0104-225 (BLDG)LIGENSED GONTRACTOR DECLARATION
I her Irm under penalty of perjury that I am licensed under provisions of
Chapo(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
f.'A..�
Date Signature of Contractor
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:
O 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 foCwhich this permiLis.;issued.
( ) I tiave and will maintain'.workers'.00mpensation insurance, as required by
Section 3700;of the Labor Code, for.the performanceof the. work for which'this
..permit -,is Issued: My workers' compensation insurance carrier & policy no. are:
'Carrier ,`t•>k..` ` t, . Policy:No. -
`(This section need.notbe completed if.:the,permh valuation is for $100.00 or,less):
( )"I certify that in the performance of the,Work for which.this permit is issued,
1.shall not; employ, any person in any manner.so'as to become subject- to the
workers' compensation laws of Cali6nia, and agree that f�l should become
subject to the'workers' compensatioirprovisions of Section 3700:of the Labor.
Code,`J shall forthwith comply with those provisions. -
Date: Applicant
Warning: Faildre..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.
IMPOR_ TANT Application'is hereby made to the Director of Building and Safety
for i;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 requestand 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.
Signature (Owner/Agent) Date
BUILDING :PERMIT PERMIT#
•
DATE VALUATION LOT 0104.2.25 TRACT•
JOB SITE
ADDRESS
APN
OAK
OWNER
.,.a•
CONTRACTOR/ DESIGNER / EN INEER .z
1'„000AV"iO
"E.A ll MAIC. PACIFIC t' 3Ylt:iEVJ%L co"krT'.t�wfO
1'<i :1 t:tK 1 CFE)
362 "TJ:IsVLN:1 AZY:f -4302
KA C,rt; i.'r•i'.t',A. CA 1''2:7, 5 3
,
SOLAWA iiFA CM
(,8.5£5)792.1500 cn-wt,'. sen
; a
USE OF PERMIT
1:C.?S',f1,I, t:tl'F1t".tti (Nh'C�6�t�t�9i'It�N �".
?E'C>'I;);}
"6.lii0IST. L•15AJt!!K:; PL`'
54 qtr 5t H' 'A 140 �C: Si i 31 t A.P: ;'fif'.tr ., };itIl l_:.PF CS}!; 'I, YI N:
t,if ��lIH'.%ii h'1f,)i•Dl�r!'yA.'T'l0Pd','5` �J. *. �..
k.
j
'i,,,,t.1.�5'iTs:?7,t �lf,itllf►.4tt7 LZ
�':ir,I.I.R�AA'D:t:.ill_`.f.),`xi�i•Of �.'-Lil�lb"E1'�'i.tE.".f7�,M
2f�'0�31.fJ� '
tf a �,1y11' t, A,gxp
-I?5^.�1t ll?S A"1 � f.a �y,1�i 1.!<<J9G\�i.H.l�%. •. ,
.
:,�:��!„1'1” iC�'.I`I`�+1� f !� 1()7-`;�Ef�•-�Il. a�-rt�i� t�tU7.�G
:�
,_i Y.)TIOH PWA k r!°!>> 16, I -000'.2-t ! ..{I{i[l
i+a
{.
D �l ry;'h,;': �: 61".. ` '3;1iti.ir..''f"tC>At !.1••31 �11..A.1J (3- ': K
$209.00
u
$0. CIO
SPR 2 0 2001 a ' .t., a'?�.11A1.1'.1' 10 YM; DUE 1` 0 W
; foxy
CITY OF LA OUINTA
FINANCE DEPT
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
3o "r� 4
lof (Oa3210 Urayw P.O. BOX 1504 APPLICATION ONLY
Building 78-495 CALLE TAMPICO
Address 7423— j21 �{ �(�fV�e LA QUINTA, CALIFORNIA 92253
r
P4 1 M 100911 "`'v S/ BUILDING: TYPE'CONST. OCC. GRP.
Mailing �
Address 0 ODK iD/
(�l
A.P. Number
CityOy1 Zip Tel.
