0008-259 (RPL)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
'*hapter 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
6187.4.2 C-53 ,,3 , r f f }t7.�.�?W
Date Iia Signature of Contractor J
f
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.
(J 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.
STATE FIIN1) 10.s4303-f��'
(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
Code, I shall forthwith comply with those �rovision ti
",/bate: G i f /r ��9 Applicant � rAi ifs a lL,
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 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).1., Date
lit.`fd"-. v
BUILDING PERMIT PERMIT#
DATE t VALUATION LOT ONiI-2 9 TRACT
JOB SITE
ADDRESS
APN +'
52-• 01..NTROBE LAVY
OWNER
CONTRACTOR / DESIGNER / EN (NEER '
GENE: NORRIS
AW -M- CAR POOL C:ON8TRUC'TION
52-820 7JMZ01AE IAkT.Es
73960 HIGHWAY 111 -
LA QUINTA Cis. 92253
PALM DIMMT CA 92255 -IS
}340.5 588 CBldt 1104
USE OF PERMIT
POOL si'1<T !0R SPA
POOL &SP.P UPRIX.Y-.ALAi2MSfF4.fl.t.R190 SHALL 89IN PLACE AT P"RR
PL ASTOR WSPEeC: T IOMPOOL J1QU1P?VfFWT LNCMSURE T3 N. 0T .NCLUDeD
IN THIS PERMIT
POOL ANlDIOR SPA 14
IFISTWA72D COST Or, C01'1S.;F12'I7+�7'1 *10N
59g51W.OiD
1PE1h;11!MIT r, KE SilNMAW i`
PLAN CHECK FPIE . 101.000-43�-318 �zvs.ag
CONSTRUCTIONVU, 101rCK33 "18_00€i $09.30
MECHANICAL FEE -- POOL� x.014000.421-000 mpq
KL.LC:TRICAL VEM ,- POOL' > 11011-b00-42.0-ACdt3 45:0(i
PLUMS1TWO "IE - POOL 101.0OO-419"000 521.00
:.=".
AUG 16 20^00
"I TY OF LAQUIN-'T'.
ffU-Z-T41AL C6WT UC -110N AND tU11.4 CHI RCK 5
$854.18
IMS PRE-PAJD US
$0.00
TOTAL PERWF F ' 'S DUE NOW
$854.18
RECEIPT
DATE }
BY t'1
DATEFINALED
INSPECTOR
OPERATION
DATE j
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
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs Zt.01 p Z
Electric Bond
,
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
a
Final
Gas Piping
PLUMBING AP OVALS
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
Q
Gas Piping
Gas Test
Appliances
Final
d
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)
�UG 14-2000 13:11
TRADITION GOLF CLUB
'Tradition
ARCHITECTURAL DESIGN REVIEW
August 14, 2000
Mr. Greg Butler
Building and Safety
CITY OF LA QUINTA
78-495 Calle Tampico
La Qvinta,,CA 92253
Re: , Norris Residence
` L6t 30, Phase 28867, 52-820 Latrobe Lane
Swimming Pool Review,
760 564 2356 P.01
via Facsimile
760-777-7011
Dear Greg,
This letter will serve as ARRC approval for the above referenced swimming pool (copy
attached). if you have any questions, please do not hesitate to call.
'shank you,
Sincerely,
Christina J. bores
Architectural Review Coordinator
/cjd
PC: Mike Fedderly (via first class mail)
M/M Gene Dorris (via firsc class mail)
c.\Uy 0WjM§1% 0KC\M1LM9X9 .-W
78505 OLD AveoA 52 LA QuncrA -- C\ 92253-1120 -- NoNE 760/564-3355 FAx 760/564-2356
h",
417