0307-173 (SOTB)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
7 19! 05 A 13111C 5', dDlt
.f
Date- I` 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.
(1j) 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:
Carrier ' .AC><' t`tU 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 Labor
Code, I shall forthwith comply with those provisions.
16ate: 1 [) Z Applicant—
Warning:
pplicant
- r
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 representatives of this City to enter upon
the above-mentioned property forinspection purposes.
Signature (Owner/Agent) f � '%' Date -1
I--,',
` BUILDING PERMIT PERMIT0�!' KI
DATE 7/1110.3 VALUATION t i" I LOT TRACT
JOB SITE _ NO WXISICOPIr
APN - -
ADDRESS
OWNER
CONTRACTOR / DESIGNER / EN (NEER
'1H{;MT.1SC N1k0Y
VEM Pckll 3
64S i TIM MRM, '
2295 E, '! KM- AXTt3X RD
MANRA'I'I AN REA- C71 CA 961,66
P.611 M 3FI;IA1C.i a Cry 92262
(7(,opn-27(lo C'f1 1 'Z951
USE OFPERMIT
(JiWr]INL B7u+)»G
P041.1J411IJ,'OR 14PA Sa0A Lu
ES'i'IhiA-171) CON .i OF CO.£4f:. 1T9;'iln:�
PLA44 CHECK RM 101.000-439.31? P113
CONS'TrR DC TaUN Amit i 3 *1 -.000-41 18-000 Ti i 3.On
FLM AMU FIFE 10.1 -MO -419.000
STIZt.;N7 MOTION FEL. ltirSID I01 -0t0-24 I .OUfl yt.Sit
IRM-1)MA1J CON:LTfeLtt''i CI N 1.t4D PLAN 01& :
`":' • ;'S
LESS PRE-11A1D MM
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A.I. P. fi.T FEESS NTE NO111ff
S1" _ y
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Cr.. _ L ,— _ .__J
RECEIPT
DATE
BY
DW N
INSPECT
/• J /
i
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
POOLS - SPAS
BLOCKWALL APPROVALS
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
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)
REINFORCEMENT
REINFORCEMENT
1(
Pools'
FIREPLACE DESIGN /FOOTING DETAIL
or
•
III
REINFORCEMENT
3'0
3'0
T
6'0
t
CONCRETE FOOTING EXTENDS
1' FROM FIREPLACE
BAR VERTICAL @ 24" OC
6X8X16 C.M.;tFLACE
TURE
AR HORIZONTAL @ 12" OC
12" CONCRETE--
FOOTING
ONCRETE R FOOTING
—30"—�
- #4 STEEL MATERIAL, #4 STEEL AT CORNERS AND 24" ON
CENTER VERTICALS
- MASONRY SHELL WILL CONSIST OF 6" C.M.U. SOLID
GROUT SURROUNDING A 36" WIDE BY 30" HIGH FIREBOX
BUILT WITH STANDARD FIREBRICK, ADJUSTABLE
FORMED DAMPER, 13" X 17" FLUE LINER, 9 GAUGE METAL
SPARK ARRESTER AND SHALL NOT EXCEED 6' IN HEIGHT
- HORIZONTAL REINFORCING SHALL BE 8" HIGH #4 STEEL AT
FIRST COURSE, MID HEIGHT (TOP OF OPENING OF FIREBOX)
AND 8" BELOW TOP OF'MASONRY.
- GAS LINE AND LOG LIGHTER PER UBC AND CITY CODES
GAS CUFF ANSI # 16.33
STEVE THOMPSON /GUY ROY
80-900 WEISKOPF WY (Lot 39)
La Quinta CA 92253 THE MASTERS
GENERAL SPECIFICATIONS
DIMENSIONS: POOL SPA
Length: 5110" 7'0"
Width: 15'6" 7'0"
Surface Area: 699 SF 49 SF
Perimeter: 140 FT 28 FT
Depth: 3'6" to 6'6" 42" MAX
Demo:
Concrete: N/A
Sod / Gravel: N/A
Plumbing:
Extra Spa to Equipment: 50'
Raised Spa Bypass w/ck value: YES
Dedicated Vac Line: NO
Gas Line Extra: 50 LF
Gas Line for BBQ/Fire Pit: YES
Spa Jets: FIVE BACK JETS
Decking:
Color w/salt finish: 1,750 SF DECKING, CAP @ RAISED SPA
Cantilever Edge: 152 LF
3" Deck Drains (per LF): 50 LF
Step Riser (per LF): N/A
Dam Wall: +18" STACKED STONE SPILLWAY
Raised Bond Beam: 35 LF @ +12", TILE FACE
Umbrella Sleeve: YES @ TANNING SHELF
Tile/Stone:
Basic Tile Group: QUARTZITE WATERLINE TILE
Quartzite 6" Waterline: 152 LF
Step Trim: 55 LF
Tile Raised Areas: 20 SF @ DAM WALL
Masonry:
Spillway: 5 FT QUARTZITE STACKED STONE
Waterfeature: 16' wide quartzite spillway w/ pump
BBQ: YES (SEE ATTACHED DETAILS)
Fireplace: YES (SEE ATTACHED DETAILS)
Boulders: N/A
Access Wall: Remove and replace
Equipment Wall: 4'h x 4'w block
Paint/Stucco/Plaster: N/A
Pool Finish:
White Pool Plaster: N/A
Pebble Pool: YES
Equipment:
Pump: HAYWARD NORTHSTAR 2.0 HP CIRC/SPA
Pump: HAYWARD NORTHSTAR 1.0 WATER FEATURE
Filter: HAYWARD 500 SF CARTRIDGE -TYPE
Heater: HAYWARD 400k BTU LO-NOX
Controller: HAYWARD IN-HOME CONTRL PSC2100
Hayward Navigator: N/A
Pool Light: ONE 400 -WATT
Spa Light: ONE 100 -WATT
Purification System: N/A
Water Feature: See above (detail attached)
Landscape: N/A
Patio Cover: N/A
Fencine• N/A
MISC. SPECIFICATIONS: ALARMS & SPRINGS PER CITY CODE
Buyer is aware that oral representation or expression by either party is not binding
unless detailed and signed by buyer and seller.
P/L
q p
uartzite s illwa
5'0 y 5'0 concrete
pilasters
18"
bench
t,,�Q�IaCP� bench ;
spa
sed i I � i i 7,0 SP SET @ +18" 18
de--� pool 3„ 7'0
6'6
15 ,6
/L -
24" - _-- quartzite!
_.. 21'9 _ _ . 51'0.. spillway
L I-6WL
24"
TANNING LEDGE
O O r i A
0
J umbrella sleeve
- - ----------------------
E
�2�3. l � 30'0
13'11
i
------------------------------ -------- decking
j
--------------------
I
I
THOMPSON
GATE F G/E RESIDENCE bobcat acce
H 80-900 WEISKOPF WY
P LA QUINTA CA 92253
760-778-2700 760-320-3667 FAX 2295 East Tamarisk Road - Palm Springs, CA 92262 • License No. 779165