9711-068 (SFD)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 ahi effect.
License # Lic. Class Exp. Date
t} 42f381 13 °4,� f�'r1r9s
D Fg' 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 3100 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.
3'CATE Fi*l) 12Sr 990 Sri
(This section need riot 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
subjecf to the workers' compensation �ovisions of Section,3700-oLthe Labor
Code, I shal fort with comply wiih tho ;,Prov°sions.
pate: 17 t"J Applicant` V .J Q1Z
Warning: Failure to secure WorkersCompensation coverage is unlawful and
shall subject an employer to criminal -penalties and civil fines up to $100,000, in
additiori 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 resultof 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.,Zuthorize representatives of this City to enter upon
the above-mentioned property for inspection purposes:.�
Signature (Owner/AgDatei f? {r7
Y
N�
BUILDING PERMIT
PERMIT#
CONTROL# ;
ti
DATE VALUATION LOT
9711+065 TRACT
6277
S131f71)S.b11
s
JOB SITE
ADDRESS
54-020 AVENI.DA ALVARADO
OWNER
CONTRACTOR / DESIGNER / ENGINEER
'DAVID ROOS Xi1LLER.
PACIFIC'1'RADES
1719 & TREMONT
P.O..BOX'722
OCEANSIDE CA 922054
LA QUINTA CA 92253 ..
(619 664-0273
C13LO 1955
¢
USE OF PERMIT
SFD -BLOCK -MALL AND POOL NOT I'NCLU_ ED
�® LJ
DEC
TRACT CONSTRUCTION 1,132..00 �qFt^p
k
UW `
1
PORMPA.TiO
11i> 0.�`:'ll
�t6.
1 t ,
GARAGEtCARPOR.T
6 FT. WOOD LENCE ?0Ef"0 LF
IIMA,`i`ED COSI' OF
CONSTRUCTION ION
89,705.60
1PE.R1Yff FRESMONfARY
_
CONSTRUCTION Mi. 101-000411;-000
$5911.50
PLAN CHECK ';~EE 10.1.000-439-318
$499.53
MECHANICrNL FIFE. 101-000-421-000
I'LEC-rRLCAL, EFF. 101-000-4.20-M)
$12186
PLUX1131NO FEE 101-000-419-000
$133.50
STRaNG MOTION FEE, - RI SID 101-00 0-211-000
GRADING FEF 101.-000-$23.000
s:,tw
INMAS'1 UC;'Pi: M FEF. '?s-000 443-347.
$1.974,34
PRECISE PIAN :101000-441-3-15
$25.00
FEE L7EPOSIT
-$250.00
SLS-TOTA1 CONI.-fit.UC"flON .AND PL.�IY CR.I.CK
$3,421.20
LESS PRE -PAID FEES
421%,01i
TOTAL P'ERM[T FEES
DUE NOW r—
53,171.20
IIIIIIIIIIIIIIIIIIIIIIIII
64
IE
RECEIPT
DATE
BY
DTE INALINSPECTOR..
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs A
Underground Ducts
Forms & Footings
Ducts
Slab Grade LV
Return Air
Steel ICombustion
Air
Roof Deck
Exhaust Fans
O.K.to Wrap
F.A.U.
Framing. , (i1A
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVA •S,-. -
POOLS - SPAS
steel
Set Backs
Electric Bond
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:
OA T44t 0 4 "
P.O. BOX 1504
Buildingr 78-495 CALLE TAMPICO
Address E-4 ' O2 C) �',vc,r,- �''L- LAQUINTA, CALIFORNIA 92253
ner
Address cl S. < •• Iti`:+a�
City, Zip Tel.
Contractolr
Address
8•Classif. Lic,# k� 1
Arch., Engr.,
Designer
Address Tel.
City IZip IState I
i _ Lic. #
('LICENSED CONTRACTOR'S DEC -ORATION
thal,l,am licensed under provisions of, e
Chapter 9 (commencing with Sectlan
3 ohth@,BCGsigess and Pry` f�ssions Codend my license is in full force and
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to'its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chaplet 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
I-] 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
1 1 I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
1-1 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
17 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
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.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof this city to enter the above.
mentioned property for inspection purposes.
Signature of a0plicant Date
Mailing Address
City, State, Zip
,z,.
