9707-083 (RPL)LICENSED CONTRACTOR DECLARATION
tj 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 # Lic. Class Exp. Date
Date 7 '� 1 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:
( ) 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 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
sybject to the workers' compensation provisions of -Section 3700 of the Labor
Goode 'I shall forthwith comply with thgse provisions./
t/Date: j ` A�Plicant tt .� . _ 9_ . c5 _...C_
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 representatives of this City to enter upon
the above-mentioned property for inspection purposes.
p � ,
/-Signature (Owner/Agent) �A ? d 1 �•- At.. Date
BUILDING PERMIT
DATE VALUATION S6 7 J 7.1i LOT
JOB SITE
ADDRESS
OWNER
P t {:;a..l.j1 (.'Kt i A1.200
USE OF PERMIT
c't A ).i..
PERMIT # CONTROL #
11700.0"t-;5563
TRACT
IAPN
CONTRACTOR/DESIGNER/ENGINEER
773- 3- i. 24-N4
'V%k u ik _1'fA "'A 'A),h0
i11(f,ir't.i-:411!1 tat i5. 31''d;
> 41AI&Ii vt., Itv4ty 5 i i- i Er.r1' LDi lJ WALf* 0 f Y K1 t1)'t011.Rb
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V1. WAI_i..
1,1'541 9. MAT EAD CONT Off°' R-ONSrti•R "Cl 10N
P4a;RMi i :F E'C. Sr;flayMARV
PLAN F€H' f.V1 1000 439:4E)i 44 a.i
'ii ,"tittPii: a!¢ h'1'? .•- f?t'i( tl. ifti -f Etf).. f7 t {^��tt %:Z4 0A
i�l.i'.:!. +i.�c+.. rlt. l�iaL, • n i..•+.,y, (tj, _000-:K:()- 0W d+.t.tit
01.4XA)-JF'-ih"u
3*J'),.1rr,.I.ii WN. FEE. I(:t'e-ltf.N, 140)418-00 :4i+Ps}-(f,;t
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Ili \EI..i
REC�I�TL/ DAEy I� �'� BY \ DATE FINALED INSPECTOR
7%,
W ` P : ; ORECORD
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 Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond oe
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I
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:
GRaoE Go (.SIM op [hIWGI BARS pGnojReo,
25ao�/�co�Jcrz�Tc R���irzEa, -
-ME-PF- A -PE NO A%,I�VZZDQT FTI NC -i = --MAT WII.L
M e
FiN1�NCD 'E� ;r, \\/ALL5 ; ALI X►ADJALE QT
FDS i INGS \,ILL HAVE 70 F5v:
-'J P -E. QUILT G 13 1560 bar_OKl,LA QLJINTA
(� E c r,:>,-aT PLA fl)
CITY OF LA QUINTA-
BUILDING & SAFETY DEPARTMENT
CON GITIONfALLY
ACCEPTED Fop, CONSTRUCTION
SUBJECT TC INST, LLATICn AS PER
AND ALL A4Pp',U CODES
BY
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TABLE 2-2 Correction Factors for
Masonty Strengths
Prism height''
-`
to thickness
13.0
ratio
2.0
2.5
3.5
4.0
4.5!
5.0
Correction
3;
Factor
0.82
0.85
0.88
0.91
0.94
0.97
1.0
ACI 530.1 Table 1.6.3.3.(b). ate
u The author suggests that Table 2-1 should:be ap-
plicable to both concrete and clay hollow unitj_prisms
and two wythc grouted prisms while Table 2-2 could be
used to ,lctermincd the strength of single wythc concrete
brick and clay brick specimens.
Eawomp.—M
#; 7 iEiMM ti t
.S !� • 1 n.t e c }�t;/%'' .' It 4FtF�S t t a,�t
_;h•l,y y+:N.!•*+�Trt1
+
Two wythe and hollow unit specimens F s�
,'Figure 2 10 Typical test specimens rf'tfrr �r
`h:i'e ,c ''_' e w�, •.a;' y `?;1 •.i' ,.'rn '"
' a,t. '�; •. , �;
2-3.E ,Strength' of Component Materials'
When the compression strength of the��masonry
assemblage, f„t, is specified, the component materials,
i grout and masonry units must be stronger than the. speci-
fied strength.
Higher strength materials must be specified in or-
der to obtain a satisfactory strength of the wall because
there are differences in the Modulus of Elasticity and the
Poisson's Ratio between the masonryunits and -the grout.
These differences cause a reduction in the strength of the
total masonry assembly and must be compensated for by
.staring out with higher strength grout' and masonry units.
In addition, the workmanship in the construction of the
prisms and the masonry walls has a significant influence
on the stren;th of the masonry system.
