9605-106 (RPL)LICENSED CONTRACTOR DECLARATION
J, he,eby 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
Date �` / Signature of Contracto ���•/ '""^�-*�-+-
. �r
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 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:
Carver :s'o i is hM0 Policy No. t:ft1�„
(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 h !A fort with comply with tho�,sq.provvigio S.
Date:--r!/��1! Applicant✓' _
Warning: Failure to secure `ompensation 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 above-mentioned property for inspection purposes. ,.
I
Signature (Owner/Agent) ADate
BUILDING PERMIT " PERMTN °°NTR°`"
960.5-106 3358
DATE VALUATION LOT TRACT
.V20196$201000-00 .
JOB SITE APN
ADDRESS 55-740 SCACll!
OWNER CONTRACTOR/DESIGNER/ENGINEER
I.C7t31 121ai'sS
STEVE noI'MON CON,,'FRUC 1100
5��1+fls 68805A PEREG Ria. sfF~9
LA O(1 brrA CA. ;�21253 CA` IIH1)RA1, (21TY' CA. 42231
(6w)124-1232 CRIA 1€44
USE OF PERMIT
)'f)t' L r'1N17 SPA
POOL AND/OkSllik
2t1,0uo.o) i's
F;.` T111ri`;Y RD C.'1;Si.C)F CONST RIX FICO
200,4 0.0
PLAN CHr, CK R%
j1)1-(X*A19-:418
$131.55
�,NSTRUC-1-10N 1'f::'
tfli-oJ(,'•
320.006,11E
• MNIC: AL 114i
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 Pibg. 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)
P.L.
400 p F
' �Mr ivt
MIN.
TBACK
FROM P.L.
W
50'TO ��o.00C11_aoK UU'Luu�
GM/EM
,POOL & SPA
EQUIPMENT infinity ,
pool
AREA (WALLS edge/fall water concrete
& GATES NOT 11 30' long level decking
BY DODSON) / W 1
door
18"
l
EXISTING i811
SLOPE
Ile pool 41311
-a- —
5'min. to
CTYOFLA'
BUIL G & SAFETY DEPARTMENT
CONDITIONALLY
ACCE ED F®RMNSTRUCTOM
SUBJECT TO INSTALLATION AS PER
1 11
BOBCAT
ACCESS
18'+
AND .ALL APPLICABLE
0
DETAIL FOR SOLID
GUNITE LOUNGES
(SLATE VENEER
BY OWNER)
DECK, PATIOS,
& TILE ARE NOT BY +0"
DODSON POOLS,
THOROSEALING FOR
TILE IS BY DODSON POOLS
1.5 FT P.L TO WATERS EDGE
T DIAMETER SPA RAISED +12"
ABOVE POOL WITH STACKED
SLATE WATERFALL TO POOL
7'+
0
SPA SPECS.
SIZE 7' 21P X 39 SQFT
RAISED " "
LITE 100 WATTS
TRI LEVEL SEATS YES
22" 24" 27"
DAMWALL WIDTH 18"
SPILLWAY SIZE PERPLAN
OPEN 3i CLOSED
JETS.#_ g___
AQUALINK LOCATION
TO BE DEYERMINED
BY MR. ROBERDES
NATURAL BOULDER
ROCKS ALL AREAS
BY DODSON POOLS
10'
GENERAL SPECIFICATIONS
SIZE '12' X 38' AREA 348
DEPTH 3'6" TO 5'
SHAPE CUSTPERIMETER 92'
TILE SIZE BY OWNER SLATE
TILE COLOR BY OWNER
RAISE BEAM STEPPED FALL
COPING CANT. + BOULDERS
POOL CAPACITY 12,335 GALS
CAPACITY 90 GPM
MOTOR HP STA MAX 2 HP 2.0
MOTOR HP STA MAX 2 HP 1.5'
FILTER SYSTEM 3 300 SQ FT
FILTER RATE 100 GPM
TURNOVER 3 HRS "
RETURN LINES. TO POOL + SPA'
MAIN DRAIN YES "
SKIMMER MODEL DUAL PORT
CHECK VALVE -FOR SPA
HEATER LAARS SIZE 400,000 BTU
GASLINE BY S.D.C. 56'
POOL LIGHT(2) 300 W
SPA LIGHT 1 100 W
CLOCK 24HR 220 V A UALINK
ELECTRIC BY S.D.C. 241'
ELECTRICAL BONDING BY: S.D.C.
TILE AND COPING NOT DODSON
DECKING BY NOT DODSON
CONTRACTOR cannot assume
responsibility for damage 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,
DATE have that neighbor's permission
5-23-96 and assume full responsibility.
Name: RoberdeS
Address: 55780 Pebble Beach
cAy; La Quinta, Ca.
Tract: PGAW
ftdomwsmdomftm
I�WAF
POO/S
SHOW ROOM
73011 COUNTRY CLUB DR.#F-4,
PALM DESERT, CA. 92260
PHONE (619) 346-4032
LIC # A-574127 jeff lamb
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