9708-126 (RPL)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chip%�r 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
[l1311i
r
/at�1: Signature of Contractie A,.
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 ..$ipnature 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, 1' 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 j, 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 ARbse provisions;,?
Date: /� � j Applicant s
Warning: Failure.to secure Workers' CompensatlonKcoverage 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 *1 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 propertyrfor inspection purposes. w ��
Signature (Owner/Agent)Date o ✓ -.
°°NTR°`#
PERMIT PERMIT4709-126
9
pBUILDING
DATEI 812 ` 'r VALUATION $24.250.00 LOT TRACT
JdErSIT 154-J4SWINGED VOM
APN
ADDRE S
OWNER
CONTRACTOR/DESIGNER/ENGINEER
�kAKI "eSAKU
IS � Vt.. DODSON Cc�l�tS�c��t�t.�a le�:�l
54 X95. Wii+il"a:"ED FOOT
8-011 C;OUNI'R CLUB DRIVE SCE. F4
1;,«t#.QM1:1'A CA 92253
P.t1.1.;M t.tL48E 'C CA. 922M.
(Fat}}1044
USE OF PERMIT
S.NVNiA
POOL AKD�011' qPA N,-250-00 LS
ye41 a �►.i �� -p to IeVP a.,c t iav�'e�a �_�A P.�PaA*
ati��ae a�J
y y rr ,gip
N1,Af4d;!HE.Cf" VIRE 101-000.4SV -3114 $11 15 ftp►
!"cNTWt?JV"r'VOWF*07P0i44)A1_4ttt-(". cy00
1V11i5. c Adti tL A4
l:l.i:�",i`:►21c°.�1, l�±ii �- f��.�t.;tl,. i6J1�11t11i�12t?-eltiU �-��:�t
Kd. MBINO J+S3 — P( .A_ i6l atm -419.000
80
IFSS PRE
TOTAL P1j*AftTFV,1i;N 0115V NOW
$511.80
SEP 15 1997
ATE
®F
BY
DATE FINALED
INSPECTOR
L�
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
BLOCKWALL APPROVALS
Stee6>
POOLS - SPAS
444
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
al
Final
a§,l?4j&ng
PLUMBING APPROVALSas
Test
ina
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
'7
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:
351 to P/I
P,
FAIRWAY PGA WEST
71.91.+/_
W
/ TAKASAKI
+�,
RESIDENCE
�l
ISPII..LWAYSI
16'-6" +1-
91-011+/-
1. _
TOP DASIN OF NVA �LRFALL
AT +24" ELEV. pt
t
HIMME I
CONTRACTOR cannot assume responsibility for
dam' to curbs, sidewalks, driveways, cement
slabs. _awers, lawns trees, fences, retaining
walls, sprinklers, telephone lines or shrubs.
When access is made through a neighbor's
property it is understood that you, the owner..
have that neighbor's permission and assume full
responsibility.
signature
WATERFALL
CROSSECTION
Boulders
Quartzite for �
sheet falls
GENERAL SPECIFICATIONS.
,,ZE 17'6" X 719"
AREA 103 PERIMETER 41
MOTOR HP STA RITE
HP 1.5
MOTOR HP
HP
FILTER STA RITE -300
SQ FT
FILTER RATE 103
GPM
-(EATER LAARS SIZE 210
BTU
TURNOVER
HRS
SUCTION. LINES
2 "
RETURN LINES 2-1.5
"
,!VIAAAA[D WnnCl A\I
"
GASLINE BY 3Lk- FT. 100
POOL LIGHT 400 'CLOCK
ELECTRICAL BY. SDC FT 200
CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
CONDITIONALLY
ACCEPTED FOR CONSTRUCTION
SUBJECT TO INSTALLATION AS PER
AND ALL APPLICABLE CODES
BY --
LITE 1 WATTS 100
- RI LEVEL SEATS 22" 24" 27'
DESIGNER DAMWALL TOP
DAMWALL " X FT.
08/19/97 SPILLWAY SIZE " X
DATE SPILLWAY OPEN C
#JETS UPER l
TOM M
NOT TO SCALE Name: STANLEY TAKASAKI
Address: 5459.5 WINGEDFOOT .
QL
LA QUINTA
TRACT LOT#
3i_0li min.
" WIDE
t:uodson
PALM DESERT TEMECULA
RTSTEBCOPY 73-011 COUNTRY 28910 RANCHO
CLUB DR. STE F-4 CALIFORNIA RD.
PALM DESERT STE 206
ULA CA.EMEC
NOTE: LANDSCAPE AND FURNITURE CA. 92260 TEHEC
ARE SHOWN FOR ILLUSTRATION92590
(619) 346-4032 (909)676 -SWIM
ONLY AND ARE NOT INCLUDED. LIC # A-574127
Y
ilii 2 , _Iii ;ti; i;l '�'��.3.v �i.4! !
1
PGA WEST It RESIDENTIAL ASSOCIATION, INC.
PO. BOX 1282; LA QULNTA, CA 92253
GA WTS 11�, (619) 776-5.100 FAX.(610) 7765111 '
COP
August 18, 1997
Mr. & Mrs. StanleyTakasaki
5305 Buckingham Avenue'
Burnaby
British Columbia, Canada V5E1z9
RE: Architectural Variance request -for pool at 54-59$ Winged f=oot
Dear Mr. & Mrs, Takasakl;
The Architectural Committee of the -PGA WEST II RESIDENTIAL ASSOCIATION
Board of Directors has reviewed the plans For a pool and spa at the above
referenced address. The Committee is.pieased to inform you that It has
approved your request with the following conditions:
1. All irrigation changes (additions or deietlons) to the system must be
coordinated with the Associations landscape maintenance. contractor,
Valley Gardening Services. Please contact Miguel Valenzuela at (760)
399-1844.
2. Per the Association's Architectural guidelines, please verify that the
rear set back is at least 5 (five) feet from the property line,
If you have any concerns or question's please call me at (760) 776-5100.
Sincerely,
John -J. Monahan
Assistant Association Manager
CC: John Handel, Association Manager
Board. of Directors
Unit f=ile