STRENGTH OF MASONRY ASSEMBLIES 35
2-3.E.1 Hollow Concrete Masonry
The specified strength is the minimum strength
that must be obtained in the wall. It is recommended that
for concrete' -block systems the strength of the masonry
unit and grout be 25 to 40 percent more than the speci-
fied strength. This may be adjusted if the strength r,1zi-
tionship has been established between the materials used
R
and the prism strength. Accordingly, for a specified f„, of `
3000 psi, the concrete masonry units and grout should
have a strength of 3700 to 4200 psi. When the,masonry
unit and the grout are combined and tested, the strength
obtained for the prism, fm, should be at least 3000 psi.
When specifying masonry units, specify a mini-
mum strength only, not a range of strengths. This mini- ,
mum strength would be the average of three units tested
with the .strength of no single unit being less that 207o ^
below the specified minimum average.
q1'r .• ; t
ot,L
2.3.E.2 Clay Brick and Hollow Brick Masonry
Clay�tbrick and hollow brick are generally of high..
strength-intyhat: the clay .are fired and fused together to i
create a strong body or masonry unit. The strength of
-units depends on the -clays or `shale used, the firing teml. �, _
perature and the duration of firing. Table 2-3 (UBC tabler{ .
No. 21'-D) provides a conservative guide for the.required
strength of clay units obtain`a specified f'.
+ m
.The strength of.clay units are normally, at lcasE' ;
one third more.than*the specified f;;1,, rout should be i
^ mixed to the proportions provided in Section 1-3.13 (UBC'
,Table No 21;B) or prisms may; be made to determine the
'4;,44
:, ., K},, . •
required strength'of grout to obtain the fm' strength. It is
suggested inat the grout have a strength at least equal to
the specified
M
2-3.E.3' Mortar
As specified in” the Uniform Building Code, See -
tion 21061:12.4 Special Provisions for Seismic Zones
Nos.`3 anA onl mortar withmimum Cabo-
ratory cube strength of 1800 psi, ot�fypemortar, with
a minimum;laboratory cube strength of 2500 psi, should
be used in:'remforced'grouted masonry. Because of the
relatively thin mortar joints, Type S or M mortar used in
masonry` may have an in-place strength of f„, = 3000 psi
or more. The h/t ratio of the mortar in the joint is very '
small, enabling the mortar to exhibit strengths far higher
than the strengths obtained from cube tests of mortar.
When the compressive strength of mortar is desired,
the mortar should be tested -in accordance with,UBC
Standard No. 21-16 (sec Section 1-2.B.2(a)).
ti
4
"I
I ly I ti
at RMEH SECTION.2-
in the plans and specifications is,' urance.tak
form of observation :by, 'a q ali,i masonry conswct
inspector as outlined�in UBC Secytions 10`8-and,1701;�-
. i
si�cfiS Azo 108..
• 08.1 Geer 1. All i
which, a' p6rr guga a us 10
_ a'
inspection b building f is n
"construction o -shall, i as I q
`exposed for in ction pu 5eyWIN r
bjthe 'jb_UJ1ding,o cicli� a 0
sof 'constructionghallll t
gas l"Spe6lfied,ln S' ion 17,0
108.5 Requ r6d Inspect ons.,
108.5'1(G 9 11".. di
aural fr�aI m:11e,wor iqlqyji
,'structure', sRq11
o, 9,c: ver ceal
out first, &W tha
A
requiredjprj t es t th
units;of laying 1f 1
gsteel, grouts . pr 0 1
wationA`and: i gr U tions
,P 41
'WEXCER 0
16" items-,Tj an abo ts
I ea,wh Stir a
a
r'
noncontinuous."
When masonri,,systems"aa"ie constructcd with;coi
tinuous special inspection as defined above, full allowab',
stresses may be used to design all structt:- il elements..i,-,
ILI'
liihtages6f Ihspectio'n*
inspection ha—s a -great advantag6 in I-,
-"
parties such as the owner, architect
official and 'masonry contractors assn
"'fihie�lrnaisonryxonstruc
D tion are in
plans and specifications
""
ising!, special' inspeciion, full" al lo
cffusdd to design the .4
masonry -Th
,j,-.mcmDers,�nigrier,�ihin'hi.;&'Is at
:1.",T,hese beneficial, factors can oftt
4 7"
an
I
api-
"these caws't'lh6ifiiW'ddsigii7iiiay-,be gd4erfied b),
�mum 'coder e
guireifienii.,.T,hiis'the cost oft*ial, i
lion,may,note teVUBCSection 1107.1.2
Ahat speciAl.ifitpectidtimeed not bie,'Di6videl if the
rible masonry,.stresks are reduced, by one half. This
,'fica-u'o'n�'r-e-S'UI'L'S"in'de-sig'ns invhc em nry c
may be bigger. and/or require more yeinforcin' 9 ste,
M,
1,-,b"SUMMARY .0 UALITY'r
'CONTROL REQUIREMENTS"fir; Wit:
I
S13111111aflid all of the conditions for verif
of the strength of masonry systems.along'with the
and ins*fidn , i6q4ir6ifients,4 the Concr6te Mason'
V
sociafion of Cali ornia and Nevada dev6loppd Tal
Quality; Control,4Ri46iieffiend,-,ijfid Table 2-7,
� - s
Inspections Requirements ",
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