9802-134 (RPL)LICENSED CONTRACTORDECLARATION . .
Qh- censed under provisions of
,preby affirm under penalty of perjury that I am li
Aaptef.9 (commencing with Section 7000) of Division 3 of the Business and
Pr-ofessicinals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
574127 1199,
ate !��'Signa'ture of'Con;'ractor 'h 4�_ JP,
-OWNER-BUILDER DECLARATION
hereby.affirm under penalty of perjury that I am exempt from the,Qontractor'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 intend.ed or offered for
sale (Sec. 7044, Business & Professionals Code),
1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
I am exempt under Section B&P.C.. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION '
| hereby affirm under penalty ofthe'following declarations:
()| have and will maintain acertificate of consent to vo|p|noumm,wmmos'
oomponmmion, as provided for by Section 37000/the Lobo, Codo, for the
performance o,the work for which this permit ioissued. .�
have and will'maintain workers' compensation insurance, ao'mqviredby
Ge6tio?»7oo���o Labor Code, � h ovthe womfor which this
pe,miiio ioouod. myworkers' compensation inoumn;ooarrior4 policy no. are:
Carrier,_ Policy No.
I Al 6 FUND 1242679-97
(This section need not be completed if the permit valuation is for $106.60 or less)'.
I certify that inthe 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
*umomcompensation laws mCalifornia, and agree. that if I should become
subjkt to the workers' compensation proysions of Section 3700 of the Labor
C64'1 shall forthwith comply with ose proLsidris
71
-'
Warning: Failure tosecure Workers' oompenuationvevomg isUnlawful and
Shall subject an employer to criminal penaltiesand civil fines $00,
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 �nd Safety
for a permit subject to the Conditions and restrictions set forth on his
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 Ouimo, no officers, and employees.
2. Any permit ixauwU as mouK of this application Uonumoa nun and void' if
work is not commenced within 180 days from date o/-ioxuanoo,o( such
permit, o,v000auono/work for 1oodays will subject permit tocancellation.
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
con�truction, and hereby authorize representatives of this City to enter upon
the above-mentioned pr6pegy, for inspection purposes.
/Signature (Owner/Agent) Da
BUILDING PERMIT
DATE VALUATION LOT 9802434 TRACT
ADDRESS
OWNER
CONTRACTOR DESIGNER ENGINEER
Ain
P00LAQ)A')R SPA 1140i-00 LS MAR
10 1998
WMMA-rco OF CON RUCTION
13,411111.00. -
.
PERMIT FEE SUMMARV
PLAN (JEECK FEE .101-000-41-4-318 $99.45
CON-TrRUCTION FEE $153.00
'101�000_41&000
NlECHAMCAL FEE -- POOL 10 1 -000-42,1 -000 S24A
F.LaIURICAL FEF'�- POOL 101-W-420-000 $45-00
TOTALL PERMIT FEES DUE NOW
$348.45
RECEIPT
DATE
BY
LE6
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 Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
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
Sewer Connection
Encapsulation
�p
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
'
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)
p
lawn
area
O
D3
IL:0j
Y,
91-01
access by backhoe
no walls yet
2
LAKE FRONT
EASEMENT 10'
boulders by others
DECKING
P/A
existing
COVERED PATIO
MASTER
BEDROOM
I
LA f'%UF, RTA.
t,u IV
AT
NG, i -A S
RTIVIENT
ACCEP7,E-D F -0,R
S L) BJ C' TO 11
NS
DESIGNER
AND ALL APPLIK-dABL--.ti �
Lj
to DATE
141 2-10-98
decking by others
GENERAL SPECIFICATIONS
SIZE 14 X , 30
AREA 320 PERIMETER 78
-DEPTH 3x5
TILE CHOICE
_group 3 s •S5
R13B. . spa at +12"
COPING cantilever
T -0 -OL CAPACITY 11,000 GALS
PUMP CAPACITY 103 GPM -
MOTOR HP STA RITE HP 1.5
MOTOR HP --------- HP ----
FILTER STA RITE 300 SQ FT
FILTERRATE102 GPM
HEATER LAARS-...SIZE 400 =BTU
TURNOVER .2 HRS
SUCTION LINES 2 @' 1.5 .1
RETURN LINES 2
SKIMMER MODEL american
_C±LECE_VA_LvE yes
GASLINE BY sdc FT.
POOL LIGHT 400* CLOCKt104r
ELECTRICAL BY. sdc FS. 200
TO CLEANER
CAEM. FEEDER --------
PASTER COLOR white
DICK BY others" SQ. -----
CK TYPE
E p
-----
CK TYPE
FT.-------
'--SPA SPECS.
IZE 6 RAISED +12"
100
ITE 100 WATTS
rRI LEVEL SEAT&22`24" 27"
bAMWALL 6 " X 8 Fr.
DAMWALL TOP stairstep
SPILLWAY SIZE crosssection WIDE
SPILLWAY xx OPEN CLOSED
4 JETS 5 1 JPFR
eft. -LE `-�'-- NADAY AND COMPANY
Address- 78-950 VIA FLORENCE
LA QUINTA C
c2y:
JR&CI LAKE LA QUINTA LOI# 228
ng,
Bod ON
POO&
0PALM DESERT TEMECULA -
11�
73-011 COUNTRY 28910 RANCHO
CLUB DR. STE F-4 CALIFORNIA RD.
PALM DESERT 'CA. STE 206
NOTE: LANDSCAPE AND FURNITURE- TEMECULA CA.
ON 92590
ARE SHOWN FOR ILLUSTRATION
(-6-1-9-)-3-4fi--4Q32- (3-0%6-7-6-2m
92260
ONLY AND ARE NOT INCLUDE I 1/- 44 A C-7 A I ') 7