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LICENSED CONTRACTOR DECLARATION
1 hereh�ffirm under penalty of perjury that I am licensed under provisions of
chapter a (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
574 Nips
Date kignature of Contractor
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 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 FF## ATn Dw1y Policy No. 040 00 OWK
(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 s all forthwith comply with those provisions.
Date: �� � J ApplicantF:.� . "r
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up toll 00,000, 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. r _-
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,,Oo,enter upon
the above-mentioned property forriiins e tion purposre-s. , ��� '
Signature (Owner/Agent)`7" r'��°� - }° //Date '1Z1,'
BUILDING PERMIT PERMIT# ,
DATE VALUATION LOT 01(W f TRACT
db8 SITE
APN
ADDRESS
OWNER
CONTRACTOR/DESIGNER/ENGINEER
(71WI.f:'U:F,Y (Ma4J.IvJ,_T Cr0MP/UA ^ `
STEVE DODSOR CcJ�+%ITYR.UCTION if.X
1535.1801 SI, BT-IMTR STI& #290
7IQI1 COUNTR Y CYLUB DR.; DUf MIR
t Ab1:�:js',�1:LB�1'e�2'�D010 C`A, 192408
F.!bT.� 7�.��?�FT CA 92260
060)346-4WZ CRIA 11 04.4
USE OF PERMIT
PX01..Ak1DIOR SRA
iPi;?f 11VA ONLY sIN9:UST 8Z Ike 111f1RCCKAT
PR&PGl`t,'usTRR FN;1MC`1' OR POOL ENCLOSURE N' -<ti`.(' INCIaUI)EWD.
POOL ANDJOUVA lE
R.14fy:1N1'.A'.lCn.�' 4•eIRIdV JC FrrC` iiJit'i �Y... A.R. irFO.'P
=20040
f •� ;�^ 5 (p 1;�� q tJi�sAR9L
PLAN ME'= FTE 101
CiINS`CRU TION M.E 101-000-418.-000 i ti .fit
T a.�+�%, � W1r_AL FER .. POOL 102-000-4,20-000 $ 45.00
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f 1 Q ll LE -33 T-l�.tsnc°.�U)
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$0,00
t, Pli�rFXES IME NOW
APR 1 3 2001'. ••.
CITY OF LA OUINTA
FINANCE DEPT
REC - !
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
41 OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
s
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
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
_ —
y
Gas Piping
0.
�D
Gas Test
1
Appliances
Final��`��
COMMENTS:
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)
AIR INDUCTION PIPE
freestyle this area
R6'-6" maintain 3' setback
36" MAX BOULDER SIZE
3'
6'-6"
4'-5"
W
- 48'-5"
33'-6"
9'-9"
1 P-2"
E 22'-0"
DECK BY SDC II
BOBCAT ACCESS'
Bedroom 2 Bedroom 3/
Op4onaI
IN&ster Suite #2 R6'-3"
®
1� Dining Living,
•---... $airi,' Ire
STACKED WATERFALL
W /ROCKY MOUNTAIN QUARTZ & CAP FOR CASCADE
WATERLL� . f l8"BB
�..'s Ta . +l3"TOP OF DAM WALL
>k ..........
............
.:......................................
24" WIDE::
. `......... SPA 1bAM WALL:::
.:..............
............... SI PERAT8:::::::
.:.......................................
VAI:.V:E
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Morning Rao W
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Den
`— R7'-6"
24'-8"
aster Scute
Opt,' -�= l��l�ll��f�l�rll� Bath
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Fury I I _ wnHc in%
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M. 101H1111�11'I11 �fl
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Service I�
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Horne- Office Z Cat C;aCa-tc
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STRIP FORMS FOR FINISH
9'-2"
7'-2"
M&
G&E
LA QUINTA HOMES
MUDSILL CROSSECTI4
TIONS
SIZE 14' X 26'
AREA 318 PERIMETER 77
DEPTH 3'x5'
TILE CHOICE GROUP 3 SQ.
RBB. 10' OF 18"
COPING CANTILEVER
POOL CAPACITY 9,510 GALS
PUMP CAPACITY 102 GPM
PUMP #1 STA RITE HP 2
HOUSE FILTER STA RITE 300 SQ FT
MUD SILL FILTER RATE 102 GPM
HEATER STA RITESIZE 250 BTU
ECK TURNOVER 4 HRS
2" BELOW )VIUDSQ.L SUCTION LINES 21/2
RETURN LINES 21/2
SKIMMER MODEL AMERICAN
CHECK VALVE YES
CITY OF LA O U 1 NTA GASLINE BY SDC FT. 120
BUILDING & SAFETY DEPT. POOL LIGHT 400 W CLOCK T104
�� � ® ELECTRICAL BY, SDC FT. 320
APPRFOR CONSTRUCTION etl&vt FEEDER
pp PLASTER COLOR WHITE
ATE" O l BY DECK BY SDC SQ. 780
DECK TYPE SALT - COLOR TBS
�� CoP�Sf EP eONe FR
A RE -INSPECTION FEE r028
SPA SPECS.
WILLBECHARGEDIFTHEAPSIZE 7 RAISED +PIANS AND JOB CARD ARELITE 100 WATTS
THE SITE FOR A SCH RI LEVEL SEATS 22" 24" 27"INSPECTION. DAMWALL . QUARTZITE
NO EXCEPTIONS! DAMWALL TOP QUARTZITE
RE.VISEij: SPILLWAY SIZE QUARTZ WIDE
SPILLWAY XX OPEN _ CLOSED
# JETS 4 UPPER LOWER
Name' MARK AND PAM WASSERMAN/
Address: CENTURY
Qfty• 78890 GALAXY DR
JOB# LA QUINTA
TRACT STARLIGHT DUNES LOT# 30
Do soar
T
P0014S
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1/8"=1' SCALE PALM DESERT TEMECULA
73-011 COUNTRY CLUB DR. 26910 RANCHO
SURE F-4 CALIFORNIA Rb. SUITE 203
PALM DESERT CA. 92260 7EMECULA CA. 92590
(760)346-4032 (909)676-7946
LIC # A-C53-HIC-574127