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9904-238 (RPL). LICENSED CONTRACTOR DECLARATION I hereby affirm ider penalty of perjury that I am licensed under provisions of Cha`p'ter 9 (corfimencing with Section 7000) of Division 3 of the Business and Professionals7Code, and my Lice 'e is in full force and effect. License #*' Lic. Class Exp. Date 574127•' A. 09131119! ©ate�'/ Signature of Contra r ., 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, willydo 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). () -1 am exempt under Section , B&P.C. for this reason Date Signature of Owner Y' 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 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, prove ions of Section 3700 of the Labor Code, I shall forthwith comply with tljose•p Isions..F Date: moi, sxf .-s APPlicarit7o"` 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. T. 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. 1 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 authoriz jepresentatives of this City to enter upon ab the ove mentioned property f9r�i4ispection purposes. �Signature,i(Owner/Agent" k�f �' -•! � ! Date BUILDING PERMIT PERMIT# DATE WALUATION $16.200.00 LOT TRACT 9415 KAV., COU r f ADD ESSf ,OWNER CONTRACTOR/DESIGNER/ENGINEER C1;N9'I'i-1p 4P i i CIVIVI f: -LL COi7i 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 O.K to Wrap F.A.U. Framing. Compressor Ins;-; ation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wali Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS steel POOLS - SPAS Set Backs Electric Bond 1/77 Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric MA 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 / Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Coriduit 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: P/L DECK VENEER 6' 9' c\ R3'-6" SPA @ + R61-6-1 5' 5,__ A q 913'-9° .. _9" S'_on 17'_3" - \ 9. 51 �— BENCH 1'�;" \v r' G/E r LIGHT -SWITCH — R4'-0" i i 13'-6" Y - R4'-0" i DOOR 4 SIT & SPIN SPA VERTICAL FINISH . - DECK DECK VENEER 0 A., 30'-6 " CONTRACTOR cannot assn Mme responsibility for GENERAL SPECIFICATIONS damage to curbs. sidewalks driveways, cement SIZE 13'6" X 27 slabs, sewers,I. awns, r e , fences, retaining walls, sprinklers, telephone lines or shrubs, AREA 298 PERIMETER 74 When access is made thro gh a neighbor's DEPTH 3X5 property it is understood that yam, the owner. TILE CHOICE GROUP 3 SQ 65 have that neighbor's permission and assume full _RBB. 10'0+18" responsibility COPING CANTILEVER DATE __— signature CAPACITY 9.500 GAI MOTOR HP STA RITE HP 1.5 MlT(9Tt RPM ® ® Em m nom m = FILTER STA RITE 300 SQ FT FILTER RATE 102 GPM CITYOrr" LA Cad % I NTA HEATER LAARS SIZE. 250 BTU _ TURNOVER 2 HRS BUILDING & SAES TY DEPARTMENT SUCTION LINES 2 " RETURN LINES C3NDITIC1\.A LY SKIMMERM DEL C " ACCEPTED FOR C NS e -RUC I_ ION YES SUBJECT a NSTALI-ATION! AS PER t GASLINE BY SDC FT. 60 POOL LIGHT 400 W CLOCK T104R ELECTRICAL BY. SDC 200 AND LL PPLiCABLE CODES r�A1 PLASTER COLOR WHITE 5/1 �� PV- Q.I„- I DECK BY SDC SQ. 521 - -7��'" DECK TYPE SLT FLASH NTRL GRY NOTE: BOBCAT ACCESS NO WALLS YEr SH, Y Name: CENTURY HOMES AddresS: 79-115 KAYE COURT QIIY:LA QUINTA TRACTMARBELLA LOT# 102 P60149 PALM DESERT TEMECULA N 73-011 COUNTRY .28910 RANCHO I/8"-1' SCALE CLUB DR. STE F-4 CALIFORNIA RD. PALM DESERT CA. STE 206 TEMECULA CA. AND FURNITURE 92260 f FOR ILLUSTRATION (760) 346-4037 92590 (909676 -SWIM ►RE NOT INCLUDED. - - — - I # A- 741 7 STEP FT. SPA SPECS. DESIGNER SIZE 7 RAISED yFS+18" RANDY/EV LITE 100 WATTS RI LEVEL SEATS 22" 24" 27" DATE DAMWALL 6" X 7 FT. 3-25-99 DAMWALL TOP TILE " SPILLWAY SIZE 3"X12" WIDE REVISED SPILLWAY 4 nOFN ri ncFn Name: CENTURY HOMES AddresS: 79-115 KAYE COURT QIIY:LA QUINTA TRACTMARBELLA LOT# 102 P60149 PALM DESERT TEMECULA N 73-011 COUNTRY .28910 RANCHO I/8"-1' SCALE CLUB DR. STE F-4 CALIFORNIA RD. PALM DESERT CA. STE 206 TEMECULA CA. AND FURNITURE 92260 f FOR ILLUSTRATION (760) 346-4037 92590 (909676 -SWIM ►RE NOT INCLUDED. - - — - I # A- 741 7