0004-161 (RPL)LICENSED CONTRACTOR DECLARATION
PF 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
5 127 A „: tl$/'.41/2t
,.,
Date'fhll'�0�Signatup,oftontracto'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, 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.
(- -' 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 STATI~ MD Policy No. 046,00400 934
(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 Labor
Codre, I shalLforthwith comply with those provsioos:" �C�.,,,.�,...
Date: + �� '�Zoi•? Applicant -""�
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
..of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application. 4%0.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or. pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation...
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction,` and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent)' Date
BUILDING PERMIT PERMIT#
I et
DATE/JI yC?L VALUATION . LOT MMI -16,11. TRACT
DATE//]
JOB SITE
APN
ADDRESS 57-615 MIKERM.A.0 MN DIUVE
OWNER
CONTRACTOR/DESIGNER/ENGINEER
I&CrliABL CROSS
MEWIDODSWCONT�fcXJ'G'TIOiS
57-6151 �t".lE[tiC.A0I?RWE
73011 COUNTRY CLUB TAR., SCTT.lk,+:t��4
LA Q)TI i 1A CA 192253
P.A,LM T.}ESKR ' CA. 922�4'j
�►{
(7610)346.4032 CBL# 1,044
USE OF PERMITI,-
POOL AND/OR &
POOL & SPA'CMY - ALARNTABA1t:RIE—RIS S1t.AU, BE IN PLACE AT C �
PRE-Pi.�STEPt INSPECTION, TION,
VALUATION 3 e,000.00 1Z
f.
E$IWAM COST OF C01gS'n?.UCF1:0K
32,000.00
FERAW I`.It R 9QII;11 ARY
;'LAN CHECK FEE 101.000.439.318 5141,38
,
CONSTRt3CTION Fft 101-040-418-000 $297-54
'
MELHAOICAL FEE -- POOH. 101'.00("21'-000 $24400
ELWI UC,AI. YEE -- POOL 101-000-420-000 $aoo
PLUMBING. FEE •• POO€, 101.000--419-000 Sd"100
-TOTAT, CON 2UCTION ,AND PLAN' CIMC
$586.96
MSS P)R. PAU
$0.00
T_ OTAL MkW_'FYE 6 DVE NOW
Ilt N .
RECEIPT
DATE
B i7 {1
.Mf�
DATE FINALED
INSPECTOR
1%J V .
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
OX 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
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
s ipin
PLUMBING APPROVALSGas
Test
Electric Final
Waste Lines -LZ
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)
=FROM Mike and Betty Cross
r
.A
WAW
A E E
March 29, 2000
FAX NO. 17148322166 Apr. 11 2000.10:40AM F2
PC;A 'FEST II RESIDENTIAL ASSOCIATION, INC:. S
P.O. BOX 1282, LA QU1N'IA.. CA 92253
(760) 776-51W FAX (760) 776-5111
11
Mr. & Mrs. C. Michael Cross
57-615 lntarlachen
_.La Quinta, CA 92253
Reference: Architectural Change Request for the Addition of Patio Dec ng, Spa, BQ and
Landscaping
Dear Mr.. & Mrs. Cross:
The Landscape Committee and the PUD Architectural Committee reviewed your request for a
room addition and additional landscaping at their meetings on March 9th and March 14th,
respectively.
The PUD Architectural Committee wishes to advise that your application has been approved as
submitted with the following conditions:
The boulders cannot encroach on the 5'setback
• The maximum height of the boulders may not exceed 24"
The Landscape Committee wishes to advise that your application has been approved as
submitted with the following conditions:
�1
The following plants are not included on the Association's Approved Plant Palette and
must be substituted for shrubs that are on the plant palette. For easy identification,
these unacceptable plants are identified by the symbol on the drawing as follows: DIB,
SG, 5L, LAM, LNG, LSS, OBM. Please note_, on all other homes the bender board is being
replaced with' a brownish Trex like material.
Review by the Committee is only for general conformance with the architectural guidelines. it is
the responsibility of the owner to fully understand and conform to the architedura! guidelines
criteria whether or not all deficiencies are noted during review. It is also the owner's full
responsibility to field verify all existing conditions. The Committee's decision, with regard to
project design will be final. Please refer to the PUD Architectural Guidelines and Application for
Change for all required submittals.
Please contact Raphael Villareal, supervisor for valley Gardening Service at 760/399-1844 and
Carol Fuller, the ASsoCiation Manager, prior to any irrigation modifications associated with this
change. Upon completion of changes, please contact Carol Fuller. Damage to the landscaping,
i.e., shrubs, trees, flowers and turf is the responsibility of the contractor. The landscaping must
be brought back to its original condition when the project is completed.
FROM Mike and Fetty Cross FAX NO. 17148322166 Apr. 11 2000 10:40AM P3
y
Mr. & Mrs. C. Michael Cross
Page Two
Approvals given by the Architectural Committee are good for only sic months from the date
on the approval letter. After that time a new application must be submitted.
