0008-088 (CP)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penaltyV perjury that Fa,rn licensed under provisions of
Chapter 9°,,,(commencing with Section 7000) of Division 3 of the Business and
Professionals Codeprid my License is in fulfforce'and effect.
License #.Zr * wgM Lic. Class ' Exp. Date
2` 11947 C-53 3 .1&
Date Signature of Contractor
gd
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.
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:
Carver S'FXT.P FUND Policy No. CL40113Ys
(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 asto become subject to the
workers' compensation laws of California, nd� agree that if I should become
subject to the workers' compensation pro sions of Sectiori 37 0 of the Labor
Code, I s 11 f - rt with complyVitfrthose prow Violas.
Date: Applicant-rr
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 rep sentatives of this City to enter upon
the above -mentioned property f r insp D pihpo es,.
Signature (Ow�1r a gent) Date?JJ[�r �` J
BUILDING PERMIT PERMIT
DATE/� /1!�5,- VALUATION' ; LOT TRACT
s6mnuo
JOB SITE
ADDRESS �n+Li99rGiJi.
APN
OWNER
CONTRACTOR / DESIGNER / EN INEER
KS7.. DRVIE-WPlaA l CORPO?-A 0.9
maltzp0ou
55-920 PGAY.5LVD
73-555 1-R011WAY 111
LA,QWfA. ,GA'' 92253
PALM DF.SMZr CA 92260
c
(760)346.6115. cBui 0016
USE OF PERMIT
��i i�s.,.+r�iCC�1.r�•
RM OV.ATION OF i%JCISTIN Cf POOL A s PER APPROVId) PLANS ON 0Y
VVA XA.TION 6,000.00 LS
XSIIMATKD COAST 010, CO0611RITC1:1Q1i
6,000.00
XPERAu ' FEE SWMA.CS.1 g
a
PLAN CHWIIY.• FRE 101-000-439.3 i S g15,00
i-t.ECTRI[CAL ME. 101-000-420-000 $13.00
PLUMBING FEE 101-000-419.000
x
4.
G �
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y
C
T .I
r
SUB -TC W, COVUIC UCTIOI-TAM PLAN CFI K
$45.00
�,. LUM . PRR -bATD 1 3
$0.00
TOTAL I' IMY � VN DtF.10
$9540
RECEIPT
DATE
B
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR
BUILDING APPROVALS MECHANICAL APPROVALS
Forms &
Slab Grade
Return Air
Steer
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
COMMENTS:
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice
PAVINGBLAST FiNISa�_ - .
AND SAWCUT SCORE JOINTS AS SHOWN
--v ,.. "nIarWcr 1a1.7 u11Q�ram of riaroscape ana site elements to be
used for coordination only. Contractor should verffy all existing conditions, grading,
drainage,
and utilities. Contractor to confirm feasibility to achieve design intent prior
to construction. Any discrepancies should be brought
Pool
'
KSL (Andrea
to the immediate attention of
Merr t i l-Moc!<�
LOMPOC RANDOM STONERenker
atBAND
4'-0" WIDTH TYP.
La Q111IIt3
PROPOSED 36" BOX TREE iN LAWN
PERIMETER SECURITY CE
6 COPiNCs
/ 61
iAQ�u.CA
WELD HOOKS ON FENCE R
OK
SHEPARDS HOt LIFE RING
TYP.
/' EXISTING PALMS C3J TO REMAIN
`
VINE PLANTING
/ + GATE
COMMONER
EIGHT (S) CABANAS
SERVICE
ON CONCRETE POOL DECK
WORKS
_LANDSCAPEARS
LOMPOC RANDOM STONE
PAVING AT NEW TRELLIS
`REST `
-- -
Q- EQ. Ea �
a
ROOMS
-s_
EXISTiNG PALM TO
PROTECT IN P
REMAIN, E
f?A r;,�
PA
�EX�STiN�s.J
LOMPOC RANDOM STONE BAND
�r��BRAMCA 01
4'-0" WIDTH TYP. 0 OT W%N �i OF
90 �SMF
NEW TRELLIS (4) 8" x all
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POSTS W/ FOOTINGSP,4
ECONSULTAKrJAmmmmmom
SEE TRELLIS PLANS a
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PROPOSED 36" BOX T P. WiTH
GATE'-
�
� 4' x 4' SQUARE CUTOUT WITH GRAVEL
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ap
VINE PLANTING (4)
PA 16'
4"
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ao
DAVIS 'PALOMINO'* 5441
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INTEGRAL COLOR CONCRETE
— �
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PAVING WITH LIGHT SAND BLAST
0
SCORE
FINISH AND SHOD
PA
NUT
JOINTS AS
— —
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.�P'-�FAouN H,aNICAFE
_— _—
/
2' .8 NEW BRICK COPING AT RENKER
■"^""'""�
P
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/
1. TO MATCH EXISTING
TYP. WITH 4' x 4' SQUA
��
SQ. CUTOUT WITH GRAVEM
L
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�.
PA TO
EXISTING TREE TO
$ AN
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_ :'
' W
REMAIN (CITRUS), 4 x 4
''
t ,L ;+� i" Ll� tOBSTRUCTED PAVED 1".ALK, MINIMUM 4' WIDE,
---
SGL CUTOUT WITH GRAVEL
Q
RAIN A:,;1Y FI�,_M POOL, SHALL
� U Firl N0:4 bt` ttii;>� e R Sri O
�
• :.
SPA W
_ c �
C PLETELY AROUND THE EDGE OF
■srt�r
EXISTING TWIN PALM -
f y�'
�
A POOL PRIOR TO FINAL APPROVAL.
•
AT SPA TO REMAIN,
Y,A
I
SCHEMATIC
LAYOUT &
[�T
'
MATERIALS
D GRAM
.40' ( 4 10
MEC `, p
� � 0 V.
EQ.
EQ.
6' EQ:
E N LDREN'S'WADINCs POOL
8' X 14' BRiCK GOPtNa TO M TCH
i
ORNAMENTAL
DOUBLE
EXISTiNG `
W.� �
GATE fo' OPENING
smioo
-
SnJ I�ITU
FUTLIf E
—VINE PLANTING l3) 0
■�
10' 20' 40'
DATE
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