IIIIIIIIIIIIIIIIIIIIIIIII 65
�, "I'll�
I
APPLICATION ONLY
BUILDING: TYPE'CONST. OCC. GRP.
A.P. Number -% 74' ^'A—
Legal Description l r -r 3 k�LlCtyoa Z 4'
Project Description -�y
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
PERMIT AMOUNT
Plan Chk. Dep. r•�,Q r 00
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line�y
I
FINAL DATE
INSPECTOR
Issued by: Date Perm I
Validated by:��i! g
Validation: "'a
r . `y v 97
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION''
DEC. 5.1997 5:48PM COMMONWEALTH
9XCOiMING REQUESTED 137[:
OLD REPUBLIC TITLE COMPACOMPANY
97.6902KC 102391,-13
WRM RECORDED MAIL THTS DZED AND,
U=ICSS O%XXRWISE SHOWN HELOK,
NAT& TAS STAT TS TO:
DAVIT] ROSS MTT LER.
1719 S. TREMONT
S, OCEANSIDE, CA 92054
S
GRAW DEWD
NO. 153 P.•1i1
IIIIIIIIIIIIIIIIIIIIIIIII
66
IE
AVX: 774-203-002
The undersignedgrantors) declare(s):
Documentary transfer tax is $12.10
(XXX) Computed on full value of property conveyed, or
( ) Computed on full value less liens and encumbrances remaining at time of sale.
( ) Unincorporated area: ( ) City of , and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
ROGER L. SCHWARTZ, TRUSTEE OF THE ROGER L. SCHWARTZ TRUST, U/A DATED SEPTEMBER 28, 1993
hereby GRANT(5) to
DAVID ROSS MILDER, A MARRIED MAN AS HIS SOLE AND SEPARATE PRQVSRTX
the real property in the City of LA QUINTA, County of Riverside, State of California,
described as:
LOT 23 OF BLOCK 253, SANTA CARM914ITA AT VALE LA QUMA, UNIT NO. 24, AS PER MAP
THEREOF RECORDED IN BOOK 19, PAGES 44 AND 45 OF MAPS, RECORDS OF RIVERSIDE
COUNTY, CALIFORNIA
Dated September 18, 1997
D( State of Gaz4zemia
County of S.S.
On S' Mi,ep
before me, _VJ-,A/,/ /1 Deborah ge er
personally appeared
I ve S byartz
personally known to me (or proved to me on
the basis of satisfactory evidence) to be
the person(s) whose name(a) is/are subscribed
to the within instrument and acknowledged to
me that 11e/she/they executed the same in
h.Lj/her/their authorized capacity(iee), and
that by !Lis/her/their signature(s) on the
instrument.the person(s), or the entity upon
behalf of which the person(s) acted, executed
the instrument.
WITNESS my hand and offiqlal seal.
Signature
MAIL TAX STATMMNTS T0: SAMR AS ABOVE
,
ROG-Eff—L—.1%qfMARTZ, TRUSTEE
OF THE ROGER L. SCHWARTZ TRUST, U/A
DATED SEPTEMBER 28, 1993
(This area fob
pcaMQ icia� notarial seal)
0 ncr
Notary Public, States of New Yorlc
N0.02KE6041699
QuaHf[ed ih New York CouTI
Coinmission FxPir cs ADrli 10, tY 1
Desert Sands Unified School District
Notice: 82-879 Highway 111 IIIIIIIIIIIIEIIIIIII����� 67
Document Cannot Be Duplicated Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Date 12/17/97
No. 16415
Owner NameDavid Roos Miller
No. 54-020 Street Avenida Alvarado
City La Quinta
Tract # Lot #
Type of Development Single Family Residence
Comments
APN # 774-203-002
Jurisdiction La Quinta
Permit #
Log #
Zip 92253 Study Area
Square Footage 1432
No. of Units 1
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered
patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes.
It has been determined the above-named owner is exempt from paying school fees at this time due to the following
reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
1.84 X 1,432 or $ 2,634.88 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
Fees Paid B Cashier's Check/Ca ital Bank of North Count-,`5'6'4-b273.,t
Y P Y Telephon�
Name on the check
By Dr. Doris Wilson _
t� t�
Superintendent
Fee collected /exempted by Ellen Patino Payment Received '$2.634.88.
