0210-104 (BLCK)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 Code, and my License is in full force and effect.
License # Lic. Class Exp. 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 a bppt Ander Section B9P.0 lfor/this90A
r
'Date Q I I�OI•' Signature of Owner
r
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.
(Q3 - 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
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date: Applicant
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 ons 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 authorift represe�atifves of this City to enter upon
the above-mentioned propertf.,4 in pection purposes.
S(Q
ignature Wner/Agent
. •, BUILDING PERMIT PERMIT�#���-��ie� ;
DATE ` IDA 7/ 0(, VALUATION �� �f�.�1 LOT TRACT '
JOB SITE�Q
APN
ADDRESS mJ7r fts:;,AVIOMA, ODREGON
OWNER
CONTRACTOR / DESIGNER / EN (NEER
RAIR, FO,r M'S
OWNER. Btr.aDIM
32-760 AVE'8'tDA OBAEGOty
1-kQUfWTA CA 92233
Mbho
USE OF PERMIT
€^S M.AT.,3T�Cil
61 1..F O CIARD911 W T L ON TOP OF EXIST WO 12ETA3NINO %'TA1 L PER
APPROM 0k4(%4'ZRSdRD,0ALCK SPECIAL 4NSWTION .RFMdra.M
0 FT, WALL 43.00 is
M, COU OV' CO'�f�u".i� 'ETC'°.1<°.�C, N
1.625.00
q �yy�[y'�y. s �yYypq�� �IyC��p'I'.I
PERS.It/Sd.Y. FEE 1:3a.JL'1,'M13L'Xd� R s
P1AN CHECK FRE 101-000-439-.118 $25.35
C014S•eRt1CTIOW FELe 1' 1 -WO -418-000 �s .
SLUR,-- K3'GAJ:. r•:°OI3:q-; ZTJM'10N- AND -PL M CHWIC
$64.35
I1�7.W3 TYRE _PM) FFX.Z
$0100
T.(?RLYKRMTYT'MS DIEM NOW
S642151
ZOO
CITY OF
E � BY I
RECIDr
DATE FINALED
INSPECTOR
INSPECTION RECORD
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
POOLS -SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
_
Footings l
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
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
,Utility Notice (Perm)
Site Requirements for:
C)60
Fencing Requrements
� "}1T1T1fp�lltfffffliflTts�fn
REAR and.EXTE.RIOR SIDEYARDS ,
mustbe completely enclosed;and screened
by a 'Five. (5) Foot High �
View -obscuring;, fence or wall. .
CHAIN-LINK FENCING t6
IS PROHIBITED.
Minimum Requires
i
— -----------
Fences.
— — -----
Fences. and walls can be a
maximum of Five. (5) feet high
in,tfie Front.;aiid Street Sideyards,
Six; (6)"feet high in the Rear and
Interior Side" ard.
A111 ..cesand walls must be
maintained`n :good repair.
C.IIY'OF LA:QUINTA
OUILDING & SAFETY DEPT.
APPROVED
LF_OR CONSTR TION
8BY
,SI.SIIAHANDEH1 CIVIL ENGMEER
45175 Panorama Dr., Suite "E" Telephone (760) 340.5597
Palm Desert, CA 92260 Fax (760) 340-1121
STRUCTURAL CALCULATIONS
FOR
6' GARDEN WALL ON 2%8" EXISTING.
RETAINING. WALL
MR. ERICK DAVIDSON."RESIDENCE
LA QUINTA, CA
CITY OF LA QUINTA
BUILDING 8 SAFEiY DEPT.
APPROVED
FOR CONSiRUC710N
Dfflt 0 2
DATE: October 8, 2002
Design by: Essi
JN: 674.00
&rd
ESSI SHAHANDEH, CIVIL ENGINEER
TitleDAVIDSON RESIDENCE
45175 PANORAMA DRIVE, SUITE "E"
Job # 674:00 Dsgnr ESSI Date: OCT 8,2002
PALM DESERT, CA 92260
Description.... t
PHONE: (760) 340-5597
6'GARDEN WALL ON 37' EXISTING RET. WALL
FAX: (760) 340-1121
This Wall in'File C:\CIVIL\STROCTURE\ERICK DAVIDSONUc9.'
