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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
AB MCI!
Signature of Contractor -
OWNER -BUILDER DECLARATION
4%S 1;,04
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 Policy No.
14T.A.'ry, FUND
(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: " Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject'an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for -inspection purposes.
I ,Signature (Owner/Agent)
Date
- BUILDING PERMIT PERMIT#
DATE VALUATION
LOTS TRACT
JOB SITE
APN
ADDRESS
qna v
OWNER
CONTRACTOR / DESIGNER / EN (NEER
&.rS./SDAN Mi
C.A-11dY011t VD11WPON,$
80.106 T3MAi'yA0:1+,
279,11'. E, ,rAWTON 10
LAQ1.71NTA CIA, 9�1-133
1?Af;MSPR31^KuS CA. 92A"62
(;`!50)? 8-2700 C;Etif ; 2931
USE OF PERMIT
g''0011AITi)/tO. R. Ull
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XMIANVAITED 470NT OF COMIUMT(.7'D: 034
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1014�00•42.0. 000 $45.06
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WfiC.K:iC3ka IANA`, 1.a4
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F MIM PRE. -TIAL? 1? , EP (ii0• 11
SEP, 0,8 2003 • `��'
&']:�:<<aTUtC:4i ' w��x'a �}
CITY OF LA C�UINTA
FINANCE DEPT.
RECEIPT
DATE
BY
D E
INffTOR
t, 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.
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
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
r Connection
Encapsulation
Gay Piping
Gas Test
Appliances
Final
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:
09/04/2003 12:23 760-320-3667
07/24/2003 b`1:1b /13U0b4L
Mr. & Mss. Dan Ort of
10968 Cloverhurst Way
San Diego CA 92130
RE: 80-706 Hermitage
Pool, Spa, BBQ, Landscape
Dear Mr. & Mrs. Greaei,.
SAUNDERS FNG
FAIRWAYS ,ASSOCIATION
PAGE 03
July 23, 2003
At the July 21, 2003 Ambitect MI/Laudscape committee meeting the plans you submitted were reviewed and approved
with following conditions.
• The hibiscus is not allowed. Please indicate a replacement. C Zt1 A- -W1 lGc'' lc-e'q4�
• An 18 -inch mow strip is to be installed behind the pool.
The bougainvilleas need to be attaeltod to three wires — 6' wide, 3° from center if the area allows, and 18" ftotn
fie•
Palm trees need to be installed 51 fmm center void tree wells and i seep root bubblers are to be installed if the trees
pare not'plarted in s planter bed.
• The distance of the BBQ from the wall reeds to be indicated. — S k
• Additional pmts and trees ere the responsibility of the botreowuer for replacement and with a no fault
Mainteoa = agreement fizz. the Association. _ p
The neighbors raced to siva off on the plans -
The plan, indicates removal of the concrete deck What will reply ce it?
If you have any questions pleuro contact toae.
Sincerely,
ccio, SCA
Ossocia4tion'
�
Dwncp
�osr 0'%'e $Ox 1658.
' —.
�a
' pholte {26.01 S64,
Pex (260) S64-2329
MR AND MRS GRENCI
LOT 41 RYDER COLLECTION
La Quinta CA 92253
GENERAL SPECIFICATIONS
DIMENSIONS: POOL
SPA
Length: 30'0"
7'0"
Width: 15'6"
7'0"
Surface Area: 338 SF
38 SF
Perimeter: 85 FT
23 FT
Depth: 3'0" to 5'0" 42" MAX
Demo:
Concrete: N/A
Sod / Gravel: N/A
Plumbing:
Extra Spa to Equipment:
22 LF
Raised Spa Bypass w/ck value: YES
Dedicated Vac Line:
YES
Gas Line Extra:
40 LF
Gas Line for BBQ/Fire Pit: N/A
Spa Jets:
FIVE BACK JETS
Decking:
Color w/salt finish:
900 SF DECKING, CAP @ RAISED SPA
Cantilever Edge:
85 LF CANTILEVER EDGE
3" Deck Drains (per LF):
iD Y D44_pr u, 5 cA -'off C;54v�.
Step Riser (per LF):
N/A Q
Dam Wall:
+18"
Raised Bond Beam:
30 LF @ +12"
Umbrella Sleeve:
YES @ TANNING LEDGE
Tile/Stone:
Basic Tile Group:
:85 LF 6" GROUP 1 OR 2 TILE
Quartzite 6" Waterline:
N/A
Step Trim:
N/A
Tile Raised Areas:
10 SF @ DAM WALL, 6 FT QTZ SPILLWAY
STACKED STONE / TILE ON RBB 20 S.F.
Masonry:
Spillway: 6 FT QUARTZITE STAIRSTEP SPILLWAY
Waterfall: N/A
BBQ: YES ( SEE ATTACHED DETAIL)
Firepit: N/A
Boulders: N/A
Access Wall: BLOCK R/R
Equipment Wall: 4'H X 4'W
Paint/Stucco/Plaster: STUCCO EXT. RBB. BACKSIDE
Pool Finish:
White Pool Plaster: N/A
Pebble Pool: PEBBLE COAT FINISH- TAHOE BLUE
Equipment:
Pump: HAYWARD NORTHSTAR 1.5 HP CIRC/SPA
Pump: N/A
Filter: HAYWARD 300 SF CARTRIDGE -TYPE
Heater: HAYWARD 2,&& BTU LO-NOX Li 0K,
Controller: POOL BOSS REMOTE INT. MOUNT
Hayward Navigator: N/A
Pool Light: ONE 400 -WATT
Spa Light: ONE 100 -WATT
Purification System: SALT SYSTEM AQUA RITE
Water Feature: CUSTOM CASCADE (2)
Landscape: SEE SEPARATE DETAIL AND COSTING
Patio Cover: N/A
Fencing: N/A
MISC. SPECIFICATIONS: ALARMS & SPRINGS PER CITY CODE
Buyer is aware that oral representatioq,or expression by either party is not binding
unless detailed and signed by buyer and seller-.