W&J-1 ' 2'LL�^ 7 �'' I f 2� I X,t Legal Description
Contractor Project Description
State Lic. I City
& Classif. Lic. #
Arch., Engr.
Designer ��AA-A
Address 451. vimrtt PiTel.
CiIf Zip State
'1 q0-1 b i Lic. # /11-16113 P
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5.8usiness and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to 'Its Issuance also
requires the applicant for such permit to file a signed Statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars (8500).
(1 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
orimprovement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
(1 I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the proiect. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
17) 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
n Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (E100) valuation
Or less.)
I certify that in the performance of thg 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.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to theWorkers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a buildingpermit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Signature of abplicant Date
Mailing Address
City, Slate, Zip
�v �i�w-�X � t � t �s.�'i.�v►-5
Sq. Ft. No. No. Dw.
Size Stories Units �'Z®
New ❑ Add ❑ AlterX Repair Demolition ❑
stfmatea valuation (PU���OD
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
WHITE = FINANCE YELLOW = APPLICANT
PINK = BUILDING DIVISION
Page -Of
DAV
-AV
E',STE ENS
n r
In"specti.0Se.Vices
-
PROJECT # gs2.&-p t — 0
CLIENT -?G+
DATE /0 i-794 L Y
ARCMTiECT(S.QL.Aoq flk_tWr7%L:rLfiAC
CONTRACTOR C6
INSPECTION REPORT
L6 I
-.ALL- Lk\ IZAIL IJA`%0ijt_,-.,
Com. LCT
en IC
CERTIFICATION OF COMPLIANCE -.70, the best of our knowledge, all bf-the.'re'ported work, unless otherwise noted,
substantially complies with approved. plans, specifications and applicable sections of thebuilding-c9desThis ie po rt covers
he locations of the -work inspected only'And does not'constftute-'engineering opi
inion.or, project control.
CERT. NO. INSPECTOR NAME
DATE Zrk LY - Cq cao
T6&�
INSPECTSIGN
A!-
> i ^r�'"q'%3,ji4't'"'^'-�q,'�`' '.i .r_" TC.•i'�',y'G'z T'T'Y<, T. e. c^�.
t ♦ t .7 .>. .�Yyt f I'.i •��'• � �,�'yS +. 'Ta � " #.. tSV"7�.'Ys" � '.�✓ *K Ncc.v. -
t'irw aA'y' t•4 .1� , Ss
Page of.
DAV ;STEAYVENS
t
Inspec on Sery ces
PROJECT�'P ..�`NtSE
lf� PROJECT #: c?voI
'ADDRESS . >A: S L
c•S CLIENT T. A '':1a1 _C T' 14
-DATE
BLDG PERMIT #
- ARCHITECT C�o�r3�;.2C.Ni7C.T taJt2G''
��,
ENGINEE 1 l r;�
Tarr t_ �L CONTRACTOR L- /►tt1R 44
::INSPECTION TYPE.
INSPECTION REPORT'
INSPECTION'
1 ..:t
"i
�
1/c1 1 �, 52/�
Y�L Gt : � �I�C`x-� r � C.�( : fir) �r-LA�J :.� �. ` •
a..11 �z�n.1r
T'T
K NX-1 � d t —� c�
77
S
il
04
0 i
i. 4s� oAK
ie �a� r [:tlti.'..
4 q
A r n 4s..:
AA
S4 - I g ( aAI.L-r�
t-a` T z�ZS; �. N ,L ►� �-cT t c. R .
CERTIFICATION OF.COMPLIANCE-Tot e best of our knowledge, all of the reported work„unless otherwise noted,
�substantialty complies with:;approved plans; specifications and applicable sections of the bwlding:codes This report covers
the locations:of the work rasp ,q only and does not constitute englnee�ing opinlon or protect control
a
CERT. NO.INSPECTOR
0
NAM
DATE
z
:• .� t F rs� t� ,
INSPECTOR SIG NA s, ”"
t Page I of �...
