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0310-088 (RPL)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 Ir Date- ¢ 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 d� Sertlon 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 w �..� .fi..: f.ft;P� k6.,.t�lf Policy No.>f sIii-�D;f (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 berome Subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation pregvisions of Section 3700 of, the Labor. Code, I shall forthwith comply with those prows ons. f Date: sl' t > ,)Iw Applicant l�IA? �7 z Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal 'penalties and civil fines up to $100,000, iri 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, 18.0 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.f I'! Signature (Owner/Agent) %' ' : -I" �%' Date /� PERMIT --BUILDING PlEAMIT DATE VALUATION 0 e .00 .,LOT. q TRACT 30"e" /1 JOB SITE ADDRESS St5•�V91 W'rL} G,10 Tf 0T ADDRESS APN ' OWNER CONTRACTOR / DESIGNER / EN INEER /fT�'.i��i',�irr�pp:?���}}f`"i�y�''�y���".�'.;yys j`y�.. f?, A ayy't.`y+�!`.+�..!J14111 �i+ ►i� DR, H :A/L7r jp? f;l..s i c% .1P, (1'01 MAN 0 C y�pp �''+\ 'XE. YttyLYf]Z'.L4ti'E :JA'01V ,' d:':> M, "KI •, . ' C7vy.�Pil yE`[1�7 - V�4,+--i 1' G f.�'b �Ta?d .i'3? .fj IRV% 003515 USE OF PERMIT -...� y'/ t 41%4,ta.l.� ;� flld •�.RT.i 1 � °„YCL . t :..?�.. C....l a., ,r F.r';.ns! r ♦ttti.rita� .. . . 014ALL BE IR rLMT .71"AUaimUTPREXT 01CUXA1 RE 140T POOL 41 ns uuammay I'LAAW C'HWK FEE 01 -009-43v-3) 'rry�CSTRUC Ti014 FEZ 16 I-1 �t '1r 13 f�61EF MEXHAVICAL P00,10 ,10 a 01.00,0a;421..,Gi%! fG�is.4lil ,h."'.,,E"CTlt.€CAL,kt'Zi ..., POO -1, I,•'>:i.,Wo-::L 4.7t,”. Ott 0 �D, /�, NOV 1" 3 2003 CITY OF LA QUIN IA . . FINANCE DEPT.' ,��• �y .yv/..ry• p pyo r� 2�,. �,y •. a g.. },:� �•�-..�q�• typ 1./111 -TO R11, a' l.w�3A":�1+.+.ti�1`! � �� �1'r/.LN .CiL.•l�ti ts, .• �3 r, ,t�,p t t� • .a /,:i..R .l .. .' LESS E TAI)MM r'2,1 SIX00 - .. ♦ 7. �qYy '/ qg�•'� p� � �•�, (./ '{gyp 5' - 1�' 6'44,a.P.�S�.'Ai.67.Li.3�.C`dkrffrf:4 Al R..l+ji�V:F a teary � 1 1jSee,u'�1ee15.�"v RECEIPT DATE BY �' DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms 6 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 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS - SPAS Steel ,✓-_, Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test i 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 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 I � I I I I � &0QcAv- 6r-k-� I - 6 - OL -r ( . I I I I I I I I I I I — I - I I I � ll:� I I I 11 I I I IGOLP I I I I 1 IS-1plAV7 P -XT- Llc�r� � I 7) 1�- I . I I . I I � � - . - I SPECIFICAT'IONS I � : I � 77, =,zml� . I I I I , I � - v I I �P-hV7 � I I I � I I I - I I 1 , - , -7 () Z /" .6 - ( I-) ( T77 I � 11 I .1 I - I I .. I . __,----*,-, -- I I, — I I — I � - I . I I � TYPE — — SIZE �13 X 511-1 &� , � U) LO � I � I I . � I I I SURFACE AREA OF POOL - . , I � I � � I I I � I . I . I ef - I fjv � , , f � I I I I 11 I . I I I 0. 