0307-015 (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
-Date ,�; *fl'% 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.
( ) 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 F:XYWPI'-XF: iD Diitn'3i Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
'(.J 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, J.shalljorthwith comply withthose, rovisions.
Date: ' ` V ?Applicant a
t i
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 p�,Rses. t I .,�
� P � .•"""- I Imo%,` ! •��
,.Signature (Owner/Agent) Date
11.BUILDING PERMIT PERMIT #�
DATE ' VALUATION �� n/� LOT (i TRACTJOB
ADDRESS M�{9 WINGI t:7 .C't}M' APN '/7;�-3TW_01
OWNER A CONTRACTOR/DESIGNER/EN &NEER
0ERVY 'DAVISON VMS
USE OF PERMIT
0r.19F..P.A.L BUTU J140
VALUAT)ON'
7,00.n Is
°t'3.M CHF.. K FE.f.' 101-000-439-315 $53.5tt
CONSTRU(7,11014 ??Ur 101-006-418-000
F LIUMrDr0FiIX 101-000.419:.u00
SF'KG'M 10 1 F.",^ 4SID f01"00
0A.11"000
1
11ff ��77ff�� W TTIM N,Y4 tf/WT MD Py f �TU'�rgq
JUL 2 9 2003
Fim-S.DVE NO W
I CITY OF LA QUINTA• • . I
i FINANCE DEPT.
RECEIPT DATE ` r BY D FlyAffi INSPI�R /
V6870
$011*10
side, 70
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms 8 Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX 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 d
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:
' t'
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)
l®UliTG ENGINEERl1�G ,�ER-VICE'
•Engineering •Architecture -Surveying- Building & Safety Services
Letter of Transmi.tftalr
To City of La Quinta Date: 7/28/03
Project: 56-039 Winged Foot
Attn: Ed Randall PC#: 0307-0.15 (2 nI Check)
Tel No.: (760) 777-7012 Tract No.:
We are forwarding: X By Messenger By Mail Your Pickup
No. of Copies Description:
1 Set of redlined plans/new plans
1 Set of structural calcs. 4
Comments: Plans are acceptable.
Thanks
This Material Sent for:
Your Files Per Your Request
Your Review z Approval
Checking At the request of;
Other -
By: Eric Frenzel
Phone # '760-360-5770
77-804 Wildcat Drive, Suite C Palm Desert, CA 92211 (760) 360-5770
Bronz Young
56 -039 vs 'n oT V4
Sr`YUc�uvcL _ DeS �� ;
Concfete! �ooTit �C r a50o psi W10 cc�
a
AS5ume 3oVotcAm
[(14
66.5o ff3
vsa. 66.50 x -3o 543
�l
P•
C�ec1< jie.�e`r,SC �.oUd
T m�b ,Zone LA =?
75 , 03,57 V
7.E a.�qr; hb6s
5Qb
V 3 0 68 x • `� = 534
T� �c,se ScJ. To (' b . F e;5
vv-:-
53
v�4 �b
.� 77-
Gly /^vv Svc.
14b7-
(150 pcf) �S) C5 �) � �) (� 5 �) - I G
MR1-5
" I'o855
/rlaT. Z, � 2
J
e, o•63 T
2qq2 (5)(1) 67q, i6
2 /AloT 1 l�
o• 63
Pr 6 �?
n2.5 ff 2.5 f4
SMae( eccr,f��c��y
uvts AUUHESS 6L • t)M ' CV/Alfie MFVI MR OWNER '4o v/So BUILDER i fi913P-A Ul 160)-s ALI
This form shall bepost ed on the job with the Building Inspection Card at al.l.times in a conspicuous Dlace. Qnly persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencemend of work. Failure to comply will result in a stoppage of work and/or the voidance
of building nPrmit Fnr aarh annlirahla traria all infnrmn'tinn rnnlloctnA tion,,,,,, —+ k- u'1___a r,_
_ L 1 _ _
Trade /Classification
Contractor.
State Contractor's License i
Workers Compensationlnsurance
City Business License
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Expl Date
(xx/xx/xx)
Carrier.Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK (C-12)
CONCRETE (C-8)
_
G ' ��v
S�Q
63 _
i/ "3 �I
r��;
M t h
_�� �y�
S3 200 YY� 1'3 7
��� iilo
r! 3
FRAMING.(C-5).:.