CantileveredAetaining,WallxDeSign" RetamProProfessiona15:0.7, 84uke (c)1989-99 •
w,
Criteria '_
ata. s. L
: '$Footing Strength 8 Dimensions
.Soil :.
.. . ,,ry
Retained Height = 2.67 ft
Allow.So'I Bearing " 18500 O.psf 4 fc - " 3,000, psi Fy = 60;000 psi
�.:.
Wall height above soil 6.00 ft
Equivalent Fluid Pressure Method
'Min. As % = 0.0018
Slope Behind Wall = 0.00:1
Pressure Heel Active Pres -
Toe Active Pressure =.
30.0 psf/ft Toe Width = 1.59 ft
30.0psf/ft Heel
Height of Soil over Toe = 20.00 in
Passive Pressure =
Width = 1.58
150:0.psf/ft Total Footing Width = 3.17
Soil Density = 110.00 pcf
Water height over heel =
0.0 ft -
Footing Thickness - 16.00 in
Using AASHTO Concrete Load Fac
FootingIlSoil Friction =
0.250. ;
Wind on Stem = 16.0 psf
Soil height to ignore
=
Key Width 0.00 in
Key -Depth = 0.00 in
for; passive pressure =
12.00 in
Key'Distance from' Toe = 0.00 ft
16Cover Top = 2.00 in @ Btm.= 3.00 in
Seismic Load
Kae for seismic earth pressure
= . 0:575 Added seismic base force 298.2 lbs
Ground Acceleration = 0;400;8.
Ka for static.earth pressure
= 0.236
Difference: Kae - Ka
= 0.338
Using Mononobe-Okabe / Seed -Whitman procedure
Design Summary, .:.
Stem7Construction
Top:Stem 2nd
Total -Bearing Load = 1,779`I6s
Deslgn,helght''-
';Stem,OK Stem OK
ft= .,r 6.00''` 2:67
...resultant ecc. = 7.46 in
Wall ;Material Above -"HC'
=. Masonry.. Masonry .
Soil Pressure @ Toe = 1,229 psf OK
Thickness
Rebar Size
= 6.00 8.00-3
- # 4' - # 4 `
Soil Pressure @ Heel = 0 psf OK
Rebar Spacing
= 32.00 32.'00..
Allowable = 1,500 psf
Soil Pressure Less Than Allowable
Rebar Placed at
= Edge Edge.
_
ACI Factored @Toe = 1,446 psf
fb/FB + fa/Fa
= 0.153
ACI Factored @ Heel; = O.psf
'
.0.395
Total Force @ Section
lbs = 42.7 96.0 ?
Footing Shear Toe = 5.8 psi OK'
Moment...: Actual
ft4 = 57.0 288:0
Footing Shear @ Heel = 4:8 ,psi OK
.
Moment. ..... Allowable-
ft-# = 372.8 730.0
Allowable = 93.1 psi
Ratios
Shear ..... Actual
psi = 1.4 1.6
Overturning - 2.09 0K
Shear....: Allowable,
psi = 38.7 .38.7.
Sliding = 1.65 OK
Bar,Develop ABOVE Ht.
in = -24.00 '24.00
Sliding Calcs (Vertical Component Used)
Bar Lap/Hook BELOW Ht. Jh = 24.00 6.00
'Lateral Sliding Force = 499.6 lbs
Wall Weight
psf= r,; 58.0 78.0 ,
less 100% Passive Force = - 600.0 lbs.
