9709-001 (RPL)LICENSED CONTRACTOR.DECLARATION
,yl 1 ereby`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
Profes5ion'als Code, and my License is in full force and effect.
License i` Lic. Class Exp. Date
ate Signature of Contractor �.•.-• : f � J'"�_'
_
3✓`
OWNER -BUILDER DECLARATIONN
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),
O 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.
{,�r) 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 Policy No. , e
.. A-�'J..i: .7 �.,l., i iA.t,fej l'v a,M i, •+r,
(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�roy�'sions of Sectio,'3700 of the Labor
Code, Lshall forthwit comply With -t bse•pro sions
date: Cm Applicant ; :.:, ^ ~.
r�
Warning: Failure to secure_Workdfs;.Corhpe, n ation cov age is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made:to the Director of Building and Safety '
for a permit ,subject to' the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at, r 1i
whose request and for whose benefit work is performed under or pursuant to Q''
any,permit issued as a result of this applicaton agrees to, & shall", indemnify;-
& hold harmless the City of La Quinta, its officers, agents and employees
2. Any permit issued as a result of this application becomes null and void if
-work is not commenced within 180 days from date of issuance• of such
permit, or cessation of work for 180 days will subject permit to cancellation. - '
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State. laws relating to the building .
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned propegy forffspection purposes
Signature (Owner/Agent) _' f�f ! . Date / r
PERMIT # CONTROL #
BUILDING PERMIT
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DATE(' VALUATION' {ff " .LOT TRACT. r
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JOB sillk - .
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OWNER y
CONTRACTOR / DESIGNER / ENGINEER -
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Vlate�r^f•'��t%!TM�•E�,�f:�:.� .F'�IL. �A� . ... .. ..
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PA QU a•� CA 9aA 53
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USE OF PERMIT
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SEP 01 1997:�a'i.1'.;t-�,t @aid.i',1" 6+;M1f SA$FF, V
5407.
cJTY OF a a
a
RECEIPT •
DATE :fI BY
DATE FINALED
INSPECTOR ,
INSPECTION RECORD
o 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., z7114 494
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam 7
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 o
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
PGA WEST.II RESIDENTIAL ASSOCIATION, INC.
P.O. BOX 1282, L-A QUINTA, CA 92253,
(619) F 76-5100 FAX(619)776-5111
" PGA WEST
August.15;1997 e
Mr. George Brown .
.12800 Plymouth Circle
Anchorage, AK 99516
Re: Architectural request for 55-535 Winged Foot
Mr. Brown:
ar The Architectural Committee of `the PGA WEST II Residential Association is '
pleased to inform you that it has approved your Architectural request for a pool
Y and spa at the above referenced address. The approval is conditioned with the
-following items: r '
• ` 1. Per the .Associations Architectural guidelines,: the rear setback -must be a ;
minimum of: 5 (five) feet from the edge of patio. Anything closer than. a
5(five)`feet requireswrittenpermission from KSL Desert Resorts,
operators of the golf course.
2. All irrigation changes, including capping of off existing lines and
rerouting of main lines needs to be coordinated with the Association's
landscape maintenance contractor.. They can be reached at (760)399-1844,
contact person is, Miguel. Valenzuela.
-Should you have any questions or concerns please call me At
(760)776-5100 ,
Sincerely, .
John J. Monahan !.
Assistant Association Manager
CC: John Handel, Association Manager
t:. t Board of Directors
Unit File .
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'CITY OF C Il�TA .,..r .
{ BUILDING - SAF s' ®E �gRTMEN
ACCEPTED F�'
i ACC w.3 `.,u +�
a 1.
.'SUBJECT TO IN:� LATI N A5
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AND ALL APP- i ABLE DES r� • d':L.L v r.• . - S�a' .
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POOL AREA SCALE 1/8° 1' . `
PLOT PLAN-NO-SCALE
POOL SIZE DEPTH TO PER SO. FT. ❑INCLUDED ;
TEMPL. NO. FILTER N0. '11,46 )Aje:O ZGO NOTE: SHAL=OW END ' . ❑ • `LADDER ❑' ..
DEEP END DIG `.. r . ❑ SLIDE ❑ r
SHAPE • V — • NO. RETURN LINES 3 Pc� L °/ 5� �7 . c�� � t-E-,� `/<< � ��v1 i� �J�'•( ht*
P-TFLAP ........ .. ❑ LIGHT IN SPA ❑
ACCESS FT. FENCE `ftTPJ lb Qt %. ~ 6-= L Ow Ei"iA% BACKWASH UNE r . '. ❑ �, SPA ` ... !. ❑
MOTOR PUivir ' HP —T � % /� FILL LINE , , . • . ❑ ^":LORINATOR
GRADING . ❑ . ROPE RINGS . ❑
LIGHT ANTISYPHO YES h—LA 74> ' UT UTD f:g ��(S l HEATER �.I.... ; ❑ MAINT. KIT ❑
ELECTRICAL IDD. ET. BONDING YES 3 Vat �Q vt i ��► Er w )4`�� GUNI T EJNSP ...... `. ❑ TREES :. • . F ° ❑ *-
GASF-=FT,TILE �COPINGNO. C % 0 BOARD .. ❑I OTHER ...� ❑ f
LOT ('_i e <a OWGJER�L�� �C (�S,'i r _lir` z
DATEMU' E E PRISES- r _ - j��a'� S t JOeADDRESS 5�i—.53 !�/ti6t`%�fOoT+
POOUSPACONSTRUCTION COMPANY, . TRACT �� �( }
r ' CIT1E Q, MAP N0. ;
ti v .� . ���t:rj �• �, �' JOB�PHONE BUS. PHONE Q.
' SALESMAN' �) PLAN N04V
`. '
CITY • LIC. NO. -CONTRACTOR NO.Li�%7 �=� ?�� _ JOBN V12