0101-077 (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
,..,,
,,Date,/*—' ``a " � �� 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.
,(n-1) 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.
VXTE FMD 4 R t t
(This section•heed 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 provisio s,'oof Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date: a / Applicant—
Warning:
pplicant Warning: Failure to secure Workers' Com ben satiomcoverage is, unlawful and
shall subject an employer to criminal penalties and civitifines 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 pu(poses.
Signature (Owner/Agent) ` """"'"-- '" Date
BUILDING PERMIT
PERMIT#
DATE VALUATION LOT
('=1(yJ'j TRACT
01 AITIVIIIN" f4l I A46 e 04
y'
JOB SITE
ADDRESS
d--4:1.011'S?�r.'�7:� A i33.�I�' X1311!.F+t
:EN
'174-2424W7OWNER
CONTRACTOR /DESIGNER NEER
PAC"iJ 1C: t!N-00 OtONSI'.Ttt"'MON
PACIFIC TRADES C:C3MMi(7C114314
.719 0 31WA RY
1719 S T.b".MVTR1'N T
a 00UR ISM- E CA P2054
3 OG�C4J��.f�G'�p�e11M11
C'.Ap
i M1l�P i^'VV4YF
rn92014
a.+*GdS r 055
USE OF PERMIT
151J? VO.AADD, I MIA, CITY STANDARD
20 i F41 I'.9f.Of"ARE F"a+IC1.0SURY,
J Ft Y` ALI,
7.00 LF
4 FT. WALL
20,00 IN
ESN...tl.Vl'Cz. IM01 Ar0SIT, OF CS:+°NRA Ril6IMCM
`Q6.55
1,846.55
CONSTRUCIIJON TSE 10 1 _000-14 18.1000
r
• �
�
r
;k
MA tl••TMAL COM:3 tZUCTION AMD PLAN t_'?i3:t�;��, C.
1W.00
LES, ]' PAWRMS
`0.00
TOTAL F ERWI AFS' DUE NNW
1643.019
RECEIPT
DATE(
81j'(,
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
I DATE
I 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 _
Footings —�� 6 ` sT
Electric Bon_ d
Main Drain
Bond Beam ?S�
Approval to Cover
Equipment Location
Underground Electric
Final 5sl
��' p
Underground Plbg. Test
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:
1� SPEC
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)
J -
� Al
Int..
SUBJECT -6-8" RE•TAIWAIC- WALL PAGE / OF 6
PROJECT -5;Z..' FAM, RZ.91A, :54-410 AVC. OAF,6GOA/ __- DATE.
DL,SIGN GR/T�,2JA
w�•✓� PieEsS • _ /5 PS. f ,dAsE� ON
70 IVPi1. FXPoSveF C, /SG . STRVGTve.ES r :` �-
.
e
/�0.2 GEvEL fjscac mil. L �- -� 3
- PsjSSI✓E P,�Ess. _ "150 51=7,tA
v�
of DEPTH. EX
� feJGTvnisi L .�cJIJTii �lCE _ ; - i � � MAS.OJ✓RY . - - � e �v �
ADE.Ap .WALL,
Sow -
As A LC,ouiED . /,J PnoTNoTF /Vv. Z
- OF TsIgLE /8 -/- A >riul uN�ru1 ��r
97
2 v
kl
PL, 16 �3 //�c eF� F PER SU3PRAII►I - :WITH.._ I ._C. f �
__5_fC_._J612_. O� 97 V. S C. PER L.F. _ GRAVEL. 5EE .
GfiJ: NOTF 7, PG. 2. Q
EXIST,--WoO1� I _ .OUTLET THRU M. WALL:
F,eNCE ow RM849
' RET/1IN/N6 WALL.. ,3„
41
NIA
PROPoS'fD_. C/TY 1 , MASONRI' / EY jST
STD, REN N
O T. WALL. ! ' _.-. WALL. - v _ I -. -=-
(--�GROU�VD
XI
. coNr. _ _ -. � :. .. 3. •. • - - - .. -
4 RETAIN/I✓G'WALL._. I 5PACf� AS :'• 6i 3 „ -'�5@/( ��_ �, � `
5#1 rylp)
FE
off`' �iy /2 /Z_._ TyK : TA,PRED
FELT- CUSHION.
