0210-224 (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
6'7x203 B 05li1/2t
�r Jff .J
Date: `,1: ' Signature of Contract er:"
.. r, - r it �-c.,.-� "� �,�,.•-S
3OWNER-BUILDER DECL/ARATIIO,N
I hereby affirm under penalty of perjury that ldm exeirpt from the Contractor's
License Law for the following reason: 1-11
(• ) . 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 js issued. My workers' compensation insurance carrier & policy no. are:.
Carrier 8TA 1,1g pVNi> Policy No. 161SM6_2092
(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•p}rov6ons
Date: % vi- ? ✓- • ,Applicant�”
Warning: Failure to secure Workers' C66pensa it on coverage 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. 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 f r,inspection purposes.
Signature (Owner/Agent)--r/• ---- Date
tc=`"' /i
= BUILDING PERMIT PERMIT
DATE,VALUATION LOT TRACT
/0 !,!6:�-2* .. MX0100
JOB SITE
ADDRESS, 7"!)J, S'.A.'T .1qG ROCK `rt71 lq
APN
_
OWNER
CONTRACTOR/DESIGNER/EN (NEER
WA 98005
T-WA4 M. RT CA" 92.261
'
(760)346.3228 mui 03031
USE OF PERMIT
���7LA TDfOR VA
;
1;0' 0.USPA_ .faLAIZUSji AR—;lY. URS SHALL BZ'At PLAC2,41 PlIt-Pi•.,PS KR.
PMNL .H.1`)1; A'A SPA A000.00 us
PLM CHECK FrZ. 101,0W-439-318 baa. i8,
f"ONSTa8.IXTION PIKE ?CJ1-000-418-000 iPW50
MECHKOICAL M. ,• POOL 101.000.421-000 $2A.00
R -f. TRACA.1. •- POOL 301-000-420-000 1$t5.r00
..
Pi.,13MBINO ME -• POOL 101-000.419.000
OCT .9 3 2002 rwwxr .VX'8 DIM! .1'YOW
CITY OF LA QUINTA
FINANCE DEPT.
RECEIPT
DATEBYi�
DAT j IN7.
INSPECT R
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
4 JBUILDING 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
A
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
Saver Lateral
Pool Cover
Sewer Connection
Encapsulation
_
;7 �7
Gas Piping
Gas Test
Appliances
Final
_
COMMENTS:
25 7
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)
10-18-02;11:48AM;ANDREW PIERCE CORP.
44835 Deep Canyon Road
Palm Deser4 CA 92261
Phone: 760-346-3228
Fax; 760-346-6263
;760+3466263 # 2
A�'M AV
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Fart Pages:
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10-18-02;11:48AM;ANDREW PIERCE CORP.. ;760+3466263
rrifion
October 1 7, 2002
Mr. and Mrs. Monte Leen
1804 West Sammamish Parkway
Bellevue, WA 98008.
Re: 78691 Talking Rock Turn
Dear W. and Mrs. Leen,
The Tradition Architectural Committee has reviewed your submittal of a'site map
showing your prosposed dbinge in the location of your pool. 'Please complete a Variance
Request form on this change and submit it to the Association office along with three site.
maps showing the origFinal location and the proposed new location. The Architectural
Conraittee approved your request subject to the following items being completed:
1. The Golf Course Landscape Committee will need to review and approve the
new pool location, The GWdelines require 5' 1tom the property line to the .
edge of the waterline to prevent cross contamination frons irrigation water on
the golf course. We will need their approval in. writing.
2. A letter of approval is required from the City o F La Quints stating that they
approve the new pool locations.
3. The Board of Directors will need to review an6. approve the variance form and
the site maps once received from you. I will contact you tivith their decision.
4. Please submit more detailed plans for con=ittc;e review.
No pweeedent is set with this approval. All variames are r, -vi on a vase by case
basis. Thank you for your submittal and patience in our review of the plan. I look
forward to hewing from you on these requvements.
Sincerely,
Mindy Gutierr z, Property Manager
Tradition Community Association
cc: Andrew Pierce Corporation
DESERT RESORT MANAGEMENT'
Poser OFFICE Box 4772 • PALM DESSNT, CAuFom)A 92261-4772
13-550 AUSSANDRO, SUITE 5 • PALM DESERT, CALIFORMA 92260
PHONE (760) 346.1161 • FAx (760) 346-9918