9911-024 (RPL)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter J (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
5741.41
t ate It - 7.3 1 Signature of Contractor— <
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 tor 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.
`(s), -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. PC 99_0101934
(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 provisions.
.Date: t t " = % `" `� Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is. made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of. La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned, property for inspection purposes.
Signature (Owner/Agent)'"`� Date
BUILDING PERMIT PERMITk
DATE 11/2V +9VALUATION SILTM+�r� ICIj) LOT TRACT
JOB SITE ADDRESS 45-11-6SUNSE,T�RY C�i�URY
OWNER ICONTRACTOR / DESIGNER /
APN
d..S-[1l` Stf�ll:IERR`� COM TVII i'`ON N ',11;1, UB Wt., Ad !'F;. F4
LAQUANTA CA. '°f: ,53 t"GlLMS DESi 0,' ('A
USE OF PERMIT
14,OL AND Ute SVA
PtX:kL Ali)j aVA 0.NLV „1.14! tNZ ta.1 AOZ` XY iskic ,
I+i,A3�'Ist:It+%VH.;'I'It 'A
5171Mt`VE11e7) (XY6 or
V(14. -S RUt" I'10 VFft' 1101.Isla Axtd� moll > t 14)
Nfi**,.IJA*.1it A MV, _, POOL 101 1�0
}�t�.R..'k<t@f1fc�� �`��' a, I�'� it tl.. 24►1 �4.�'I3S#��Jl�y-64tiit �_''�.�t
•1l li)art. 0TAt C N1o`- YtI.Ji.�7'1! N 'i,1, , Vf.-AN 4 I 04W
LE111Fa 3'i l"J'r' I) f` ;
'�'ffiTc'�.1� �';��$d�1�5°z7 it')'a�.�;`� �SD1�P'<',''•�li)'��'
RECEIPT DATE BY �i �,t '4� i DATE FINALED INSPECTOR
;$�2!Vkl
«,f
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts'.
Slab Grade
Refum 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 Hacks
Electric Bond
Footings
Bond Beam
Main Drain
Approval to Cover
_`LTJ✓
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)
A RE -NSP_ 0ON FEE OF $30
WILL g�{ GtU IF THE APPROVED
PLANS AND JOBB AD SCHEDU EQ
ARE NOT ON -
THE SITE EO
T�NO E'XOEP os,
PIL
BACKHOE ACCESS
RAR BLOCK WACZ �
OUTSIDE EDGE FU41SH
DECKING
1DE
r
GUNI7E
Ql.
GE
Y WIDESIDEWALK
TO DRIVEWAY
RT 41'
L
�s
.1
18" mE
SPA DAM
WALL
�wme�niEility.
i DATE
CITY OF LA QUINT A
BUILDING & SAFFTY-DEPT.
APPHOVED
FOR CONSTRUCTION
Y:
_\ i- CANTILEVER CAP
/% ,:P -A COLD QUARTZITE VENEER
- - A -
6'
31611
-T
BENCH
13
PIA
LIGHT SWITCH
IF
SLIDER
RESIDENCE
BROOM FINISH
nESIGNFlL
SUE. HRS
A�9
tSiNEs -
NEE
J RICHARIYF-R'LEVELSEA-TS-22=24'27'
r
� DATE DAMWALL STAOCED
11-2-99
1 =� DAMWALL TOP QUART2TM
SPILLWAY IRE .x WIDE
REVISED A r
M 4 1
C 'N9®� CHRLSMARGISON
A4dram, 4S 115 SUNBERRY CRT
ji�1GIA QUINCA Z. -
IBACLDFSEICT PRIDE r.LQI� l7
a -— 14' - Poo/s
+ 4 PALM DESERT TEMECULA
ATERB W • N 73-011 COUNIRI' 28910 RANDIO
US'_l' Ai F CLAS OIL STE F-4 CA 2ORNA ID.
PALM DESERT CA. TEME,CULA CA
NOTE: LANIDSCANE AND FURNITURE 91260 92590
ARE SHOWN POR ILLUSTRATION (7so13a6 4032 y� yylw
T
m
N
~cannot ass ume r esponsibility forGENERAL SPECIFICATIONS .
