0205-145 (RPL)` LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of.perjury that'l 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. c
License # Lic. Class f.• xp. Date _
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_ X21* 2Signature of
OWNER -BUILDER
N
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:,;T
( ) I, as owner of the property,r 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
�b
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.
Sr( I have and will maintain workers' compensation insurance, as required by
ction 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 STAI"iy.�l"tYND Policy No. 22902-0009671
(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 asrt'o�become subject to the
workers' compensation laws of California, and agree that if I should become
subject to the workers' compensation provisions 0f Sec Ion 3700 of the Labor.•
Code,. I shall forthwith comply with those provisions.
Date: 'S Applicant—., -6 '•'x� %, la5i7 tee' 'i't •v.
Warning: Failure to secure Workers' Compen"sati6n dbVefa`ge is'urilawful and
shall subject an employer to criminal penalties and civil fines up to $100�,qp0"in
addition to the cost of compensation`damages as provided for inSection 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 tt(e conditions and restrictions set forth on: his
application. w
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)Aws relating to the building
construction, and hereby ?uthorize representativ s of this City to enter upon
the above-mentioned . ..Zrty for;inspect- , Urposes
Signature (Owner/Agent)
PERMIT#
BUILDING`PERMIT
DATE / VALUATION1 4¢�:94 (p y nip LOT TRACT
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JOB SITEti `
S 52-'775 A��.TiAa�,.�.:. ., 'rCa
APN
'ADS
OWNER. tint : ' ,'ri
CONTRACTOR/ DESIGNER/ EN &NEER
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204
LA QUINT A i SpA 92253
T:A c�U:kl"r'E'.A. CA 92a.11 3
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.(760)564-1866 CIAR. 1359
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USE OF PERMITAM
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SHALL BE IN PLACEPRIOR O
pP•lL�',IITc'•�USId�.�A+t,�7R.1��i];1t�",,Fq�.�YiyD,Att�:yl�2.`1.En''
I.'XtiJ,r•.�bahe�TY ��: �f!1 sAf�%.'M•+34F1�1. .
PO('A, A.NbVOR IPA 14000.0,0 Ls
jumma
PLAN ttiHE?CK I > 1lil at?ili}- # 9 18 $1€ 30
CON,-, 'RIUCTIGN WE 101-000-418-000 �33�.Qii
MECHd' 141c.rui P'Li"ft; -- POOL 101,, (i O.4 1-000 %X00
-ELIWI RIC. L FEE •- POO1, 201-i�li'1.IU-tJ2E1-diI?W �f�:OC1
17'L,U/M 0 FEE. — POOL 101-000419-000
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CITY OF LAQUINTA
FINANCEDEPT-
RECEIPT
DATE' J :
�'�
BY f ..--- ^-�
D E FINALED
INSPECTOR
t
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 Wali 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
Final
Underground Plbg. Test
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)
ADD 1 BLOCK TO TOP
PROPERTY LINE 65.0' OF EXISTING WALL
I
If
COLUMN
5k5' CONC. OQtv�� SLOPE 1 "� MIN. p j o ?
/ PAD FLOW LINE 7� ; i o w
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3'-0" t'
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(3' 'GALE
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F.F.Y-0" ABOVE THE CURB
PAD: 0'-6" ABOVE CURB MEASURED
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0 I CENTER OF LOT Q
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A.P.N.: 773-323-014 ,•;�:•5.. �O � I � ,
j ADDRESS: 52-775 AVENIDAVALlEJO 4 6_ �' ►;`- i
' 1L.. . wnlrr ,
1' 0" resume ,
LEGAL: LOT i t . aLOCK t Ise .' 1'
SANTA CARMELRA QVALE LA IXINTA
WntER .• O nV 10
rEIUA 72. ; ILL
` •POOL.;,. Q ...33
ROLL -UP GARAGE DOOR DECK
1' 3'-0" 1' 0" ^�� 1,-6,:
POOL Z :'REtUf ti 7 '
3' GATE r . POOL WAT
EQl}tF'?� FILTERco 0
rE RN
3 til PUMP DRAIN _ a LENCH DESIGN GROUP
of Y _ EAT = WAT R-�� " O P.O. BOX 450
Tp ����00�� - U` Q FAAI 2•
> _ LA ouwTA, (A M53
Z, Jm`� :,f / ' • % na1n.ITm fM.uu uwne�fe,.me
U �t �� ",:: f ARCI11'1'F.C`f1JR1F CONSTRUCTION
:• • j
'u o — SEAT SKIMME
w
r a
O .a , `.%-. ':f.'':'`' �IEW S HIGH BKOWN
(V BLOCK WALL
w '12" RAISED
Q BEAMD PIANS PREPARED OY:
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LENDEL VENTURES, INC.
aba ;
I,ENCII DESIGN GROUP
i
A.P. LENCII n
PRESIDENT
CURB
DRIVEWAY APPROACH REQUIRES A
SEPARATE PERMIT AND INSPECTION
FROM CITY OF LA QUINTA PUBLIC
WORKS DEPARTMENT
AVENIDA VALLEJO
SITE. PLAN
SHEET # 1
CITY OF LA Q INTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE5/1j Oz gy S
SPA -POOL DETAIL
SCALE: NONE
2 BENCH DETAIL
SCALE: NONE ,
LENCH IDESIGN GROUP
P.O. BOX 490..
LA QUINTA, G1 42257
" PNOYS'i li(AI SN1566 FA\, Ofl0 SN361
ARCHITECTURE & CON517RUMON
" PIANS PREPARED RV:
LENDEI, VENTURES, INC.
dba "
LENCH DESIGN GROUP
A.P. LENCII II
PRESIDENT
SHEET # 2