9601-177 (RPL), Hc~- LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with
W, Section 7000) of Division 3 of the Business and Professionals Code, and my
3i3 � License is in full force and effect. 479M9 13 12/31/97
r,� W License # Lic. Class Exp. Date—
r- CC
r; Dateev rSignatureofContractor !' _a 41
co H rn OWNER -BUILDER DECLARATION
J U I hereby affirm that I am exempt from the Contractor's License Law for the
LLJ
following reason:
� () 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
�
Date Signature of Owner
N
rn '" WORKER'S COMPENSATION DECLARATION
Q I hereby affirm under penalty of perjury one of the following declarations:
o Z () I have and will maintain a certificate of consent to self -insure for workers'
�O cc compensation, as provided for by Section 3700 of the Labor Code, for the
X W LL, performance of the work for which this permit is issued.
O —J J ( ) I have and will maintain workers' compensation insurance, as required by
IM Q U Section 3700 of the Labor Code, for the performance of the work for which this
p U permit is issued. My workers' compensation insurance carrier & policy no. are:
CL rn H Carrier " -1s i> �s r Policy No. S� ` .erne;�
_Z (This section need not be completed if the permit valuation Is for $100.00 or less).
Z)() I certify that in the performance of the work for which this permit is issued,
C7 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
0 c Code, I shall forthwith comply with`those provisions.
Date: a � � cy fApplicante
Warning: Failure to secure Works' 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
44
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
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)'IIIA yA h Date T -
ALC#
BUILDING PERMIT
PE11IT4
601-177
I
DATE VZ906
VALUATION SAI f. 1j LOT ltd TRACT to 1)1
JOB SITE ADDRESS 79.975 DU LCE DEL Nl"
APN
OWNER
CONTRACTOR
IA4PERIAL SUN C09STItUMO:N
I A1v DA.1.1 DEVELOPMENT CO DX
2825 T A1 -ii UI -1Z CAIN YO.N #D I
RO. BOX 172.-5
PALMI SPRJNCaS CA 92263
PALM SPRINGS C.A. 92263
(619)$2.8-2277 CBE.0 :3737 .
(639)329-2277
DESIGNER/ENGINEER
USE OF PERRMPOOL .fiNti/Qlz SpA,
1'001, AND SPA
FEE DESCRIPTION
FEES
CONTRACT AMOUNT /6,000.00 LS
COSTOF CUINSTRUCUION`
'2161110 100
++3�AAQQy ♦M" iF yy,, �y,g aypq ay,$).`S,'1.MATED
1Li.R5s R\[s:Flf� �,Aa �'l !]YJ ICl1S`]:9.Y.i 3.
PLAN CifRCT; f'FE 101-000-1*9h318 $87.75
CO3NS11 UC'T1ON"4-E1✓ 101 -ow -.418-000 5135.00
L1ECF)��N AL 178-a:4'UC)L 101-Q1fb qZi-01Jt3 $ F.40
1:.EC1RICAL.l°hl?._-.POOL 101-000-42.0-000 $45.00
PLUN48ING F116- "Pool 101-0004.19-0()0 $27.00
1
..
SUB-1WAL CQNS'1`RUCTION AND PLAISI CHECK
$318.75
o LESS PRE-PA10 FEE S
hpTOTAL,
$0.00
r.ERMIT FES DUE, NOW
�o
$3:121.7
✓g1v3
0
Jay 1996
RECEIPT ATE
BY
DATE RNALED
INSPECTOR
i
INSPECTION, RECORD
OPERATION DATE INSPECTOR
BUILDING APPROVALS
Set Backs
Forms & Footings
Slab Grade
Steel
Roof Deck
O.K. to Wrap
Framing
Insulation
Fireplace P.L.
Fireplace T.O.
Party Wall Insulation
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
BLOCKWALL APPROVALS
Set Backs
PLUMBING APPROVALS
Waste Lines
Water Piping
Plumbina Top Out
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
OPERATION DATE INSPECTOR
MECHANICAL APPROVALS
Underground Ducts
Ducts
Return Air
Combustion Air _
Exhaust Fans
F.A.U. `
Compressor
Vents
Grills
Fans & Controls
Steel
Electric Bond
Main Drain
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Gas Piping
Gas Test
Electric Final
Heater Final
Plumbing Final
Equipment Enclosure
O.K. for Finish Plaster
Pool Cover
Encapsulation
Final
COMMENTS:
POOLS - SPAS
a
78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 - (760) 777-7000
FAX (760) 777-7101
TDD (760) 777-1227
December 23, 1997
Landau Dev Co Inc.
P.O. Box 1725
La Quinta, CA., 92253
RE: Pool & Spa Permit #9601-177
Dear Landau Dev Co Inc.
The purpose of this letter is to inform you that your Pool & Spa Permit #9601-177, for the
project at 78-975 Dulce Del Mar, has expired. In accordance with 1994 UBC section 106.4.4,
no further work may be performed until a new permit has been issued.
Please contact Daniel P. Crawford Jr., Building Inspector I, at (760) 777-7012 to obtain any
information you need regarding a new permit and/or any required inspections. Should you
choose not to complete the project, we would then have to pursue any or all of the following
actions:
1) Abatement of the project through the City Attorney's -Office and Code Compliance Division.
2) Notice of non -conforming structure placed upon property profile.
3) Action filed with Contractor.State License Board. Optional if Owner/Builder.-
Please contact us at your earliest convenience prior to 10 working days to resolve this issue, and
for any questions you may have.
Sincerely,
Mark Harold
Buildi & Safety Manager
Daniel P. Crawford Jr.
Building Inspector I
cc: file
dpc
4f ' 2
MAILING ADDRESS - P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253 rJ ii
1'