0108-303 (RPL)H
N
W
O=ch
r` W
o Z l�
(D00
F-CD
J
~a
U)
Z
M
LID
N
ON
U °'
� Q
Z
L0 aIr
0
LU LL
0 JJ
mUU
O
DL
rn N
Z
oO
Q
J
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
6156128 C-53 Ric C -8N
Date " Signature of Contractor's
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
��f•,;t�ion 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.
:C
ax�T`R"t9ogPl1�'¢9 fJ�4�E1iN34f
(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 t 6 e pro /'sionsf
Date: � Applicant p % `
Warning: Failure to secure Workers' Compens ion coverage isunlawful and
shall subject an employer to criminal penalties and civil fines up td $100,000, in
addition to the cost of compensation, damages as provided for in Se
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Buildingrersn
for a permit subject to the conditions and restrictions set fo
application.
1. Each person upon whose behalf this application is made & eachwhose request and for whose benefit work is performed under or pany permit issued as a result of this applicaton agrees to, & shall,& hold harmless the City of La Quinta, its officers, agents and e
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 f spection purposes.
01
Signature (Owner/Agent) A X / Date -Q%
• w +i •--
BUILDING PERMIT PERMIT#
ti
P: '
DATE VALUATION LOT �, TRACT-
JOB SITE
APN
ADDRESS c p 36 Wmyp W DRIVF
OWNER
CONTRACTOR/DESIGNER/EN (NEER
ha. &1ARP LUGAR
CAI, A-YORNI. POOLS & SPAS (TOP MAW C Of
81.1:35 OOLF`UsM DRIVE
74725 JONIDIZM1, 4L1FLE#A
LAQEI*JNfA CA 92253
b'A]!M1'JIMEW CA 92264
(WO)MO-9000 C..a: .9 335
USE OF PERMIT
AT PlIt'.PP��ry4.a,�.S` ER I S111F.:;TION, POOL W.UIPMENT a;43CW9 typ.lk )1
POOL A?Ii1.•11OR SPA IS
h�
PLAN C1WX F147 1101.000-43.318 S134.5.55
CyyGIffg�TwUCTgJQ yEEZ 101 -000-4 18^000 ��l•1 ¢ fJ1t
_ ., '
.C:F4. RIVIAL FRE -d t11001, 101-0=47,14= $24,0
1'a1 Cr',::'I`I"KIA-1. Mr!". P0011 $45.00
d?I; NMMNG FK .. P-,001 ; 1iy1=E11Sg0�919e�Ff1Q S3`%�i►
e
3 0 2001
OF LA OUINTA lu TOTAL f`:C?N VINr d$I;��'3,01T Ys<k�l:L"11ti3„AW C.'fcLi<=
ANCE DEPT. 1;;F1913 .FxM,1'A1Y) FM
$0.00
L, DUEV NOW
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
el. _'%•4, ,it
T.:
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.
T.O.
Exterior Lath
Drywall - Int. Lath
Final
Final
COMMENTS:
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.1.
Smoke Detectors
Temp. Use of Power
Notice
POOLS - SPAS
Final
Final
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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 Finis Plaster
Sewer Lateral
P� ; over
Sewer Connection
_
Encapsulation
Gas Piping
Gas Test
Final
Final
COMMENTS:
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.1.
Smoke Detectors
Temp. Use of Power
Notice
POOLS - SPAS
AUG -29-U1 WED 8r.1, <, AM . ,P'A. WEST .HOA Y` 4; �; FtiL10.. 76U 5-64 2329•:.. P. 1
«s n,
PGA
FAIRWAYS ASSOCIATION
August 28, 2001
California Pools & Spas
74-725 Joni Drive, Ste. A
Palm Desert, CA 92260
Attn: Steve Pvle
RE: 81-13.5 Golf View Dr.
iDear Steve.
-Me Architectural Committee has approved the plans submitted for Spa & Pool at the
above ;eferenc--d location.
Please place the Pump & Heater as far back as possible.
5iucerely,
,'onna anraccio
.Associ ;ion Manager
DM:pwh
P.O. BOX 1.3710 • PALM. DESERT, CALIFORNIA 92255 • Tel. (760) 776-5100 • Fax (760) 776-5111
emall: pga%vest@monarchgrp.com ZO