK1
PLOd Q3;1140M, . i'OfX 10114X)0_419�000 $27.00
St..tsi-"+'{7TA!,C(.)'NS.r :(:1GT1';3N AND i'tAfitC.1i.ECK.
LENS i RE-R,s1W FELSi
$0.0o
RECEIPT -�,� - '
DATEr',
BYDATE
FIN ALED
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
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
4 T1 -7795P
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
Final
COMMENTS:
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)
TRADITION GOLF CLUB 760.564 2356 08/11/99 12:53 :01/02 NO:455
71
Tradition
ARCHITECTURAL DESIGN REVIEW ,
August 10, 1999
Via First Qau Mail
Mr. Larry Kennett, AIA _
JCA ,
2121 E. Tahquitz, Suite 3
Palm Springs, CA 92262
Re: Kaplan Residence
Lot 45, Tract 28470-Z 78-651 Talking Rock Turn
Swimming Pool ,
Dear Larry,
This letter will serve as approval of the swimming pool plan CM Plating Plan delta -date
July 3, 1998) submitted for the above referenced residence, If you have any questions or
need additional information, please do not hesitate to call.
Thank you. ,
Sincerely,
r .
Christina J. Dores
Architectural Review Coordinator
�cjd
pc: Greg Butler, City of La Quinta (via fax)
sur o.auan�oe
78505 Ow AveNvb 52,— LA Qu6TrA — CA 92253-1120 --- NoNF 760/564.3355 -- FAx 760/564-2356
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