0111-156 (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 e%11
fect.
License # Lia Class i 1Exp. Date
C33 MCI
x•37,1€>3
Date�,,\i�
7 Signature of Contractor
OWNER -BUILDER
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;
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
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
�_ B
Final
Gas PipingI
1.2� /
a
PLUMBING APPROVALS
Gas Test
%Z
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
fZ
Gas Piping
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'Y
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)
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I Gil -Y O1= LA QUINTA
J BUILDING & SAFETY DEPT
APPROVED
I FOR CONSTRUCTION
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91,
5�
VACATION POOLS & SPAS.
,.e` 9522 Donaldson Road
Lucerne Valley, CA 92356
' (760) 248-6045
• (760) 248-2919 FAX
Lic. #C-53=351673
Sales Locations
Bermuda Dunes, Irvine,
California City, Rialto,
Lucerne Valley
1 800 999-1811
GENERAL SPECIF1CATION
C-1-7ff i � i - v n
AA1
34�-X803 .
ITOot4
GALS
GPM
IL :3.DOSQ FT
GPM
SKIMMER MODEL /'+►M EYLI(fA X-)
CHECK VALVE 5
GASLINE BY 42 Q FT.
POOL LIGHT S CLOCK
ELECTRICAL BY VFT'
AUTO CLEANER
CHEM.FEEDER —
PLASTER COLOR U
DECK BY D SQ:
DECK TYPE 4xx.- S A4LT'
STEP 3 FT l
SPA SPECS.
SIZE RAISED O
LITE /O WATTS
DUAL LEVEL SEATS £ S
T:✓ �l A(� dF.QC- ' Cc it ¢ AitlO/t FA - DAMWALL
Q J -72z - /,2D! DAMWALL TOP Ti L £
V.6. 33/'/ - - SPILLWAY SIZE, - X WIDE
CONTRACTOR cannot assume responsibility for DATE SPILLWAY 'T L'F
damage to cubs, sidewalks; driveways, cement- - #iJETS
slabs, sewers, lawns, trees, fences, retaining walls,
sprinklers, telephone lines or shrubs. Name:
When access is made through a neighbors property
it is understood that you, the owner, have that Address:
neighbor's permission and assume full respon'Sibility.
C
SIGNATURE
TRACT AL SD LOT#