Signature
—v
Check No. 7014
40TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
above will begin to run from the dale on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
.,tact them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
IIIIIII VIII III VIII IIII 68
IE
RETAINING WALL DESIGN CALCS
FOR
A RESID NCE
CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
AT CONDITIONALLY
54-020 AVEN11DA ALVAMWOrED FOR CONSTRUCTION
LA QUINA ,&USJECT TO INSTALLATION AS PER
AND ALL APPLICABLE
BY
-2�
BY
CAL WEST ENGINEERING
4/17/98
PREPARED UNDER THE DIRECT SUPERVISION OF:
TE
RCE 43750
Y
GAL MST ENcS.INEERIN6
32-812 AJRORA- VISTA NO.I
CATHEDRAL CITY, CA.
42234
PHONE: (?60) 328-8130
JOB NO. % 12— '0
SHEET NO. I OF y
CALCULATED BY DATE %111M
CHECKED BY Q` DATE jZlle
ADD177ONAL 8 COURSES
14 ® 32"% 8" C.M.U.
CENTER OF CELL
RN/SHED GROUND
DOWEL INTO EXISTING 8"
I I DRILL 5/8" DIA. HOLE
r I EPDXY w/S/MPSON ET22 EPDXY
SPECIAL INSPECTION REQUIRED
I I
L J
EX.4 ® 32
CENTER OF CELL
I I
#4 BARS I
EXISTING 4 COURSES AND
FOO LING
— — — — = -INITIAL DESIGN
(3' HIGH MAX RET. I
ADDITIONAL 8 COUR
Title :
Dsgnr.
Description
Scope:
Date:
Job #
Cantilevered Retaining Wall Page 1
General
Retained Height = 3.00 ft
Wall height above retained soil = 4.00 ft
Slope Behind Wall = 0.00: 1
Height of Soil over Toe = 4.00 in
Soil Density = 110.00 pcf
LFootinq Data
308.1
Toe Width
= 0.50 ft
Heel Width
= 2.00 ft
Total Footing Width
= 2.50 ft
Footing Thickness
= 12.00 in
Footin KeV Data
150.0 pcf
Distance from Toe
= 0.00 ft
Width
= 0.00 in
Depth
= 0.00 in
Soil Data
308.1
Allow Soil Bearing =
1,500.0 psf
Equivalent Fluid Pressure Method
- 344.8 lbs
Active Soil Pressure - Heel Side =
35.0 psf
Active Soil Pressure - Toe Side =
35.0 pcf
Passive Pressure =
150.0 pcf
Water table height over heel =
0.0 ft
Slidinq Data
Wind on Stem =
Friction Factor @ Footing & Soil =
0.250
...neglect ht. for passive =
0.00 in
Lateral Sliding Force =
308.1
less Passive Pressure Force =
- 133.3 lbs
less Friction Force =
- 344.8 lbs
Added Restraint Force Required =
0.0 lbs
Added Lateral Load on Stem
Adjacent Footing Data
Lateral Load =
0.0 #/ft
Adjacent Footing Load = 0.0 lbs
...Height to Top =
0.00 ft
Footing Width = 0.00 ft
...Height to Bottom =
0.00 ft
Eccentricity . = 0.00 in
Wall to Ftg CL Dist = 0.00 ft
Wind on Stem =
14.8 psf
Footing Type = Line Load
Base Above/Below Soil at Back of Wall = 0.0 ft
Footing Design Results
fc =
2,000 psi
Minimum Footing Rebar Options......
Fy
Minimum As % =
40,
0.0018000
00018 psi
Toe Side...... Heel Side....
Rebar Cover @ Top =
2.00 in
Not req'd Not req'd
Rebar Cover @ Bottom =
3.00 in
Mu < S * Fr Mu < S * Fr
Toe
Heel
ACI Factored Soil Pressure =
1,740
0 psf
Mu': From Upward Loads =
348
0 ft-#
Mu': From Downward Loads =
58
756 ft-#
Mu: Used For Design =
290
756 ft-#
Actual One -Way Shear =
6.29
Key Reinforcement: Not Req'd = Mu<S*Fr
7.86 psi
Allowable One -Way Shear =
76.03
76.03 psi
Desiqn Summary
Total Bearing Load =
1,379 lbs
Summary of Stem Section Designs....
