0403-187 (RPL)LICENSED CONTRACTOR DECLARATION
I he Eby affier6 under penalty of pei`jury that I am licensed under provisions of
H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
C14 W Professionals Code, and my License is in full force and effect.
O =) ch License # Lic. Class Exp. Date
�w�'� al F3C12C353T 4l3'YYC
oZ t Date L' Signature of Contractor -
CO O.
r—F- � OWNER -BUILDER DECLARATION
Hd I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following_ reason:
Z_ ( ) 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).
co () I am exempt under Section , B&P.C. for this reason
LO
N Date Signature of Owner
ON
CA
Q WORKER'S COMPENSATION DECLARATION
p cc I hereby affirm under penalty of perjury one of the following declarations:
LO O ( ) I have and will maintain a certificate of consent to self -insure for workers'
X U compensation, as provided for by Section 3700 of the Labor Code, for the
O - Q performance of the work for which this permit is issued.
m Q U ,1( ) I have and will maintain workers' compensation insurance, as required by
D U Q Section 3700 of the Labor Code, for the performance of the work for which this
d rn H permit is issued. My workers' compensation insurance carrier & policy no. are:
? z CarrierS'1 w. FUND . Policy No. 16445°`7$-290'2
w
J
(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
3subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
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.
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 t
any permit issued as a result of this applicaton agrees to, & shall, indemnif D
& hold harmless the City of La Quinta, its officers, agents and employee
2. Any permit issued as a result of this application becomes null and void i
work is not commenced within 180 days from date of issuance of suc
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. l 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 inspe'ction'purposes.
Signature (Owner/Agent) ° Date-
BUILDING PERMIT PERMIT#
ON A-187
DATE VALUATION LOT TRACT
JOB SITE j
APN '
ADDRESS 57-745 f'.I;.i?.X ArQ7fq
OWNER "'
CONTRACTOR/DESIGNER/ENGINEER
MC K EVA \RS
I xlAA+IC)M) P001S AND SPAS
57.74.5 JNI;�x'.Idi-.C::IiRN
i7-700 ENI -1k; L X) € AI4E q•faMM H
!.AQVIITTA, CA 92253
PAU.4DMI EF CA -92 I1
USE OF PERMIT
P001..ANY:fOR 03M
DEMO OF iXIS,f'f 0 SRAMATEP, F EATUR& NEW SPA 0WL V-J1.UMf r L7L 013
NOT INCLUDE 9QUIPMERT ENC'L,00URF WAL,L9,
M r
POOL AINDICIR SPA lO,flflfl.(3fl I.S
ESTMATRI) COrW OF CONS,111Rt[TMON
- 1010019.00
PERMIT ME 60hWARY
PLAN CH EY EFIF. 101 -000-4 9-338 SX03
CONr;'I UCTION 1EL
c, >
DEMOUTION FSE 101-000-423-000 a $43: 0
N'l,Ir.,CTR?CAL F ?L - POOL 101-000-412-0-000
�f X45. G
1.321.Gfl
PL,Utt8BRIG F�''EE -� POOL. 101 -000-41 9-00 �
� F
a � �-b' r CC2+%�i�:�.T3�.� ON AND PLAN Cl -WAN
$310.03
0 LTn.9 x'�-PA1, T�I�9
$0.00
MAR 112004 :y : �aL'PE:-'1W'F : •S DUB Now
CiFINANCE DEM. OF LA A
,-1
RECEIPT
DATE
I BY ;
DATE FINALED
INSPECTOR
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
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I
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
Gas Piping
Encapsulation
_ �Y
Gas Test
Appliances
Final
Z l
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:
-66104 � I Ur-) I I -. C f I mt: t vfim uumrmiv t
sate/Time MAR-01-2004(MON) 17:05
j3/01/2004 16:13 7765111
Match 1. 2004
Mr. Ride Evims
57-745 Interlaclicn
La Quinta. CA 92253
krMA) r. vve/rive
7765111 P. 001
MONARCH PAGE 01
PGA WEST 11 RESiDENTIAL ASSOCIATION, INC.
P.O. BOX 1282, LA.QUINTA, CA 92253
(760) 776-5100 FAX (700) 776-5111
Rcfercn=. 57-745 li tcrlachen, L3 Quinta, CA
ArChiteeturli C1larage Request - Fircplacr- remodel spa arca and patio cover
Deter Mr. Evyta;
711e Architectural Committee reviewed your plans to add a fKcpl3cc, patio cover and remodel idle spa arca.
