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0204-178 (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 3 11TC (% 1 "'VW Date f'' ` Signature of Contractorr"�y�fv. OWNER -BUILDER DECLARATION zrys. 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. 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 STAM C(7MPF— MATI Policy No. 0466 L1616S•pi (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 those rovlslo s. Date: !v -/ , APPlicant ir�:!fia.< S � T -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 authorze representatives of this City to enter upon the above-mentioned property"for. inspection purposes. OU 'x Signature (Owner/Agent) '' - Date t 13 ILDING PERMIT PERMIT# DATE / f VALUATION LOT y3 TRACT r+ . JOB SITE ADDRESS W-295 W177GED F()(Yr APN OWNERCONTRACTOR/DESIGNER/EN (NEER CENT M41 1,. L'A.iJJ%I]JI:!S � .0 T (W,e•Lf°)OPSIAPtl4fluS tali 17C AS> (X01)'MAN Cd � 22.80 ZiAiiM,_�Yw CIRCLE, giilNE 150 A CA 91720 PIAW,111,10 :(' Cdr. 912,60 (:760>340.9000141. 1. ®©a4,5 USE OF PERMIT POOL AiNW(YA SPA ,• k+A� [A7�i:L..�.Age;[t{��O4�PAyydj�¢2�Jy'qL,�Y�.y(�.isASyL�yiltd�ZyPiAtri'Ppi3�"p.�•:p,B[yEI�3'1 N,4411 if2tj.--f54E,*lgg{•"_y, .' YaA.t6'16Ftl14:Y�6d'c53s�i.91:rRS SCA.fy,F..dL RJB+ .N. Y L.A.CE, i �. I09 O K58�,19L'.L�S s F b•. . FOOL EQUI.T'M4T )",A7C7.MUIRi:,14d "t MCLt DED IN MWIT. Sj001..+`fNWOR SPsa; W �'�l�9.,t�� 0��°:t' aJ�r �;e,i�S':L��Cv",0�®!^�' ��;�'4J ►.�3U Pum, rr Fre SUMMARY PLAN CFDROK Mil: $.122.85 (;.1 NST111 71 YN THEE 101_000( 418-000 $199.0 MEQUAIRICAL ME -- POOL 10)-0M47,1o0G0 U-61.00 PLUM91w)"tz •- p(m 101-000i.419-000 • -+I !4 ­ SOUP. 46TAT- 7f Y; c+t M APYY g `' 80.00 e� ; `�� 07,85 APR 4 2 2002 CITVOFLAgUIMA FWANCEDEpT se RECEIPT DATE BY ,rr D lJIAL NSPECT A iiTT RP/ 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 POOLS - SPAS BLOCKWALL APPROVALS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover s 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 Gas Piping Encapsulation Gas Test Appliances jq Final COMMENTS: Final Utility Notice (Gas) _ ,Y 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) 1 �� � �fWO Wv�►�E� E LIQ fit -_ _r _._._. 0.7�rtZ `� O !� SPA AT - o W ITN TYf*LC pAr✓� .t , LL t_ - — — — Mit ' I, _ x r 1Z - _.,_ __ i, i 1 f OL% I✓ \��� L�� / ^i ,' {; f �•+I / i✓ i i! } .� f P i !. ("GS + •� „.f ," x BRLAKFAST i _ _ t ' Fol 0q is 1 1001; Cn -e� f 1CZ'TCAl1f - . ! R^.- I `�► �� . 5PEGIFIGATION5 h u N E'« SIZE 2 2 7 TYPE x 5: c_. 0 SUQFACE AREA OF POOL - PERIMETER j ! Z DEPTHS MN. 3 �' Ot' MAX (V � (r� Q a� 1(1 � � N � .r O IL W >tt f � tiT ^ 1 _ Q in in r , T 551a 5 PEGIF IGATIONSr 5 F 1— x 5a. FT. SPA DAN WALL MRDTH NO. OF JETS LI&4T f RA� SPA '.SPECIAL NOTES J A , TILE rILE rY>°euj WATER LINE TILE TRIM OUNRTER ROUND - RDD. TILE DEGKI NG EXCAVATION /STEEL AGGEY� PROM A�L ELEVATION lJ . Lt _ G DEEP E`1D RAW LDIM SEAT Kle, CONCRETE REMOVAL LOAM SOD REMOVALLOADS TREE R' MOVAL Erf IRRIGATION R -CM 7V _" "MhSATION