0008-295 (RPL)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
��Cbapter 9 (commencing with Section 7000) of Division 3 of the Business and
,Professionals Code, and my License is in full force and effect.
License # w Lic. Class Exp. Date
, 777601 C53
aate ��'Signature of Contractor
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.
( a- 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 ENEWTION ON CILV Policy No.
(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,Lab"o'r
Coderhshall forthwith comply with those,provjsions_o��.
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 rep,- en"tative's of,th_l City to enter upon
the above-mentioned property foorr, i'nsp. dtlo �urp
�Signature (Owner/Ag Date "• %' ���'
BUILDING PERMIT PERMIT#
DATEVALUATION LOTTRACT
C5I�? $16101XIM
JOB SITE Y
ADDRESS 799--3.W DESE&M CRZST
APN
-
OWNER
CONTRACTOR / DESIGNER / EN (NEER
JOE & XR13rEW HOWE.t. L
CAIAW V POOLS, INC.
79-355 DE.1'UMT CREST
70-1501TIIMIER ROAD #3
LA QirINTA CA 92253
RANCHO:.IYIIMWE CA 92270
(760)831.0860 CBS 3731
USE OF PERMIT
POUL AWD/OR. SPA
POOL &.SPA ONLY -ALA2ZR WBARRIERS SHALL HE IN PLACE AT € U
PL.ASTVR INSPECTION. POOL EQtIIPMIW.T ENCLOWRE 11, NOT INNt"C.ttCi 0
12J.'. HIS PERMIT
POOL ANWOR SPA 1"00,00 L5
EsInUATED C'OS'T' OF CONSIrRuCTdom r
16100D.00
YkMbA`.1' FRE SruAn Ry
PLAN CHECK FUS' 401.000-439-318 �l11.I3
CONSTRUCTION FEF 4101l -o00-418-000 SI71_f!0
MECHANICAL = -- POOL. 101-000-4V-000 $241.00
ELECTRICAL ME - POOL 101-000474-000 $45.00
PLUMSi'00 ",,Z -- POOH, 101.000-419.000 $27,00
A1
t
2,
CONWRUrTIOI3' AND PLAN CHM. C
�378.15
AtT 5X -M PRE -PAM FEES
$0.00
-4-r.LA ®TAT, mwTIi cs DvE now
$378,15
H�
RECEIPT DATE Fj BYE ➢ DATE FINALED INSPECTOR
t�
INSPECTION RECORD
P'
I 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
BLOCKWALL APPROVALS
Set Backs '
Steel
Electric Bond
POOLS - SPAS
Footings .'
Main Drain
t�
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
D CQ
Gas Piping
Gas Test
Appliances
Final
c�
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:
BclT
LNG � .�,C.��/.
- •Fort C : 7-
O/�STRv
DAtF g CT/O�
'm C ey
A RE -INSPECTION F
EE OF 0
WILL BE CHARGED IF THE APPROVED
PLANS AND jOB CARD ARE NOT ON
THE SITE
NSPECTON. FOR A SCHEDULED
NO EXCEPTIONS
CAL-NEV INC. De '51 DIY d,
POOLS
ea ,2
Mark V. Tom
70180 Thunder Rd.
Rancho Mirage. California 92270 / 0-00/2
J - tJD�
760-770-5853 j�p
License #777601 cell phone: 760-831-0860
j
.vlcaINS
Deco R&shtoll
/S'
POOL UM ! % X 3
alaw ka 35J Padmar -7 &
EXCAVATION C A Te Gradbp ji Ki .
Oq fran S'i w Leo w Obsfades ` sS
ways Removed A) J RAptaced Jd
PLUMBING Rw_19f*r —(""r st,�o�
Pt w ,, a42c eoowr Pwnv )rte
Oft Rw 50 Main
Ri Uw &! j-_rv._ ' P1 frw � N o
Ado Chm. 11 4 t G *tot
S otG 61s 1/F '��
FOUNTANE- 41PRAY NDS—WATER_ EFFECFS
I- SAki L4
STEEL GUMS
— r RM Ir za•:
. loin ",ww ,
Tom Rum
TiLEwnAler00GN"f
Upa 91whTeer
_ - -- -
Dt116
S4- _
IMat Canaeee Sq R - Cerrtl W. Y4"
--
Mise.
SPA Aron � Per
Pwn� Blower_,_ Spmw
.rae smv uont._ _
INTERIOR FINISH 2Lk 61 -P& Cob_ G&t -fes
oats
UWNER to fence pod am and bOd SAM dOW4 and $AIF atchtn9 OM W aode. /
3 ,5 NOTE: No dirt will be removed. retumed or graded attar day of Ucavat M OWNER �ojt „►_.��, �-ic-J lio ti► P.�l`
NOTE Relocation of Aauipm d pad A r=& In addltnl amt to mw
-
Wm- FiI pool hmem* after pmm (maw hudrrcftm� 0o rat use rubber hose. ADDRESS 74 155 D es'e rrr,G�ee G -t
NOTE 0o not tum on pool Wit when pool is empty..
NOTE Wit down cmas, shd at Nest Wo My for w m days dfdr she! N kofaBed. CrnrLA SOLD BY t Q,t� OATE_ S=S -Oy
I here reviewed this pan and hereby aporwe teal plan a tpAdlkdlons.
( PHONE M. � (W1
DRAWN DATE 3`•i '
Q culff laBr soma=