Loading...
0207-181 (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 614611 L5 3t'31103 Date Y� O ``Signature of Contractor ✓ E�'F" OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 1, 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 ZITATF,. YU14D Policy No. 0461046702 (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 provis' S. Date: ' �" d �• 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 construction, and hereby, authorize representatives of this City to enter upon the above-mentioned pr4pperty for. inspectionp-qrposes. Signature (Owner/Agent) t '� %"" Date BUILa1NG..�ERMIT PERMIT# 0207-9.1 DATE VALUATION d' LOT TRACT JOB SITE ADDRESS _ATa_M,. - GRAINAI)A rtaum- APN OWNER CONTRACTOR/DESIGNER/EN (NEER SET)ONA HOW..% INC POOL'S & SPAS 77-564 COCl + IRY C-?a.I.E� .I'rdVE OLTMI 137 .P,O, BOX, 3791 ALM DIJI DIRT• CIA .92211 LA TA�TI A C.Pd�f je�-�3'CaaZ(fit Y��j'.2_gy}I33 (760)3 00 3585 • �.IHL4 1945 USE OF PERMIT :001, XMIOR SPA ` KJOUSPA. 1hLARAIS st .ATt:Ytf' RS SHALL BE IN P1.ACr AT 1sTLZ.PLASTER. , r POOL ATdi MOR S.°.4, MD©4 NLai PLAN CHECK FE 2.{13 Rt3i�Cg�a9131L� Slt��,�t� WA S' i I;2'UCT 1041 ELF X16', m " Ml;?CkIAP ICAIr Is'U .. Pool1 a1.000.421.000 S.24.60 ELECTRI,CA1, flt- PCS&3L, a�J9�{3�7�--d20�CiGt1 84 .ca PLIl) PING FU P004 1011.000.419'-000 WIN i o1LjZOF LQUIT ANCE DEPT. I UM-1+)TALCOJNSjRCM09AMPI.AN T363.30 T13Ssti .,0mv.4., 3T�'c�.ts $0.00 'A)TAII FFMOT FEE - 5 DUE 1401Y RECEIPT DATE BY DATE INALEDI X1INSPECT � i 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 BLOCKWALL APPROVALS POOLS - SPAS Steel _ r_1,_-7 _ <-- Set,Backs Electric Bond _ �0 _C_ Footings Main Drain Bo d Beam Approval to Cover Equipment Location ' Underground Electric rJ Underground Plbg. Test Final 'Gas Piping PLUMBING APPROVALS Gas Test ` v( 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 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) _ Final COMMENTS: THIS PAGE IS FOR BIDDING PURrl-ES' ONLY ! C PRINTED NOT TO SCALE) -R=y:S:]%S i3' oo� - ISO -oas / X, s - SD7CS I POOL DIM. :i' - y I: !POOL PER. — 5' W_T r \ R CUARTZITE STONE WAI R; -INE. 5' I 6' X 6' RAISED SPA AT +18' WITH CONCRETE CAP AND QUARTZITE. 6'.. f -� STONE: STACKED SPILLVA —, CQEAI RMM II POOL S.A. ' TO i DEPTHS. .-;- s 1 IDECK AREA 1040 SC 'T I' I;AJ mem APPROVE® FOR CONSTRUC ON �Arp Z�311bZ BY X (s cff to sq - SCALE: yg = t DRAWN BY: T Hubb I j OF SHEETS FIRE PIT AT +12' N WITH CONCRETE CAP. w cu t?AT►o CAKQ�YR� Ctt.IS�Gc l° �Irg►C� AUct ce..l)L- ►i ���c t ❑ o Ice aao� Za -�►a�� ►Ns�-j� Q ¢5 ?........._.. z Q D ❑z a , Q U J 5D - oq5 Q7M: CITY OF LA QUINTA L- . BUILDING & SAFETY DEPT. DAT -:-19-02 APPROVE® FOR CONSTRUC ON �Arp Z�311bZ BY X (s cff to sq - SCALE: yg = t DRAWN BY: T Hubb I j OF SHEETS