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9606-032 (RPL)U) N LLI O c7 0 LO Lu — O _J w Ll.l H D- U) Z C0 LJON ON U °' CL Q Z L0 aCr 0 tL 0 J•Q 00 < O LO Z_ cb D Q J - 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 #s, . Lic. Class Exp. Date 258947 C-53 3f31I96 Date r y Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am cxcmpt 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 J 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 istissued;My,ayvgMr,s' compensation insurance cayr u&lpolicytno. are: Carrier 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 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. isapplication. 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, indemnity & 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. Signature (Owner/Agent) Date BUILDING PERMIT PERMIT# W1)6-{032 CONTROL# 3467 DATE 61 6M6 VALUATION SR:2'"),0R) LOT TRACT A JOB SITE ADDRESS 7!7-200 C"'I'ERRA (3111 APN OWNER CONTRACTOR/DESIGNER/ENGINEER DAUIL MAS'T'ER POOLS 79-200 CXNWEP KA C I k 73555 MY I I 1 1.,A 0111' T'A C.A 92253 PALM DESERT CA 92260 1619)34-611 i 081141 16 USE OF PERMIT AMADR ,SP Y 00 ,& S11A ONLY t"l:K)L f1NWOR ;• PA LS 9811MATED CONS'.1'.1 UCCIO1Y 92,lIRfl�.fM: !!t,wwg■, [. c+1y�,j 6 �'tFl9llY7 �,�• �R+'i+. �A '743 i1'3jia:�Rt.'Y PL, AN CHECK f"ER 101.000-439-3111 SV.75 CONSMUMONt••M 101-000-118-000 �13S.t3f) NIJECI1ANICAL -1;Ts -- POOL lot -m-<12.1-6140 iFiLW.71'k1CAL 'F'6l;s -- NDO . 101-4110+420-00{3 S.ii(i co P(. TfVft31w1 Fu -- P Xx. 1.(6)' -M) -419 -OW) S27.00 M © crn SUIS-i'C!TAJ,. t.IJNSMUCTI(,iAI AND PLA14 CI EC'K $.318.75 1: US .ME -PAM FEES $0.00 'f0'1'AliPE:RtMIT FEES 17.1D:E YVt:A1V $315.75 RECEIPT DATEBY ` �f. ' 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 Fans O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wali Insulation Condensate Lines Party Wali Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS - SPAS 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 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: , yp�a�yy�t Imo; rp��yr�Irt Iy�t yyrgq`pIJSt?ItIVE' 1I`4d{'y�L�LLec� 4 y�-ry�gy 5+ 11SI II�.I �y�� iIID`�71'•J�Ir'J-4Cfr�C` V leirDp-A bA KA tnw, Ti L E, r A i �—rJJ r` 1 lly C_7 C;--)r A Ali Ire f { ry 4, A .4,, • Li�tiJ V I [ux �V ♦'--� 4 `--' r 1r i,l -..r ���� - F I r1001 MWER P LS SPAS:,. �irrlwl�� .l.dkidi5�L5 '. IPA PWL86SPAS w.T�erGM == ' 0 ZA•9 &qj aa+Aafans from plans shop hs teftmW b MASTER POOLS & SPAS forwrti8mfiort WkInP Wm g Vft,hVM*.OrYxrkpm esed9without YArIf1C ft".G7nb=ftr d jMas. a,�nhbwmm-7=r.-IbdBLIr� tryand6ahfi jhD PVWOM per. dm:gn. L ,foul and spugaff= � hmQlbrwrrftaa ft PMPGNy of =W 1 DL38 $P - &�1 * ra�aluaio,'r. ax r�El'�l KMS S SPAS is F. Q1%�ggo r r,-M3lrf�L. 0Wig nars Builders.