0205-236 (RPL)4
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I amilicensed 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
312872 C5a OW1/22
Date a/ :" za x Signature of Contractor f,d. • l%s'� f I
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. yMY FWAD 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 shallfforthwith comply with those provisions. a/� `✓ y'
Date: Applicant—
:^'??r /!r,1f "•.
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, damagesasprovided 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, indemnity
»;F& 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 (Own/er/Agent) `+��% r"iDate
BUILDING PERMIT PERMIT#
Vd.�.7's.. -
nATF !• j VAI I IATInN I OT TRAr.T
' l j '1 1�sbL'pL/�/4Y.'V'S7
Z E a
JOB SITE
APN `
ADDRESS 45-170
OWNER
CONTRACTOR / DESIGNER / EN (NEER
.1l &I AJIORALAS
11SRO1 U1VM'ViM,WG PCiCA"16
45-170
811. _5 65 MM)OW AWME
LA QUWTA CA 92233
INWO CA 92.20'
(760)347-3218 MIR 5238
USE OF PERMIT
POOL .t DAtIR 3RA,
POM .A3i!1;'? SPA ONLY. At..ATtMtaIF11SMIDMS S;HAlA;,.,11t 314 PLAZZ PRIOR,
T0P.F}EPLAOTFR,WSPlySrilOKPOOL 'NQUIPM}•;NTR CIDI�4, IZZEiJOT
YN1C°:3..TDE11) ?:31
POOL KNDIOR SPA AM.s7t1 US'
C"OS"1t' Off' f:�'d�3'S°1�.'���.`�t'. 0ti
� 20,�3€?AX)
yy g,g � �ry;y; � y y ,Q � g�';I
.'7. i .wI'89.r.L!,4Lmr guha I.Wr�.O�I.L.
PLAN CHF. K JW i of { 00439.318 1134.33
{"i' NSs f.'UCTICI'm 41W, 101.,000-418,-00.0
WICIIRAI jle /AU ITS — Pc; O.6 101-000421-000 :3X00
9111XICTRIC'.Az Y92 .. POOL 101-000.420-000 i.ttti
PLUMMO VNE •- P0011 101.O(N-439M000 V7.00
lk-1110`�ALC OVMI TT IM1'�CiA Ali]).FILaA7' HECK
$437.5S
U1493 P:€tt-PAED lois
'$0.00
Dp 'Al, MOW ISWE'NOW
037N75
MAY 2
CITYOFLAQUINTA
REC BY„ DAT FINALED INSPECT
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
_
i
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
_
Shower Pans
O.K. for Finish Plaster
_
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp'Use of Power
Final
Utility Notice (Perm)
p
7.
CITY OF IA QUANTA
BUILDING & SAFETY DEPT.
LAPPROVED
FOR CONSTRUCTION
DATe�80
-
i
5
TROPIC - -
SWIMMING POOLS, INC.
P.O. BOX 1772
W DIO, CA 92202
TEL 764347-3218
CONCRETE
LICENSED BUILDERS
REPAIR & REMODELING
UC. # 312872
LARRY MORALES _
-0®-.,,
�Iq
sly
0
v�I
6
0
L
1�
POOL SPECIFICATIONS
SHAn
PEiMYfTEf J! AREA
DE�IL_X.� �'OLItYF� TnU �
EXCAVATION
RAJNP�,0 GRAOIN� STUMP_
SWIMOUT tea,,
SPA7,ALeLCONCRETE__ Pjuw-D a
STEEL
SvAMOUT LOVESEATJ�a RAMP
SURCHARGE POOL LJGHT -,4
RAISED 80 N 0 BEA��`- SpA �-
MISC.
PLU-MBING
SUCT_Zf RET --Z-- PUMPLah, 2
SOLAJZ.,['-,---1 POOL SWI?
HTa� FILTER f• d!G �h Fl L I SNEs -
SPA % SPA LIGHT_ I_�ET�_. JETS
BONDING
PATIOS.- ON. BO.
SLIDE OTHER
F
GUNITE
RAMP — NOTCH 8.13LOVESEAT-
RAISED BOND BEAM L P.S. STUB
SWIMOU31L SPAO.:1$,, ANCH
MISC.
TILE & COPING
TILE 1, A re'14 •C.4 COPI NGIdo.t-,57 _
TILE TRIM 1<1G-2- SPA WALCW 1TH
SPA/�JSEO B.B.
misc.
PLASTER
�
COLOR. l� 1C SPA1.1J _
DECKING
BYr2�alac�_fZTYP�SO FT
FINISH
ELECT BY =;�i1<obJ c
sPC. lhw.
GAS eY -::Cee p 1
SPC. I NST.
ADDITIONAL NOTES:
A CUSTOM POOL DESI NED
_ ESPECIALLY -•FOR: '-
m
MAP PAGE NAME _ P
LOT ADORES• vo< OWNER:
TRACT .� CITY POOL AREA TO BE FENCED. PER COUNTY OR C1'
APN X STREET ORDINANCE GATES TO BE SELF-CLOSING AND SEL
HOME PH `% 72 �� BUS. PH LATCHING.
PLANS BY WET DOWN CONCRETE SHELL AT LEAST TWIC
�onc -CHK, DAILY FOR 7 DAYS.
T"PICMo►ousasrws DESIGNER _ DO NOT TURN ON POOL LIGHT WHENSwumPOOL
�. 0 EMPTY. -