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9512-139 (RPL)LICENSED CONTRACTOR DECLARATION I Weieby.af$rm that I am licensed under provisions of Chapter 9 (commencing with r W Section 7000) of Division 3 of the Business and Professionals Code, and my :5 C) License is in full force and effect. ,% , r; LU O License # Lic.0 ass 1! _114. Date 10/306 t Date t _ , .. r_ Signatureof Contractor t Z a cTo 0 OWNER -BUILDER DECLARATION J U I hereby affirm that I am exempt from the Contractor's License Law for the ULI following reason: U) () I, as owner of the property, or my employees with wages as their sole Z 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 co Date Signature of Owner LO .N Orn U WORKER'S COMPENSATION DECLARATION FL < I hereby affirm under penalty of perjury one of the following declarations: Z ' ( ) I have and will maintain a certificate of consent to self -insure for workers' �ncc compensation, as provided for by Section 3700 of the Labor Code, for the O W 0 performance of the work for which this permit is issued. J LL J () I have and will maintain workers' compensation insurance, as required by n Q U Section:3700 of the Labor Code, for the performance of the work for which this j U permit is issued. My workers' compensation insurance carrier & policy no. are: L1.0 H Carriern n��.„ n is )oPolicy No. z , Z (This sectioeed not be completed if the permit valuatior $ d0A0 or less)co . a () 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'provisions. Date: , . _.Applicant rf e - t 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 application agrees to, & shall, indemnify & hold harmless the City of Indian Wells, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if Code, work, is not commenced within 186 -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�bty, and State laws relating to the building construction,. and hereby authorize/epresentatives of this City to enter upon the • above-mentioned property for inspection purposes. ,,,Signature (Owner/Agent) " / Date ALC>t BUILDING PERMITPERMITa 9.Si2-139 DATE VALUATION Ns,000.0tLOT TRACT JOB SITE ADDRESS "" 79-91 D DoLA3LE k'_- LO APN OWNER CONTRACTOR CA.11FORNIA POOLS & SPAS KSL LAND CORP. 41910 B OAI VIVA1. K #A2 . 56140.PGA BLVD PALM DESERT CA 92260 .LA QLfiN ('A CEI. 92243 (619)340.9x00 CBL# 355 DESIGNERIENGINEER .777-1294 USE OF PERMIj)Q©L ANDIOR SPA SPA/WATER FEATURE ONLY FEE DESCRIPTION FEES POOL -MM/Ole SPA 5.000.00 LS &STINIATED COST OF CONSIMUC ION S."O.00 PERMIT 1+'Ex: SU10 I%"IZY ' 'PLAN CW.CKFLF 101-000439-3111 $46.80 CONS'1RC,ii:'1ION FEE 101-000-415-000 VIA* IVIEf:14ANICAL FFE -- POOL 101.-000-421-000 $2,1.00 &bit TR CAL M ->'POOL 101-(3Q 420 -WO $45.00 P1.411VII31NO ME -s POL7:tL 101-000-4.19-000 $27.00 y, r SUB *1KXrAL CONSTRUCTION SAND PLAN CHECK $214.80 •� LESS PRE -PAID FEES D a o ' .OTAL PERMIT FEES DUE NONA $0.00 $2.14.80 JAIV ® 2 1996 Ry RECEIPT DATE 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 POOLS - SPAS steel 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 Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: I RECREATION. CORPORATION TM December 29, 1995 Building & Safety Department City of La Quinta 78-495 Calle Tampico La Quinta, CA 92253 Re:. Construction of pools within the setback area - Plot Plan 95-552 Gentlemen: KSL Land II Corporation ("Land II") is currently building nine (9) homes as part of the Model Homes and Sales Center Complex on PGA Boulevard serving the new residential project developed by Land II at the PGA WEST Resort. The model homes are located adjacent to the "Bye Hole" of the new Weiskopf Private Course. Land II is proposing to construct pools in the rear yard of each home and has requested the adjacent property owner, KSI PGA WEST Corporation, approve the construction of the subject pools within the five foot setback area. The City of La Quinta Municipal Code §9.156.170 requires a minimum setback of five feet to any property line except with the approval of the adjacent property owner. This letter shall service as notice of approval by KSL PGA WEST Corporation to the City of La Quinta of the request by Land II to allow construction of a pool within the five foot setback area in the rear yard of each model home. If you have need of further clarification or have questions, please do not hesitate to contact me. Sincerely, KSL PGA WEST CORPORATION Larry Lic iter Executive Vice President LEL/bl cc: Nola S. Dyal, Esq. Grant Hombeak PHH, L.L.C. America's Leader In Distinctive. Lifestyle and Recreation 56-140 PGA Boulevard - ' La Quinta, California 91253 - (619) 564-1088 - Fax (619) 564-4880