Rebar DeptK-'d'
in= 2.75 .5.25
less 100% Friction Force = - 444.8 lbs
Masonry' Data
Added Force Req'd = 0.0 lbs OK
fm
psi_ 1`1500 1,500
for 1.5: 1 Stability = 0.0 lbs OK
Fs
psi = 24,000 24,000
Solid Grouting
= Yes Yes
Footing Design Results
Special Inspection
_ Yes Yes
Modular Ration' ",
_ 25.78 25.78
Toe - Heel
Short Term'Factor
= 1.000 1.000
Factored Pressure = 1,446 0 psf Equiv. Solid -Thick.
in= '5.60 7.60
Mu' : Upward = 0 .0 ft-# Masonry Block Type ='-'Medium Weight
Mu': Downward = 0 O.ft_# Concrete Data
Mu: Design = 487 487 ft-# fc
psi
Actual 1 -Way Shear = 5.84 4.77 psi
Fy t
psi =
Allow 1 -Way Shear = 93.11 93.11 psi
Other Acceptable Sizes .;Spacings
Toe Reinforcing = # 4 @ 18.00 in
Toe: Not req'd, Mu.5 S' -'•Fr
Heel Reinforcing = # 4 @ 18.00 in
Heel: Not req'd, Mu < S '
Fr
Key Reinforcing = # 4 @ 22.25 in
Key: No key defined .
ESSI SHAHANDEH, CIVIL ENGINEER
45175 PANORAMA DRIVE, SUITE "E"
PALM DESERT, CA 92260
PHONE: (760) 340.5597
FAX: (760) 340-1121
Summary of Overturning & Resisting
Forces & M
Job # 674.00
.....OVERTURNING....:
OCT 8,2002
Force
Distance
Moment
Item
lbs
ft
ft-#
Heel Active Pressure =
240.4
1.33
320.8
Toe Active Pressure =
-135.0
1.00
-135.0
Surcharge Over Toe
lbs ft
ft-#
Adjacent Footing Load =
269.2 2.72
730.9
Sloped Soil Over Heel =
Added Lateral Load =
Surcharge Over Heel =
Load @ Stem Above Soil =
96.0
7.00
672.3
SeismicLoad =
298.2
2.40
716.4
Total =
499.6
O.T.M.
= 1,574.5
Resisting/Overturning Ratio
Stem Weights) =
=
2.09
Vertical Loads used for Soil Pressure = 1,779.0 lbs
Vertical component of active pressure used for soil pressure
Title ; DAVIDSON RESIDENCE
Job # 674.00
Dsgnr: ESSI Date:
OCT 8,2002
Descript'ion.... .
5 GARDEN WALL ON 32" EXISTING RET.
WALL
This Wallin File: C:\CIVIL\STRUCTURE\ERICK DAVIDSONM
Nall Design RetainPro Professional 5.0:7, 8 -Jul -99, (c) 198999
tS .
..RESISTING.....
Force Distance
Moment
lbs ft
ft-#
Soil Over Heel =
269.2 2.72
730.9
Sloped Soil Over Heel =
Surcharge Over Heel =
Adjadent Footing Load, _
Axial Dead Load on Stem =
0.00
Soil Over Toe =
291.5 0.80
231.7
Surcharge Over Toe =
Stem Weights) =
414.6 1.89
784.5
Earth @ Stem Transitions =
Footing Weight =
634 .7 1.59
1,007.0
Key Weight =
Vert. Component =
1691 3.17
536.5
Total=
1,779.0 lbs R.M.=
3,290.7
16.
Pp= 600.#pppppw
240.9#
1229.5psf
CHANGE IN MAT'L SPEC, OR BAR SIZE/SPACING
6" SLUMP BLOCK., SLD, GROUT, SP, INSP,
f"m- 1500, psi, Fy= 60000, psi
#4 @ 32." Vert @ Edged
#4--@ 24" Horiz
8" SLUMP BLOCK, SLD. GROUT., SP, INSP,
f'm= 15.00, psi, Fy= 60000. psi
#4 @ 32." Vert @ Edge -1,41,
H Itt -
„
HEEL (top) ; #4 @ 18."
