9710-076 (RPL)LICENSED CONTRACTOR DECLARATION
,R„!;.here!jy 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. ' •.
Llicense # Lic. Class Exp. Date
V_4�
Date_ Signature of Contractors - r
4. r
OWNER -BUILDER DECLARATION
_
I hereby affirm under penalty of perjury that l 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. 7.044; Business & Professionals
Code).
O I am exempt under, ection , 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 .
p@rformance 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:
Cartier Policy No. . '
(This sectil- Meed fo"e a completed if the permit valuation AP % NO or less).
( fl 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
2orkers' compensation laws of California, and agree that if l should become
ubject to the workers', compensation provisions of Sectio 3700 of the Labor
Code,- I hal f�rtl]with comply wit ahf s1
Date: L� '� j Applicant f
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 q
& 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 inspectionA�ose r '
�y>Si nature In—/A � Date/
PERMIT# CONTROL#
!BUILDING PERMIT SO4-5
VALUATION, LOT'. (�'''�o-o76 TRACT
i
DATEq till
JOB SITE
APN
ADDRESS
OWNER -
CONTRACTOR / DESIGNER / ENGINEER
JAMES & SUSAN BULGRIN.
STEVE DODSON CONS" CCtU4 "TION
54-0-51, 01MMRN HILLS
73.0-1 '1 COUNTR'YCLUB t..).PJV'F,SIT. F4
LA QUINTA. CA 02253
P? Wkf DESERT CA 9t,.60
(700)34&403-2 CBL# 1044
USE OF PERMIT
POOL AND SPA ONLY
POOL AW/OR SPA 30,000.00 'LS
EST M,ai.FV, 0 COST UE WNSTRJUC.flo'N
�I��Otifl.tDf9
PERMIT FEE ST3IrMARY
PLAN CtW.CK'-FE6 ' 1$4;03
W14STRUCTION Fffi 10.1-000-418.000 S284.50
WCHANICAL.FEE -- POOL 101-000-421.000 $24.06
EL,,hC'fiUCAL FE'k -- POOL 101-000-420-000 S45M
PLUMBING ME -- POOL 1014)W4.9.9-000 $27:00
PP2 D
CONSTRWIT`ION AND PLAN CHECK
�5�0.43'
OCT + LESS PkE-PAID.FEgS
!S0,00
'P,TAL PERMIT FEES DUE NOW
V56541
:.
RECEIPT ,�
DATE 4 C" BY
DATE FINALED
INSPECTOR
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
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
Set Backs
Electric Bond
Footings 7_
Main Drain
Bond Beam 2
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
G
PLUMBING APPROVALS
as9�
ectdc Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Piaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
_
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:
ND OF NEW DECK..
`- ---
R6'-0
+1 "
1 S p/a j
v
B TY 0 � L A a.,.e�: �.' %t4 '' A
BUILDING & SAFETY; DE,r-�-';
C 0 N D I T L -
ACCEPTED FOR
SUBJECT TO
151711
S
2 0'8
- �-
- ►-16'
AND ALL AFPLiC''ABLE CODES
L___ Y_LL�) -
NOTE: LANDSCAPE AND FURNITURE
` ARE SHOWN FOR ILLUSTRATION
4 ONLY AND ARE NOT INCLUDED.
• r F
W
llk��
r
CONTRACTOR cannot assume responsibility for
' damage to curbs, sidewalks driveways cement
slabs, sewers, lawns trees fences retaining
wal& sprinklers telephone lines or shrubs
When access is made through a neighbor's
property it is understood that you the owner,
have that neighbor's permission and assume full
R 1T- 8 responsibility.
DATE signature
`
/ +
``2 2' R1 1 ' -,0"! 10' 5
r
(7 1_ 7
r .
131411
WATERFALL
MOTOR HP
4'X6'X36'TALL
FILTER STA RITE 300
W/CRESTA BOULDERS
FILTER RATE 103
�—
(UP TO 24"_DIA.)
HEATER LAARS SIZE 400
(WATERLINE TILE BELOW ROCK)
GENERAL SPECIFICATIONS
SIZE 13 x 34
\REA 380 PERIMETER 7°
)EPTH 3'x5'
-ILE CHOICE T. B.S. SO
2RR- +12"--35'/+18'!='1(
MOTOR HP STA RITE
HP
MOTOR HP
HP
FILTER STA RITE 300
SQ FT
FILTER RATE 103
GPM
HEATER LAARS SIZE 400
BTU
TURNOVER
HRS
SUCTION LINES 2 "
RETURN LINES 2-1.5
"
ckinnnAP0 nnnnGi * n U
,
GASLINE BY S.D.C. FT.
_ +12" .RAISED BOND BEAM POOL LIGHT 400 CLOCK
2':7[t (with tile face on pool side stucco to ELECTRICAL BY. S.D.C.
7 match house on golf course/plant areas)
AUTO CLEANER
CHEM FE
R171_81lu _ 8,6., EDER
5' S' •---SPA RAISED +1 8" PLASTER COLOR WHITE
a DECK BY S. D.C. SQ. 1087
12 CRESTA BOULDERS RANDOM PLACEMENT STEP FT.
(CHUNKY BROWN/GREY UP T0.24 DIA.) SPA SPECS. -
12' 4.22 6" "
- slzE 7 RAISED +18
34' k 13' POOL W/7' SPA LITE 1 WATTS 100
1
18'94" PER X°418 SQFT RI LEVEL SEATS 22" 24" 27"
S- W j ;
35' OF +12" RBB W/TILE
DAMWALL 6 " X '
DESIGNER
DAMWALL TOP the
vy p a I
'
/ J.
S
TILE FACING BELOW �<
CANTILEVER CAP
10' OF +18" RBB W/TILE
12"OF 18" TILE FACE AT SPASPILLWAY
10 SQFT STUCCO +PAINT WALLS
2'X 5' STUCCO EQUIP WALL REQ'D
Jamie
SIZE 3 -11x 12 WIDE
SPILLWAY X OPEN CLOSED
DATE'
#JETS • 4 UPER LOWER
.12-16-96
p !
Name: LJi/1 /-l/�
g
Address: 54051 Southern Hills
City: La Quinta, Ca.
SAWCUT END OF NEW DECK
SENCE
1000 SQFT DEMO EXISTING DECK
6 LIN FT SAWCUT
1087 SQFT NEW DECK
COLOR W/SALT FINISH
102' CANTILEVER
TRACT PGAW LOT# t
i' ` electric `stub
.(4) 2 pvc stubs IN
ANDSCAPE -REPAIRS "
DDITIONAL DRAINAGE RUNS
,., .
w/b ond were s
` 0
®®
s' TALL X 2'WIDE srucco WALL
-
PALM DESERT TEMECULA
gas Stub '----�. 400$tale:
1 /8' , , 0"
73-011 COUNTRY 28910 RANCHO
CLUB DR. STE•F-4 CALIFORNIA RD.
gas & electric meters
ALL AC ESS
l THRU GATES
(HAND EXCAVATION)
=1
HBO COFYY1
PALM DESERT CA. STE 206
TEMECULA CA.
92260 92590
(619) 346-4032 (909)676 -SWIM
S
y