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9710-164 (RPL)_ LICENSED CONTRACTOR DECLARATION ri erip-b dffirm under penalty of perjury that I am licensed under provisions of s•'Cliapter 9 (commencing with Section 7000) of Division 3 of the Business and f?rofessionals Code; and my. License is, in full force and effect. License #, Lic. Class Exp. Date Zia, „17 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 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. ofthe 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. BUILDINGPERMIT PERMIT# °°NTR°`" DATE / VALUATION LOT �71Q���� TRACT qq ��++ SIt,tfQC1.00 61 O 5 JOB SITE APN ADDRESS '78-88.5 SUNHIROOK OWNER CONTRACTOR / DESIGNER / ENGINEER FNC0 x0&4E.S C0P,P. UAT: r.,ALM FNTERPR1SE8 1282 W. ARROW HWY 74-819 VELE WAY ; 6 UPLAND CA 91785 PALM. DESERT CA 92.280 '~760)346-2504 CBL4# 1888 USE OF PERMIT POOL AND SPA. ONLY POOL AND/OR SPA. 12,00k00 LS S7, .TE R;ND 1061487-97 ESTIMATED COST C3>t+ CONSTRUC'1 [ON (This section need not be completed if the permit valuation is for,$100.00 or less): Pjll;RMff ri EE 9%itr MARY () .1 certify that in the performance of the work for which this permit is issued, PLAN CHECK FEE 101-0004391,418 $87,75 I shall not employ any person, in any manner so as to become subject to the CC)IdS C'`LI[TCTIOtd Ffi1 101--418=(100 workers' compensation laws of California, and agree that if I should become subject to the workers''compensation pro�isions,of Section'3700 of the Labor NlECHANWA[, FE -6-- PL�OL 10t-000-431-000 $2Ft 00 Code, I sba I�forthyya h cdmply with Those prow SIO s. ,:..--w iL FaC i'RCGAL t' i s -- POOL 101-0000.424-000 $45,00 1%Date:. If� W" Applicant_ �~' w: I'.[.t)1VIB1NGt b'i"sE .. PL7Plx 101-000-419-M $27.90 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 ;s 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. '40TAL CONSTRUCTION AND PLAN CHECK LESS PRLi-PAID `GEL'S V,00 ocr Z9. 1997 I certify that I have read this application and state that the above Information Is r- correct. I agree to comply with all City, and,State laws relating to the building �j9f �� x i9; construction, and hereby authorize representatives of this City to enter upon the above-mentioned propeay-for„inspection purposes. k , i RECEIPT DATE �l Signature (Owner/Agent) :VA-? Date. � TO' ,AL PERMIT PEES DUE NG''VV $3,8:74 INSPECTION RECORD i' 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 POOLS - SPAS BLOCKWALL APPROVALS Steel 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 Sewer Lateral Pool Cover Sewer Connection Encapsulation f 7 , Gas Piping Gas Test Appliances Final COMMENTS: 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) 3 Ll CITY OF LA OUN"'IA BUILDING & SAFETY DEPARTMENT CONDITIONALLY ACCEPTED FOR CONSTRUCTION SUBJECT TO INSTALLATION AS PER t o 2a BY POOL AREA SCALE 1/8° 1' PLOT PLAN -NO -SCALE POOL SIZE DEPTH TO ` - PER.Ye. 115 SO. FT. n / / �R TEMPL. NO. L FILTER NO. } j/ fl c,',6 25X) NOTE: 5 PA SHAPE,* NO. RETURN LIIN�ES ACCESS _L0_ FT. FENCEG� {. il.� •J ra l -L 3 U I� /AY1 a°i / /J MUC I- • MOTOR „ i1.'. Pi iivr�� HP I 'vi ANTISYPHON YES 4 tj f o m�� D LIGHT ELECTRICAL FT. BONDING YES �� Jv GAS � FT. TILEZ63�COPING N0. r1l Or r ne DATE PALM ENTERPRISES POOL/SPA CONSTRUCTION COMPANY 619-325-2187 CITY UC. NO. CONTRACTOR NO. C53-591925 INCLUDED SHALLOW END ..... LADDER ...... 11DEEP END DIG ...... ❑ SLIDE ....... ❑ P -TRAP .......... ❑ LIGHT IN SPA :.. ❑ BACKWASH UNE ..... Cl SPA ........ 13FILL LINE . �Q q T o. .. CHLORINATOR GRADING ......... ❑ ROPE RINGS .... ❑ HEATER20;9� ...... ❑ MAINT. KIT L.. A ,GUNITE INSP ........ ClTREES ....... BOARD ........... ❑ OTHER ........ ❑ LOT ;a OWNER ISL AP.&IF-e P -es JOB ADDRESS 78 -6B S SUN lw6c ` W TRACTJill: D CITY L(� , MAPNO: ^^�� JOB PHONE ' as-- BUS. PHONE SALESMAN LAN NO. L� JOB NO.