_ J/ &LLdamage to curbs, sidewalks, driveways. cement
` 0 W /ROCKY MOUNTAIN QMARTZ SIZE 20 X40 ,
' a FOR CASCADE . slabs sewers lawns trees fences retaining
w TERLINE a CAP 556 105 _
co (7 Y 4 .ta`res walls, s rinklers, telephone lines or shrubs. _ AREA: PERIMETER
m - - - ^'"' >Q;fr: • w:,; • 2`•s e 15"TOP OF DAM - -316"X
1 n 1
r— % > ° ;:<; <:_ ' WALL - When access is made throw h a neighbor's DEPTH
O .>F:rr :::� e, :.,,w.n. 9
OUTSIDE EDGE 'FINISH, «=1`€> :=>r. ><: '.
' GOLD QUARTZITE WATERLINE
D `•�<>'�`>�`••'":3L-
property it is understood that `'ou the owner. �.
`<3;ae�ars i2.L�•y �-•.� .
T Hn's I.
• � _ y;, >�. ,� have that neighbor s r�ermission and assume full RBg. 91@+1811121@+12"21@+6"
..
..
w responsibility, ij �T..� areac:i:ve Q
�<w >:� CANTILEVER.
T
., y„ COPING
V) iS
DECKING
DATE
P APA
29,190 GALS
—1
si n
ature
o D
€>I°w•
M CAPACITY
1
03
U C P
DE
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G M
Cft.-;
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MOTOR P sTA RrrF HP 1.5
m
C
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18 WIDE
MOTOR HP,
�•_> :��. mss••
:S M
O c%r.3'l::.
0 ^s `
Z
... , . ... LER STA RITE 300
S FT •
rn
.WALT,
�G
Z .
GUNITE GPM
--� D
f
y
.. ..ac.. HEATER R LA
E4OO
T
'Z
..... ..�TURN0 E NRS
. 9 ........ :s'`SUCTION LINE
s . ' TURN LINES
,H �•••
RETURN
E "AMERICAN
1 -
,• 3g
mo+. y > a ` ; - R7' -O°' r, ,GASLINE BY SDCHECK VALVE C FT. 126
:o vs LL . - '`
POOL' LIGHT 400.W CLOCK T 104R
n _ ,..•� • , ELECTRICAL BY. 'SDC 250 .
C2 r•n -� LEAVE DIRT s I _
c� c o.. ', CANTILEVER -CAP AUTO CLEANER GREAT WHITE
WATERBRITE
c a
� n = r"'„ j PLASTER COLOR WHITE' `
P2 = m c .1•. '� *' . GOLD QUARTZITE VENEER DECK BY Q•
2 -v _ ,. SDC S 1171
c S o DECK TYPE'BROOM FNSH CANYON
rn o m w t' CI" --- -- -. _._ /r/��:',EI" _ STEP (� FT
. / �'(�
cp C2 C 1�},� — VI + r• s 3_ SPA ►7PEl.l7e
BROOM FINISH SIZE
.. E'1 6 .".5'•6" _ 316ii► >•� ti DESIGNER 7 RAISED YES +18"
BACK HOE ACCESS .....-._. _._. _.__ _'_ _ - 401-0" _- _._. - , 1h _ ; - - -._-._ _. _._. _._. _ _. y LITE. 100 WATTS ;
1 25 3 - �� r RICHARD/E RI LEVEL SEATS 22" 24" 27"
R&R BLOCK WALL - DATE' DAMWALL STACKED
BENCH ;
DAMWALL TOP UARTZITE
• 11-2-99 11
�{ a SPILLWAY SIZE X WIDE
REVISED P LLWAY XX PEN CLOSED
# JETS 4 PER '1 LOWER
Name:,CHRIS MARGISON
0'-�' •BENCH Address• -
• - - f _ -- a _ - _ _ _ .. - .v- _-.. - - - - - - - __ _ -v - - -
/1 Y f
• , S
19` �ULLA QUINTA
TRACIDESERT PRIDE LQI# 17 .
P/L ', e. LIGHT SWITCH' ,, a. •,�;��°v a '.
SLIDER
. SLIDER
` G� " , 14'
o_ 's
t P. 00/s
of
__ _ _ _ PALM_ DESERT , ,, TEMECULA
_,. 31 WIDE SIDEWALK. ^^WATERBRIT W N 73-011 COUNTRY 28910 RANCHO
r� TO DRIVEWAY CLUB DR. STET -4 . CALIFORNIA RD. .
1/8'1=1' SCALE PALM DESERT'CA. STE 206 "
-
RESIDENCE NOTE: LANDSCAPE AND FURNITURE' 92260 TEMECULA.CA.
ARE SHOWN FOR ILLUSTRATION X760) 346-4032 - 92590
ONLY AND ARE NOT INCLUDED: X909)676 SWIM
- - _ - LIC # A-574127 `