760-778-2700
P/L
decking
ANSI Z223.1
� BBQ
(see attached detail)
gas
{ elect.
----------------------------
-o shower
EXISTING
4 LF EQ WALL @ +48" I PATIO
E
{
760-320-3667 FAX
I
U__ F
.0— H
P
S/S
bobcat access
POND AREA
5'6 5'0
Spa set @ +16"
8'4 stucco ext.
+12 RAISED 5- back jets
BOND BEAM
/
7'0 7'10—
3I 6—
pool / 15'6
13'0 30'0 5 9'
/ vac �_ I
Tanning ledge � \
-6�GI
267 .19'2 �
15'3 � P/A /
/ �3'0
i
8r VO 20'9
DECK DRAINS 13'6
----------------------.-
- - -- ----
REMOVE CONCRE PATI \
pool boss remote G/E
GRENCI RESIDENCE 55'
80-706 HERMITAGE
LA QUINTA CA 92253
LOT 41 @ THE RYDER COLLECTION
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRU
BY
2295 East Tamarisk Road a Pain Springs, CA 92262,. ° License N®o 779165
MR AND NIRS GRENCI
LOT 41 RYDER COLLECTION
La Quints CA 92253
r GENERA[. SPECIFICATIONS
-1W-dSIOIvS: POOL SPA
Length: 30'0' 710"
Width: 15'5" TV.
S19ribm Arra: 338 SF 39 SF
Ph'neter 85 FT 23 FT
Deptb: 310r fQ5'0" 42".MAX
Demo:
Ccomte:NIA
Sod I Gravel: NeA .
P rnbknQ:
Elan Spa to Egwptnem: 22 LF
Raised SpaBypassw.rek�aIue: YES -
Dedicated Vac Line: YES
Gas Linz Extra: 40 LF
Gas Lim for SBQTaePit: VIA
Spa lets: FIVE BACK JETS
Dedrme:
Coloy wAalt alsb: MSFDECKING, CAP @RAIS1_DSPA
Cantilever Edtx: 85 LF CANTU-11VER EDGE
3 -Deep Dmirs (per LF): 34IA 10 3' ox -Sc � C:. rn'y
J
Step Risn(peyLF): NO.
Dern wall: ♦18"
IR'sed Bead Beam: 30 EF @+I2"
umbrella Sfeeye: YES ^e3 TANNLNC, LEDGE
TPruSttonm
A sla TiJe Group: .35 LF 6- GROUP I OR 2 TR2
Quarmte6" WatrrlW-- MA
Step Trim: N!A
Tile Rand Areas LO SFr@ D.A.\4 WAIL, 6 FT QTZ SPTLLW.AY
STACKED STONE! TD..E ON RBB 20 S.F-
Mwazry-
Spillway. 6 FT QU ARTZI M STAMSTEP SPILLWAY
II Wmerfall: NIA
ann- VF.S f SEE ATTACHED DETAIL)
Fircpit MA
Bmlders: `VA
Access Wali: BLOCK WR
Egvipmrnt waft_ 4'11 X 4' W
PairbStuectvPlater. STUCCOEXT.RBB.BACKSIDE
Pe01 Fletsh.
W-hste Pool Plaster. t•UA
Pebble Poo F. PEBBLE COAT FIMSH- T-AHOE BLUE
Rawliment:
Pump: RAN WARD NORTHSTAR 15 Ely CIROSPA
PUR31K WA
Mier.HAYWA,RD 3-00 SF C.ARTRIDGE-TYPE
Healey: HAYWARDlighBTU LO-NOX4)l K.
CoMtotler FOOL BOSS REMOTE INT. MOUNT
Haya•ardNavigalcr. NLA
PcolLiohC ONE 400 -WATT
Spa Light- ONE I -XV -WATT
Pwiflealion System: SALT SYSMI AQUA RITE
SWxfer HeStere: CUSTOM CASCADE (2)
Laedscaoe: SEE SEPARATE DEPAII.ANDCOSTING
Palin Craver: WA
Feoeiase: MA
1fISC.MCIFICAT1OM: ALARMS& SPRINGS PER CITY CODE
Bayer is rWrre that and represtntshon it erpresaioo by either party isnot hlnrling
a antey dessa-kda�d stgocd by hvytr +ud seller. __-_ ,
�0 - 7c(,=, �Aew-�u�je--)
POND AREA
i 5'6
8'3
.t2 RAI:0
l5'4 { t3U
decking \-nrirg redge
I. Bc.MS( Z�3_i ss3 l� t
I l� m�xhod rktaill
9e$ B'O
�I elect. �
?�'ehonrer•----�--
r D(15TIN6
PATIO
O i
71IYL i
i I
PM1 ]5'6
30 a src _ i
3EROVE COW
pool bras: [nota
GRENCI RESIDENCE
I '
ybeot onecs
6!`c
I
1764-778-2704 760-320-3667 FAX 2295 East Tamarisk Road • Palm Springs, CA 92262
License No. 779165 ]
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