'1710 eommittce approved die freplace and spa arca. However, ager csrdul review and consideration. the
, c- lc ectei3 nor to approve the palia cow Uclfib7.+ThisTM,- •SPR( Rte` -dUV lttfnT {Fc I'GA
WEST I RI;SiDENTIAL ASSOCIATION. -
Reviav by the Committee is only for Renertl confotnaalux with the architcaunl guidelines. It is the
responsibility of dte owner ao .flilty undersand and conform to die 3rdritectural guidelines criteria ahetber
or not all deficiencies arc noted during review. It is also the owner's full responsibility to field verify all
existing conditions. 7110 Comnliuco'9 decision with rc6,, t to prof ea design will be final. Please refer to
the Architectural Rules for a!1 rcrluired submittals.
Approvals given by the Architectural Coinrnincc are good for only six. months from the d3tc on the
npprov41 Iona. If constriletion huts not commenced within sic monp� afbor the project approval date. q t1C%v
application must be m bmittcd.
If baturid gate is to be used in your Ilrcplicc. the itlstallation mast be pernti
and inspected ncd by The Clrr of La Quints
Please contact Javier colwm. s, supervisor for Vanes GardCWrag d: Landscape at 760n76-6667 anal Carol
-
on the Association Marwger, prior to any imgation modifications associated with this change. Dimlage
to the landscaping. i.e., sluubs. bees. flowers and heel is rho responsibility of the contractor. The
landscaping must be brought back to its original condition when the proiect is comptettd Thers was no
l4nd=0119 shown on this drawing and dtemlore. Ibis approval applies to the referenced items only.
Upon completion of your pro
Change. jcC4 please complete and )tlum -Me Notice of Completion of Architectural
!n the meantime If you have any additional questions or concerns, please do not hesitate to contact Carol
Fuller. Associalion Manager. at 7oon76-510A. Ext. 20.
Sincerely.
PGA WEST 13 RESIDENTIAL ASSOCIATION
For the Architectural Committcc
Carat Fldlcr. CCAM
Association Manager
cc, Board of Directors
Unit Filc
i
o
i
P.L:
0 ;m
� O
O
OC
cl-
Q L.Li
_ d
F-
LA:
d
co
J
_,S jyile>►rojj� Daus - 6�c,K �vl—_v 4� %
GOLF COURSE
F. .•...
WX "
EXISTING PATIO
f
WATER FEATURE-\ -DEMO AREA
AREA TO REMAIN
AW CUT
--;—'�An
1 EXISTNG PATIO I .
CITY OF LA QUINTA y -- -
BUILDING & SAFETY DEPT. Exlsrlrac PATIO
APPROVED
FOR CONSTRUCTION
DATE BY
P
EXISTING INLAID
SANDSTONE FINISH
IS TO REMAIN
A
LL -
EXISTING RESIDENCE .;a,
--
EXISTING POOL
EQUIPMENT
EMO AREA
EMO AREA
03/02/04 04:21pm P. 006
GAS FIRE PLACE ELEVATQN DETAIL
(NOT TO SCALE)
STUCCO FINISH TO MATCH HOUSE w 'c
DECORITIVE NICHE
GAS FIRE PLACE
T
gp_0„
T
5'-0"
3-6 IF
"111 12
5' BLIND WALL-- STONE FINISH HARTH --' t -
s
ACC
I
EMO AREA
03/02/04 04:21pm P. 006
GAS FIRE PLACE ELEVATQN DETAIL
(NOT TO SCALE)
STUCCO FINISH TO MATCH HOUSE w 'c
DECORITIVE NICHE
GAS FIRE PLACE
T
gp_0„
T
5'-0"
3-6 IF
"111 12
5' BLIND WALL-- STONE FINISH HARTH --' t -
s
ACC
PATIO
EXISTING RESIDENCE
03102104 04:21pm P. 005
EXISTING PA' n0_ I I
i
XISTING POOL
EA dC I EQUIPMENT
nAC
AC
ul�j uO
NEW GAS IRE PLACE, / ' •
I
BLOCK WA I
W/STUCC FINISH TO �— m
MATCH H SE -'\ (� LANI
VOID
REFLECTIVE FERE /
BLO;K /
3" e
• I i ./
T HOUSE
if,
03/02/04 04:21pm, P. 004
EXISTING LANS41NG I
a e o
STING PALMS A
A rH ENTRY REMAIN
EXISTING LANSCA
\ AW CUT
E FINISH
BEACFI
PA LAGOON TYPE XISTING INLAID
9'--16' tSANDSTONE FINISH
TO WATERLINE ti I TO REMAIN
I I EXISTIN,'7 PATIO I I
EXISTING R - SIDENCE
s�=���
o`�
EXISTING PA110