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0308-258 (RPL)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 # Nc. Class Exp. Date 6t10t80�. 10/31/2( Date f' a Signature of Contt ctor 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). n O 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 of4the Labor Code, for the performance of the work for which this permit is issued: My workers' compensation insurance carrier & :policy no. are: Carrier EXEMPT -DEED gLtBt 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 shall forthwith. comply with those provisions. 'Date: `' s� ,.Applicant I `1I �' ►� 1 r r z a r s41.. 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 180days 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. �' i I Signature (Owner/Agerit) )+ r ' `�' �''� � "�-� y Date / 2° 6 !` BUILDING PERMIT.* PERM'T# DATE .VALUATION LOT �°4 ,•, RACT� °t� Mao= 518,10 .00 215. 17 JOB SITE ADDRESS .94-944 SQU.'1awlK HILLIs APN OWNER CONTRACTOR/DESIGNER/EN (NEER MEI LO1COSC,ARC. i I 3 1�I2A "C c af3T � iTa ��t 54.9" SO'CD'i"j31W HILJ,;3 . 46880 MOMMAW C OVE DRD41,71194 LA QUINTA CA 92253 INDTAX WRIZZ CA 92210 (760)348.1376 CBLO 6697 USE OF PERMIT POOL A14DIO 2 IPA POe)L, RA, AL..41JJASIBARRIERa SRAL I,,BE IN :PL.ACE Ys1L,OR TO PRET PLAcj'1'ER INSPF.CTION..BBQ BY SI,PEIEATIV PL Rml'.r, . . POOL ANWOR SPA 18,000100 LS ' ESTI AT COS OJT C:C)MSE.,tTCWON 16,00.00 IPKRbmlr, 17, 3U.ARIr: }'LAN CHLWK FEE 101.000-439.3113. $132.85 ' COA15'rpat ON FEE 1,01-600-4,18-000 $189.00 2, F.C1dANICALo FEE -- POOL 101.000.41.000. 01.00. PLWTRJC,AL. FEE •. POOL, 101-000-420-000 445.00 PLUMBING FEE POOL 101.00.0.4-19.000 SUB -TOTAL COX.MUCTIWANDPLAU CHECK $407.85 :IY-13 3 FIRE -PAW F.Ehl$0.00 ,.PEiiWY:F'1MS J.D1i9liOW. $407M AUG 202003:. CITY OF LA QUINTA FINANCE DepT �~ 'RECEIPT DAT,6. -� BY AT FI A CTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE TINSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans OX 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 I I BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs Electric Bond 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 Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Kms.. Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring, Los) Voltage Wiring Fixtures Main Service ' Sud Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: _. . JUts AU10HESS 5-!V, il;"Z CEnd42t�, ) /}2L(fPERMIT NUMBER '' OWNER_BUILDER jS6-A13G4>6,! U'00) -S JYF— This form shall be posted on the job with the Building Inspection Card at all times in a conspi6uous place. Only persons appearing on this list or their employees are authorized to work h• h it • on t is lob. Any c anges to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of of building permit. For each applicable trade, all information requested below must be comr lctari by nnnlirant "On -Pilo" is not nn nrrantnhla racnnncc Business License gl%� work and/or the voidance K Trade / Classification Contractor State Contractor's License (, rte..__ .. �.. .. .. ... r .. r .. , Workers Compensation Insurance Cit ss "EARTHWORK (C-12) Company Name Classification (e.g. A, B, C-8) "n�^ t< ' cL_, License Number (xxxxxx) Exp. Date (xx/xz/xx1 Carrier Name (e.g. State Fund; CalComp) '� Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) I�4CONCRETE (C-8) y �I M << �� 3 2 0� � /'3 r/ FRAMING.(C-5) � ` :,7 -_moi 1 8 % STRUCT.:STEEL (C-51) 6i c: 3% MASONRY (C-29) PLUMBING (C-36)�f(�3jS0 10 3! 04 s 1E%7 �}��' byo� G CJ6'7/1 % 0 LATH, PLASTER (C'-35) 4 DRYWALL (C-9) HVAC (C-20)` ELECTRICAL (C-10) 61 31 b S Ali C! " 00�.�� / 01 014 e)& ROOFING (C-39) . 'SHEET METAL (C-43) FLOORING GLAZING (C-17) INSULATION (C72) : S SEWAGE',DISP. (C-42) . PAINTING (C=33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING LANDSCAPING (C-27).. POOL IC 531 I L114tb Di' % b ©0y 3� G�i2. TWO PILASTERS 2'6" x2'6" 18" HI WITH TWO 18" WIDE CASCADES +12" RBB ---- 1 7'-0" 1 1 SPA +18" WITH QUARTZITE VENEER _ AND STACKED QUARTZITE SPILLWAY m BENCH 12" CALIFORNIA TRIM 8" CALIFORNIA TRIM PLANTER P/L LAYOUT OF POOL AND SPA '.ACCEPTED X DATE: m +12" RBB 1-06 Z/ r +12�� „RBB 11'-0" x_5_'_0" � m 1 - / 7'-3f4'-0" m " • R a 3'6" DEEP o R °` 5' DEEP` /V 32'-0" o, o Ln 0 SKIMMER o AUTOFILL o" o� - t- - t JOE MELLO & GINNY COSCARELLI� RESIDENCE k i 22 -3'' o , ■ UMBRELLA SLEEVE RAISED PLANTER QUARTZITE BENCH +18' - TANNING LEDGE PLANTER MASONRY BBQ 3'X6'X 36" HI QUARTZITE TOP STUCCO SIDES EQUIPMENT WALL 4' HI STUCCO FINISH PD/It 4' LONG., EQ 7'-6" 1404 ITY OF LA QUINTA I ILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION BY oPF-lce EMBRAND POOLS & SPAS INC CA. LIC. 800680 C-53 78-910 VIA VENTANA TEL (760)'/71A292153 FAX (760) 771-2181 POOL &SPA SPECS POOL..SIZE: 32' X 12' .POOL- AREA: 346 SF POOL PER. 6 FT POOLPEPTH: 3'6" -TO 5' ' SPA SIZE: 7'X7' . . -SPA AREA: 44 SF, SPA PER: 2.6 FT - DECK AREA: 1,32.9 SF COLOR/FINISH: PUMP:_ 2 HP FILTER: 400 SF _. HEATER: 400K BTU CONTROL: _JANDY RS -4 CHLOR: A UARITE CLEANER: NAVIGATOR PEBBLE: PEBBLE FINISH TILE: PEBBLE WATERLINE POOL LIGHT: 1-40OW SPA LIGHT:! -100 W RBB: +12" MISC: SPA SIDE.CONTROL JOE MELLO & GINNY COSCARELLI ADDRESS: 54-944 SOUTHERN HILL CITY: LA OUINTA LOT : DATE: SCALE: 1 "=8' DRAWN Y: JOB 1 -