€or over35 years -- -I3-5�4:7_Higliw�yi-1=�1�Ier�s�n's��ap.�ii�gI1e�t��- -- PaJm Desert, California 92-260 State License # C53-238947 APPE A GUSTDM DESIGN FOR' F00L.rk! PL_u"ffi, y _ n A 1 DATE: I I� ...�d�l�F✓ ++may 3?ECIFICATIONS L Sriir --VGlwmt . .. . G#Nuns Tarr+platr No. Shope Surface ;Z ---Pertnreree .,[P depths §10'. 5ps 511e � Vol ume ___ - - - r:alloru. EXCAVATION F,rnshEl.v ton � �r�� Melded Accaer Sit■ Prep#roman _-- Guiding Qirl Rernpral rLP lso rrip, DrY Wo it 141 -- --- -- --- --- Fer+te Aeh+Orsd Bw Aepkacad BY - 1.Ierer,ar [fi�E4d Srxep! Opernrr__- NOTE No Peinr•no dr-matah•ngoi lelltur* w,al pp 00na{- _-- PLIJNISMG PvmP TYPa . j�yyrfyy�T_Siae " - ------ Skrmmer TYPtA.F- Sin r No �r • �..- Heater Venl SYTbt--- lei Pu-p Slag Blowei Type � F -- Size _.. ..... la*uipment Lx3ripn fr{b},_f�L PXS!#t1.Prr Plurnbinp Maul it Suction S.en+{ Length _ _ FI Drseharge 5r2er Lpih. Fee, W.6tr Tom_ - . - _ _ .. Fl etur-s.. Pcol Nurr,b.r RaT4rn InWq TYPe yyy''' F1II L-v rYVrTM Ng srwce,oY,c hS=ae _ M Fs. A}S L+ Ire Lccat n Gas Line$V M j -- Sou Fli s . SPA 041FOAMATlON Sucvaniae 'j �+-_Lg1h, i-diicnq.yr2e ._ lgSh Jet TrPe._.�,_14,lc_o T-------_. Number i� Jet Air Line Number._ 5kae -. - Length -•�T Farir. Btay,Rr 110;urn 512e . _ Lcnglrl stlectet var,w Typo `• i..�__Nurntaar S rr_ _ Fr11er Type PwmnTypt Sile-- Skunrner Tvpt-- -- ' ----- ---- - N4 - Haaitr TV Pt . - _ Siee ---- --- - •-- Heater Veni By Jolplump TYPR - .--- Slvw4!r Typ--- -- EQukprneni LoCalranw_.-- PiCS�ab:;rrt - -. �� FtumbFnq M11bf creel - • .--� ",1e1ep0n- 5ixe Length Ft 41sdtaf4la ;llYa.._�_ Lpih„_,..Pest. Waste To. __ --- . _ - Slab _ Ltego .__ Peet. Re wins In P4W Number Remn inlet Type- ,FW Ltr-c iWiids No obil fikotl am ISl:e__LDih. Ft_ A1S Val,ro Lacailon Gal Unt By . _-,--Sl�a Automatic Cleaning -.- _-- T - -- -• -- ------ -- RaireA Rand $ram 6" ---.-- _12" TB" --- Other.-. _ SPa an Wall GLINYTF ---� iarner R , ?LT- _ _ It, leis SiRp, f4 . _ Kea{ Line Locat,vr,------- GrPb rail _ -. Hand Rul._ _ -- .. CuP ArwJiws .- Sanr.6PRSh . Spa Inforrruuon T1LE AND GGPILNCi -- a�j7lltrrxr irifn _Numbered 711r "� ---- f3f:+Ck � ---'----- �- - $pec,allxer;i See"5TE0UNI P ~- - k12, EEL.,ECTRIrA4 2 9Y k , Light �.2. - --Cord Lan ��}+ Flct "1" Bcp LaGeian 'Rs (_ Sw�iCh tyye#nan 1Pi r-- Filter Run FT. ki Rl+n -___ €1. L*ht Run Swrlch Run._ t P c?%onge Spa fxMWi Loca[iorl Ft9alrr $wilSn LPCar14n _i_ �- -�'------ DECKING By arrF# ,.Frnw, Sq. Fi -- - - - %10• -. -. Can Cavity _ - Rail Anchors --- Q,ieri_..--_.-- T Ft.E*Pani+nn Standards ... - --. - --_--- Deck Orlin - 4- PLASTE)l Lights Name Plain T-Rrceised reps . %Jp AnC Or�i Y"r Ci110% NAME �I ADDRES'S CITY L-A, PHONE AREA DATE E �. I::� Cr Af.E - +/�a ��t-0 DWN..B.Y Ci��--1 GHK, BY � +'� _J S}IEET ; — �F 1 IGGLAVAPHIGS REORQEA 40. ACM4710