9906-082 (RPL)r _
LICENSED CONTRACTOR DECLARATION
,_I areby 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 DATE(
Professionals Code, and my License is in full force and effect. t
License # Lic. Class Exp. Date t
JOB SITE
374,12 i A. O�tJ.11 l`l: ADDRESS
/Date ' Signature of Contractor P -'~ OWNER
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 ti ' Policy No.
TATE F��1 73 ' AMOM0019a9
(This section need not be completed if the permit valuation` is for $100.00 or less).
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 those7provisions.'Y t r
Date: Applicant
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.. ,
BUILDING PERMIT
VALUATION $7A),54)0.410i LOT
ow yr " r'
A . a_1 a a
794110 T+:.ra"E COURT
LA QUINTA , .
USE OF PERMIT
POOL ANDIOR SPA
PERMIT #
TRACT
APN
CONTRACTOR/DESIGNER/ENGINEER
G•T'6 Ff.'f1fi7�CelTt /-'I'�-h?Q`r'r 1 RI-11r^fa~r
3011. CW+(�'C'��Y -CLUB i R.,, SU%TE F4
CA 92253 PXL,M U:laS4.WV CA X2260
(766;346-1032 0.31.11 A044
POOL &; .SPA i3TvLY, A:i.ri;i`tMS ,ti.'£�WO#R BARRMR lsEQVIRED FOR
PRR9-PL.AH('c
POOL ANIVORMI,
>T"ER NAIT FRIdt. SUMMARY
XS00.00 LS
C ()N8JrRW JCT !0 N 11TE E.
'101-00-415-W0
$2)bM
MECHANICAL FEE --POOL
101•000-111211.000
$24V
,FLEtCCRICAL FE.E --, POOL
101-000-420-000
545.00
PLLMi3INa'FEE. -- POOL
101-000-419-000
$47.00
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 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 i pection purposes. RECEIPT
-f �r
S ig ature (Owner/Agent)-''��rT�'� Date
LESS ME --PAID FE :-S
TOMAL PERMIT FEES DUE NI ONY
a�
DATE I BY t I DATE FINALED I INSPECTOR
x,45?, 40
SOO)
5452,40
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
I 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
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
Gas Piping
Gas Test
Appliances
Final
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:
y . 1
+18"BB
-+15'TOP OF D&M
WALL
WATERLINE
40"
SIT & SPIN SPA VERTICAL FINISH
DECK
DECK
VENEER
BACKSIDE 9+18"
SPA @+18"
CONTRACTOR cannot tl ••1 . for
R,11.. .curbs-. .. .1 .. 11-1
low 0=1 I it
iFlo =-q ill.
il--
responsibdity,
DATE
REVISION*ALER
r/L
R3'-6 " LEAVE DIRT S NE SARY
� FREEFORM
`-
R4'-6" +18"
-�
AIRPIPE 13'
8' 81-6" 3 ' 17-9"
231-3-
1
+18
5 -9"
5� � 'TANNING LEDGE
1
14-9 CITY
A
22'-6�'-6" ' BUILD
/ p .
RS' 28'3 •
/ FREEFORM FOR
20'-6"
BENCH ;
GE
LIGHT SWITCH /
I ATE
7' N I �r
Y WIDE SIDEWALK TO GATE
APPROX Y X 50'
T
RESIDENCE. .
BOBCAT ACCESS
NO ACCESS REPAIR
P/L
GENERAL SPECIFICATIONS
SIZE 17X35
kRFA W PERIMETER 95
RBB 35'@+18"
COPING CANTILEVER
103
MOTORN"======tel m
FILTER STA RITE 300 SQ FT
FILTER RATE 102 GPM
HEATER LAARS SIZE 250 BTU
TURNOVER 2 HRS
SUCTION LINES 2 "
RETURN LINES 2 "
SKIMMER MODEL 2 "
CHECK VALVE AMERICAN
GASLINE BY SDC FT. 120
POOL LIGHT 400 W CLOCK T104R
ELECTRICAL BY. SDC FT -250
AUTOI(!Lmmt,7"======
sHENf.TMM=������
PEBBLE FINISH TAHOE BLUE
1FCIC RY SDC SO.1320
DECK TYPE SLT FLASH NTRLGRY
DF LA Q U I N TA STEP FT.
SPA SPECS.
JG & SAFETY DEPT. DESIGNER SIZE 7 RAISED YES+18"
'PROVED- — LITE -100 —WATTS—,-,—= --
RANDY /EV TRI LEVEL SEATS 22" 24" 27"
;ONSTRUCTION DATE DAMWALL STACKED
5-26-99 DAMWALL TOP QUARTZITE"
SPILLWAY SIZE 3" X 12" WIDE
REVISED SPILLWAY XX OPEN CLOSED
^n „ # JET 4 UPER LOWER
v h !X 6 i4 99
Name: CENTURY HOMES/ TUTTLE
Y WIDE SIDEWALK TO
DRIVEWAY Address: 79-1.40 KAYE CT
APPROX TX 50' CAA: LA QUINTA
TRACTMARBELLA LM 94
Bodsoff
Poo/s
PALM DESERT TEMECULA
73-011 COUNTRY - 28910 RANCHO
1/8"=1' SCALE CLUB DR. STE F-4 SAE IFORNIA RD.
PALM DESERT CA. TEMECULA CA.
LANDSCAPE AND FURNITURE 92260
ARE SHOWN FOR ILLUSTRATION (760) 346-4032 92590
ONLY AND ARE NOT INCLUDED. !~9o91f�76-SWIM