DAVE: STEAVENS -
Inspection Services, :
PROJECT t�. C -,A J)P-S7 PHASE IA PROJECT # 07 voe - o �
ADDRESS A S L-1 S -MEQ
CLIENT ;D 6-, A uJ sT �-loe4
DATE oZ'i Gree N E c,2 00 i
BLDG. PERMIT # ARCHITECT QLBA ,A,eCM TECTu,Qz;
ENGINEER_3(t,k 0 Q ,SAy of E t lj<- CONTRACTOR
•INSPECTION TYPE
INSPECTION REPORT
r0LC.ouJ1" Loc_A_% tUN S EPDXY 51m450&) EToC. 07--X P
1F �s��1�°►t.e-�, i3�t�S�-c�= _� A0J) CLC AO nE 1aFP_t5 .,A 9P4-1CA-r1o'J
Ad : :t ,,jSTAc.L-ATi Q,J 65 _:;Nz:R- . 2rc-160 q2 stS .
•1� 3 rt U S/ rr
Lac- - ��- - tw �y a►a. �o�- rc� Lt=�'TN ��4%
�� �3 �N�As -1 t..��`- E-ro� z - r7. a��Q�w, � �tfi. �O�S - Ih l..•r.►.tC�wi �' �� A
!T1 4-tyu n AW E
3�LS )�
l�e�rt, ,)Pn i L10 - i Low - �it�L-E PTN - 1 �.` DE/yl� �tA ►20-z - rLEE C'T' H
k lacZ wrr�R - LuC. - Ho S - I �c rr\ V-1 Z • 1`I u
I ) A. 12th 5 LE:QC.T4 ?I� .J t A -
-�'Ee'n aL-oL - kko"L�P_s -la' zxpz�-A I. it�lA. 12ot>>- I.'1 "LC:u(;T►-r
-1 4t�.uo' 1
t, S� ,t r�
0*rAM Qr s,)z-r..o2 a't_v� - �3AOL4 5 - aL�7 H /4 �) K PoIC - /G 4-EM01 N 9,� #
1 t� / 'o
S/�
Vy�A2 v►��.� (... d- Loc_- AUt-r—' oZ z#TW 3y o1A. OD- )Lr l Lr_IjC. i.W „ 0NA-
-/SX. CUAkTIZEC i-AAJ 3
C 1 a
CERTIFICATION OF COMPLIANCE: To the best of our knowledge,' all of the reported work, unless'otherwise noted,
substantially complies with approved plans, specifications and applicable sections of the building'codes. This report covers
.the locations of the work inspected only and does not constitute engineering opinion or project control.
CERT. NO. S 7.341 ' Sy'_ INSPECTOR NAME
DATE InI, INSPECTOR SIGNATURE
DUNN `SAVOIE INC. 'JOB P6 i4 c✓Es T X99/ ZI,)
STRUCTURAL ENGINEERS
908 S. Cleveland Street. SHEET NO. OF
OCEANSIDE,CA 92054 /
Tel:''(760) 966-6355 CALCULATED By �W DATE
Fax: (760) 966-6360
CHECKED BY DATE
SCALE
DESIGN LOADS'
ROOF
2x10.Rafters;,: 24"o;c.•
2x10 Rafters.
2x10 Rafters 2zMkafters.
2x6 CJ
DEAD LOADS
16" o.c:.
24" ox.,�
16" o c.
24" o c.; . Stucco
.8:0.
(4:12 Slope)
(4+12 Slope)
: (Flat).
(Drop Ceiling) =Soffit .
: • y _
(PSS .
(PSS.:
(PSS
(Psf),
Clay Roof Tiles
10:0
10.0
-
- -
Built Up Roof.+ Re -Roof
-
-
4.0
- -
5/8" Plywood'
Ttucco
Batt Insulation
(0.2xThickness)
1/2" PI
•1.5 .
1.5:.:
1.5
'
Miscellaneous
0.7 ;
06
2x10.Rafters;,: 24"o;c.•
:• -
1.9>
-
-
-
2x10;Rafteis" 16"o:e. `
f`
-
.8:0.
