9704-124 (RPL)to
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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 effect.
License # Lic. Class Exp. Date
574171 A ,�%� I r 1197
/Datel/ �� 17 Signature of Contractor 'i
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 Policy No.
3TX1% FUND
(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 Withthoseprovision
Date: t/- Id -41 Applicant e�O/1a ,�i � Y,
41
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $1,00,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
s
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his,
application. 1,
41
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
12. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives .of this City to enter upon
the above-mentioned propert .for inspection purposes.
/Signature (Owner/Agent) h"(4w '(f /1412A Date ✓9J � �
BUILDINGPERMIT PERMIT# CONTROL#
9,74W1245051
„� LOT TRACT
DATEVALUATION s �.at�ri.tw
JOB SITEt,
ADDRESS 79-315 iiili.`s�+i.IRX CRKST
APN
OWNER
CONTRACTOR/DESIGNER/ENGINEER
BILx. FRERICHS
g rEVE DODSON cO;v1e11111U(Tllfotl
79-30) bESG1sI' CRE -`'r
73.01.1 CYOtJN°1'I. y CLUB DRIVE, -STE, Fit
CAQ)(JiN'1A. CA 92253
PALM DESERT CA 92260
(760�34�r9U32. .. CBLY 1044
USE OF PERMIT
P,'DOL o1NlliOR 3,Rik I LI1.ft i00 LS
:..07t1$s'+'I D:.�DS'!
PLAN CHW"k M- ']: V7.75
r�(3�d't'f'CeX'I�'lif�?t3i!? 1(il-iJ(30�Q1,d}fi0 $135.00
)CWkNICAL 048 Pock.
1::L ,14' fRICAC: FW13—POOL � 101 -W -420 -WO $15.00
PLC NWI i O FIE- 1'`001; 101-0ti0-4113-. 00 V27,t10
}
ARia+ T(TrAT, C!f]N4"MUC1,10N ANDPLAN (,HUCCC
LESS PRE-VAIU V.I ES
$0.0ft ..
APR 3 ® 1997 ' r
TOTfi . lF° .1 M IT Fug's p MJ M,. Nf,W
$304.75
CITY OF LA', 0!.11R° -TA,
EVIPT
DATE
By
DATEFINALED
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
Root 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
POOLS - SPAS
Steel 4124
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 Defectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
o�� +12'
Foam
GENERAL SPECIFICATIONS
SIZE 15 x 30
4REA 364 PERIMETER 81
DEPTH .3'6"x5'
FILE CHOICE T.B.S. SO. 62
RBB. 24' +6"
-_OPING CANT
MOTOR HP STA RITE HP 1
MOTOR HP HP
FILTER STA RITE 300 SQ FT
FII TFR BATF 1 n1 GPM
2
u
u
CHECK VALVE NO
GASLINE BY S.D.C. FT. 31
POOL LIGHT 400 CLOCK
ELECTRICAL BY. S.D.C. rr 100
STEP b" FT. b'
SPA SPECS.
SIZE 7 DIA RAISED
LrrE 1 WATTS 100
RI LEVEL SEATS 22" 24" 27"
DAMWALL " " X FT..
DESIGNER DAMWALL TOP TILE
SPILLWAY SIZE 3""x ' WIC
Jamie SPILLWAY X OPEN CLOSE
DATE # JETS 4 UPER LOWE
-17-97
Name: MR MRS FRERICHS
Address: 79315 DESARTCREST DR
City: Iq
TRACT TOPAZ LOT#
Qo ion
Poo/w
4' bobsl� PALM DESERT TEMECULA
73-011 COUNTRY 28910 RANCHO
Scale: 1 /H" =1' O" CLUB DR. STE F-4 CALIFORNIA RD.
PALM DESERT CA. STE 206
LANDSCAPE AND FURNITURE 92260 TEMECULA CA.
ARE SHOWN FOR ILLUSTRATION (619) 346-4032 90 90
(9092590
ONLY AND ARE NOT INCLUDED. I , ,/' is „ C7A1 .,7