0109-218 (RPL),. H
N to
04 W
o co
d
1
c Z n
O.c
Ho
Iw— a
U)
Z
co
LO
N
ON
Uo
CLa
Z
SPccO
0 J J
mUU
O
Il rn
"t Z_
cb
I� 0
Q
J
LICENSED CONTRACTOR DECLARATION
I heref? affirrn;,;;nder penalty of perjury that I am licensed under provisions of
Chapter 9' (cor Si encing 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 r !: Signature of Contractor••'" d �-
I 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 ISignature 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 Policy No.
S'C'ATZ.7102313 �4t)•C�^Ufld 31
(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 provisions.
Date:. T / 1�. <.Applicant
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
constr(fction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent). % r Date'"%
r .
*� BUILDING_ PERMIT PERMIT//
DATE VALUATION LOT 010-0-218 TRACT
10,410).W
JOB SITE
APN
ADDRESS
qra m aa -G A r ply > ;yyyp
OWNER O ^ (,Z
CONTRACTOR / DESIGNER / EN (NEER
.1�'�t IXFCTIMWN0
SIEVE DODSON CON5dTJLLW1.A.l.014we,
"A8-050'Ca:.AI.WY DRIVE
73011 t:iiT.WRY CL013 DR, WAIEF4
LA 0 UN 1A CA 92253
PALM: DEM.T C A
{{9yy2260 /g
USE OF PERMIT
1"'OL"sL AWl.JIOR AiPA
E�'CTt:);..�53`��,..,�ll,t►.�•Pl���!k),A�n'c>f.c�ht.� S�'fA.]IsL �� t1� �l,,,E\€;k� �,'I" I��.6;�I�i..� fat'.i+
P001,.AND/0P. RA 24.000.00 LS
MMKQ D e:01W OF COINK UMOR
��I�fB01l.QY4➢
I 101
MECRANICAL k'H17 -. POG1- 101_000_417-111X000
?;%XXt.ItFf,"AL 90%.. POOLZO�A-(100-42MOO
'Pl ilMMO FEE- POOL, 3 C1%�+t1Q0•419.000
i
r.�
D�
SEP 2=7 2001Q
SEP 2 i 2001
CITYOF LA QUINTA
LIM, 1r'R.1K-PA6)7MX
$0.00
T(Y.FALFAK. Mr YMN )ME A IVY
$496.95
RECEIPT
DATE} �
BY
DATE FINALED
INSPECTOR
! .r
INSPECTION RECORD
OPERATION :
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
d BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
- ns & 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
Steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Final
Equipment Location
Underground Electric
Underground Plbg. Test
Gas Piping
b
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
/2
Gas Piping
Gas Test
Appliances
Final
7 — XCX_�.
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:
BOULDER MAX SIZE NOT TO
EXCEED 36" IN DIAMETER
DESERT GOLD STYLE
M4ETER COPY
I LL Y L 1-111\ 1 1-
NO WALLS YET
BACKHOE
CITY p LA
BUILDING & SAF
A PPR
FOR Cr)NlQrr-%
ERL.IIYETII.E> £:i`... TOP...
signature
D WATERFALL
QUARTZ & CAP FOR CASCADE
+l8"BB
+15"TOP OF DAM WALL
LA QUINTA HOMES
MUDSILL CROSSECTII
HOUSE
)F MUD SILL
DECK
2" BELOW MUDSILL
E -INSPECTION FEE 0
$30
BE CHARGED IF THE APPROVED
AND JOB CARD ARE NOON
S TE FOR A SCHEDULED ON
L ED
,TER COPY
N
1/8"=1' SCALE
+0" Ins
GENERAL SPECIFICATIONS
SIZE 16 X 34
SQ FT
AREA 386 PERIMETER
87
DEPTH 3' X 5'
BTU
TILE CHOICE GROUP 3 SQ. 80
RBB. BACKSIDE AT +12"
SUCTION LINES
COPING CANTILEVER
RETURN LINES
POOL CAPACITY 16,00p
GALS
PUMP CAPACITY 102
GPM
PUMP #1 STA RITE
HP 1.5
FILTER STA RITE 300
SQ FT
FILTER RATE 102
GPM
HEATER STA RITE SIZE 400
BTU
TURNOVER 4
HRS
SUCTION LINES
2 "
RETURN LINES
2 "
SKIMMER MODEL AMERICAN
CHECK VALVE YES
GASLINE BY SDC FT.
50
POOL LIGHT 400 W CLOCK
AQUA
ELECTRICAL BY. SDC FT.
300
PLASTER COLOR PEBL TAHOE BLUE
DECK BY SDC SQ. 1053
DECK TYPE SALT - S.D. BUFF
RANDY [SIZE 7 RAISED +18"PH ITE 100 WATTS
..........
DATE:::::: RI LEVEL SEATS 22" 24" 27"
...............
6/21/01 DAMWALL. QUARTZITE
DAMWALL TOP QUARTZITE
:iZV.18ED. SPILLWAY SIZE QUARTZITE WIDE
SPILLWAY XX OPEN CLOSED
# JETS 4 UPPER LOWER
Name: CENTURY /KITTY GERMINO
Address: 78-YIKGALAXY DRIVE
Qty. LA QUINTA
JOB# -79
TRACT STARLIGHT DUNES LOT# 4
PALM DESERT TEMECULA
73 -01 1 COUNTRY CLUB DR. 28910 RANCHO
SUITE F-4 CALIFORNIA RD. SUITE 203
PALM DESERT CA. 92260 TEMECULA CA. 92590
(760) 346-4032 (909)676-7946
LIC # A—C53—HIC-574127
� o
s CITY OF LA QUINTA
cFyoFo BUILDING & SAFETY DEPARTMENT
777-7012
INSPECTION REQUEST LINE
777-7153
Owner KITTY GERMINO
Contractor STEVE DODSON CONSTRUCTION, INC.
Permit Number 0109-218
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 78-865 GALAXY DRIVE
POOL/SPA. ALARMS/BARRIERS SHALL BE IN
PLACE AT PRE -PLASTER INSPECTION. POOL
EQUIPMENT ENCLOSURE NOT INCLUDED
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
t
AUG -20-2001 1509 WESTERN
INSULATION 909 686 8786
P,03i14
TRACT / PHASE:
STARLIGHT DUNES #23773-6/PHASE 5
LOT # :
46
WE STERN
INSULATION,
L.P.
.
I -`Z65 G�;�Q�C C�D.i'' .... - - - .. .
4211 Lath= SUM, Riverskle, C M=im 92501
TeL (909) 68b-8760 PAX (909) 686-8788
INSULATION CERTIFICATE
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24,
STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
TRACT / PHASE:
STARLIGHT DUNES #23773-6/PHASE 5
LOT # :
46
�SI-T-E-ADDRESS: '
. LAQI-I.NTA,_CA
EXTERIttR WALLS .:
.
I -`Z65 G�;�Q�C C�D.i'' .... - - - .. .
MANUFACTURER:
JOHNS MAWILLE THICKNESS: 3 5/8 ° R -VALUE: 9-13
SLINGS:
BATTS =BLOW�
MANUFACTURER:
GREENSTONE THICKNESS: 10.3 " R -VALUE: R-38
CEILINGS:
BATTS BLOW
MANUFACTURER!
JOHNS MANVILLE THICKNESS: 13 ° R -VALUE: R-38
GENE NTRACTOR: CENTURY HOMES
BY:
TITLE:
DATE:
INSULATION CONTRACT -0-8: WESTERN INSULATION, L.P.
LICENSE NUMBER: 794484
BY:
TITLE: PRO ON MANAGER
DATE A T 20, 2001