0301-247 (PAT)79770 America Ct
0301-247
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed uWer 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 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). /,
O I am exempt under Section B&P.C. fg 4 rPeason s 1
Date'l / • > Signature of Owner , %/ r '✓ ! r
/ ' r
WORKER'S COMPENSATION.,.D'ECL`ARATIO'N l
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 .fall 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' compensatiop <pr9yisions of Section 3700 of the Labor
Code, I sha l4yrthwith comply with tKose provisions. 'r ` t
Date: Applicant Cry (--'t 11n__
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 9f such
permit, or cessation of work for 180 days will subject permit to cancellation.
kcertify that I have read this application and state that the above information is
correct. I agree to comply with all •ify, and State laws relating to the building
construction, and hereby authorize epresentatives of thls Clty to enter upon
the above-mentioned prope Xfo.i pOion.purposses.
-r/Ag ff ' ' DatetSignature (Owni f fr r
BUIL" PERMIT. PERM'T#
(001 247
DATE 0X11 MM VALUATION 7p j S7•G• LOT TRACT
JOB SITE
ADDRESS% `B(j eJc-'g"=
AME,2 E Couer 1,5 Go atzer ✓
APN
1C,H
OWNER
CONTRACTOR / DESIGNER / ENGINEER
ALRM.:i x
oww"R - BMDER
6401NC>MRAWC.Y11:ROAD 01
A1UAI,[f .. M LLS CA
( Cr
USE OF PERMIT
340 SY. I.A TT!CE PATIO COVER, PER XPI PROVEn PUA14S
540,00 3F
R MN,!M) CONT OF C;ON S IRITC'fi; ON
7„9 a3 •t3f
PER ,r M1 6MUMARY
PLAN CHECK FEE 101-000-439-319 X44 3
Cr32dSTRl)CTION 101-000-416.000 W0
013TRONG MOTdOW ME - R SID 101-000-241-000
. «r
ff(a Tt' M,CCir} "I`RUC1.TON AND PLAN ONMCK
11019 F: -PAY +Y'dTSS
$0.00
CQ •li>a x ., . >•a 140w
j
p
EAN 7 2003
IIIIIIIIIIIIIIIIIIIIIIIII 58
IE
CITY OF LA QUINTA -
FINANCE
RECEIPT DATE
DAT NALED
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
m 3
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wali Firewall
Exterior Lath
-Drywall - Int. Lath
Final
Final Z_ _ b
BLOCKWALL AP ROVALS
Steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
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
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:
f
t 13
T' C3, ;
21)
P' AN
FF
p I -A IN 5X6
tie'
Y ,... PAD 81.2 1
FF 61.70
ISO
C. L -_'
Cl
w BUILDING & SAFETY DEPT.
APPROVED f
FOR CONSTRUCTI
un I B
-n-77a-74 '
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 party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than 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 State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception 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 family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be 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 tax withholding, federal social security taxes, worker's
compensation-insuranEe, clisaity-insurance costs and -unemployment compensation contributions.-
There
ontributions.
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, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their, own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building
permit, erroneously implying that 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 Contractors' 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 verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 9225
(760) 777-7012
FAX: (760) 7 -
OWNER'S SIGNATURE/ DATE
PROPERTY ADDRESS
0301- a'4'7
PERMIT NUMBER(s)
r
RAFTER SIZE ANDPACING i SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE
y - (SEE FOOFING NOTE ON << REVERSE)- /
------
ROOF PITCH
CONTINUOUS LEDGER
(SAME SIZE AS RAFTERS)
HEADER SIZE
'T_ .1 'L' STRAPS 77
J I 6 xCxl,'xt/8" WITH
(4) 16Q NAILS OR/BOLT I
RAFTER SPAN: POST SPACING._l /
O.H. ! --- _, CL , O.H.
CL i
o --
OVERALL LENGTH: a OVERALL INGTH:
POSSIZE: v
T. - -_
/ REAR SETBACK I 4x MIN. `O
/ SIDE SETBACK '
( r )
2000 P.S.I CONCRETE —y1 I FINISH GRADE I FINISH GRADE
L__J I i I — J -- MIN. 12" x 12'* FOOTING I I
12" (BELOW GRADE L _ J
I
PROVIDE 1" CLEARANCE
BETWEEN POST AND
NOTE CONCRETE
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA i
VIA ONE 1/4" x 5" LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL.
U -STRAP OR ANLL
io
x 5' LAG SCREWS INTO STUDS AT 16' O.C. i NON -CORROSIVE P TE pE
r RP
CONTINUOUS LEDGER I
JOIST) HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING
.: BUILDIf G DEPARTMENT APPROVAL BELOW
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DA E /- / -03 BY t
;
(4)- 16d NAILS
OR BOLT
U -STRAP OR ANGL —
(4)- 16d NAILS
OR BOLT
PROVIDE 1" CLEARANCE
BETWEEN POST AND)
ANCHOR BOLT (EMBED -
iT MIN. INTO CONCRETE)
TYPICAL PATIO COVER
DATE OF APPLICATION '_,,J93
OwNER'S NAME A Gi r A
I I [ /
STREET aDDRESS CA
CITY. ST 21P !