If you have any additional questions or concerns, please do not hesitate to contact Carol Fuller,
Association Manager, at 760/776-5100, Ext. 20.
Sincerely, .
AGA WEST II RESIDENTIAL ASSOCIATION
For the
�PUD
�Architectural Committee
Cara Fuller
Association Manager
cc: Board of Directors
Unit File
P/L
P/L
SEE ATTACHED
PAGES FOR
DETAILS
0
0
0
0
v
ATTACHED DETAIL PLANS TO GO WITH THIS CONSTRUCTION PLAN
BE SURE TO REVIEW ALL PLANS PRIOR TO EACH STAGE OF CONSTRUCTION
CONTRACTOR •: .-.nn• aresponsibility
danace to . . ... .i u
• �.
Ile
..v
DATE sip -nature
r
26'6
NOTE TO CON STRUCTION
BOULDERS NOT LESS SLEEVE ALL PLANTERS MAKE SURE TO HAVE ATTACHED
THAN 24" SPEC SHEETS FROM ARCHITECT
WITH EACH PLAN.
NOTE ANY SPECIFIC CALL OUTS FOR
�q P/A FINISH DETAILS AS NOTED.
-12" _
BBQ
BY OTHERS TSI
G&E '
_— 9 --SDC ---__
I
I
I P/
I
l----------
A'RE-INSPECTION FEE OF $30
WILL BE CHARGED IF THE APPROVED
PLANS AND JOB CARD ARE NOT ON
THE SITE FOR A SCHEDULED
INSPECTION.
.NO EXCEPTIONS!
EXISTING DECK
TO REMAIN
-
R R8" 1 ,
\ -5
2� I
A \� 5'
v
�:
I P/A 1
I AP I
-1- NI
AQUASWITCH
EXACT LOCATION TO BE
DETERMINED
C/Ty OF LA QUANT
BUILDING & SAFE A
� SEPT,
�PPR
�
FOR.Cp ��D
NSTRUCTION
DATE -L/
eY
_ RESIDENCE
G
18'
2'-9"
5'
P/L
R810
'11 '-9 "
NOTE EQUIP
LOCATION NEAR
GAS AND ELEC
1
EQ
20'
HAND DIG SPA AND DECKING
AREA SURROUNDING SPA
RPIPE
/8°-_1'�SC
NOTE: LANDSCAM-AND FURNII
ARE SHOWN FOR ILLUSTRATIO]
ONLY AND ARE NOT INCLUDED.
GENERAL SPECIFICATIONS
SIZE 8 h
kREA 40 PERIMETER 24
3'6'
FILE CHOICE VM662 sn
I Uf WM-W*W0Wb.W — — — — OWA.0
MO%R 4P -------HP
FILTER STA RITE
300 SQ FT
FILTER RATE
102 GPM
HEATER LAARS SIZE
400 BTI
TURNOVER
2 HRS
SUCTION LINES
2 "
RETURN LINES
2 "
SKIMMER MODEL AMERICAN
"
CHECK Sh4L40E--------
GASLINE BY SDC
FT.
POOL LIGHT 400 W
CLOCK An[IA
In
UIU LLtANt--------HE", ----
PEBBLE SANDY BEACH
FrK Ry cnr SO. 1 115
Name* MR AND MRS MIKE CROSS
Address: 57-615 INTERLOCHEN DRIVE
LA QUINTA
TRACT PGA WEST LOT#
Do son
POO/S
PALM DESERT TEMECULA
73-011 COUNTRY 28910 RANCHO
CLUB DR. STE F-4 CALIFORNIA RD.
PALM DESERT CA. STE 206
92260 TEMECULA CA.
(760) 346-4032 92590
(909)676 -SWIM
.a
DECK TYPE VARIOUS SPEC BY ARCH.
STEP FT.
SPA SPECS.
DESIGNER
SIZE 8 RAISED +18"
RANDY/EV
LITE 100 WATTS
TRI LEVEL SEATS.22" 24" 27"
DATE
DAMWAtL— -1'-E — +T-% — — — — -
3-14-00
DAMWA&�L-T-QR — — — — — s= -
SPILL"AT SYLC — r' X- — —'WIDE'
REVISED
SPI&WA1'- — -f)P W — —-PIfKFn
Name* MR AND MRS MIKE CROSS
Address: 57-615 INTERLOCHEN DRIVE
LA QUINTA
TRACT PGA WEST LOT#
Do son
POO/S
PALM DESERT TEMECULA
73-011 COUNTRY 28910 RANCHO
CLUB DR. STE F-4 CALIFORNIA RD.
PALM DESERT CA. STE 206
92260 TEMECULA CA.
(760) 346-4032 92590
(909)676 -SWIM
.a