Rl`'PAIR RDD. 24' RBD DO' RDD ft TAN SHELF • / 1 . _ ,_ ROCK CexrcRS FINISH ExPA"ON JOI L L ` DECCO DRAIN e--,- CURD GORE STEPS A 9CS ASE SAIV AND VI-<XIMN Ices" N t3 MOY'I STRIP �- MA50NRY COMM$ TYPE RDD, FACING/ SPILLA" TYP"- SIZE 1 I { i I f1liL - _ ` - irMO ROOK DLNVQ Q URDIA l ; I I { I ; I 1 ZZZ 1Z (fj z 5 f. - POOL. t� E:A, �j J CJO L) R'f / AP�� i+ , STEPS PROP, EXT. WALLS . PLANTER WALL RETAINNb �� EGtJIP F rIALL.!s �.. IREPIT ++ PLUMBING FILTER 1 �' 1 �_ SIZE SL7 `� POOL PUMP �" ! 'SIZE • S ! T - - ElOOSTER R1MP SIZE SIZE ADDt PUMP SIZE Z . S N Y ADOL PUMP � -• ' HEATER SIZE ' L \ SLD PANEL '� A00"L TV 3 5KRe49R TYPE !� FILL LINE � s s,, GAS LINE STUBS �� t,IniE F0UNTA1N5/5PRAYHEADS - (i rxa So U LIbNTS N POM(I N SPA J AC -Lr -JT- _ iL PEBBLE/PLA5TE i -o v LIGHTS SPOA S :> I ROLLED BOND DHAP" EIEHIND SFA — EYEBALLS Ov' `LR a BUITL rorn� ©ULST SUITS i I . I STLEI SET EOUPMENT \ = S PLUIem s1ZE _71 Z ,+ -T �- O ENGING FENCE TYP" ~T REMOVEATI a SAL e �D fPl CRAMP R`A ExTErDED Zed 5 {o TEP t. f - - ! f LOVESEAT S+RLLWAY TYPE >I e `..>' 3 I`. CT� - C`` GANTTLEVEIR c RBD. - SEE STEEL D (3 —.-_c Z 2 a° T. START L EST. COMPLETION i S b OTHER Q U It OWNER RES-PON515ILITIE5 O 01 _•: .�.. _ : -: f--- - ' I+ OVtCR TO, O) DETER ARe THE APPROAMATE ELEVATION OF POOL OR SPA AT LAYOI)T ON DAY OF EXCAVATION (2) TAKE NOTICE THAT POOL AND EOUIM-E':T LOCATIONS ARE SUB,=T TO AGCI°'PTANCE OF LOCAL EULDINS DE7'ARTMENT AT TIME OF 15WANCE OF 100 "iT i I Q ! OURST SUITK no Iy 111 i+ ��' ' i (5) MET DOWN CONCRETE SFC.L AT LEAST TWICE DAILY FOR SEVEN DAYS AFTER SHELL 15 INSTALLED (4) AGREE THAT CALIFORNIA FOOLS 15 NOT RE500NSISLE FOR LNXIe6ROL1W CANDITIONS OR 05mGT5, AND ANY DAMAGE TO CUR65, SIDEWALKS, DRIVEWAYS, LA", OR OTHER fTEMS N THE ACC!!�S AREA (5) SEE THAT ALL FENU146, GATES. AND 6ARA6E DOORS MEET LOCAL CODES POR A POOL ENUDSURE PRIOR TO FREPLASTER R15PECTION (6) FILL POOL MATELY LATER BLASTER. MOLLOW INSTRUCTIONS - DO NOT USE MMM HOM (T) TAKE NOTICE THAT THIS DRAANS IS THE SOLE PROPERTY OF CA.IPORNIA FOOLS AND THAT ANY O I USE WITHOUT IWITTEN PERMI55ION OF CALIFORNIA POOLS, INC. iS PROHIBITED BY LAK OWNER APPROVES PLAN. POOL. AND EOUI*FENT LOCATIO45 AND HA5 READ THE Ree OILmE5 AND NOTICES ABOVE Q 5164ATURE(5) DATE _ NIMMIINTr�'GPOOLL PLAN FOR: �5 NAME lrl�i 1 EL1 I G C� STREET uJ}vC t��oT- JOB ADDRESS c,.�F– r_s'I E,.X ICITY I .GARAOR PHONE OFFICE RES LOT 1 TRACT PAGE BOOK MAP BOOK PAGE NO. CITY MAIL ADDRESS Vit) ii o CONSTRUCTION OFFICE PHONE NO. SCALE, DATE I%-02- DRAWN BY SOLD BY E; CHECKED BY REVISIONS DATE - ( 2 GITY OF 1A QUINITA BUILDING & SAFETY DEPT. 3AVPROVED FOR CONSTRUCTION 4 _ 5 m SELECTIONS CONSTRUCTION AUTHORIZATION SALES FIELD DIG DIG W [�] STONE ----- TILE BOULDERS DECK COLOR-.. PRF.-G J ITE V JANDY - UNDERGR 0UND PEBB./PLAS Sr4Nr]'f AC -1-1 MASONARY SIGNATURE DECK DRAINAGE NOTE: Drainage and irrigation for planters and pots, by others, unless otherwise noted. PRE -PEBBLE z