9512-138 (RPL)LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with
o W co Section 7000) of Division 3 of the Business and Professionals Code, and my
u) License is in full force and effect.ti> 1 i'S C. 3 I.Or'31JMi
r- W -n License # w Lic. ass p. Date
ZDate Signatureof Contractor
cro F OWNER -BUILDER DECLARATION
J WCD
1 hereby affirm that I am exempt from the Contractor's License Law for the
a following reason:
Z( ) 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 Signatureof Owner
N
OU rn WORKER'S COMPENSATION DECLARATION
d Q I hereby affirm under penalty of perjury one of the following declarations:
C'2 Z ( ) I have and will maintain a certificate of consent to self -insure for workers'
� H 0 compensation, as provided for by Section 3700 of the Labor Code, for the
X w LL performance of the work for which this permit is issued.
OJ J ( ) I have and will maintain workers' compensation insurance, as required by
CO Q U Section 3700 of the Labor Code, for the performance of the work for which this
d U permit is issued. My workers' compensation insurance carrier & policy no. are:
CL Carrier Policy No.
? (This sectio'n'nee not be completed if the permit valuation is or $� 00.00 or less).
C3 () I certify that in the performance of the work for which this permit is issued,
00
C7 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
3 Warning: Failure to secure Workers' Compensation coverage is unlawful and shall
subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this application agrees to, & shall, indemnify
& hold harmless the City of Indian Wells, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the buildin
construction, and hereby authorize representatives of this City to enter upon th
• above-mentioned property for inspection purposes.
a
Signature (Owner/Agent) Date
ALCi
BUILDING PERMIT
PERMITi
9.512-138
DATE
VALUATION S12,0W,0C1
LOT TRACT
JOB SITE ADDRESS
APN
79-965 .PGA JJL Q
OWNER
CONTRACTOR
CALIFORNIA POOLS & SPAS
"I.:i,AND CORP.
41"111 f1GARD.�JALK,111.2
36i40 PGA. BLD
PALM DESERT CA 92260
L,AQUINTA CA 92253
fC%l0 "A-QfM
DESIGNER/ENGINEER
777-1294
USE OF PERMIT 000 AND/OR SPA
F'00LlSPA ONLY
--��ry
✓'6A"CT! -• 5! ,
FEE DESCRIPTION
FEES
POOR. AND/OR SPA.. 121000.00 .LS
F.STIiVIMED MS DF CONST RUC,fICIN
12,000.00
I►.r` HAS T FEE SUMAzARY
PLAN CIMCK FEE 101-000.439-31.$ 187.75
CONS11RUC'TIONFE.E 101-000-413.000 $135.00
MMIANICAL FM - POOH. 101-000.321-000 $24.00
F'LF?CTRICAL M. -- POOL, 101--1i00-420-000 545,00
PLUIV13ING FEE -- .POOL 1014X)0.419-000
SUB TOTAL CONSIRLJC`nON AND PLAN CHECK
$3I8,75
LESS PRE -PAID FEES
$0.00
D gZ J� 10TAL PERMIT FFTS DISE NOW
$318.75
JA IV 0 2
1996
t (
RECEIPT TE
by
DATE FINALED
INSPECTOR
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 Wali 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 I
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
Gas 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:
Y
M
RECREATION CORPORATION.
TM
December 29, 1995
Building & Safety Department
City of La Quinta,
78-495 Calle Tampico
La Quinta, CA 92253
Re: Construction of pools within the setback area - Plot Plan 95-552..
Gentlemen:
KSL Land II' Corporation ("Land II") is currently building nine (9) homes as part of the
Model Homes and Sales Center Complex on PGA Boulevard serving the new residential project
developed by Land II at the PGA WEST Resort. The model homes are located adjacent to the
"Bye Hole" of the new Weiskopf Private Course. Land II is proposing to construct pools in the
rear yard of each home and has requested the' adjacent property owner, KSL PGA WEST
Corporation, approve the construction of the subject pools within the five foot setback area. The
City of La Quinta Municipal Code §9.156.170 requires a minimum setback of five feet to any
property line except with the approval of the adjacent property owner.
This letter shall service as notice of approval by KSL PGA WEST Corporation to the
City of La Quinta of the request by Land, H to allow construction of a pool within the five foot
setback area in the rear yard of each model home.
If you have need of further clarification or have questions, please do not hesitate to
contact me.
Sincerely',
KSL PGA WEST CORPORATION
Larry . Lic iter
Executive Vice President
LEL/bl
cc: Nola S. Dyal; Esq.
Grant Hornbeak
PHH, L.L.C.
America's Leader In Distinctive_ Lifestyle and Recreation
56-140 PGA Boulevard • La Quinta, California 92253 • (619) 564-1088 • Fax (619) 5644880