No. 25MEXPIES _ _.
P1-AA1 __.. _ W Dec 31-2001 Q T%�"
ND- 5'CALE ;, c I „, �� BUILDING & SAFE
SOF CA% -%F0 Ai �R® `/ RG SON
X7%1 z
gR CONSTRUCTION
�6-414 R UDEL LANE
LA OUIN A. CA 92253.
RCE 25203 EX? �, �, g
'77S-12;36
�87
SCBJECT_______G—f3.._.._.SPE_TA/NII✓G__.__.WA.LL____._._.. -----PAGE Z OF to
PROJECT �5G[�fAM• RfS_/.D,_.5_4_ -_4/O AVf_T_OB.RfGON�__.DATE_ _ . 1-3-01
MATERIAL SPECIFhCATIONS & GENERAL NOTES
MATERIALS
Concrete: f'c = 2500 p.s.i. ® 28'days.
Re -bar per ASTM A-615 Grade 40 '
Block I Grade Aper ASTM C-90
Mortar 1 part cement., 1/4 part lime putty or hydrated lime.
3 1/2 parts sand.per ASTM C-270.
Grout 1 part cement )•
3 parts sand ) for 4". & 6" Block
I part cement )
.2 1/2 parts sand ) for 8" & larger Block
2 parts pea gravel )
Grout shall be of fluid consistency.
Cement Portland Cement per ASTM C-150, Type V.•
GENERAL NOTES.
-------------
1. Solid grout a l l cells in retaining portion and all cells
containing steel.
2. All footings shall be poured on undisturbed natural ground or on -
undisturbed engineered compacted fill.
3. Wall shall be laid true & plumb.
4.
Provisions
shall
be made for
adjoining construction.
5.
'All splices
shall
be 48 bar
diameters.
6.. Provisions shall be made for planter drainage piping
as shown on drainage plan.
7. Perforated subdrain pipe shall consist of 4 -inch minimum
diameter. PVC ScheduliB40, or ABS SDR -35, with perforations
laid down. Gravel encasement shall be 3/4 -inch to 1 1/2 -
inch open graded. Filter fabric shall consist of Marafi
140N, or equivalent..'Subdrains shall be connected by
solid outlet *.p:ipes t.6 .project _ under.ground drainage: system
where practical, or outletted .through wall.
8. Stone or tile veneer shall be attache' d. to concrete block
masonry.in accordance with Section 1403.,,: U.B.C.
1997 Edition.
9. Earth face of retaining walls shall be dampproofed in
accordance with Chapter 18, U.B.C. 1997 Edition.
287
SUBJECT —G_-.8-_RF.TA. IN/NG WALL _...__ ._ __.--_...--_-PAGE ,3 OF
PROJECT: -SGL.
STEM "
BASE 0,-- 6 0 LVALL `
771 0,— -3Z n I� CENTC� OC WALL. r
Af = .075 a„ d 2.8 .,
P : Ar 3 075_ _ , o0 ZZ3 np.= . o" a
ra
bd /Z ( -L-8)
7.70 P
w
yr,, = Z ( ?�) = 270(7,20)
M = ?7p
Ar d . 075-(, 9047,) ( Z . 8) - /7 063 p t• o
/NGe2cASC AGGOWAB[t
Z = _ _ _ 9 ` z 3 �.r. O_� (< /9 P.t.�.) 'woe w.✓o,
bA
J d G ( 9a�z>(Z sS
TE�,s.E,¢ATy.�r' ,ec i�FoecFi�E„ir
DO2 ,5r _ . 002 ( /Z)(G) _ . /¢4 -
.As fv,2 04 5 2, _ .075
I
_=
-& ~
SUBJECT _ � R6TAlN/�/G WALL PAGE
OF 6
— - , -A VF_:%QBRfIOI✓ —DATE
35) = 7.80.. #. :/error = 90
f Z60'.= 3.70'#
Z .1- 4:0
_ —.__. _ _.._:..r..._.... -
= . 37.3 .30 ...... - 1003
-
._ ._._ _.._... .._�,._�t ._.....=.... _. ./S.�___ ... Q02:3l0--._____......_ P = � O�o/..._ ✓. = : 90 ZZ.....---
k-; -_ -- ..---- . ---
%003 _ 7_7.
