0007-214 (CP)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 Cude, and my License is in full force and effect.
License # Lic. Class Exp. Date
ate Signature of Contractor
J)
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:
Carrier STA.f I ta14 Policy No. CL110 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 Californl and agree that if I should become ,
subject to the workers' compensation ptvisibns of Section 3700,of the Labor
Code, I s ' II f hwith complywit.%those�p evis9ns.
t'Date: Applicant 1 �.
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $106,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of therL'abor 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 insp ction • urposes.
VSignature (Owner/Agent) Date 1'fto
BUILDING PERMIT PERMIT#
„..-+.y�
DATE ��gJVAT0ATION LOT OW7.414
�.f ll...//
TRACT
JOB SITE'
APN
ADDRESS 4949.9 ]ETS"HOWER DIM
OWNER
CONTRACTOR / DESIGNER / EN INEER
XSE L DEVEL.C3PlvIMT C0100RA110M
MASTRAPOOLS
5_5,920PIGABLtTD
73-.5551=1xGHWA.Y I
I I
LA Q1T.i;AT.CA CA g22S3
17ALM 13UM
CA
922&"
760)346-6l15
CBI.#
001E
USE OF PERMIT
POOL A1`1WOR SPA
POOL & SPA.G'NL,Y- ALARK't'FsARP.tR S SHALL BE IN PLACE AT
PR&PLA.S3T911 INSPECTION, THIS PEY3.1 IT DOP8140T INMUDR, BI..00
WALL FOR POOLS EQUIPMENT ENCLOSURE.
VALUATION 1%500100 IS
r%S'.I:i1'MXX COM'.0F CONSrRUCTION
12 wom
PEk1R4.iT PRY gUbg"R-Y
PLAN CHECK YKE 101-000-439-318 $93.60
CONSTRUCTION FEE 101-.000-419.000 $144.00 ''�
�n
MECHANICAL ITA -- POOL 101.000-411.000 $74.00.-
NLEC TttiCAL FEE -• POOL 1-01-000-420-000 $45.00
��
`2► p
P1AfMBINO FPE - POOL 101-000-419.000 $27,00e.
a #,
MR -TOTAL COMMUC;1 .09 AND FLAW CZ1ECOKC
$333.60
LESS PIRE PAW FM
$0.00
TOTAL 062 f 1.ME5 D'(X KOW
S3311.60
RECEIPT
DATE
B k
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION DATE INSPECTOR
BUILDING APPROVALS
Set Backs `
Forms & Footings
Slab Grade
Steel
Roof Deck
O.K. to Wrap
Framing
Insulation
Fireplace P.L.
Fireplace T.O.
Party Wall Insulation
Party Wall Firewall
Exterior Lath
Drvwall - Int. Lath
OPERATION DATE INSPECTOR
MECHANICAL APPROVALS
Underground Ducts
Ducts
Return Air
Combustion Air
Exhaust Fans
F.A.U.
Compressor
Vents
Grills
Fans & Controls
Condensate Lines
Final
Final
POOLS -SPAS'
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
L
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
COMMENTS:
Final
ELECTRICAL APPROVALS
Pole
Conduit
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility
:r
- .'.COUNTY. OF RIVERSIDE, HEALTH SERVICES AGENCY"
DEPARTMENT'OF•ENVIRONMENT4L HEALTH
District Ent lrohmental Semicei Dlvisi®n .. -
POOL AMD SPA PLAK CORRE PTI M
I
District No. Plan No. Date A 0
PROJECT NAME L. c,_ �1V. ��C1 P�c nr� Cn`Y1►•410 1e c U 115 6' 1. ,
PROJECT LOCATION c �iL.61r•►�{ �-
OWNER / CONTRACTOR kZ L
The plans are now approved subject to the conditions listed below.
+ i C 0 0 �- C� P c
�_ rev r rye ►�n t� , `E 4 e c:� - �1� ��, i Sao a�..s a,, =- ,mot; c�� o� a M.X!� 1
� .
