0105-196 (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
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
656+17€y C53 MC
JW1
Date, "; %) Signature of Contractor r'
y. pc
OWNER -BUILDER DECLARATION f
I hereby affirm under penalty of perjury that I am exempt from the Contractor'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 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 Sectior 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
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 r Policy No.
(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 pirovisions of Section 3700 of the Labor
Code, I shall forthwith comply with t b�sg prov Ions. . .
Date: Applicants ,
Warning: Failure to secure Workers' Compensatio coverage is unl
shall subject an'employer to criminal penalties and civil fines up to $10 00,
addition to the cost of compensation, damages as provided for in Sect
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building ad Safe
for a permit subject to the conditions and restrictions set fort on his
application.
1. Each person upon whose behalf this application is made & each person a
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
the above-mentioned property form spectl � purposes
A
Signature (Owner/Agent)! �a�`�r`d°��" Date10
a
777 ;� PERMIT#
BUILDING PERMIT
DATE VALUATION LOT (n Q.&. 196 TRACT
PP/Np�.84.riP�A1,l � V6D ��y
JOB SITE
ADDRESS
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OWNER
CONTRACTOR / DESIGNER / EN (NEER
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:x°101 Boys, 1716
74775 JONIDRTVYO,,. 9`,R PAA,
LA Qu.04u., CA 97213
1',M.3 d i1?WEVr CA 97260
(760,340-9000 CP.. 353
USE OF PERMIT
.POOL ANDIM niPA
I,'f;:iOM;F`A. 8HQZZi U I995.44AAFWM.ARRILERS SHAU BY. IM )Pu',ACZ
POOL AN i3IOR SPS, 24,000.00 LS
ISS MAM CT) sr art COMM'di'Md.'eN
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PUN
&':ONSTRUC T ON WE 101-000-418-00.0 $243:tib
f,d 1 1•iSC�Ai.p�i!F°4 . - POOL 101-000,421-000 $24.00
EI:Wxrx CAL WX — POOL 101-000420-000 $45.00
dcf I .;,,. 101-000-.419.000 527,00
AY 1 6 2001
CdTsQF-LA OUINTA
FkAi5E DEPT y
OU - OTAL CONWI€U °ItTIO1.1'AM PLAN ivWC&C
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MISS FRE—.FORM 11703
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RECEIPT
DATE j
BY
DATE FINALED
INSPECTOR
a
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
Set Backs
steel
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
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 petectors
Temp. ,Qse of Power
4
Final
Utility Notice (Perm)
Master Association for Rancho L'aQuinta
1 79-285 Rancho La Quinta Drive
w \ La Quinta CA 92253
Phone: 760-777-8807 Fax: 760-777-8961
www.rigma.com
July 24, 2015
Gary Benvenuti
2020 Rockwood Dr
Sacramento CA 95864
Re: 48875 Vista Estrella -Approval of Submission
Dear Mr. Benvenuti,
The Architectural Committee reviewed your submission for'the following improvements:
New pool, spa, barbeque, fire pit and pavers in rear yard and courtyard.
Your submission as presented, is approved contingent on the following:
• Any damage to the common area caused during this construction shall be repaired by the Owner to the
'r satisfaction of the Association.
• All work is to be done in accordance with all applicable requirements of governmental entities,
including the City of La Quinta and in accordance with all Homeowners Association
Architectural/Landscape Guidelines and governing documents.
• If required,.a City'of La Quinta building permit will be obtained and copy furnished to the Association -
prior to commencement of work:
• No other structural changes are approved with this submission.
Once completed, please submit a "Notice of Completion" and the Association's Architect will schedule an
inspection so we can process your deposit for return. If you have any questions, please contact the onsite
office at 760-777-8807.
'ncerel,
Jamie Cir
Architectural & Communications Manager
Master Association for Rancho La Quinta