0310-314 (CP)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
800680 Cs3 ,. a<:� �
��� r
°Date Signature of Contractor J✓�
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 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 +A41,T-AF:F`J g5UDjL Policy No
(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 shalljfortwith.comply with t`ho'►'s@,e�provisiond
4
Date: 2,fplrr
I
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 propertyTfor inspection purposes.
Signature (Owner/Agent) Y � � A,-,, Date F i �' � i� cJ
BUILDING PERMIT PERMITq
- �
DATE fj� ' !'v VALUATION LOT TRACT
$15X0.00
r t s r
JOB SITE
11
APN
ADDRESS .5,'Z..?AS sr. .MNMJWS
w
OWNER CONTRACTOR / DESIGNER / EN (NEER
1I11 I2MBRA'Ai>,•?T POOLS . 'II SPAS
57-.285 ST AR DR:E S 46880MG1UNTAIN COVE DRINFF, 494 "
1A QLM4TA CA, 42253 I1 DIA1.3 W-17.,9 CA 92210
(760)'345-1376 ("BT -4 66x'3
USE OF PERMIT
>x�L.ANDAD r, SPA,
POOIJSP)R f BQ ALARMS18ARRIERSISHALL BE 11.1 PPJOA TO
PR.%P"8,T3,R O'SSPECTION' r
POOL AA117lOR SPA. 15100100 LS
�aATED COST OF COXYMUCIION
PLA14 CHW1 3C FAL, libl-000-4.39.318 S1US.30
CO14ST),ZUC T 1014 PEE 101 -000 -4 -19 -OW $161M
MECHANICAL FEE —*- POOL 101-000-421-000 :1Q.UG
ZLZCTP.1CP.L LPX -. P001. 101-000-420-000 X45.00
K�zOCYu419�fPOtD
PLUMFJD40 FEF .'. POOL q01.
.la D
D
NOV '0 4 2003..
CITY OF LA QUINTA
TO i11 T' 'PLAN (11410
$361303
}X33 PR1Z-PA,1D FM
$0.03
. .i OI.P , S-].?cvRihA- .si7`EES DUE 11 o Y1&3C,3-IM)
RECEIPT
.
DATE BY !
It- �� . r
D E FI . ED
,--
INS TOR
.
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 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond r
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric ,..
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Strwer Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover -q 12o
Sewer Connection
Encapsulation 22
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:
if r
BENCH
SIX JETS m °°
LANTE '
SPA +18" PLANTER
WITH STACKED' +12..
QUARTZITE SPILLWAY - `6,_0„ , ° QUARTZITE VENEER
SIX JETS o • � - �, ' -- - • o -
CANTILEVER
QUARTZITE VENEER CONCRETE CAP
m 5
3'6 11I
o DEEP DEEP �,; P/L
° . ° BBQ TILE COUNTER
TOP, STUCCO SIDES
\ X 24'
2i,ILI
P/L
4 d LANTER
SAWCUT
CONCRETE
46 ,
SALT FINISH
,. N
LANTER -
PLANTER ! ° EQUIPMENT WALL
- -
. t I EQ /
to
HE IHLENFELD RESIDENCE\
NOTE: -
LANDSCAPE NOT INCLUDED
CI OF LA QUINTA
BUI ING &'SAFETY DEPT.
APPROVED
OR CONSTRUCTION
oAArE o 3e
9- - -S-t
S •
EMBRAND
POOLS & SPAS INC
CA. LIC. 800680 C-53
78-910 VIA VENTANA
TEL (760)'!7 -212153 '
FAX (760) 771-2181
POOL & SPA SPECS
POOL SIZE: 29'6" X 1 V
POOL AREA: 285
POOL P •.80
POOL DEPTH: '� X 5'
SIZE:SPA -'
SPA AREA: 49 SF
SPA PER: 28'
DECK AREA:.1 394 SF -
COLOR/FINISH: SALT FINISH' }
PUMP: 1.5. HP
'FILTER: 400 S
HEATER: 400K BTU
CONTROL: A UAS_WITCH
CHLOR: A UARITE SALT
CLEANER: NAVIGATOR
PLASTER:
TILE: GROUP 1-3
POOL LIGHT: 1-400 WATT
SPA LIGHT: 1-100 WATT
RBB:
MISC: _
IHLENFELD RESIDENCE
ADDRESS: 57-285 ST ANDREWS
CITY: LA OUINTA
DATE:
SCALE: 1 "=8'
DRAWN- BY:
JOB :
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