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9909-162 (RPL)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapfsr 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 �351673 C-53 04JIUM 44",% lie" L'Aign t re of Co j{`ntract 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. (,d 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: Cartier Policy No. 1113� 1191334 (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' compensationfprofvisions of Section 3700 of the Labor Code, I shall foj�hwith comply with those prov donls'. ©ate: { �� Applicant 7 r�� ./ '`✓`/ t'� ' 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 be 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 ins ection pur oses. j gnature (Owner/Agent) + 4" Date) BUILDING PERMIT PERMIT# DATE VALUATION LOT TRACT JOB SITE' ADDRESS 47-125 VIA OWNER CONTRACTOR/DESIGNER/ENGINEER rAVJ7r,tii�slihY��rr,a.�rittmwT1u',, rrC .,1ti,lsv. � 4.al.Pl�!!11\d Y1,1 trin1,n'ftf-imT,(',r%y�� 15701: RCX)KH LV0W-DR1` E,'SUiTE 208 9522 M)NAT.DSUN ROAD SFaN'1AA.NA CA 9:2705 dJ��yCiT--at��1,,`l1ktAaVAL1XY CA ry4'N235(') ('JSR.f,l748-6045 f�'.fAIA 4115 USE OF PERMIT s-zOOLAN1.10)k SPA. :RX}L & sit\ wi\I • ALM.4\46if AEc"WW .MALL TIL, iN i'EA.03 _i'E: POOL, ANOX)RI SPA Ls 3'+i�3"BPAI�' A y vJ ini..IRtl`1 SYv� roiG• d+r'�ti2ti.*n•�11f �p'��y S *,fir. •r ilv .Ni. J. W �J ^.-,!}�M) i 0..6' c.,4.,. J SIN Ci nN � f 7�.. p ��b V � a fif?ts 39��' �.>�iJF4�!..1vtr ,(, jj I j.��,�.�!>y �. •y4�"9.rya PL. SIN' Cl«LEs::.K 0-:E r'OM STR f K I0W F&%f9 141 t-flft!'1-•d lr,-flw $1,44 d 0 l�j.�t:;'a #ilc>At ht::.ts:-_:r�:3Cj1.. �C�15i���1�t3-fKi1'► �+§o.Ehi , . fir UNIBINO tr01; PWi: 1111-OZ04194.KYJ S27MIU .. ; I 3S-'0T'r, j, C".11ti 1'1i S 1f' a"l;� iN ANt7 T4, AN t"' U S f'>° 1:3'Az sill . S S. 311.>9113. 73 AA IjTY yy _11}�111 ' LESS. 311>11311VAIT) 04 ��ry j� (� �.yS y.4�m{,f}:�J.q 1,,@`. ' 10 d AL �38�.i',�Ltl11 �� h� P,,V..S rj: 13C NlA'V�S 10T �y. f�.yJg�.Si�(F�f ,Vui�D.� 60 i' ECEIPT DATE BY, I DYJF L INSPECTOR INSPECTION RECORD 4� OPERATION I DATE I INSPECTOR BUILDING APPROVALS Set Backs Forms & Footings Slab Grade Steel Roof Deck O.K to Wrap Framing Insulation Fireplace P.L. Fireplace T.O. Party Wall Insulation Party Wall Firewall Exterior Lath Drvwall - Int. Lath OPERATION DATE INSPECTOR MECHANICAL APPROVALS Underground Ducts Ducts Return Air Combustion Air Exhaust Fans F.A.U. Compressor Vents Grills Fans & Controls Condensate Lines ELECTRICAL APPROVALS Temp. Power Pole Underaround Conduit Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) Final Final BLOCKWALL APPROVALS _ Steel POOLS - PAS Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final PLUMBING APPROVALS Gas Piping Gas Test Electric Final ( i 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) COMMENTS: C �;,- - /M a h - ELECTRICAL APPROVALS Temp. Power Pole Underaround Conduit Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) SENT BY:Classic Office ; 9-10-99 ;10:15AM Bob Hope Chryslers 7602482919;# 1 September 10, 1999 Mr. Gerald Hampton C-740 2. C( $ - �ri Vacation Pools Dear Gerald, The Lake La' Quinta Homeowners Association's Architectural Committee met and approved your three (3) pool & spa projects. Please note we ask that you adhere to the HOA's 5 foot set back restriction from the lake's edge and side property lines as indicated in your planes. Also, we ask that the lighting plans conformed to our lighting policy. One final question. Where is the pool and spa equipment located on lot 226 on Via Florence? The other plans included the equipment's location, but the lot 226 plan did not. Also, as a reminder, once the projects are completed the equipment must be hidden from the view of across the lake neighbors. Call with your questions: 7.60-346-8184 (work) or 760-771-3640 (home, ager 6 pm). Best regards, Rich Lane FROM AVE S MAIL N MORE PHONE NO. 285 4318 Sep. 10 1999 10:55AM P2 FROM AVE S MAIL N MORE PHONE NO. : 2854318 Sep. 10 1999 10:56AM P3 VVA(WrION P00US & SPAS - 9522 Donaldson.Road L Lucerne Valley,: CA 92356 (760) 248-6045 90 (760) 248-2919 FAX Lic. #C-53-351673 �- � t1 �-• _ Sales Locations Bermuda Dunes, Irvine, Nay' r M j California City, Rialto, c-1" (r Lucerne Valley e,-1811 1 800 999 TION- vEMMAURPH0111 =, AREA PERHEI93-- i r r <!' r•. t"` - .' I 1 I „' r •1 T.i/�~ �`~ PTH TILE CHOICE 9„ COPING We 5 POOL CAPACITYGA SMP CAPACITY GPM or MOTOR HP H t ! &_Axz MOTOR HP HP FILTER S 1=T 0� � $IU ' . '• , � = FILTER RATE P i ��.�• � _-�F 4 .� HATER SIZ�., E3TU • .. � -• � � / , -•t •. , � „ ' � � } �; � TURNOVER HRS LLItjES RETURN LINES SKIMMER MODEL _ - a CHECK VALVE t L GASLINE BY FT.- r j G -POOL LIGHT - CLOCK • �/ ` ELECTRICAL SY•`� t=T ' ✓ i -� �� t•j 4 AUTO CLEANER y �,� CHEM. FEEDER .1'� L. , -PLASTERCOLOR DECK BY SQ. TA DECK TYPE �.•y� --.. �,,.,OF LAO U I N STEP FT. ITY • � w �'`�'C G & SAFETY DEPT. �f�4C h. BUILDIN sizE RAISED /° 7 ••�! lj j APP O� �® LITE WATTS.,:: STRUCTION DUAL LEVEL SEATS _— FOR CON DAM DAMWALL TOP SPILLWAY SIZE X WIDE: _. DATE SPILLWAY 'p, � 1 alt, A/ G^e CONTRACTOR canno TE s Pity for #JETS damage to cubs, sidewalks, ' driveways, cement slabs, sewers, lawns, trees, fences, retaining walls, { sprinklers, telephone lines or shrubs. Name: �r; �`avi� ;P�lt4tit 5 When access Is made through a neighbor's property It Is understood that you, the owner, have that neighbor's permission and assume full responsibility. ` DATE . _.. TRACT LQT SIGNATURE