9603-115 (SOTB)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
57,5392 J
.f� �� `' :�- S . til /!.I '�.." Z;✓d �}
Hate o ` � Signature of Contractor
OWNER -BUILDER DECLARATION'S
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
perfoance of the work for which this permit is issued.
(%4, 1 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:.
Cartier, " Policy No.
CRL 04010 INS �� �, 1202:.?i
(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
Code, I shall forthwith comply with those provisions.
Date: Applicant
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
the abv�2 mel,bned property for inspection purposes. .
Signature (Owner/Agerit) Date -
-BUILDING PERMIT PERMIT# °°NTR°`" '
�� 3082`
DATEr 4t 2/9r VALUATIONt,i�"1�.�ai LOT TRACT
JOB SITE
ADDRESS 50-24%f�rsvl�i��1# ��ii;�#t�et�l�iiTl
APN
OWNER
CONTRACTOR/DESIGNER/ENGINEER
'KSL LA t73„,riT!' A C011M.
tl'd°+111"tr2 � Py � 'F fi�:'I:CJPd' i 1r11'.p .i�1
5w 140 K'P!BVD.
3x,5 L Cfi3 %vNCli ial3.
L..rl. Q[JtNTA CSA 92253
Kt1Idf: HO C[ lC: "i0W CA 91730
USE OF PERMIT
OQLfa BALL BAttl ; ER.
13,7-59.4,10 LS
VSTINIA TEM C`C ST OF i".�c3NS fps .�,fMON
13,7561.00
f+w�N'Tia?f�lie7 ,�.94a f0-cloo.'Itgd1!)}
sut%Vt'a n, UC:HON AND PLAN "HEC K
$153AX)
ti
[RECEIPT
BATE'
BY
DATIS.FI ALE
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
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)
RECREATION CORPORATION
March 4, 1996
M .
Mr. Greg Trousdell
Associate Planner, COLQ
P.O. Box 1504
78-495 Calle Tampico .
La Quinta, CA 92253
Dear Mr. Trousdell:
KSL La Quinta Corporation is trying to solve a long time safety issue at our
Mountain/Dunes Golf.Course Driving Range.
In short, the driving range does not have the length to accommodate some of.
the -longer hitters using woods. This presents a problem because the #7 Mountain.
hole runs perpendicular to the rear of the range. Members and guests playing the ."
hole have been hit and there have been several near misses.
In 1994, the rear of the range was contoured using high mounds to try and
alleviate some of the danger. This helped slightly but "still left an untenable.
situation.
With the installation of this net 20 feet high and 500 feet long we. feel the
safety issue will be solved. I thank you in advance for your consideration of this
issue and, with the permit, we are ready to proceed.
Sincerely,
KSL Recreation Corporation
Virgil Robinson,
Director of Agronomy
3i ::er:u� 9 L Quinta, Ca!ifor iia 92253' a (619)564-4463 Fax (619) 77t-0546
v
78-495 CALLE TAMPICO — LA-QUINTA, CALIFORNIA 92253 - (619) 777-7000
OF TNS FAX (619) 7774101
CITY Oi 1� Caf1PN pA
March 14, 1996
VAR 1•4
ECT
R
Mr. Virgil Robinson, Director of Agronomy ��IL®I�iC�i�sL��,
KSL Recreation Corporation
79-811 Avenue 54
La Quinta, CA 92253 :
SUBJECT:' PLOT PLAN 96-578
Dear Mr. Robinson:
This is to report that, the Community Development has .approved your request to install safety
netting at Mountain/unes Golf Course Drive Range to protect golfers on -the 7th -hole of the
Mountain Golf Course, subject to the •following conditions: `
.1. A building permit shall be obtained through the Building and Safety Department.
2. The filing fee.of $75.00 for the Plot Plan application ispaid before bu_lding permit
issuance. :
Our Department will, not require approval of the".Santa Rosa Cove Homeowners' Association to.
obtain a building permit to construct the -safety netting since your company is attempting to ,fix an
existing problem on the golf course. However, it is 'to your benefit to meet with the Association
before any on-site construction to inform them of the project and/or its benefits.
If you have any questions, please feel free to contact me at. 619-777-7067.,
Very truly yours,
Y RMAN
ITY DEVELOPMENT DIRECTOR
/'G SDELL g Q
soc ate Planner
'GT.
Y 17, cBuldng� �andS _tyD�rtment
pp96578
MAILING ADDRESS P.O. BOX 1504 - LA QUINTA, . CALIFORNIA 92253 ��