�G1 L/ 4. �..: ^{ _ •..gi p+ 1,i' y.� x -
ti
f .�"' '
ll i
�;.
(rIJ Imo'• .� �`�•.Q r C O K I+f r �� � stir=-
I
�- f, • .r,j .F Rw y...�w.'q"'. �.•� 3t�. - - Ai.
- f-
J� y
•.bi �� .7 }• l f ` �,y;'...n �F ��.iL` l ��* 2 i..f � ...r �. ' � �
. ' /V1 t 2 u rr�t✓
i ��, 1 , n ,1�„_ :i �L. ' y���,ti. inn K t•, ,o • ...
V
P._s (1&Al2Q./ �O a" k-t`i'�v.-s r- 1'�' 1� oe ob
T
I�I�i)u��Gt.e kn � ►ti I � L_r� �kte,- r rb� � 1 � �� 1 t� e��' tciceCQ e_�qj oc � � ar• c� � ' .
4 y
CONSTRUCTION INSPECTIONS: Contact the 7Plan Checker,for pre-guNte7ane� re -plaster. inspect(onsat'4ast three` ,3) •
.working.days in.advance. �' ,a . , 1:
y -Y ^' ' Yw• 1 • .. �;, .� 1 • •.� Y ��~ i 11. ,. f'j �f iat
A FINAL -INSPECTION MUST be.made upon' completion of all work including fencing, safety equipment ,,eind signs,
APPROVAL to operate shall not be grant®d until the facillty'has passed the FINAL INSPECTIONS and 'APPLICATION TO - '
OPERATE" has been completed and PERMIT fees have been paid.
REQUEST FOR FINAL INSPECTION S GULC BE MADE AT LEAST FIVE (5) WORKING DAYS IN ADVANCE.
Plan Check By(J _� Phone
_ � .�
I acknowledge the corrections noted herein and as ' ted o the plans and agree to incorporate them during construction:
Signature
Company zz'w�=Awg5
Date z-- no
DOH-9AN-181 (Rev 11R15) MrtribtAion: WHITE--0fl{cs; CANARY —Applicant; PINK --Bldg. Dept.
� _ . .. 5.'�_. s -.K .'. I • �T'yO+• r .�- .R'.+•.. Y. - 1 w ..w u - . e . ve ^!A •« •+- ti.. ..
07/20/2000 16:48 7765889
73-355 HfQHWAY 111. PALM DESERT, CAUFORNIA 922.60
OORPORATQ/CONSTRUMON
1 760.346,6115 vdtb 7ft778.6889 fax
7d0.34�81 iS ce, 780.341.7138 fax
[
MASTER POOLS AND SPA PAGE 02
MASTER. r, • ' •
Front
Pkolm bets:
Ron e
13 Urgent 0 For Review 0 Please Comment G Plesse Reply CJ Please RooWs
If you do not receive this fax in legible condition, please conW OUr Office jmmedblely_
t
I6'
NAI IENTAL DOUBLE -
logo
=gin
MEN
EXISTING PALMS (3) TO REMAIN
GATE
EIGHT (5) CABANAS
ON CONCRETE POOL DECK
cA
LOMPOC RANDOM STONE BAND
4'-0" WIDTH TYP.
PROPOSED 36" BOX TREE TYP. WITH
4' x 4' S=ARE CUTOUT WITH GRAVEL
DAVIS 'PALOMINO' » 544�
cA
INTEGRAL COLOR CONCRETE
PAVING WITH L IGWT SAND BLAST
FINISH AND SAWCUT SCORE
JOINTS AS 5HOUN
NEW BRICK COPING AT RENKER
TO MATCH EXISTING
EXISTING PALM TO REMAIN
iClUlf { IGI`l I
PA
PA
\,—
NEW CHILDREN'S U! I OOL
EQ. EQ_ 5- X 14' BRICK COPING TO MATCH
EXISTING Fm
I"=20'-0"