9512-137 (RPL)LICENSED CONTRACTOR DECLARATION
[2 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with
W Section 7000) of Division 3 of the Business and Professionals Code, and my
C) Q � License is in full force and effect. ti56178 C53 10/31/46
r W r License # Uc. Class Exp. Date
Z^ Date I Signatureof Contractor 1 '
cTo F- o) OWNER -BUILDER DECLARATION
J W 1 hereby affirm that I am exempt from the Contractor's License Law for the
H0- 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 Signature of Owner
N
O rn WORKER'S COMPENSATION DECLARATION
dQ 1 hereby affirm under penalty of perjury one of the following declarations:
Z () I have and will maintain a certificate of consent to self -insure for workers'
75
cc compensation, as provided for by Section 3700 of the Labor Code, for the
K W LL performance of the work for which this permit is issued.
D J —J () I have and will maintain workers' compensation insurance, as required by
n Q U Section 3700 of the Labor Code, for the performance of the work for which this
j U permit is issued. My workers' compensation insurance carrier & policy no. are:
LLoFa— Carrier r..I ream Policy No. �;!!? dcnnha a
Z (This section need not be completed if the permit valuators Is for $100.00 or less).
n 00 Cy() I certify that in the performance of the work for which this permit is issued,
Cl 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: I 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.
t 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 building
construction, and hereby authorize representatives of this City to enter upon the
• above-mentioned property for inspection purposes.
Signature (Owner/Agent) / Date 7i
A"'
BUILDING
PERMIT PERMITar
�s>iz->la7
LOT TRACT • ~'
DATE
VALUATION�juXuU.tlt'
JOB SITE ADDRESS 79-975 PCA BLVD
APN
OWNER
CONTRACTOR
CALIFORNIA POOLS A SPAS
KSI, LAND CORP.
41910 BOARDWALK #A2
561,10 PGA BLVD
PALM DESERT CA 92260
LA QUINCA CA 92253
(619)340-9M CBE.# 355
777-1204
DESIGNERIENGINEER
USE OF PERNPOOL ARID/UEZ .SPA
POOL ONLY a3 1 " / , , -7 +
FEE DESCRIPTION
FEES
FOOL AND/OR SPA 10,000.00 LS
ESTUNWED COST OF CONSTRUCTION
10,000.00
1' 'RMI'1' F1',N SUMMARY
PIAN CHECK FFC 101-000-439-318 $76.05
CONSTRUCTION FEF 101-000-415-0M $117.00
NIECHANI.CAL FII -- POOL 101400-421-000 $21.00
FLWrRICAL F.ER — POOL 101400-420400 $45.00
PLUMBING FEE -- POOL 10141,0419-000 $27.00
SUB TOTAL CONSi'RUCI fON .AND PLAN CHECK
r284.05
LESS PRI: -PAID FEES
$0.00
1%,L PERMIT FBFnV DUE NOW
$2719.05
FJANO21996
RV
RECEIPT
—
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 r SPAS
steel
Set Backs
Electric Bond
Footin s
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
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
Tromp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
mry RECREATION. CORPORATION
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
C ity of 'La Quinta of the . request by Land II 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) 564-4880