0307-354 (RC)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
653945 B � � 09/30t2(
Date r w' ~Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I jam 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 (iTAT,p 1?1fA1I) Policy No. 19106-2003
(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. .
Dale: —Applicant -
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correc0l agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) Date :�' �•`
V--,
BUILDING PERMIT PERMIT#
DATE / VALUATION LOT UY?. TRACT
JOB SITE L r' i .
APN
ADDRESS �S{�_d �i� NVIK S
1�•V{�^.
_
OWNER
CONTRACTOR / DESIGNER / EN &NEER
IM LA QU NTA PARnT.fi S LLC
ALL PHASE COAP MIT TCT ON RU
-81-I OD AVMLTE 53
92.822 VIA PALERMO '
LA QUINT.A CA 92253 •
INDIO CA 92201
(760)2757721 C''BL 4213
USE OF PERMIT
CO --CML IR.040DEL
HE
SCRI?ENINCI AROUND ROOF AfC MUIPMENT COUNTRYCLUB OFTHE
DESERTfl•IID AWAY MA MIT, 8UIL,L R40
VALUATION 14,000.00 is
r
ESITIMMD CoSr Oxr cokismucMON
I t,010f) (tt)
PIOWT iMP, WWWARY
PLAN CHECK FEZ 101-000-439-316 8122.3$
CONSTRUCTION FEE 101-900-41€3-000 $11;9.00
STdtONO MOTION IEE - COMM 100.000.2441.000 1338
AUG2 5 2003 DI
CITY OF LA QUINTA .
FINANCE DEPT. i
it -TOTAL CORTI. C.i'!CTI.ON fiasM PLAlti CRFXX
LESS P.RR—PAM F ?"S
$0.00
T(3TAL F =T M_ S I, UE .L' OW
S1 315.63
IIIIIIIIIIIIIIIIIIIIIIIII 25
IE
RECEIPT
DATE '` �r
BY —
DATE FINALED
INSPECTOR
7 t
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
OX 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
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
'Underground Pibg. 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
2.1
COMMENTS:
C I V
U v
/►
r
Final
Utility Notice (Gas)
ELECTRICAL. APPROVALS
Temp. Power Pole
Underground Conduft.
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels.
Exteriof Receptacles
G.F.I.. -
Smoke Detectors
Temp: Use of Power
Final
Utility Notice (Perm)
a
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P.O. BOX 1504 BUILDING & SAFETY DEPARTMENT
78-495 CALLS TAMPICO (760) 777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
To: Greg Butler, Building & Safety Manager
From: Oscar Orci, Planning Manager
.Td,CDD: 7-31-2003
Due date: 8-11-2003
Status: 1st Review
Building Plans Approval
(This is an approval to issue a Building Permit)
The Community Development Department has reviewed the Building Plans for the
following project:
Description: ROOF EQUIPMENT SCREENWALL (MAINTENANCE BLD -HIDEAWAY).
Address or general location: 80-955 AVENUE 52
Applicant Contact: RUBEN URRUTIA 275-7721
The Community Development Department finds that:
❑ ...these Building Plans do not require Community Development Department
approval.
❑ ...these Building Plans are approved by the Community Development
Department.
❑ ...these Building Plans require corrections. Please forward a copy of the attached
corrections to the applicant. When the corrections are made please return them to
the Community Development Department for review.
Oscar Orci, Planning. Manager Date
Tit!t4#4"
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
To: Greg Butler, Building & Safety Manager
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
To CDD: 7-31-2003
From: Oscar Orci, Planning Manager Due date: 8-11-2003
Status: 1st Review
Building Plans Approval
(This is an approval to issue a Building Permit)
The Community Development Department has reviewed the Building Plans for the
following project:
Description: ROOF EQUIPMENT SCREENWALL (MAINTENANCE BLD -HIDEAWAY.
Address or general location: 80-955 AVENUE 52
Applicant Contact: RUBEN URRUTIA 275-7721
The Community Development Department finds that:
❑ ...these Building Plans do not require Community Development Department
approval. ha y,�
...these Building Plans )(e approved by the Community Development
Department.
❑ ...these Building Plans require corrections. Please forward a copy of the attached
corrections to the applicant. When the corrections are made please return them to
the Community Development Department for review.
Oscar Orci, Planning Manager Date
8 .( ' AZ6zz -e4,C. z6 C a_0
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LANGSTON & ASSOCIATES
1810 E. 16th Street
Santa Ana, .CA 9270
(714) 836-8655
PROJECT: Roof Mounted HVAC Enclosure For
TheHideaway — Maintenance Building
80955 Avenue 52
La Quinta, CA 92253 .
CLIENT: The Hideaway
81100 Avenue 53
La Quinta, CA 92253
BUILDING CODE: C.B.C. 2001, LACO 2002.
Job #8803
CITY OF LA QUIP4A
BUILDING & SAFETY DEPT.
APPROVED
FOR CONST UCTION
z�! �n�, 4�
MATERIALS, Except as otherwise specified herein:���%' 3�
Concrete *
2,500 PSI at 28 days- �JG Sc` -95 oh�
Concrete Block
Grade N. +. Unit, C-62
Brick Masonry
Grade MW, 2,500 PSI Units, C-62
Reinf Steel
20,000 PSI (ASTM A615, Grade 40)
Structural Steel
24,000 PSI (Compact) (ASTM A-36)
Structural Pipe
22,000 PSI (ASTM A-53, Grd. `B")
Plywood Sheathing
D.F.P.A., Structural II, INTR. P.S. 1-83
Glue Lam. Beams
2,400 PSI (D.F. - Larch, Comb. "A" or Comb. 24F
Lumber
Grade Marked D.F. - Larch, W.C.L.B. Grdg. Rulel6
Soil Pressure
See Foundation Plan for Complete Data
DESIGN REFERENCES, including Charts and Tables from:
Lumber & Timber Wood Structural Design Data (Volume 1 National
Forest Products Association)
Steel Manual of Steel Construction, AISC
Concrete Reinforced Concrete Design Handbook, ACI: Ultimate
Strength Design Handbook, ACI
Concrete Block Masonry Design Manual, by Masonry Industry
Advertising Committee
C.E. 29373
Registration No.
'•0%•03
Date
PROJECT SHEET NO.
LANGSTON & ASSOCIATES YY
FOR JOB NO.
STRUCTURAL CONSULTANTS
LOCATION DATE / .)
�- -1 181.0 EAST 16TH ST.,SANTA ANA,CALIFORNIA, 92701 -�
ITEM: (714)836-8655 ENGINEER y'
GtY - to " -t.. : 3
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YOUNG ENGINEERING SERVICES
• Engineering • Architecture -Surveying- Building & Safety Services
Letter of Transmittal
To: City of La Quinta
Attn: Ed Randall
Tel No.: (760) 777-7012
Date: 8/8/03
Project. 80-955 Ave. 52
PC#:
Tract No.:
0307-354 (1" Check)
We are forwarding: X By Messenger By Mail Your Pickup
No. of Copies Description:
1 Set of plans
1 Set of approved plans
Set of structural calcs
Set of approved structural calcs
Comments: Plans are acceptable.
Thanks
This Material Sent for:
Your Files Per Your Request
Your Review z Approval
Checking At the request of.
Other
By: Eric Frenzel
Phone # 760-360-5770
77-804 Wildcat Drive, Suite C Palm Desert, CA 92211 (760) 360-5770
Bronz Young