8'A
50' G
2x6 Rafters 24"o.c
_
: • y _
=
1.1_
-
Batt Insulation
(0.2xThickness), . _, ..:....
1.2.
7°-2. . ....:
_ .1.2 Z.
1..2...
_
5/8" GYP. Ceiling;:
'2.8:.. `
2:8
•2.8
218...
-
Ttucco
Batt Insulation
(0.2xThickness)
8.0
0:8
Miscellaneous
to.`5
'
Miscellaneous
0.7 ;
06
z` : 0�.7
0.4
0.1
E Dead Loads.
20 0:-
19:0
: .14;0
5.5
12:0
Live Loads. a .. ....•Flat/Sloped
(0=200'
20/x16 ::
.:Flat/Sloped_ �,M#V$leped
2.0/16.. �., 20116
;. FIat/Sioped....:..,
20/16
. .......
WALLS
DEAD LOADS
:Intenpr
Partition
•
. ....
Pa Wall-
(Psi
Exterior
Plywood
Extengr ..... _.
Struxo
Stucco
f`
-
.8:0.
8'A
50' G
.:2.8
1/2" Gyp
4:4 "'
'-
2.2.
= 2.2
W8 Plywood
2x4 @ 161o.c.
Batt Insulation
(0.2xThickness)
0:8
Miscellaneous
to.`5
;D8
E Dead ;Loads
64,
;5'5
140',
14.0-
DU.NN SAVOIE1INC. J JOe �Gt4 w—c i
STRUCTURAL ENGINEERS
908' S Cleveland Street,' SHEET No. Z. of
OCEANSIDE; .CA 92054 . /
Tel: `.(7.60) 966-6355 "CALCULATED BY DATE '4 z. a od
F=4760) 966=6360
CHECKED BY DATE
SCALE
LATERAL LOADS
SEISMIC
Repair Calcs Based on 1997'UBC-,
97 UBC '
Seisrnic`Zone 4
Zone Factor Z :=.0.40,
Soil Profile'= Sp
Structure'Height. hn :=8
Nv:= 1.2 :N a.:=-1.0 R:,=4.5 1:= T:0 Ca :=0:020
Com:=0.64.N.:' Cv=0.768.: .,
C a :=0.44•N:a ` C a.-.0.44
75
T:=Ct (hn`:'.- T=0.095..'
CvI 1
Vb:=
w V ='1.794 '
b
Eq. 30.4
RTI',
V2.._
W. .. V2-0.244 ..
6430.5........
R
V 3 0:11 C 8='0;048
Eq. 30.6. .
... ....... .... ............. .......:.......... ..... ................. ..... :. ... _..
t;.
0.8 •Z N � L
.....
V4;=
-
w. V4 - 0.085
Eq, 30.7
R
Vb shall riot be < V3 or V4 and' V - need not be >,V2 .
Use, Vb = 0.244,.
.......... .....
V.
w.
.
.. ............. .....
p
- 1
DUNN SAVOFE-INC.
STRUCTURAL ENGINEERS:
908 S. Cleveland Street
OCEANSIDE,,CA"92054
Tel: (760) 966-6355
Fax: (766) 966-6360
JOB �G wFC T X99/Z/i
SHEET NO. OF
CALCULATED BY P W DATE !f l2 8/O o
CHECKED BY DATE
SCALE
k EY pi -,f
P4v1-J. 3 S g .
L lZ.83�
I �
bRoP CE/G /NGS oce VA
k,fc�icn� /745T2 6rf1
., Ai. = 136. LA vry p /L,Y •
r13 33
A(
DINING
p
l9.4i,tJs.oB� =:293h
z%3A3
w
vEz,""
= /o 13i Fr
LivING;
... .... ... .
;.
-
.. ...
_3;51/2.,8,3',=
At= I Z.oB �/2.1�3 =:155 •.
a
lis: BAgr��SoB�= jZz
KlTCfiE - i:.
/�6 = 37 SS' �i2 83 �: 48Z fr
r.
AV
/S .
