9803-011 (RPL)LICENSED CONTRACTOR DECLARATION
I, hereby affirm under penalty of perjury that I am licensed under provisions of
hapter 6 (commencing with Section 7000) of Division 3 of the. Business and
Profe9sionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
y}
X75 C_53 _ -. r . ,16 30%98
VIate �^1f 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 isnot 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 ll&eby 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 Policy No.
STATE FUND 106.1437! 9R
(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. ,
lSate:. 2 r //"Applicant. .._
Warning. Failure to secure Workers'-Compensationn`froverage�ls,unlawful and
shall subject an employer to criminal penalties and,clvil fines up to $100,000, in
addition to the cost of compensation, damages s 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
fora 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
tth "above-mentioned property for inspection purposes.
Si nature (Owner%A�nt) X>,/� , !-7+:%--"Date-' '» '
PERMiTli °°NTiaOL#.
BUILDING PERMIT
DATE VALUATION LOT 9803-011 TRACT. 8606 � 0
y 514,000.00
JOB SITE (
APN f ,
ADDRESS
7"20 S1J'NBROOK 1 A1'� E
r
OWNER
CONTRACTOR/DESIGNER/ENGINEER
7OFIN RA.RJ?CASTLER
DKK PALM ENi`F.RPRISES
78-820 SUNBROO) , WiE _
74-818 VELIE WAY #6
LA. QUINTA. CA 92253
PALM DESERT CA 92260
(760)344-x504 CBL# 1888
USE OF PERMIT
P00 .
POOL, & SPA OiNLY ALARM& ARR IER.S ARE. TO EE OPERATIONAL
PRIOR TO EN-C.1P1PR&PLASTER MSP.ECTIOtT
.POOL ANIXOR SPA 14,000.00 I,S
ES'T%10 XfED COST Cir OUNS'A" UCTION
14,000.00
PE .MT FESUiV MARY
PLAN CHECK 1:EE 101-000-439-318 $999.45
CONS'TRUCTiO?4FE:E 101 -000.418 -ow $15;3.00
MECkIANI AL -- 101-000421-000 V9.00
.POOL
ELECTRICAL PEE -- POOL 101-000-420-000 '$45 , 00
0
C
PLUAMING -- POOL 101_000-419-0W $37,0.
®�
cc
qe
U
SUB -TOTAL CONSTRUCTION AKD PLAN CHECK
$345.45
LESS, PR&PAR) FEES
$0.00
TOTAL PERMIT FEES DUE NOW
$349.45
RECEIPT
DATE t
BY / y" r
D INAL
INSPECTOR
' OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms 8 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
Electric Bond '
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test i
Final I
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 _(o
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
i
f
Final
utility Notice (Perm)
COMMENTS:
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CITY i a x (�
BUiLDI� fir;,.-�m �r ` I,�Fj
ACCEPTED FOR,
SUBJECT TO INSTALL f;_ . - �� t
U E CJS
AND ALL APPLICABLE COO, E03
BY
POO 8- -
PLOT PLAN -NO -SCALE t ,
POOL SIZE m DEPTH TO PER 3W.Wfo SO. FT. ❑INCLUDED
TEMPL. NO. J I _ FILTER NO. _- N'A N I Q AI2 b 200
—� NOTE: ^ SHALLOW END ..... El LADDER ...... ❑
SHAPE � NO. RETURN LINES -Is - Z rZA15 (� 5%PA q -76TS DEEP END DIG ...... ❑ SLIDE ....... ❑
ACCESS FT. FENCE - D/GJ - PIA I� .. �G%,� Tu t�r✓F�;�2 3 R �c;2u r P w► P -TRAP ' .. ' ' ' . • • • 11LIGHT IN SPA ...
-- BLLKWESH. �A
MOTOR }�PUi,r' HP I RC-FLoLJ 4t_UTv.ORINATOR
LIGHT ANTISYPHONYES_OrQTD LJ9p AhT4*0"/p/"jas PLtlt j GRADING . . . .. . . .. ❑ ROPE RINGS . . . ❑
HEATER ?00, DC)q MAINT. KIT .. . .. ❑
ELECTRICAL S�FT. BONDING YES LANpscf PL Pte Py-A/i GUNREINSP ...... ❑ TREES ....... ❑
GAS j2_Fr. TILE COPING NO. C~At\)T (c5(o 30 QAC( �T�}eT �HP /VIA IN'(, BOARD .......... ❑ OTHER ...... ❑
S
DATE PALM ENTERPRISES LOT'. Z OWNER - �) = I
POOI./SPA CONSTRUCTION/IANDSCAPING• �� JOBADDRESS -7&)- 20
(760) 346-2504 TRACT Cm' MAP NO.
CONTRACTOR NO. Wl;&53;C-27 690775 SALESMAN PLANNO.t, 2D `1 PHONE 777-7p/ BUS. PHONE
JOB NO. on