9803-040 (RPL)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Pioteasionals Code, and my License is in full force and effect. . .
License # Lic. Class Exp. Date
Date, " Signature of Contractor
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 T 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.
STATE .P UMC 1242679-97
(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' compensation provisions of Section 3700 of the Labor
ode, I shall forthwith comply with/{hose,grovislo. s ��'
Date:
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set 'forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicator agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such .
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property; for inspection pkroses.
Signature.(Owner/Agent)= ✓le��` Dat? �l
BUILDING PERMIT PERMIT# "` �, . CONTROL#
DATE VALUATION_ LOT 803-040 TRACT 861
3I1 c3AiO.M.00
JOB SITE
APN
ADDRESS
�']ICTORIA
OWNER
CONTRACTOR/DESIGNER/ENGINEER
HEUER
SlYVE DODSON CONSTRilG`i't
1N
79-280 VICTORA .
73-011 COUNTRY CLUB I3RIVE~, STE, F4
LA Q CA 92253
PALM DESERT
CA 92260
(700)3�1b-403a
C;13L# 10 44
USE OF PERMIT
Ar -f
POOH, & SPA ON[:Y, POOI. AL ARMIBATtCt1 A IS RF.QUIRF__U�F0R
'ENC 1lP/.PI EPLASTER TgSPECTI N #'
POOL A:M.7iOR SPA. 20,300.00 LS MA
' 1 0 .1998
CITY ®' F
LA QUiNTA
+' 'nmAn1) COST OF C'ONSI.ffet7C`y`ION
20; 00.4111
'..RML T F: R SL1I1 MARY
t
PLAN CHECK F"h:'E 10.1-000-439-31$ Sltft►A0
CONSTRUCTION FEE 101-000-41.8-000 $216.00
ME.CHA, IIC:AL c -- .POOL ' 101-000-421-000 $24.00
E,'LEC t'f•t:[CAI, FEE -- POOL 10.1-000-120-000 1�1S.0U,
PI:f> i13iNc�:FI •--Poo..[, 101 -(HIO -419-000 b'3.00
SUB -1O`1 Al CONaS'TRUCTIUN-AND •1'LAR CHECK
$452,40
LESS PRE -PAW FEES
9>uo
TOTAL. PERMIT 61EES DUE NOT"r
54:5'2.4
RECEIPT
DATE
BYD
�EDj
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 b
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
i
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
Sewer Connection
Pool Cover
Encapsulation
.Gas Piping
Gas Test
Appliances
Final
.
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low VoRage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
C
t
Final
Utility Notice (Perm)
COMMENTS:
R8`-0
CONIBAGZO�canllo>`asume_C�spQnsibilityjo[ . GE\TERAL SPECIFICATIONS
18'"WIT — alks_,._dime-ways—cement
4- 1-N .SPRAY HEAD damage_t9 curbs_,-s�dQ�r
2 TONS OF ROCK T.B. S
s.labs,-sewcers La-wo ,tLe-e-a,_f-encea,-LetainiN SIZE .16 X_,30 .
AREA-:395. -39.5 PERIMETER -_85'
�a nnkLee one s
Jing o.�shrubs
a_cces-s�slnad�thLougfLa_r�eig DEPTH. `
RLop-or-t-y-�t is urtder�t-o-o-d -that_y-ou,-the_ov-per_, TILE CHOICE GROUP 3 -
S
4-10„ PL tha�tbat_n-eignb�s-p�rroisaio_n-a.ad_assume_ful.l B . •x•18 =50' .
+18 WITH SPLAY HEAD _ _
3.,
._ -
� RBB.,
1.0'4” ,i'. CDAoEsibility-
COPING CANT
9 signature
SOL CAPACITY GALS •
PUMP CAPACITY GPM ._
8„ 111411 +18 DIRT S (AYS MOTOR HP STA RITE HP1:S
FOR SPA -
MOTOR HP HP
I _ FILTER_ STA,RITE 300 SQ. FT'
_14'9" g' \h: I BRAZE 102. GP' .
--
3. „X..:. :-- ...10 9 HEATER LAAR$ SIZE 250 BTU
. 138
. R1 �'-g .
X ....._ . _ TURNOVER. HRS
- \ 101411 „
- 24'-9 --- -----.-s►.
16'4'1' :.PL
_ SUCTION LINES � 2
�- - ---- RETURN LINES 2-1 ._5 11
SKIMMER MODEL AM
CHECK VA vE YES
`X_ GASLINE BY S.D.C. FT: 50'
P/A, i POOL LIGHT 400 W -CLOCK '
2 6.6
it ELECTRICAL BY. S.D.C.
2-1811 ;' AUTO CLEANER
R3'-8 .
HEM. FEEDER
PLASTER COLOR WHITE
P/A i PECK BY S.D.C. SQ. 710
P/A . DECK TYPE SUNSET- ROSE SALT
STEP FT.
SPA SPECS.
SIZE 7 RAISED x.181,
_ LITE .100 WATTS
6 �9 - RI LEVEL SEATS 22" 24" 27"
LIGHT DESIGNER
• iJ�r�4'vYril,!_ '12' „ .� 'R 0 i=�T`. .
SWITCH
DAMWALL TOP Co "
HEUER RESIDENCE SPILLWAY SIZE 3 "X 18 WIDE
r IDATE. SPILLWAY X OPEN CLOS
~ TINA 23-98 #JETS ,5 OPER LOWER
ENT am-e MR&MRS HEUER
C�}tH��i: � 6e"'«� �.�� "y e_ss, 79280VICTORIA
,
ACCEPTED
i Sit
-City-
7. Lr�kw�T Ct�-
'�C`,,
%; Y
Fti4 ' w;; s ` TRACT DEL RE L0
ou
-- r PALM DESERT TEMECULA
poo/s
g/e 18'�lGc 73-011 COUNTRY 28910 RANCHO
CLUB DR.. STE F-4 . CALIFORNIA RD.
BA" KHOE ' . . ' PALM DESERT CA. STE 206
TEMECULA CA.
NOTE: LANDSCAPE' FURNITURE 92260 92590
ARE SHOWN FOR ILLUSTRATION ' �61 q 6-4Q32
ONLY AND ARE NOT INCLUDED.
.(_99�)4zZ6�WJM
,
LIC # A- 41 7