0
I
t0 :4 .
00
00
#4 H❑RIZ. AS SHOWN M
6'
RETAINING WALL
NTS
00
s
I
Cu
0v
#4 H❑RIZ. AS SHOWN M
6'
RETAINING WALL
NTS
CORE DRILL AND EPO'.
#4 @ 32' O.C. @ NEW
EXTENSION LOCATION
t Ix
PROPOSED FOOTING 2' I I
EXTENSION
4 ��1
,
2' 1 ---'EXISTING WALL
FOOTING
I'—Of
CORE DRILL AND EPDXY
#4 @ 24' D.C. @ NEW FOOTING
EXTENSION LOCATION
FOOTING DETAIL
NOT TO SCALE
—ftWng
ESSI SHAHANDEH _^
CIVIL ENGINEER sir-ff"9
PALM DESERT
17s Rna®o oAw sola c-�. Ma oemt a 970'.
(� �o-� • �.� inn
i t• `
1 .
M
r,
e ,
�55
1
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C\ -•
fr o ! . tC c.l � r, t a ,� 1..(�._ T`.A. � . �,'
i
(� per.
Y:
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OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a -building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner:/Builder' you are the;responsible:patty of record on such a
permit. Building permits are not,iequired to be signed$y property.owners,-unless they-are'peisonally performing their
own work. If your work is`being performed by someone otherthan yourself, you'may protect yourself from possible
liability if that person applies for the proper permit, in his or her"name:
Contractors are required by law to: be licensed and bonded by the Siate o,f California and to have a business license
from the City or County. They are also required by law to •put their'license, number ori all permits for which they
It
apply.
If you plan to do your own work, with the;ezcepiion of various trades that you..plan to subcontract, you -should be.
aware of the following information for your benefit and protection: "
If you employ, or otherwise;engage'any persons'other than your :immediate farbily',.and the work,(including materials
and other costs) is $200.06.or more for the entire .project, "and such';persons are nor'licensed as contractors -of
subcontractors, then you maybe an employer.
If you are an employer, you must register with the State and Federal Government as""'an employer,and.you, are subject
to several obligations including State and :Federal income tSx,.withhol'ding "federal social security taxes, worker's
compensation insurance,,.disability,insuiance c6sts�and unetnploymenrcompensation-contributions:
There may, be financial risks for you if you do not carry out these- obligations; and -these risks are especially serious with.
respect to worker's compensation insurance. -
For more specific information about your obligations under Federal Law contac"cth�e Internal Revenue Service (and; if
you wish, the U.S 'Small Business Adminstration) For more specific information about:.yotir obligations under"Stare
Law, contact the Department•of Benefit Payments and the Division of Industrial Accidents.
If -the structure is intended for sale, property owners. who are,n6licensed contractors are allowed to perform their
work" personally or through their own employees, without a licensed contractor, or subcontractor; only under limited
conditions.
t
A frequent practice of unlicensed persons professing to be contractors is to_., secum an ."bw'i ner%Builder" building
permit,. erroneously implying tliat the property owner,is;providing his or her own labor''and material=personally.
Building permits are not required ,to be signed - by property.,owners unless they are performing "their own work
personally:
Information about licensed contractors may be obtained by contacting the�Contiaciots' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814,
Please complete and return the enclosed owner -builder verification form'so that we can confirm that you'are aware of
these matters. The building permit will not be issued until the vetificar ion'-ts returried
Very truly yours,
CITY OF LA QUINTA
DEPT. OF. BUILDING AND SAFETY
78-495 Cal1e'Tampico
La Quinta, CA 92253 -"
(76 7. 12
F (7 77 - 11
c. .
OWNER'S SIGNATURE/DATE
Uyi. D,,I-
PROPERTY ADDRESS
PERMIT NUMBER(s) -
.. -.. ._-,.. - .. .., ._.. ,.tea �.. m. r.. ,.. ....... .x.... .