RER (9911-286)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
%apter 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
67407.1
Date 1�1171� Signature of Contractor =) 2
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 Sianature 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 SIArPolicy No. i�2�sG(=Z733.i
(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 Calif ornia,,.and•agree that if I should become
subject to tl7e workers' compensation,provisions off Section 3700 of-fte Labor
Code, I shall rthwith comply with�those provisions.
Date: // 1/ Applicant--
�r ,/' {
Warning: Failure'to secure Workers' Compensation coverage is unlawful a d
shall subject an employer to criminal penalties and civil fines up to $100,0001 in
71
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, indemnity
& 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 reprep ntdt'iv�st of this City to enter upon
the above-mentioned property for inspect%n purposes.
Signature (Owner/Agent) Q Date/� M
BUILDING PERMIT PERMIT#86
DATE i VALUATION , &W. p:0 LOT 55 TRACT i 829912
JOB SITE 49-."6 MONTANA WAY
APN
ADDRESS
OWNER
CONTRACTOR/DESIGNER/ENGINEER
"11)M.IS"3RIIDENFt.G1AML:I+".1'
SPARKS CONS1h'%li;-;`1":ION
PO BOX 173.6
►3-'6195 R;11,R CHO LA. 0UIN ; A GR
LtlalLiE1`P[A CA 92253
1A QT7IVW A. Cha 92253
�7tit9}77 -1 Q 1 C1.�:11# 2
USE OF PERMIT
�SIUF'1�'rt�il., ftlA+at:3T1F'l,.
C'"WEE O.[V.4M FOR .8090 D0011, Ff,€,-31YEEN 1111 VANUL'k W:Y5M 'ANT)
03lv.fri3c� �&,C�QM -Y�K ishfC.,#i1vbr�t:I:,U ��i1.Ar''�f3
VALUATION 5i1f OO.GS
KIAK C (HECK 1 &;. 101-000.439.318
i�7N."VIRW1110NFFE, 101 -OM -419-004 g1�.
17R01r(l &10117101 M- 61- ROAD 101-M-441-91?Q
`t 03-¢YA!, e/NSI I(ACN ANT) fvl,Ay^HEICK
_(_'11 $15,25 5
LESS P L PAID FEES
1 $000
TOTAL PERMIT MEN RUENOW
}
V
RECEIPT
DATE
BY
DATE FINALED INSP T R
�P
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
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I 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 Vottage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
G O-U VI S 'ENGINEERING
• C A L I F .O' R N J -A •
"Member 9, 1999 E-MAIL TO • SUPPORT@GOUVISGROUP.COM • SALES@GOUVISGROUP.COM
T.D. Desert Development
c/o Sparks Construction
P.O. Box 1716
La Quinta, CA 92253
C ITY•-O F^LA .QUI NTA
Attn: Nolan Sparks .,'BUILDING & SAFETY DEPT.
Re:APPROVED
Montanas .
"Plan # 2 FOR CONSTRUCTION
GEC-Job-No.: 20505
DATE J11-1'! -4 BY'
Dear Mr. Sparks: `
Pursuant to your request, regarding the above captioned project, per our phone
conversation on 11 /9/99, we. submit the following:
See the attached partial.. framing, and foundation plan and detail"A" for the added 8090
door between the dining room and the family room.
Note: Please verify the above with the.building department prior, to construction.
If you have any questions, please do not hesitate to contact this office.
Sincerely, ;dam
y v
'EIt>1�b �. r..
<. .
K!o. C38276,
z
e4w! Xf
Saeed J. Bekam a Y.. Exp. 3/31/00 z�J aand Frangie
t President �a Pro' ct manager
SB:cb
20505
attachments: (6)
GOUVIS ENGINEERING GROUP OF COMPANIES WITH OFFICES I.N.• WEB-SITE: WFYWIGOUVISGROURCOM
4400 CAMPUSDRIVE, SUITEA • NEWPORTBEACH, CAIrFomm 92660 • (949) 752-1612. • FAX (949) 752-5321 ^
2150 EAST TAHQunz CANYON, SUITE 9 • PALM SPRnvcs, CAuFomm 92262 • . (760).323-50,90 • FAX (760) 325-2863
f 5465 MoREHOUSEDRIM. SUITE 100 • SANDIEGO, CALIFORNIA 92121 • (858) 623-9941 FAX (858) 623-0278 4. '
FIELD OFFICES: LAs VEGAS (702) 597-2005' • FAX(702)597-0905 • ,REMONT. (510) 252-9195 •. FAX (510) 252-9196
l..\:.ol�R.ui\li��.►,� �yt,),rV►\t�;l ,. "t.w '
f Job No : 20505
Client : TD
_ Plan No : 2
F. Date : D4110/99
" Wind 3768 ;�� QSa f3�/� Engineer: STEVEN(Ver3.00)
•Sllsmic 4550
• � 11.0 •. "
1. o 1N MOR HOLDDOµ'N .
1537 _
A B D A "
- 12.! 37.7
0.0 ; 7,0 310 — — _ --
Drag Force Analysit3
A: SIMPSON ST22 (1150 LB) ALT (12) # 16d.sinker .per-top plate splice
B: SIMPSON ST6224(2116 LB) ALT .(18) # 16d sinker per top plate splice
16 AT RIGHT.OF DINING INTERIOR WALL
STORY.: FIRST FLOOR.. TWO. POUR FOUNDATION 94 UBC
TOTAL WALL LENGTH = 50.5(FT) TOTAL PANEL LENGTH 0(FT)
SHEAR DIAPHRAM= 4550/ 50.5 90(PLF)
SHEAR 4550/ �. 0= f&S.56(PLF) MAXIMUM. DRAG FORCE a 1577 (LB)
F USE TYPE V w/ V.2" DIAMETER x10" LONG ANCHOR. HOLT MAX.
DEAD LOADS:
Wall 140 s 10 * 14'
.Roof P 38.0 19 *-4.0/2 FROM 0.0' TO 50.5'
OVERT ANALYSIS
PANEL(q LEFT SIDE UPLIFT Sb?/ya '.(LB) USE *844x�a
RIGHT SIDE: UPLIFT =6Q1 ' (LB) USE �f ��]],/4x<
SF'fil<KS
S .
t1