0307-007 (RPL)LICENSED CONTRACTOR DECLARATION
PERMIT#
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hereby affirm under penalty of perjury that I am licensed under provisions of
BUILDING PERMIT d�;iBldD�S'�
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Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
DATE ,., , •VALUATIOtJ �: LOT TRACT
WProfessionals
Code, and my License is in full force and effect.:a%,a1d1:P..J
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License # Lic. Class Exp. Date
ADDRESS l�'uIOB SITE+✓ % �vo9L74vLii ? �.
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OWNER
CONTRACTOR/DESIGNER/EN (NEER
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Date `�J�"% % =Signature of Contractor Ry.+t,...� /•
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IXC & PS'I"t'n 1AI' RYAN
CANYON VJE i*01,8
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OWNER -BUILDER DECLARATION
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6—OC'7 MUNCTED FOOT
17195 X TIN NrIMSICRD
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I hereby affirm under penalty of perjury that I a i exempt from the Contractor's
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' Y �3 CA. 9.' 262
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License Law for the following reason:
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( ) 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
USE OF PERMIT
sale (Sec. 7044, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
POOL AND/Ok 'P.E1
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
O I am exempt under Section B&P.C. for this reason
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Date Signature of Owner
ST.AVDA1) J1.L.AtcrvA : BARR1FJ`5 ZRALL RZ rM PL.A.CF AJ L'':i&PiwftTVz- R
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WORKER'S COMPENSATION DECLARATION
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I hereby affirm under penalty of perjury one of the following declarations:
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O 1 have and will maintain a certificate of consent to self -insure for workers'
POOL A; WOR SPA 29,80&10 I's
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compensation, as provided for by Section 3700 of the Labor Code, for the
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performance of the work for which this permit is issued.
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( ) I have and will maintain workers' compensation insurance, as required by
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Section 3700 of the Labor Code, for the performance of the work for which this
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permit is issued. My workers' compensation insurance carrier & policy no. are:
Cartier �:TAPIr>*tl�;I) Policy No. 1f�i 44.7•�,'s)�+
?V�tt:;L�Fvfe C:+�u'�' SJF CC_1MT.ff,;) ,'`1'10
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PRRWY ME &VN1MA RY
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(This section need not be completed if the permit valuation is for $100.00 or less).
?U -,N CIMMY;1 x'^11= 01-0,01'D-439-318 i F" 4.P3
( ) I certify that in the performance of the work for which this permit is issued,
CONS•TRUCTIOT) FEE 01 -000-416-Cl O N34.50
I shall not employ any person in any manner so as to become subject to the
MiSCFiAIM.C'>..t. FEE POOL 3 ("11 000-4,11 _000
workers' compensation laws of California, and agree that if I should become
KLEC'TRK A1, FEE — I OOk. 1014J00-420-000 �vt�.t10
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subject to the workers' compensation p�ovisions of Section';,3760 of the Labor
Code, I shall forthwith comply with those rovisions. wY p�
-bate: %."'::,tr Applicant �e�% ,•i C fr
i�L6.1�lY�37i" f Y,.M, • • POOL 1101-01N-419-000
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
a �#3-�1 a1a7.Or.�t��iD:.'tR;i.11.;'IVION 144) PTAH !:,Fll ;' =
'�:1to�i,el`3
whose request and for whose benefit work is performed under or pursuant to
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x;0100
any permit issued as a result of this applicaton agrees to, & shall, indemn�If
& hold harmless the City of La Quinta, its officers, agents and employe es��
a���a�a�F«i�<k:.1ij:IYI°�8t#
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2. Any permit issued as a result of this application becomes null and void �f)
work is not commenced within 180 days from date of issuance of suer
permit, or cessation of work for 180 days will subject permit to cancellatio
JUL� .
