9906-017 (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
` X7127 OS/31/19,.
Dae . ` r Signature of Contracrtor --�"4—___-7 ~� J/
V 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 & Profess;onals Code).
( ) 1, as owner of the property,,am exclusively contracting with licensed
contractors to construct the. project (Sec. 7044, Business & Professionals
Code). s
( ) 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.
( 1 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.
( ) .I certify that inthe 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 shallrforthwith comply with those provisions.
Date: ( `k'✓,Applicant
Warning: Failure to secure Workers' Compensation coverage,is unlawful and
shall subject an employer to criminal penalties and civil fines Up1,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 applicator 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 laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
,,ignature (Owner/Agent). - --- "'W r #e-- '�� Date
BUILDING PERMIT PERMIT9
904-017
DATE J .;/199VALUATION .S16.*e00:IDO LOT TRACT
JOB SITE
ADDRESS %9-130 KAYE �:t��JR �
APN -
OWNER.
CONTRACTORDESIGNER ENGINEER
Ej\�yU{RY/P,Q , LtC()Ni.,�•�111I`
,i7vlDODSON iUMSIy .iGN
1535 SO. 4)" STREET,. MT. 11-200
,17_101 301 i COUNTIRY C;f UB DR, S1- VVE F4
SAN :jBss'iiNA.f DINO CA92409
RALM DESS U CA. 97260
(760)3.6-4032 CBL 1044
USE OF PERMIT
POOL MWOR SPA
Pf?OUSPA ONLY - ALARiM.<V`f X RPM1 CtS ]Y LJPT B,E; I:N;PLACIr AT $
Pi•lPLAS1['1�IL iMSJ�k:..CCIOA7 p
POOL ANWOR _SRA 16,400,00 LS
EST [rev t%'.FE0 COwST0.�
j
PLAN CHECK FE 101-00-434-31.8 $117A%
AlECIIAbUCAI, FW, --..POOL 101.001421-000 $24,00
HLUMICAL FEZ -- K)OL E0,f-000-420.000 V15.00
PLUMBING Mft--POOL, 101.000419-000 $27.00
LESS PRE-P.AUD FEES
$0.00
b
..'1.°�d�'A1,:�'It.1��xd�'1+.1•t��.S.lb'iJE,1gOW
4.i�3,d9i.4
RECEIPT
DATE
BY C /
DATE FINALED
INSPECTOR
INSPECTION RECORD
r
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 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall 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
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 e11715.9
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbitures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
RAISED BOND BEAM CROSS—SECTION
OUTSIDE EDGE FINISH
WATERPROOF BOND BEAM REVISION ALERT
DECKING
z-- TWO SPRAYHEADS
GUNITE I ____1 �7 BACKSIDE @+12" ;
81-09
�( P/L
G
,50 .18'9"
P OWN
12 9"/
BOBCAT ACCESS
NO WALLS YET
LEAVE DIRT IF NrECESSAR�
-- 31'-3" -
I
i n ��%►
81-6"
12'-6" — 11'49 " _
'A
25'6"
R61-6"
0
43'-3"
R3'-6"
v
SPA @+12"
I \
R4'-6"
22'-3" \\
G/E
RESIDENC
r•
f
r
SIT & SPIN SPA VERTICAL FINISH
DECK
DECK
P/L
CONTRACTOR cannot assum_e_resa_a-tSbkty�
aT
1-1
•�-� l .1�-••• 1. • 1- • •,
..,. .
AIRPIPE
DECK VENEER
R6'-3 "
REVISED
5-29-99
GENERAL SPECIFICATIONS
SIZE 11'6" X 32'
AREA 309 PERIMETER 83
DEPTH 3X5
TILE CHOICE GROUP 3 SQ,96
RBB 35'9+12"
COPING CANTILEVER
PUMP CAPACITY 103 GPM
MOTOR HP STA RITF HP 1.5
MOTIOMAJ&=m====N -"m■
FILTER STA RITE 300 SQ FT
FILTER RATE 102 GPM
HEATER LAARS SIZE 250 BTU
TURNOVER 2 HRS
SUCTION LINES 2 of
RETURN LINES 2 if
SKIMMER MODEL AMERICAN If
HECK VALVE YES
SASLINE BY SDC FT. 60
POOL LIGHT 400 W CLOCKT104R
_LECTRICAL BY. SDC FT. 200
'LASTER COLOR WHITE
writ Ry Snc SO. 700
DESIGNER
RANDY/EV
DATE
3-25-99
REVISED
in
I
STEP FT.
SPA SPECS.
SIZE 7 RAISED YES +12'
LITE 100 WATTS
TRI LEVEL SEATS 22" 24" 27"
DAMWALL 6 " X 7 FT.
DAMWALL TOP TILE "
SPILLWAY SIZE 3" X 12" WIDE
SPILLWAY XX OPEN L D
IF 1.1% 4 11PFR I OWFR
I \
R4'-6"
22'-3" \\
G/E
RESIDENC
r•
f
r
SIT & SPIN SPA VERTICAL FINISH
DECK
DECK
P/L
CONTRACTOR cannot assum_e_resa_a-tSbkty�
aT
1-1
•�-� l .1�-••• 1. • 1- • •,
..,. .
AIRPIPE
DECK VENEER
R6'-3 "
REVISED
5-29-99
GENERAL SPECIFICATIONS
SIZE 11'6" X 32'
AREA 309 PERIMETER 83
DEPTH 3X5
TILE CHOICE GROUP 3 SQ,96
RBB 35'9+12"
COPING CANTILEVER
PUMP CAPACITY 103 GPM
MOTOR HP STA RITF HP 1.5
MOTIOMAJ&=m====N -"m■
FILTER STA RITE 300 SQ FT
FILTER RATE 102 GPM
HEATER LAARS SIZE 250 BTU
TURNOVER 2 HRS
SUCTION LINES 2 of
RETURN LINES 2 if
SKIMMER MODEL AMERICAN If
HECK VALVE YES
SASLINE BY SDC FT. 60
POOL LIGHT 400 W CLOCKT104R
_LECTRICAL BY. SDC FT. 200
'LASTER COLOR WHITE
writ Ry Snc SO. 700
DESIGNER
RANDY/EV
DATE
3-25-99
REVISED
in
DECK TYPESLT FNSH
STEP FT.
SPA SPECS.
SIZE 7 RAISED YES +12'
LITE 100 WATTS
TRI LEVEL SEATS 22" 24" 27"
DAMWALL 6 " X 7 FT.
DAMWALL TOP TILE "
SPILLWAY SIZE 3" X 12" WIDE
SPILLWAY XX OPEN L D
IF 1.1% 4 11PFR I OWFR
Name: CENTURY HOMES
Address: 79-130 KAYE COURT
Qfty: LA QUINTA
TRACT MARBELLA LOT# 95
Do'dsor
P0015
PALM DESERT TEMECULA
73-011 COUNTRY 28910 RANCHO
_ CLUB DR. STE F-4. CALIFORNIA RD.
1/8, —1, SCALE PALM DESERT CA. STE 206
LANDSCAPE AND FURNITURE 92260 TEMECULA CA.
ARE SHOWN FOR ILLUSTRATION (76o) 346-4032 90
90
ONLY AND ARE NOT INCLUDED. (909)676 -SWIM
1