0 'S i PERIMETER - t I I .., MAX. --- F-,.Z'r I DEPTHS MIN. I C'4 to 0) n . CNI 1 1 � I I 1 1 � I I I 11 I � I , .2 I I � I � I - I I 4;�� , I 1 * � I ,4 I I . . � I � - I . I CA 00 4m (7) to CIFICATIONS I . Tlt F . I � I 1cp 6 1 I I I I I - I � -7 'X i 0 1 SIZE 6- ' SO. FT. I TILE rME . -� - U a I I . ;. 1 � I I � � I co -- I . I � I , ? � ,�� I 1, I I ! ��,"��-, I , � I A - 1. - \ I - , SPA DAM WALL WIDTH 15, WATER LINE - - �l < r- 1, � co " � I A -f stt- , 0�jv-'01 ----------- --- 511-111q,C) 1.(,A -t- 1�; �^o i Till, 4,10. i , ") . � - - I I I I --- - , � � I I ----- -, - - - - -.- � �.-,-��,.--.--�,,�-,-�--.,.-,,�,-, I .- I" I . I I I I NO. 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A , ". , -, ., � - -1 -- - - , ,� -� I * -, (., " � - ,-!i� 'MA'$t . I .. � I i I I . OW,r4ER RESPONSIBILITIES . p ! � I ; i �- I - "­-�-' I -lle-t- ,� , -- --.--�tl� � I .�,, 1�1,�,-`.-�,,�;;'- �.- � , - , 11 . I I " ", I I -, , . , nl- � -��-,2,� �, ,"i ..'r 71��,A-, 1 � �: ,,�-�.,� - ,-."--,',-, ,�-��;,J, I � , I � � I � - 'N - I I . �- � 14�1 �� I I � , 71 le� ,, -,.. , �,t z t; ,�,� 1� C�- - I- ,,, 7, w I I i lll�.;- "-" ( ;. �;� � ,,, �, - , , , 1 , : ItA -41 T ,- ��;� '�,'��` - a '- , -- � I I . � I I . . I I � I I � . . � _ "'; L� [ � �111;71 .�;, , i � , al � , - , -1 �-,� -1� � t 1* - - . ; " -. , -, �_- , I - �� . � --�, I ,1:1� -, ,7. `� -il�'l ,--i , I * , � I - I ,�-,� - i'�.- � � � ,�l _ " �l - - , . 1 ,4 " - - -, ,�, I . � I 1 t � I OW40 TO: (1) DETEP,WNE THE APPROXMATE ELEVATION OF POOL OR SPA AT LAYOUT ON DAY OF EXCAVATION I I i I . , , ��^ , - - - -, � _ -111 � - " � -vl� � - I I � , , , � , - , � � ". , - I - ., -, � ��, �� . "I , . - � .. I � - ,� -4� , I 14 _ I , � , , I - �- , -, i��-.�--��t�-" , _ I`% -, , ,;�,,� � - 11 -A �l 4-1 . �'- � '. "'. . I -1 ,� ­ -.�-- -1 �,�, , ,,� isp Ni�:.!� - � ,� �� I �� . jLA .1 - �' 1`10 .iz, ;,��,-�� -� - 1� - � I I 4 1 I � TICE THAT POOL AND EM~ -NT LOCATI S ARE SUBJECT TO A017EPTANCE (2) TAKE NO ON , OF , i - I t I I . - �J'­. I 'IT p��--w "r�,�**r�z,,' -�t4i;,,,;��'�k,L,t�:����',',�e,� ""ir , , � �. � f-,�� � 't --�f m--jA-, - R -I -S -�l �,,, -""?C�',,?�!�41. -,.,,--.,�,���--;,.Z;��i�����;-�',,�..�� . - � ,,,ll - I , ,.� - , ", - w --N- ,- .1 1�1' " 1, , � - - �� � " _ - , - - I , ", ; ,,� �:, I �,� ", :� :� I ��V-E'!-.7 - �;-� l: -4-z--- . . - , � � Atl-l' "-�,14,�l?"!�,,�,"�.;,--t,�1-11-,-� � - - , - - - ", ` "4'- I I I . : � LOCAL MtDNG DEPARTMENT AT TIME OF ISSUANCE OF PEPUIT � � . i I . . , � I -1 I -- �... �-,i I 11 4. - .v ,,,�-.�����L,�-.,����,--,-",--,�'�"-i-,��,�Z3 , .'- -, I,,- - - jv 1-'�,, � � , -,,,�;�;',,�-.` ,'-'�'�lll -1;- �� - , I I - �- - I - 11, - ;, 4 -- - - -, , - , , I �� -, - - � 11 - ,�; -�',', ,i - " , -.- ,,, I . 1� 11- � " - � � A -t�,��--�7',k--��:�t.