UUS
I certify that I have read this application and state that the above information s
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correct. I agree to comply with all City, and State laws relating to the buildi g
CITY OF La 4` Up"TA
construction, and hereby authorize representatives of this City to enter up n
FI6dAPdCE DEPT.
tl�e above-mentioned property for inspection purposed
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RECEIPT DATE BY DATE FIN D INS
OR
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Signature (Owner/Agent)' A%�� j Date
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INSPECTION RECORD
OPERATION I DATE I INSPECTOR
BUILDING APPROVALS
Set Backs
Forms & Footings
Slab Grade
Steel
Roof Deck
O.K to Wrap
Framing
Insulation
Fireplace P.L.
Fireplace T.O.
Party Wall Insulation
Party Wall Firewall
Exterior Lath
Drvwall , Int. Lath
OPERATION DATE INSPECTOR
MECHANICAL APPROVALS
Underground Ducts
Ducts
Return Air
Combustion Air
Exhaust Fans
F.A.U.
Compressor
Vents
Grills
Fans & Controls
Condensate Lines
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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)
I
Final
Final I
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric_
Underground Plbg. Test
Final
Gas Piping Mwl
PLUMBING APPROVALS
Gas Test IF- I
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
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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)
LES AND PRISCILLA RYAN
56-007 Winged Foot Dr- (Lot 1)
La Quinta CA 92253 FA= Bmp
GENERAL SPECIFICATIONS
J)V NSIONS: POOL SPA
Length 32V" 10 '
Wrdth:.t4'0" 7'O"
Surface area 346V 39 SF
Pcginvicr a2 FT 23 FT �
Depth: 310- to 51tr 42 biAX
Coatreta.N/A
Sad /(haaid: N/A
Ptamblaa
Extra Spa [o Equip • 20 LF
Raised Spa Bypass svlck %nl= YES-
DedScated Vac Line: YES «
Gas Line Extra: go.
Cras Line 1br BBQIFlmFit: 15'
Spa jets: FIVE BACK JETS
mimic
Color wlsall fins: 13CO SF POOL CAP RAISED SPA
Caj�rlldg� 105LF
3- Do* Draim (yrs LF): 50' (SCENE ALL PLAN ER5)
Step Riser (per LFr MA
Dam wan: Stacked momo TR! ay -QZT g spa sades(acer peat)
Raised Bund Bean- 20 LE •g+12", BACKSIDE OF PO0L
Umbrella Sleeve: YES @ TANN` M LEDM
Batt Tilt Group: - t05 LF C GROUP 1 OR 2 TII fi
Qaartm 6" Vhtalee: IVA
Stop Trim:. NIA
Ti}e Raised Arras NIA
mmmrl.
Sodtvmy; 6 FT QUARTZYl E STACXHD . '
Walzrfan: WA
BB(�: YES (SPE ATTACHED DErAEL)
Boulders: FERDBSIGN
Access Wail: PURBLOCK WALL
Equipment Wall: 4' H X 6' W
P`Rb*StttsnrPlas}cr: STUCOD EXT. BACKSIDE TO C01F COURSE
Pool B)®alm
VAhe Pool Prager. WA
P&ble pool: YES-TAHOE BLUE
Eraalpmeut:
Pump: HAYWARD NORXHSTAR 1.5 HP CI RCISPA
Pump: NIA
Furor: HAYWARD 4CO SF CARTRIDGE -n -PE .
Healer. HAYWARD 40ak BTU LONOX
Conumtla: POOL BOSS REMOTE IYT. MOUNT
Baynard Natip[or. WA
Poul LiZJr1: ONE 400 -WATT
Spa Lim ONE 1C0 -WAIF
Parifieatioa Symem: SALT SYSTEM - (AQUA -RITE)
Wz tr 9¢adnre Cnstomcaxa& 2r wide @ RBB (2)
Laedacsm SEE SEPARSTE DETAIL.
Ratio Cover. NIA
NIA
MMC. SPECIFICATIONS: ALARMS $ SPRR:OS PER CITY CODE
Buyer L aware fiat oral repmsm0tbo or eiprcrbm by ultler pally Is not biad[m
im[ess dadW aed s1ped by buyer and w&r. -
P/L
11 GAT
existing wall
bobcat acces
- 1.
76W
GOLF COURSE
PA
760 -320 -36.67F -AX 2295 East Taniari.sk Road Pain) Springs, CA 92262 - License N¢. 77911
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