0008-411 (RPL)CO
H
N U)
W
Ouch
�
I � u7
W
I, Er
�ZI�
to O Pro
F-
t`
�a
Z
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. ClassExp. Date
i98681 >~53 j 0?1�112C
Date -1 I 1'2 22 SIgnatur&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:
( ) 1, as owner of the property, or myemployees 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 haveand 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 carver & policy no. are:
Carrier FRFh40NT 1~sMHA>YE Policy No. WCN 301203-5
(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 this-Ify1 should becopme
subject to the workers' compensattion-plovisionsd� Sgcbon 3'700 of the Libor
Code, I s all fq'rthwith comply with those ptgvisions�'
Date: ` �I !r') Applicant T� .ilk ` r 'l ;j
.f
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 attomey'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 ate
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 authQuze representatives o this City to enter upon
the above-mentioned props y for inspection purposes.
Signature (Owner/Agent) 1 3 11 i Dates
BUILDING PERMIT PERMIT#
DAT `- ... f"'GALUATION LOT @0M_411 TRACT
911 a 10M.0
JOB SITE
APN
ADDRESS V_J 10 DVJXL M (70UKA
- '
OWNER
CONTRACTOR / DESIGNER / ENGINEER
MMM HAWIRSOAT
#:UBER1 ATN:iW01<111 POOL CO]t &MUMIC1
5y-110 DCJA1"1: -14E COURT
74652 LX?AIX01,i PLACE 43
Lk CL1 IZITA CA. 92253
PALM :CtMTP J2T CA 92211
(760)566.45,93 CBL4- 5115
USE OF PERMIT
POOL ANIVOR SPA
POOL & SFA ONLY-ALARDAS/BARRIERS SHALL BE 114 PLACE AT PRE
PLAR FR NOPF,OTIONTOOL SQUIPMYNT fiAit`!"ORlr IS HOT INCLUDED
1N THIS T)ZP MIT
POOL ANNORSPA A000.00 LS'
VNI ATIM) COST OF C'OlY9MUClTON
25;( W.00
i';Cj Wfs . '' SUMMARY
PLM C FP_K FEL 101.000.439.318 $163,P
CONSTRUCTION FFV 101-000418-040 $252.06
iJKHANiCAL ITT -- POOL 101.000.421-000 $24,00
ELECTRICAL FER, — POOL 101-000-420-000 $45.011
PLUNIRM0 FU -- POOL 101-000-419-000 $217.00
y
•�ti
SUB-7XY 'AL C0k4V117LTC'i i0U A'ND PL" CBEC"k.
$:11.60
LESS PPM -PAM FM9
�
\ 7
TOTAL rT-' frkX6DUENOW
41
RECEIPT
DATE
BY ��,•
DATE'FINALED
INSPECTOR
P_
k17
ii!`JSPECTI JN RELOO RJ
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
BLOCKWA+LL APPROVALS
Steel
POOLS - SPAaS
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
100, 01
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
12, 1-11
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)
COftflMENTS:
'Tra lfl' 'on
ARCHITECTURAL DESIGN REVIEW
August 28, 2000
Ms. Nickie Gormley
Building and Safety
CITY OF LA QUINTA
78-495 Calle Tampico
x
La Quinta, CA 92253
Re: Lot 3, Phase 28612, 52-110 Dunlevie Court
Swimming Pool Review
Dear Nickie,
This letter will serve as ADRC approval for the above referenced residence to obtain
a permit for a swimming pool (copy attached). If you have any questions, please do not,
hesitate to call.
Thank you.
Sincerely,
6?-� - -
Christina J. Dores
Architectural Revievyk
A jd
pc: Jody Jones, APC (via first class mail)
78505 OLD AVENUE 52 — LA QUMA -- CA 92253-1120 — PHONE 760/564-3355 -- FAX 760/564-2356
08/15/:2000 20:20 760-5r.4-7907 ANDREW PIERCE CORP PAGE 02
rn
1 1
9G 4�
s
431,
of
woo
Q' fCyF g4l
f O
JSP.
•��•
C00yam CANYON WMT
NILS NSOtJ 1 `[s� `' w of m
Pei°�
------------ ........... -Oy�TorS