-.F7�,�',,,.�--17 C a"",�� -�-'7t--- --i�- -,,i� ��,��,� � , �, " �, -�,� ,� � - -- - W�_ --, - r � � , ­ , s - �� I , i#-,7�i�,-v-, 4- ,,�-"!:�, -�� �� L W'� ; , �uf , �. , � - � -,,�,- , , - �;-- %----, �,7�,-v,l - , , - � . - , , I � . (3) WE -T DOWN CON,':PE-,E SHELL AT LEAST TWCE DAkY FOR SEVe4 DAYS AFTER SHELL IS INSTALLED -OR4 'A I I I I �j . - . . _4 --4�: - ,:-,;:�; - -, �, , , 1.� I , *, ,4 , - , � - - � �. , , ;,� �4, -, - - , �- � - � I -,��' - 1� - .,,�-;,� --�-- ,-�- i �i '7� �, �'!T ", - - 7- � I.", � 1, lf�rl--44�' : -4 ��z - I , - --'I , , " , ,-� - - , �� - ; ��,.�-;!;:�,,���l,��""..'�����,��,�: Z�i ,;'i ,&;�'-'i, � " � � � (4) AGPEE THAT CALJF , I ITI I I I , I I i -"_"'t'�'.--_--_-�' I I I ,,�L�` - � _ _j� - ,�, 1W � I ,-,."I I . ,- - , - - , , , , I 4- i ,��, 1. " � 1", ,�& - , � 4 -7 -i -,W- , �. - "�f, -, -� I - �- - - , - -7 - - .- A �- , ,-- - -, - -�� ! ','- �: --�,-; , ,� � , - , , %:�,� ��-,,,'�,�,��2N� !�'.,,' -4�-,� ,",�'J.'- 'i .�.��,--,, ,,--!-,�_-,-!� - - -,"', I I I t 1 I AND ANY DAMAGE TO CURBS. SIDEWALKS� DRIVEWAYS. LAWNS. OR OTHER ITEMS IN THE ACCESS AREA . � I � � : � `-,vl� -,;,�- -��, ;1�: t�;� � ., , , - "n",, , - 4 , : �,- :. -,�. . l4j.'�, �'--� , .-.-I'll, �,-!�� .,�, � , , - ,� 1. , -, , ". , t -t �, -�. 4 -,-'ht , -,. -A %� . 't .1 - .,-�i�­�­14,1-1'1 I I . -,�l �r.� k I --, -t �- ­ ,�� , �� �,,iL 4 ,`,�, - I I - I" - t - , -- �,�j , , — , - , I I , . � - . , , I " ", ��,- ��,--�,f�,,Zi;.',�;�--*""�,,,�'!"�wi,,-- V'j�T- "�,� "eltt- I - Wa k uf�- pi I -) ill, i ! t -- , � t - � , , � , I �� - �, � ', " Q--�t,'�,F��`!�,- �- - , , t1A � t - �� ,.�� - -, �,�j "-�, '.. ��`zl�ll � 7- 0 -�111.'- � i !- ,�,� ?� 3. �-- - -,,��--,;��4T"-.�,,-��,, ,`��- �� I - ,�� � � � ! I I I � I (5) SET THAT ALL FENCING, CATS, AND GARAGE DOORS MEET LOCAL CODES FOR A POOL ENCLOSURE . PRIOR TO PREPLASTER INSPECTION � I � I . ; � 0 - �11--- ---- - r� I � - " , ,�, �, - "--�,�- 1�k�F' `;;�,, -4 * � 1pscl,� - 7., - � t I . "7%' - � � C � , , , ', - �� N-, , t- -­ -­ ­ , -- .­ -1 - �� , . , I . . 1. - o- - -m -- ---�:-­.�-,,'F"i-ij-�i -�-,��,�-*4i �� ltlu I., ��" -, ��-- , - -- 1-:- ��- � �� 4 -&, � .- - ;, -qgz � , , r -- - -� ��,` - �:,4�� ­,�� -,l� --,`-,,4,-��,,--�-�,- I � I I I . . . I I � (6) FILL POOL WMEDIATELY AFTER PLASTER. (FOLLOW INSTRUCTIONS -- DO NOT USE RUB-9ruR Hm) I I � I y . I- -, - I w-, I I 11 1 " -, -� , , �` ;, �i , �-, �. . a N , , , I �,-.,. '. � ,,,� , � -, - �:, � - I � -;q, " �, -,�-,! -�, - �', !- 1::,l , -.11 '%" 1 , p? --��r :t-vii,W�,��';�� L, --;,�,%,;�,,,. .k �A�1,�- , , �,�-., � I 141. , , - I - 1. - ,� -, , * - - -4 '4'. � 0 ��7,�, , - -'� "" - `�-- - � , , - 1, �T 1� I - �.., -�, � " , c� -�� � - , , , - - �, - �j!U-":,- .I- ��,� '� � �� . I I I T I (7) TAKE NOTICE THAT THIS DRAWNG IS THE SOLE PROPERTY OF CALIFORWA POOLS AND THAT ANY � . 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