��, `
7' f %
51 /o
STRUCT.. STEEL (C-51)/�
f>YU
/'�
/;�10I
J o
3i
;
S'i`i ►=
y' On'Z
MASONRY (C=29)
PLUMBING (C-36)
S;oir;M�
9�3.' �.
dyo, a
0611)/1
LATH, -'PLASTER (C=35)
DRYWALL (C-9)
HVAC (C.-20):...
ELECTRICAL (C 10)
D r i �� �3-�-Y
o b35 �U
0 13% b 11
Sly
Cl ' 002.i l
(yl o I 0
V� ��� l
ROOFING (C-39).:' .:
I
.SHEET METAL (C-43)
d
FLOORING (C 15)
GLAZING (C'-17);...1-.'...
INSULATION (C-2)*-.-:
'
r
SEWAGE DISP.
PAINTING (C=33)
CERAMIC -TILE (C-54)
t
t,
CABINETS ,(C-6) ' .
FENCING (.C-13):`-
.0-13):
LANDSCAPING (C-27)".*
LANDSCAPING
�` _ - -
C—S3C 4
b;�,.. � 1061,
LE
POOL (C-53) ..
••
M
+12" PLANTER DAVISON
QUARTZITE CAP/ SIDES WATER FEATURE
SPA +18" / 18" WIDE CASCADE
WITH STACKED 18" WIDE CASCADE/
SCADE +12" PLANTER
QUARTZITE SPILLWAY/ CAP '+42 %"' QUARTZITE CAP/ SIDES
P/L
FIREPLACE 1' _ „ R �A��, „
+72" \' .. a K F20' -6" fBBQ
HX
3'-6" R T QUARTZITE
4-611
11 " o TOP
DECK +12" 6 +6
ADD 36 —� n +
� > `� 6„ •- . -POOL SIZE 37' X 13' 7 -0
„ R
-
m
BLOCK 5' —0" 5' DEEP?, ,0.. 4'-6"
rn
WALL , _' „ 3 3.6.. EE -4 +36 �— 'ADD 36"
\18 0
Mt- _ P/V — +42" 3 -_. - BLOCK
TWO 6" WALL
STEPS
QUARTZITE
OVER
SKIMMER. i
TOP HANG
" AUTO FILL • .
P/L �, PLANTER PLANTER UMBRELLA SLEEVE PSL
CALIFORNIA
- PLANTER 6' -0" R
TRIM DECK TO BE CALIFORNIA
GOLD QUARTZITE. 31 ' PLANTER
EQUIPMENT DANDY RS 6
)L EQUI '
WALL 5' HI
PLANTER
6 -6'--
NEW GATE
MATCH
OPPOSITE
SIDE
j DATE:
/ s SCALE: 1 "=8'
ALL QUARTZITE CALIFORNIA GOLD BRAWN BY: DALLAS
JOB
5h -o�I Gt�iN6t� A)D
k
w
_yVj
�f W ' 7834
LU cz
Exp. U-1111W
No:
4.
- j/!`�' �/.'• _` pi 0 _ SOF CAL1� �� ��Vi-� v
jj�
I
_ie_-_
ol
`i �,� YLJ.✓a . I, I rR - 1 v' Gf/!�� '� � Y •2/�� ,'i , � T'. ��"�yC�. � �//_�� 1 ��p"/��(�� y
LA Ir N-1 V���✓
i y
...
� s` � � j ' ,` �� ` • }rt„�` �; •� t ( � � Yy� �• �_ ��/,� ,� .� • � „', f '''Y ,; ti,.. F�`-. �L.t�C. � f �"' •
/ [ �{ `r C4 l u�.i nr ?' l�✓�r ! s' Y. j
F° ! /
G 1'�AScsaR'( �iaoc�( 6
S
<�FYafo���^ JAP T
No.;
-'7--7
(�
ti P6 �� a E�cFeo�., Ems. tzf3t o3 .�'
SOF CAL1��
- G�rD �
5��� T—z 2-•03
e93�w/