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0304-059 (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 # Lic. Class Exp. Date 4 04 ,10103 Date ^'Signature of Contr 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). () 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 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 SteTe ltttlO Policy No. 104441W -D2 (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.L"abor Code; I sli 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 ,o Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping 02) PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans OX for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation _ (� Gvs Piping Cas Test Appliances ZVI Final vooc 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: MERRITT POOL CONSTRUCTION Inc. 41-995 Boardwolk Palm Desert 760-56"20D Calif. tic.# 542660 cn_ — — — — — — — — — -- --rn.-1 — --- -- — — — — .. I 6!s Avco H� ID I 12'D IQ eil MMER ED 38'0 l I I , DECKM* DY OTHERS i o WD SPECIFICATIONS Pool Size..... 12'-0" X 38`-0"_ Spa Size... -W-6' Oct. Pool Areu,..450 sq.ft. Spa, Area... 50 Pool perimeter ... 300 ft. Spa Perimeter.... 28 FT, Pool Depth 3'6" X 5' Spa EEeva. , ..+ I&' Spa Jets.... 4 . Uois..2 /400 1/100 Autotl IL .. M. r. rroavcts EQUIPMENT Pumvhntafr W.F. J.5 H.P. Nter—Pentair CC420 Heater Telodyne Lo6ws. EPL400 Ti? er...Jandy Aquaswitch beAiig ..... BV OTHERS Tile Choice ... CP108 (Classic) PLASTER . French Grey PONDEROSA HOME. Lor 334 61ODeL UI QVINTA