6 5 P. s. L, ..... 0.�
< /00 )
TfihPE,�.ATveE ,eFiN�aeC�/hF.v7-
--
f� f .. fox e ie, voAr
/3 M�,✓ • ,¢ cQ /�✓ OAF �i�EcTla�/ = %3 0 . /9 Z a =
.Old a
_ ...._ _. 7-9 � Z - #¢ ftf = Z . 20) _ , /0 `_ �� 0.4
. GAG¢ )
T�i►�P�,�l!/.�� SPE/N�yZI.�/`7fNT" --
Af Foe 5 GIG " ✓vzT, , Z3
2.67
--PAGE
OF
-......
PROJECT
/Z" sTB_WALL _
x:'67)
a
PL
7Zy : t-S&/G', .. 3, ci-x .... err =.13
74j.--
bd 1Z(9)
Z4Z9 7.87) !Z = Z3(o
p- .L ,
o.X• <
ZSo�.
= /2 �►') _ /Z2428) _ /-5 532 p•r.
0. X,
( < Sc oa��
869 _ 9 P r.�. O•/� (�
19)
°.
),j ci .
T�i►�P�,�l!/.�� SPE/N�yZI.�/`7fNT" --
Af Foe 5 GIG " ✓vzT, , Z3
2.67
28� '
SUBJECT G-S",2i;TAlN��/ls WALL PAGE eo OF 6,
PROJECT 5561, -`AM. XeV P-, . 54 4/O AV e, .OB.PeGON DATE
FooTh/G
�E = 7,671
z,-
TOTAL = /J Z p #
/`'1 or = /030 ( 7.67) f . 90 ( 3 * 7. f.7) = S&33 t 9Go = 3 59 3 I +#
3
RES/rfa•�cr To D✓,C,¢•rye.✓i�./G-
tit/ X Ma
:.:33
8 fjGOC,tC.
.4x 9Z 348 . 4-2 /55
/Z" 131,ocic 7-.&7x /¢a 374 :58 Z1.7..
Fl,�T/N�r 4,o8>41 x /So G/Z Z.08 /Z48
r.v,¢17I oi✓ �r� Mc"Ort 5.0 x 6,33x /O0 / 8 3 9 Z . 58 4899;
/2" 13Lo�K 3,67,E 33 x /oa /' 2 ! :"92 ! //.
94Y
390$ # 75 37 ';0-
7<
#,< - r'I2. = Ah, r = 7S3 7. 3 5� 3 /, o/ i,¢o.-I Toc (o vrTw/Rp)
W 3 90�
/"IAX. 6yAr2/i✓G /��J 1. = z = 2 ( 3 945) = 2 579 PSF.
<
f,�croe of f�Fr>+Y Roe a�r�r�.eNI�JG = _� = 7537
Mor 359 3
;PESISTANC,E To 11-11>9JC, _
25w. =
yRSSI vF
Z..837 -
..83z ( /SD 1 (1.33 _ Soo
z J TOTAL = 1770
f -Acne oG -c* FTy i-o,z suPwc = /776
/I ZO
REEL
� 111 111' ► IY=
2'. 02) #
Z 3 M
/"IoM = �/8 99.4- 3x 15-0.) z� _t 'ZZ5 2.5) •
�'lor "ZI• . = 4D87
o.,
4�3z'
9/8 = . ZZ
-05 14,O.Y. (Ar Z3
,CEY /zflNyoec�/ylfi�T , I '
4:08
�D TDP a,� ,rFy /; 33 x /�o x 1,33 = ZG7 PsF
3 03'
/`'P aorr or I�zY =
-Z,03 x 1;5'o x l- 33 - 56 PSF 2.02
Z6,7,K J. - t. (SGG - Z4,7 (
Z
-t,, Z2¢ = 5Z¢ # aC
As dwQ `� - �- = 5 Z 4 = 04 s