0210-165 (BLCK)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
Date Signature of Contractor��f
OWNER -BUILDER DECD 'R'ATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor
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
r
1 -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 1?REMONT COMPENw Policy No. SAS006 19320
(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, fort( with comply with*thoyse provision
Date:.) 1 ! Applicant 1 t� E!� f ✓ '""�
Warning: Failure to secure Worker's' 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 applicationa
%nd state that the above information is
correct. I agree to comply with all Cityf and State laws relating to the building
construction, and hereby authori;iefrep` esentatives of this City to enter upon
the above; mentioned property for -inspection purposes.
INSignature (Owner/Agent) . f � � DateJ VV
l.y
BUILDING PERMIT PERMTN
DATE J / VALUATION LOT TRACT
/ !> r• P r : %
*19176040 43 28430-2
JOB SITE_ k�� APN
ADDRESS .L
K.i�OT�iii A4p laaeai 7 -10 -MV -028
OWNER CONTRACTOR/DESIGNER/ENGINEER
@r1ON'1E LOLA LBE14 ANDRR—:W.1?'LL1;;L% CC"IRPORKIION'
118N, WEST L,ea16 - 3"d! PARKWAY 44 83 5 DE'P CASTi 014,, RD
90k1T. ,k'Tr.BF:,1:i11KW 'W- A 98008 PAUADk7,"MT CA 92261
(76G)346.322€d CBIA 03031
USE OF PERMIT
GiNERAL BUILDING
590 UP 6' OFt%C,9W,F'►LUt'OURTESY tNSPECT,40N R' d2ETA114NO
`NAWCOMPL,1J NCEWITH ALL FEDERAL &S"!'AYFe UNM 7Ni".:C.UDDT0, 114B
ftWAN01 RXD SPECIES ACT OF 1973 11PAP1li IC.AS1:E IS AFQUIRED
X9 MANIZI) CONTE OF CONSTR-OCrhbill
CONST' UC`:TION F0 101-000-418-000 $126.00
SIM-, TIM. L CONOT TC"I ION A +lD,�''LW i'IMX $126.00
I'MAXoPERMITIF MU -Simi -now S126.00
d
RECEIPT DAT FIpI�LED INSPEC�QRR
--h
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
Footings
Bond Beam
_
�7 U
Electric Bond
Main Drain
Approval to Cover
Equipment Location
Underground Electric
Final
Underground Plbg. Test
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
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:
10-17-02; 2:08RM;'ANDR.=W P=RDE �-'CRR. TRAD,,_TF(7-R#2-LE=N •760+3466263
VQ
October 10, 2002
Tradition ADRG "
Attn: Mindy Crutierez`
78505 Old Ave. '52
La Quinta CA 92253
Re: 7MOI Talking Rock Tum QvIr. Mrs. Leen Residence)
Dear Mindy:
Attached please•find a revised site snap indicating movementin' the pool location. 'The
homeowners are requesting that the committee review the revised pool location. The
purpose of this request is to obtain a variance in order to move the pool 5' (five feet)
toward the rear property line. '
Thank you for the your time and attention in this matter:; if you have any questions or
concerns please`feel free to contact me at your cc�nvenia:�ce.
Sincerely
Jody Jones
Project Manager
!0-21-32;-7:45AM;ANDREW PIERCE ''ORP. TRAD TRLR#2-LE=N ;760+3466263 # 1/ 2
10/1 /12UU:2 1b: 775 • IbU3469918. DQMT PAGE 02/02
g(,Tradition
• f 6
• October 17, 2002
Mr. and Mrs. Monte Leen
r •T %
1804 crest Samma wsh Parkway '
Bellevue, WA 98008,
Re:,,. 78691 Taking Rock Turn v,
w Dear Mr. and Mrs. Leen,
' til • , The Tradition Architectural Committee has reviewed '"'',our submit ttal of a site map
showing your prosposed charge in the location of your pool. 'Please complete aVariaince
Request form on this change and submit it 6'the Association office'along with three site
maps showing the original location and the'proposed new location. The Architectural
Committee approved youre'request subject to the following items being completed:
1. The Golf Course Landscape, Co»mittee will heed to review -and approve the
new pool location. The Guidelines require 5' from the property line to the
r edge of the waterline to prevent cross contamination from irrigation water on
the golf course. We Nvill need their. approval in writing.
2. A letter of approval is required from the City of La Quinta stating that they
approve the new pool location. ,
3. The Board of Directors will need to review and approve the variance form and
the site maps once received froze you. I will contact you with their decision.
4. Please submit more detailed plans for cou mitte , review.
No precedent is setwth this approval .All variames are reviewed on a case by case
basis. Thank you for j�rour submittal and patience mi our review of the plan. Y look
forward to hearing fro -in you on these requ8e rents.
Sincerely, "
Mindy Crutierr z, Property Manager
Tradition Community :Association
cc: Andrew Pierce Corporation `
DESERT RESORT MANAGEMENT
Pwr OFFICE Box 4772 ' PALM DEssm, CAUFORNiA 92261-47?2 •
73-550 ALESSANDRO, SUITE 5 • PALM DESERT, CALIFORNIA 92260
PHONE (160) 346-1161 • Fwf (760) 346.9918 '
, 4
t i. t
1.7-21-02; 7:45AM;ANDR=_WI PIERCE CORP. 7RAD TRLR#2-LE=N ;760+3466263 L/ 2;
I raditioll"
October 18, 2002
Mr. Jeff Lohman
Andrew Pierce Corporation
Sent via fax 34.6-6263
Dear Mr. Lohman,
As per our discussion yesterday, itie club will *ork closely. with you
to repair and remove any-irrigation •irrigation and landscaping that will need to be
changed due to the infinity. edge pool being built at the Leen residence,
Any. work or repairs that the club will incur. will be billed to you and
,will be reimbursed within 30 days of completion. Please let me know if this
meets with your approval and realize that this is. not the typical course of .
action in matters such as this.
Any further requests 'will have 'to 'be submitted to the club by the'
,homeowner for review.
Please get a letter back to me acknowledging that you accept this
condition orjust sign a copy of this. and send it back to me for my file.
_Siuqerely,'
John:S. eynolds
Genetal M4n:ager =.
MAIN C .IIA-1 01inI flito swv SAWS & M,ARKLTING 06.1(10JI($li MAIN'I'17NnN!'ai
"1111.; 'iG0/5<1877,'i "I'm.060/564-1067 rn.: 760/564.5429
nx; 760/564-6691 FnY.c 760,156-1-.740.5 FAX; 760/5644,356 I'c,x; 7C>U/..^,Cdf:•<iJ28
78505 OLD Avlimu ti 52 - Ln QUINi*A.- CA 72253••11 ZO
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