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9708-137 (RPL)LICENSED CONTRACTOR DECLARATION I+,hereby affirm under penalty of perjury that I am licensed under provisions of tY dhapter 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 374 A 9/31/97 /'97 /ate Signature of Contractor"" Z�;' 1'7 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that l 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). ( ) 1, as owner of the property, 'am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). () I ani exempt under Section B&P.C. for this reason Date Signature of Owner ,WORKER'S COMPENSATION. DECLARATION •1 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. K 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 FjA Policy No. (This section need not be completed if the permit valuation is for $100.00 or less). O I certify that in the performance of the work for which this permit is issued, 1.`S'611,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 Oode, Ishall forthwith comply with those provisions. VDate:d'_411 Applicant' —If-5— el a' ii/ ± � "✓'' .• r - 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 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 t e above-mentioned property for inspection purposes. Signature (Owner/ gent) ---7,—" �. ` ,,, - Date BUILDING PERMIT PERMIT# °°NTR°`" 5810" DATE � .VALUATION , ' i.3:2,5►.28.0 LOT TRACT Vhf $`,iEZSSa:41.%`U, APN ADDR SS.a OWNER CONTRACTOR / DESIGNER / ENGINEER �,�.�•a Y� �r�� e�. �;;s:��3r- ter: � ���:��7 ��,:4a�r: ��5���ce ��,� ��; •3 1570 BROOK1 •A LUO'd -9 20 f1-0 ► ICOUNTRY C —.1 r ., `t't , F1 SAKF'A Afi1 N 4.'A, 9770 11A..M DEM.P0," (,,',A 92260 QUM 44 USE OF PERMIT POOL 11,11�028Z 11-13 . P:t�1'�F.�tl)4'Y�!'3•J..67:.sf L.u4Jr�.`ip I,ES 6�.,,.+L'!-1 �,Y`�e,, a1 eW�M. Y�3.i..iA'! -*v--^ n,F.y�L.�iY# i(A €Jt -43 _�:t i sii84'it{[!i":!'i(17y}i?�:__ . I.()1 ftll(1a1:1fi�f)(1fi - j"i1.4rtti i:3 #;L•'!Ia(c.1�f, t I �, s'ti�if,� st°►l. trioti-d�at7-tri)t] �as.s3c fn1r• k"HY,.y KKA, 27.tw) . . C CD CL_ LLJ crit: 5:: SUR -Tr) ('fir,, ( ''C_)*NR'M(Jt.. JX)N AIN"`'? 'PLAN CRt-at.:K 811"3i.,SRd i !' F!VNI 0dJ,M01,'IN (01 5$133,60 RECEIPT DATE 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 Fansf 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 BLOCKWALL APPROVALS POOLS - SPAS SteeG> 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 1/7 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: 3 standard deck lawn area • SPA +6" R 14 1--1.0 X\ 1 \ - i 22'8" 16' \ � 1 '22' 20' 3'-6 X AIR LINE \ % 8' ill 1 , ,y /' 1 17' 22' �•� Jy \ 16' 1 8" / 1 1 ' % 18'4" © ;,1l7'_ slider slider LIGHT SWITCH �I lake la quinta by canaday&canaday home site #47 28' '-R4!ft8 \\ slider d_amacLe_to_ curbs —Sidewalks : driveways; cement slabs, sewers, lawns.trees, fences, retaining walls, sprinklers, telephone lines or shrubs: When access is made through a neighbor's property it is understood that you, the owner, have that neighbor's permission and assume full resporisibility. DATE ----- signature SIZE—r-+— � %REA 265 PERIMETER 74— )FPTH 3-5 TILE CHOICE GROUPE 3 g RBB. +6"/SPA COPING CANT PUMP CAPACITY 100 GPM MOTOR HP STARITE HP 1. MOTOR HP HP FILTER STARITE 300 SQ FT FILTER RATE GPM + HEATER LAARS S17F 400 RTII —22' — R6° -S CI BUILDI optional deck SUCTION LINES 2-1.5 " RETURN LINES 2 " CWIMUPP AAnr1Gl CHECK E YES GAS LINE BY S.D.C. FT. POOL LIGHT 400 CLOCK 220V ELECTRICAL BY. S.D.C. AUTO CLEANER P1 ffyOF LA O U I N T® 1 & SAFETY DEPARTMENT CONDITIONALLY PTED FOR CONSTRUCT4101-1 DESIGNER JAMIE DATE 8-20-97 �r ritM- ttutK PLASTER COLOR WHITE DECK BY OTHERS -SQ. STEP FT. SPA SPECS. SIZE 6 RAISED +6" LITE 1 WATTS 100 RI LEVEL SEATS 22" 24" 27" DAMWALL 6" X 6 FT. DAMWALL TOP TILE SPILLWAY SIZE 3 "X " WII SPILLWAY X OPEN CLOSI # JETS 5 UPER LOWI SUBJE T TO INSTALLATION AS PER Name: CANADAY&CANADAY Address: 47-765 VIA TRIESTE City:. LQ At ID ALL APPLICABLE CODES TRACT LK.LQ LOT# LOT 47 BY 00 dsoff PM/S IMSTEB COPY PALM DESERT TEMECULA 73-011 COUNTRY .28910 RANCHO CLUB DR. STE F-4 CALIFORNIA RD. PALM DESERT CA. STE 206 NOTE: LANDSCAPE AND FURNITURE 92260 TEMECULA CA. ARE SHOWN FOR ILLUSTRATION (619) 346-4032 90 90 � 909) 676 -SWIM ONLY AND ARE NOT INCLUDED. , „ C -7A, In M f ? r i iTi