9807-050 (RPL)LICENSED CONTRACTOR DECLARATION
-I hereby affirm underz-penalty,of•perjury that I am licensed under provisions of
t,h��pte� 9 (commencing "with Section 7000) of Division 3 of the Business and
Prdt'essionals Code, and my License is in full force and effect.
License # Lic. Class , Exp. Date
1444-33 ra i}i i.i{iCi
Date Signature of Contractor
OWNER -BUILDER DECLARAT ON
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.
wit
(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 s'Rall 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�provsiolns of Section 3700 of the Labor
Code, I shall forthwith comply with thos • rovl le s.
date:_:f , k' a Applicant
1p
Warning: Failure to secure Workers-c'�ompensatiN', coverage is unlawful and
shall subject an employer to criminal penalties andjl 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. l 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 Bove mentioned property for inspection pu oses.
tignature (Owner/Agent) Dated
' x"73
PERMIT #
BUILDING PERMIT
923V -10.S41
DATE VALUATION '� LOT TRACT
JOB ADDRESS , U-735 VILA SONATA
APN
OWNER
/ ENGINEER
CONTRACTOR�*
t y� i ��r
Fi 1. M ti. E K.L 11Eilk
9�/1D�E�ISIGNER
�.IJ.f�RI'l �.,JLV i,i VVESA�.i iiJ �5�t;♦}
.
'18,-735 V.iA SONA'T'A
12930 ALM 'RE91'U"i'
LA OUC1J'"1'A. CA 92253
Y C tC:AIRA CA.
M,1`i 52R,R,
USE OF PERMIT
POOL
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V�R, i
IN°sl'.VC1110N, iNk-1.8TIO ATAON k I:'E,PiAt 1994 UAC q 304.5 F012 W(ARK
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1'I. AN 0IWK Fly? 101-00-4-19-318 V)3 69
`t'1?!Tt"!'fi'rry144., 10 1400-419,000 $f+t•tt0
:Li3' iv'i1:1JJI '��I;17I ks-1';'(;iOL .101-�(110-11.,1.000 2zt1..t;
l'.►_<(1NWINU 117131? —• 1"OCTI. 10114* _4194*0 $27,N)
1tt1r'r:c','! ii7to'3'!C'tfv i.r:f 1111 fIC1f1-�37.i={Ulla Y, aCr w
AND PLAN CMECK
60
'!'dl'TAt, P1ERXIIT'lli;1 N DO NOW
S!;73.60
RECEIPT
DATE
BY DATE FINALED
INSPECTOR
f
INSPECTION RECORD
'-i
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 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
steel
POOLS - SPAS
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
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:
C_r
I I ofl _AFID I J \1
POOL I -\DDI
CITY
@�' >i L.: QUI[�0Prt is rchitecl:
. BUILDi 2 & SA � Tag DER T
IN, n o E 'NII LY,
• '
LEGAL DESCRIPTION g Er�3'd l�f o�4?b a t� : a�. M
€ f''ire
lB7 J SUBJECTTO ii��t� 8 r . g�e�ie Go s n Engineer:
• ; . -- �i � �L Q� — ��z;,ripe ���,�,���ez� � - •� � r
o l!
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DEGK4
SPA ; - 4' WALK -WAY
-7' 8'-
_ _ t 4 JETS .,._
y WROUGHT '.IN
RO
FENCE OEawing Status Date
Schematics
- }} Design Dev.
i TILE Agencies
SPILLWAY Estimating,
�� DEEP Bidding
f GATE Far Const.
Revisions Dote
y3. 5' DEEP ' TILE + -
i '
r TRIM
DEEP
GRAY ROCK' SALT i
(NATURAL F I N I 5H) {?
�p�ESS/0
% Job No.
O ' i•' V�. C.�^ �/�j Client No.
y t r POOL. _ `V ��`� ,� 'Drawn°R
w i r
no EQU I P.
Lu Checked -
.12 -31-2000
,t p (1
� . � - ., . ♦ � � 8�`'L )'!L/•'"'_' I .AS NOTED -
_ - �2-3-2�Oe Sheet Title
E) FRONT WALL
(
". ' r � � y SITE 'PLAN
CIV`
xf' Sheet No..
POOL LAYOUT ._ _
�: • _ m t .. SCALE: H77 TO SCALE
- ... NOTE: P THIS ORAANC 6 HOT i 1/' w 36'. a 5 NOT TO SCLC
T
CITY OF UINTA
01116-010W:. , . , �..; t >, Wit. ;BUILD
QDRE.SS{ .v rs:. g., . PE E�i� �N - _ e E _ x
This form shall be Posted on the�ob with the Building Pe�tion Card at all times in,a conspicuous place. Only persons appearing ori list or their employees are authorized to work
__ .�:_ - A..., „.,.,...,. +.. •�,:. Bct m,Icf ha mnnr�..ar1'hu tha°Ridirlinn nivicinn nrinr to cnmmencement of work. Failure to'comply will result in a stoppage of work and/or the voidance
1. ?y
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