...resultant ecc. =
6.12 in
Top: 8 in Mas, #4@32.00 in.@Cntr, From 7.0 ft to 0.0 ft
Soil Pressure @ Toe = 1,243 <=
1,500 psf
Soil Pressure @ Heel = 0 <=
1,500 psf
ACI Factored Press @ Toe =
1,740 psf
ACI Factored Press @ Heel =
0 psf
Footing Shear @ Toe = 6.3 <=
76.0 psi
Footing Shear @ Heel = 7.9 <=
76.0 psi
WALL STABILITY RATIOS
Overturning Stability Ratio =
2.43
Sliding Ratio Ratio =
1.55
Title: Job #
Dsgnr. Date:
Description:
Scope:
Cantilevered Retaining Wall Page 2'
Stem Design & Construction 1
Design at this height above ftg =
Wall Material Above "Ht"
Thickness =
Rebar Size =
Rebar Spacing =
Rebar Placed at =
Design Data
fb/FB + fa/Fa =
Total Force @ Section =
Moment.... Actual =
Moment..... Allowable =
Shear..... Actual =
Shear..... Allowable =
Bar Embed ABOVE Ht. _
Bar Embed BELOW Ht. _
Wall Weight =
Rebar Depth 'd' _
Masonry Data
fm
Fs =
Solid Grouting =
Speciallnspection =
Modular Ratio'n' _
Short Term Factor
Equiv. Solid Thick. _
Concrete Data
fc =
Fy =
Top Stem
Stem OK
0.00 ft
Masonry
8.00 in
# 4
32.00 in
Cente
0.823
214.8 lbs
453.3 ft-#
550.7 ft-#
5.08 psi
25.76 psi
20.00 in
6.00 in
78.0 psf
3.81 in
1,500 psi
20,000 psi
Yes
No
25.78
1.330
7.60 in
Title: Job
Dsgnr: Date:
Description
Scope:
Cantilevered Retaining Wall Page 3
Summary of Overturning & Resisting Forces & Moments
.....OVERTURNING...:. .....RESISTING.....
Force Distance
Moment Force
Distance
Moment
Item
lbs ft
ft-# lbs
ft
ft-#
Heel Active Pressure_ =
280.0 1.33
373.3
Soil Over Heel
.440.0
1.83
806.7
Sloped Soil Over Heel =
Surcharge Over Heel =
Adjacent Footing Load =
Axial Dead Load on Stem =
0.00
Toe Active Pressure =
-31.1 0.44
-13.8
Soil Over Toe
18.3
0.25
4.6
Surcharge Over Toe =
Stem Weight(s) =
546.0
0.83
455.0
Earth @ Stem Transitions =
Footing Weight =
375.0
1.25
468.7
Key Weight =
Vert. Component =
Added Lateral Load =
Load @ Stem Above Soil =
59.2 6.00
355.2
TOTALS =
308.1 lbs O.T.M. =
714.7 1,379.3
R.M. =
1,735.0
Resisting/Overturning Ratio =
2.43
Total used for Soil Pressure =
1,379.3 ( +Axial Live Load, - Vertical Soil Component)
Vertical component of active pressure used for soil pressure
Toe Surcharge Not Used To Resist Overturning
Heel Surcharge Not Used To Resist Overturning
' TEIII 69
EARTH SYSTEMS CONSULTANTS
SOUTHERN CALIFORNIA
Ber79-811 B Country Club Drive
muda Dunes, GA=92201 • (619) 345-1588
Client Name a e-& , e. —Tl m A es
Client
Client Phone
�'�L� .� Trf f`ca�! \fin ([.•r Q/f�+
DATE
JOB NO.
—9
- ei
PROJECT tke--; 4����
1
ac,4�
LOCATION
e
E-7 c2AM e5 co vmjfca
Sri
r
--
CONTRACTOR
OWNER
WEATHER TEMP.
0 at AM
11
WQcva..
0 at PM
PRESENT A S E
a ..a\Ce✓ b u O
T
Moxcln, 1000
c 1
cx /
4. /D4
1
k Ise
x
-
Q !1
THE FOLLOWING WAS NOTED:
X1S 1 n� w���/
e
E-7 c2AM e5 co vmjfca
Sri
r
--
S_. � t
a ..a\Ce✓ b u O
Moxcln, 1000
1�
x
-
Q !1
c 2
e c_%0 v
ti 0" q
FIELD REPORT
�s
CLIREPRESENTATIVE SIGNATURE TECHNICIA S SIGNATURE