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0301-050 (RPL)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 TIE31,196 C 5 3 11", *I AI3 ' Ifitrr33t'tk� Date 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: Carder STATE 17f,,"PEO Policy No. 1635M-92 (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 with those provisions. Date: Applicant "" Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties andcivilfines 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 applicatiop 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 Quints, 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) `�! Date BU,+DING PERMIT PERMIT# 3� DATE ((ygam y VAL ATION ■,��yyq� ]](()) LOT TRACT ��hhw��}qy JOB SITE ADDRESS 80 Oji)VM&K011' D APN A OWNER CONTRACTOR / DESIGNER / EN (NEER 81.1 KI"PL.W."t' H JU1:SMAITIVE VIOWNGS 80-51-30 WEIMER J 1509 OAA G ROON10 T.1 QLi,i? VA Q1 92253 R.J!,Nt;HOWe-AGE Cly 92270 (760)34.1-2336 C'`I3IA 5486 USE OF PERMIT :['0C%.1+ND/0A UIDA P001,Si'A i''63U"R4TA1.K ttA'i L114E VUR 1rLPTIME tiHQ. AI..flltllV'!MAXWERS SHALL VIN PLACE AT PRE-PLAqTER 1"PiSHO'1'1'C'W, >TQU1#?itdL►'9d'I` ;�'t�Glt'3SiJittJ 3dC3`�' >ti.LLl13F.Cf ; POOL A.NDIOR SRA IA PLAN C:104,C°.K, FEE 101-000-435)-31V $130, J0 CONSTR LICTION FEM 101-00oK4113-Ct,'i0 $ 1&fW 1! �EOi.KNICAL .FEE -- P01, 101-000-421-000 $24, N kY:4.i•:.t':T RIC A1. ELL « POOL 101-=,4206,000 543.00 P'i.lfMf3 OG ME -- ,POOL 101-000-419-000 %37A MPrILYTAT, CONMOMION A1dD P AV CO3h`"K M54.76- ��1U U r2303 CITY OF LA QUINIA FINANgE DEPT. RECEIPT DATE 2 BY � � DATE I ALED INSPE INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms 8 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. Griffis Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath ' Final Final . POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final Gas Piping PLUMBING APPROVALS Gas Test - - Electric Final �e Lines Heater Final .ter 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 COMMENTS: 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) FAIRWAYS ASSOCIATION December 26, 2002 Mr. Bill Klappenbach 80-580 Weiskopf Way La Quinta CA 92253 RE: Pool, Spa, and Landscape Dear Mr.. Klappenbach: At the December 16th, 2002 Architectural/Landscape Committee meeting the plans that you submitted were reviewed and approved ,with -the following conditions: ❖ The irrigation -is to be hooked up to your individual water meter * A letter of variance must be received from KSL on the pool setback If you have any questions or need to contact me please call (7 60) 564-3858. Sincerely, DONNA. MARINACCIO, ("MCA Association Manager /ncp Post Office Box 1658 - La Quirita, California 92253 • Phope (760) 564-3858 • fax (760) 564-2.329 LEGEND LIST OF COLORS AND VENEERS DIECK - Stamped Concrete Finish, Adobe with Medium Gray Release TILE - At Waterline, F Bone Portabello CHINK SPILLWAY(at spa) - Sunburst Gold Quartzite RAISED SPA BOND BEAM - F Bone Portabello Tile +24" PEDESTALS (on backside of pool) - Stamped concrete cap to match deck and all sides plaster to match house Pool & Spa - Kerber Bros. Inc. Pebble Coat -Tahoe Blue K.S.L. - Barbara Larsch (760)564-8023 North Neighbor Approval SIGNATURE MTE South Neighbor Approval SIGNATURE MTS , Mow Band +24" Pedestals (2' x 3') wRh Su 30 pply &Drains W"QUEEN/ PALM /xN F'IL ................................................................ Mow Band ................................................................................................................................ ..... 70 Planting Bed Composite 70 Seasonal Flowers bender board around planting \ J beds 30 _ 4" Pedestal +24" Pedestal QUEEN-- ® / PALM4. i Planting Bed / LAWN Seasonal Flowers A, Composite `✓�� bender board / Swlm Out with Umbrella Sleeve around planting vaZ�'-s�-Ij4i ® .a ,Umbrella Sleeve ® O O O o Bim' • Planting Bed • EQUIPMENT W40LOCATION 'FROM HOUSE CORNER I TORWARD STREET 0 1ON BLOCK ENCLOSURE ON GOLF COURSE SIDE •M>L OF POOL EOUIPMENT a Planting Bed Seasonal Flowers • • Existing House O o s 0o BUBBL 0 0 jDSPRINGJ0 1/8" = 1' a 5.0' - 14'6 Planting Beds• Seasonal Flowers Composite . bender board around planting F SPA 8'x 8' � beds +18" SPA with Stacked Quartzite Waterfall POOL 38' x 18' x 13.5' o ® LAWN 07 36" MESQUITE 21'6 P. • Planting Bed ■ Seasonal Flowers 4.• 4• 8'0��"'ii:�� BILL KLAPPENBACH 80580 Wieskopf & Brass Valves Rainbi Brass es La Quinta, CA, 92253 (760) 771-3540 = PINK POWDERUFF • = BUBBLER = DEEP ROOT BUBBLER = LAWN SPRINKLER DRAINAGE FLOW (TO FOLLOW EXISTING P RECISE GRADING PLAN) LIST OF COLORS AND VENEERS DIECK - Stamped Concrete Finish, Adobe with Medium Gray Release TILE - At Waterline, F Bone Portabello CHINK SPILLWAY(at spa) - Sunburst Gold Quartzite RAISED SPA BOND BEAM - F Bone Portabello Tile +24" PEDESTALS (on backside of pool) - Stamped concrete cap to match deck and all sides plaster to match house Pool & Spa - Kerber Bros. Inc. Pebble Coat -Tahoe Blue K.S.L. - Barbara Larsch (760)564-8023 North Neighbor Approval SIGNATURE MTE South Neighbor Approval SIGNATURE MTS , Mow Band +24" Pedestals (2' x 3') wRh Su 30 pply &Drains W"QUEEN/ PALM /xN F'IL ................................................................ Mow Band ................................................................................................................................ ..... 70 Planting Bed Composite 70 Seasonal Flowers bender board around planting \ J beds 30 _ 4" Pedestal +24" Pedestal QUEEN-- ® / PALM4. i Planting Bed / LAWN Seasonal Flowers A, Composite `✓�� bender board / Swlm Out with Umbrella Sleeve around planting vaZ�'-s�-Ij4i ® .a ,Umbrella Sleeve ® O O O o Bim' • Planting Bed • EQUIPMENT W40LOCATION 'FROM HOUSE CORNER I TORWARD STREET 0 1ON BLOCK ENCLOSURE ON GOLF COURSE SIDE •M>L OF POOL EOUIPMENT a Planting Bed Seasonal Flowers • • Existing House O o s 0o BUBBL 0 0 jDSPRINGJ0 1/8" = 1' a 5.0' - 14'6 Planting Beds• Seasonal Flowers Composite . bender board around planting F SPA 8'x 8' � beds +18" SPA with Stacked Quartzite Waterfall POOL 38' x 18' x 13.5' o ® LAWN 07 36" MESQUITE 21'6 P. • Planting Bed ■ Seasonal Flowers 4.• 4• 8'0��"'ii:�� BILL KLAPPENBACH 80580 Wieskopf & Brass Valves Rainbi Brass es La Quinta, CA, 92253 (760) 771-3540 !I' O U R T Y A� R D D E T A L LEGEND = 24" QUEEN PALMS = POT BOUGANVILLEA P/B = MESQUITE P/B P/B = PLANTING BED (Seasonal Flowers) Q = 6.5' ENTRY POND WITH SCULPTURE -- STAMPED P/B CONCRETE P/B 4 P/B ° P/B P/B