= TELEPHONE
H.O.A. APPROVAL
RAFTER SPAN TABLE
GRADING RULES
PS 20-70
(FEET & INCHES)
v v v
C') C"?
7
! C
J
00 C? P
Oolz
c
2x4
16" O.C.
24.,
10'—x"
11 9'-6" 1 7'—:;'
8'-6"
1 8'-0" 6'-0" 1( 7'-3"
DOUGLAS
Ii
2x6
16" - O.C.
24"
32"
15'—b"
14'-0" 10'-9" 13'-0"
12'-6"
11'-6" 8'-9" 10'-6"
10'-b"
8'-6" N A I N/A
41-0"
4x6
2x8
16" 0. C.
24" "
32" "
18'-0"
17'-0" 13'-6" 16'-0"
15'-6"
—6" 11'-0" 13'-0"
13'4"
1 1 v-6" N/A I N19
14'-0"
4x10
NOTES:
1. 32 RAFTER SPICING CING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY.
2. FOR SOLID PATIIL COVERS (NOT LATTICE)
RAFTER SPAN 15 LIMITED TO 10'-0" USING
THIS STANDAR[.
LATTICE
ROOF
BUILT—UP ROOF
HEADERS
HEADERS'
DOUGLAS
FIR NO. 1
DOUGLAS FIR NO. 1
51
i
SPAN
SIZE
SPAN
4 >: 4
5'-0"
4x4
41-0"
4x6
8'—C"
4x6
E1-0"
4x8
11'-0"
14x8
8i-0"
4x10
14'-0"
4x10
10i-0"
4x 1 2
17'-0"
4x 1 2
1-0"
121-0"
_i
I
I 6x8
14'-0" '
6x8
,
12i—O"
6x l 0
i 7'-0"
600
141-0"
I
—7 !
1
ALL CONSTRUCTION SHALL CONFORM
TO THE PROVISIONS OF 'fHE:.
1998 CALIFORNIA BUILDING ODE.
SUPPLEMENTAL NOTES:
ROOFING NOTES:
A. BUILT—UP, ROLLED ROOF: SLOPE TO DRAIN.
B. POCK ROOF: 3/'12 MAXIMUM PITCH.
// /' / / / /y/ IIIIIIII VIII III VIII IIII 5n
1E
_ _ INSULATION CERTIFICATE
r This is to certify that insulation has beep installed in conformance with the current energy
a '.,„i,regulation, California Administrative Code, Title 24, State of California, in the building located at:
79-770 America Co.urt, Lot 21, Monticello -Classics, La Quinta, California
CEILINGS:
TYPE: BLOW MANUFACTURER: Certainteed Thickness: ,R-38
WALLS:
TYPE: BATTS MANUFACTURER: Certainteed Thickness: R-13
GENERAL CONTRACTOR: CENTURY CROWELL COMMUNIT S ICENSE # T
BY: TITLE: /
PA ON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072
B TITLE: ADMINISTRATIVE ASSISTANT DATE: 12/5/2002
`- CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF -4R
Prdject Title
Project Address
Joe- r-"oe'l►JSoo 772- 3 15g
Builder Contact Telephone
-
Hs R D I` Zow ( 76,o) 66 4, 2 o e4— 4 -
HE
ertifvinOignature
Firm:f E5E2T
Street Address: t'0 F -1-0x (o2I
Copies to: Builder, HERS Provider
Telephone
e
t_
I 5 Te c> r I /-4-/o z-
Date —I
-F Li d 0 w1E5
Builder ame T-
ELAIJ 5XF>
Ian Number
G 20 tJ P Z.
Sample Group Number
_[.40 21 79 77o 4jngX1C'A
Sample House Number
HERS Provider: ,►-I . E, (Z, .
City/State/Zip: rA} Id -H o rl 1 KA GS A • °i 770
HERS RATER COMPLIANCE STATEMENT
The house %as: Tested ❑ Approved as part of sample testing, but was not tested
As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form comply
ill 0 diagnostic tested compliance requirements as checked on this form.
he installer has provided a copy of CF -6R (Installation Certificate.
Le Istribution system is fully ducted (i.e., does not use building cavities as plenums or platform retums in lieu of ducts)
L w'here cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth
backed. rubber adhesive duct tape to seal leaks at duct connections.
2/!N1INII`1UM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
Measured
Dort Pressurization Test Results (CFM a 25 Pa) values
Test Leakage Flow in CFM I O 0
If fan now is calculated as 400cfm/ton x number of tons enter calculated
value here 2000
If fan now is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) = .+%
Check Box for Pass or Fail (Pass=6% or less)
THERMOSTATIC EXPANSION VALVE (TXV)
U 1'es ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection
Yes is a pass
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
' ❑ Yes ❑ No ACCA Manual D Design requirements have been met (rater has
verified that actual installation matches values in CF -1 R and
design on plan.
U Yes ❑ No
Compliance Forms
TXV is installed or Fan flow has been verified. If no TXV,
verified fan flow matches design from CF - IR.
Measured Fan Flow =
Yes for both I and 2 is a Pass
August 2001
Er, El
Pass Fail
Pass Fail
❑ ❑
Pass Fail
Iw