0008-0296 (POOL)48950 Avenida Anselmo
LICENSED CONTRACTOR DECLARATION
I•herX4 affirr'rrund4 pe ialty of perjury that I am licensed under provisions of
Chapter 9 (commerwjng vlm ii bectran 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
Licens # r Lic. Class Exp. Date
6 4 ) C53 3/31/2(
''QQ ..-. '
ate Signature of Contractor—
OWNER-BUILDER
ontractor
OWNER -BUILDER DECLARATION
1 -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.
<( )r I have and will maintain workers' compensation insurance, as required by
SIiQn 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 'WILLIAMSBURO INS, Policy No. WC0I I?934-0I
(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'4compensation laws of California, and agree that if I should become
subje tepail",
the workers' comp sen ation provislIo ns of Sec n 3700 of the Labor
Co I'40comply 'th ose p visQ ns.
f Det"e: V Applicant
Warning: Failure to secure Workers' Compea tion 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 Safe,ty
for a permit subject to the conditions and restrictions set forth onQ is j
application.
1. Each person upon whose behalf this application is made & each persona't%
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, inderrkfyd
& 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 i
correct. I agree to comply with all City, and,State laws relating to the bis?din
construction, and hereby'du orize representatives of this City to enterupn
the
above-mentioned 6,roperty for inspection p s -e . d
Signature (Owner/Agent) . M Date /8
BUILDING PERMIT __- PERMIT
'%
DATE t//VALUATION LOT &296 TRACT
1,% }
/0
-
f/7 Gi/l {J J
SI510W.€ 0
JOB SITE
ADDRESS 48-9W A VENMA iI WLM.O
APN
NER
CONTRACTOR / DESIGNER/ EN INEER.r
CLASSIC BUILDLW
MCS` tdT'tU POOLS 6lr• SPAS
45.260 CLUB DRIVE
P.O, BOX 1791
INDIAN WELLS CA 92210
LA QUINTA CA 92253
(760)360.3585 CBL40 1945
USE OF PERMIT '
POOL AI&OR SPA
POOL &SPA ONLY-ALARMS/BAMERS SHALL SE IN PLACE AT PR
PI ASTFX. rNS ECT ION.POOL EQIJITt1MKNT R14CLOSiiRE IS 140T lWCLUDI1 D
IN THIS PERMIT
PIDOLANDIORSPA IUKDO LS
J
ESTD"n'D C:OYrOF C0.149'a2iT%UON
151010.00-,r
PR .P b LPL suhn"Ry
PLAN CHECK PER 101-000.439.318 8105,30
CO STRRUCTION FRE 101-000-418-000 $162.00
M&CHANICAIs FZ% -- POM.. 101-000-421-000 $24.00
L'LI; TRIC A,L FEE — POOL 101 -000-420=000 $45.00
PLUMBF140 FEE-- POOL 101-000.419.000 $27.00
4
$w ,
rt
SIM TOTAL COh'7PRtJCTION AM PLAID t CK
$3Ea3.30
INM :PRE -PAM F1013
$0100
UG 18 2000 TO:r.ALMOM FMDUE NOW
M. 33 0
SIT QIN,
_1"
r
IIII IIIIIIIIII III 02
r ;
IE
RECEIPT
DATEr=
BY y
D F ql.
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs :
Underground Ducts
Forms & Footings
Ducts
Slab Grade ,a
Return Air
Sieel
Combustion Air
Roof Deck
Exhaust Fans
K. to Wrap
F.A.U.
,Aiming
Compressor
sulation
Vents
" Rrephace P.L.
Grills
Fireplace T.O.
Fans 8 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
Equipmenl Location
(7�
Underground Electric
Underground Pibg. Test
_
Final
Gas Piping
Gas Test
4-240
PLUMBING APPROVALS
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Piaster
Sewer Lateral
Sewer Connection
Pool Cover
Encapsulation
Gas Piping,
Gas Test
Appliances
Final
A� 7
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
x
Final
Utility Notice (Perm) ;