0305-216 (RPL)U)
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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
7i 4165 ALFOXMC �. 5/3 1/04
Date 75'f'R Signature of Contractore,' X ,v '
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 structurels 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:
Carrier a�'TATA IRUI D 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 thoso prouisions,�
�Date:TZ Applicant—
Warning:
pplicant 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 for inspection purposes. a:
�,�.Signature (Owner/Agent)` * s Date
PERMIT #
BUILDING PERMIT
J.t2� ♦,
DATE VALUATION ' •7��;�yen,;�„�1EJ LOT', TRACT
JOB SITE6.021 `S�,•PN(a M) FO Y1'
APN _
ADDRESS
OWNER
CONTRACTOR/DESIGNER/EN (NEER
C'C�1't? 1„11 t;?�? I•: 0 92679
IRAI.tM SpYlac-4.1 CIA, 92262 .
(76q08--:s?CO MILO 2951
USE OF PERMIT
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PLAN 01WIC FEE 10; 316,?AQ
CONSTRUCITION FE -F, 101-000-4 1 8 -OW "52.00
MEC`•1'rAI NIC7A:r FRE --.13:x71. 101.900-421.00 424,00
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SIS 1.60
RECEIPT
DATE,
BY
DA FI E
INSP R
y;e
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
steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Un
��L
Final
G
8�
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
T 1W
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
- -
BOB ANI )EBRA KOVACS
SHEER DESCENT
GOLF COURSE CASCADE
GOLF COURSE
t Dr. C
y X23 Foor. S
>h g
Y� La Quinta CA 92253 EAGLE BEND
QUARTZITE SLAB P
SEE DETAILS FOR STACKED planter 4'6 8'0 10'6 + 15'0
sT
NE FINISHES ON POOL
�'2
GENERAL SPECIFICATIONS ' AREAS
DIMENSIONS: POOL SPA
b'OS�a
bench
26'6
P/L
Length: 33'0" 8'0"
/
(
Width: 5656" .6>0„
\
planter
Surface Area: 370 SF 48 SF
20' 0
,
3 � -
lawn-
awn
Perimeter: 95 FT 28 FT
Perimeter:
- Depth: 3W'to5'0" 42" MAX
-
i
+Z
.x :, po 0
area
Demo: .. ; , ,.
.:,
F
a le
tanning ledge
g
1 3'9
5'
r „ _
Concrete: N/A .
_
decking
�
• -
-
Sod / Gravel: N/A
lawn area
-6 WL
planter.
Plumbing: 7
Extra Spa to Equipment: 70 LF
4
Raised Spa Bypass w/ck value: YESumbrel
is sleeve
VAC
Dedicated Vac Line: YES
10 LF
24 9 4'6
•3 -
Gas Line Extra:
t: 20 LF
planter
planter
■
-nnA-C FIREPLAC
Spa Jets: FIVE BACK JETS
"
deCiCl n g
Decking•
Color w/salt finish: 1500 SF DECKING, CAP @ RAISED SPA-
12'
4 a
l
p nter I
9
� Ptio=.io6
G �..►Si z221.5�
Cantilever Edge: 122 LF
SMOOTH BAND TR IM
3" Deck Drains (per LF): N/A yI
FULL PERIMETER loggia area I
p lar►1
Step Riser (per LF): N/A
Dam Wall: +18"
smooth
nd trim
bbq
Raised Bond Beam: 33 LF @ +12", STACKED STONE FACE
P/L
planter
G/E
Umbrella Sleeve: YES @ TANNING LEDGE
35'
Tile/Stone:
{ SLEEVE ALL PLANTERS
Basic Tile Group: 122 LF 6" GROUP 1 OR 2 TILE
WATER/L.V.WIRE .
Quartzite 6" Waterline: N/A
Step Trim: N/A
_
Tile Raised Areas: 30 SF @ DAM WALL, 6 FT SLAB SPILLWAY
STACKED STONE (SEE DETAIL SPEC)
BOSS REMOTE
Masonry:
Spillway: 6 FT SLAB QUARTZITE 2" THICK
`
STAGGER STEP STONES
Waterfall: (2) 18" CUSTOM CASCADES (CENTERED)
❑
„
BBQ: YES (SEE ATTACHED DETAIL)
Firepit: OUTDOOR FIREPLACE (STACKED STN HRTH)
KOVACS R CNCE
a/c
Bim: PER LANDSCAPE DESIGN
J
❑
Access Wall: N/A
.
Equipment Wall: N/A
existing Wall
PLAN ICR
a/c
Paint/Stucco/Plaster: STUCCO EXT. RBB. BACKSIDE
13'b
LOT 5
Pool Finish:
F
6
White Pool Plaster: :N/A
Pebble Pool: PEBBLE COAT TAHOE BLUE
bobcat aCC6SS
APPROVED BY CONSTRUCTION SUPERINTENDANT
'
12
• Equipment•
1
P
I,
Pump: HAYWARD NORTHSTAR 2 HP CIRC/SPA (2-SPEED)
DATE
existing Wa)
Pump: N/A
S/S
Filter: HAYWARD 500 SF CARTRIDGE-TYPE
Heater: HAYWARD 400k BTU LO-NOX
"
APPROVED BY DESIGNER & SALES PERSON
Controller: POOL BOSS REMOTE INT. MOUNT -.
SMOOTH BAND TRIM
Hayward Navigator: N/A
DATE
FULL PERIMETER
Pool Light: ONE 400-WATT
Spa Light: ONE 100-WATT
patio deck
Purification System: SALT SYSTEM — (AQUA -RITE)
Water Feature: 2 CUSTOM CASCADES ON RBB PER PLAN
APPROVED BY CUSTOMER
r ' 's
C' FI
Landscape: SEE SEPARATE DETAIL
Patio Cover: N/A
DATE
FOUNTAIN BY OWNER
Fencing: N/A
760-778-2700 760-320
3667 FAX ' 2295 East Tamarix oa a n1 Sprlin�s; A
92262 a
icense No. 779165
MISC. SPECIFICATIONS: ALARMS, & SPRINGS PER CITY CODE
GATE
Buyer is aware that oral representation or expression by either party is not binding