N
O
_
A?.-..r� (�S•o8•) 211; At
•ASN
<.
204 Ft
N
EN'Ry �
.... ..... ................. ........ .........
.
<......
OOM Y
r.
•ASN
.... ..... ................. ........ .........
.
<......
.........__...
_ _
...
.. . ...... .. .... „
W
HAT ,2 iii
1
s
Ag
ZF
MASTER .
..
.
BEDROOM�
S 3
`
r.
ZA
.,7..4,7-
..... ....... .........
...................
„
I2.75'
/S• 17'
D UN N. -SA-VO I E'l N C.
STRUCTURAL ENGINEERS
octANSift,"':CA'92054
Tel; (-76 0) - 966-6,355
Fax: (760) 966-6360,-
L) ti -c> J&
•l 7 -
ROOF
,5Lop6-i.l;i. T-0 e,
.2O•S
13b + 2-11 -1-
ek
UP -0P CCI L //j
S-,
/7--Z 4 Z/t
14.0
60 4 -'Q,
.. ...... . .... . .....
736...
4, 7 5-
Zz
DUNN SAVOIE INC . ,DB" a6A wcs r (19912-1)
STRUCTURAL ENGINEERS -
908 S_ Cleveland, Street skEET No: S of
OCEANSIDE, .CA 92054
Tel:., (760) 966-6355 CALCULATED 6Y p #y DATE S�Z/ / Lae
Fax: (760) 966-6360
CHECKED BY DATE
SCALE
L 11 re/t 64 L Lo #1.;7) CeN r .
W Iry Q. FL 4" 3 a
4.
L'
V......
...... ....... ...... .... ....... .:......... :........
40
...............
..... ..........:.....:.....:......:....................:.....<..... .....:.. .... E
1
.:......:...............:............:.............:............:.............'......:......:.....i.....
f
�
DUNN SAUOIE dNC. ioB 1�6r� wFl- 7—
STRUCTURAL-ENGINEERS
9'S..Cleveland'S#eeet SHEET NO. b of
OCEANSIDE; TCA 92Q54 /
Tel:; (760):,;9,666355 CALCULATED BY pN DATE o0
Fax: (760) 966=6360
CHECKED BY DATE
SCALE
Lv4./'i� S Co/i
W N D
G -o/,. r, ry.e-c 7-/,g,,-/
DUNN SAV.01E `1NC. ioB P61.4 tv'' r �99iu)
STRUCTURAL ENGINEERS
908 S C16vela 6d Street SHEET NO. DF
OCEANSIDE, CA 92054
Tel (760), 9GG-F>355 CALCULATED BY DATE
Fax: (760)`9.66'=6360
CHECKED. BY DATE
SCALE
Height Area -: ;:
° . `P' '
`: Total
(ft42) -:
.: : (P�.
:: (kiPs)`.'
.........415'.....:.::........:..._6.8...........`.:.::::;,..:1.0`16:.::.....:.`
::..:0:.6...9,:; ..:.
15-1715': 329
10:97;.
, ':3;61. ,.
4:30
Vw
TRANSVERS-DIRECTION .......L'= 60 :........:......E/ owEytau S..... .... .... ........ ....... ...... .._
Height
MY
Area
:(ft2)
-P
(P
Total::
(kips
-4,15'
58, .
10A 6
15-175.
602:.:
6:61'.;
Dl
StR
IN SAVOIE*INC,:.,
ETURAL ENGINEERS
Tel::
Fax:
D.UN:.N SAVOIE, INC. JOB PG d G✓es T- (9912i)
STRUCTURAL ENGINEERS
908 S. Cleveland Street SHEET NO. 9 of
OCEANSIDE; CA_92054.
Tel: (760) 966-6355 CALCULATED BY ►mow DATE �DU
Fax: (760) 966-6360
CHECKED BY DATE
SCALE
key Pcif-j 44 1 /:
F���N /Q 5, 08' IZ• 75 %�i4reff//-/G. .GNU1--.4TES..
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96 S.`Gieveland.- tfeet SHEET NO. of
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