PLBG (0403-043)78010 Main St Ste 102
0403-043
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Fes— Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
cv W Professionals Code, and my License is in full force and effect.
p =) ch License # Lic. Class ` Exp. Date
f_CY LO nI
Y7Z88 13
0.
Z r--Date •_ -' Signature of Contractor y-
00lt - /
It— U OWNER-BUILDER DECLARATION
W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following reason:
Z_ ( ) 1, 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
LID
N Date Signature of Owner
ON
0)d Q WORKER'S COMPENSATION DECLARATION
o cc I hereby affirm under penalty of perjury one of the following declarations:
r H O () 1 have and will maintain a certificate of consent to self-insure for workers'
X W L= compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
C0 Q I have and will maintain workers' compensation insurance, as required by
Q C Q Section 3700 of the Labor Code, for the performance of the work for which this
IlulH permit is issued. My workers' compensation insurance carrier & policy no. are:
Z CarrierPolicy No.
CIS Z) 8T'ATB i 4JIM 1.440133.03
a
J (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_ghall forthwith comply with ,those proal lons,,t.
Date: / %WApplicant AC^0
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
• 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 purpose's.
r %
Signature (Owner/Agent) 'yl`r'O' ' Date
tIe"
BUILDING PERMIT PERMIT#
DATE VALUA `ON LOT 0403-&13 TRACT
JOB SITE }
ADDRESS 78 :'l1li.dYi u I'ltltS"t Im
APN
-
OWNER
CONTRACTOR/DESIGNER/EN &NEER
OLD TOWH LA QLRM.A, TIX
1VWtV19 H0ME8
38.0$0 C.P > 9-1MO, MZ 201
W-080 CAL3..1sEMADO MEN]
LAQMTI.6, CA 92233
L.A.QLTN —A CA 922$3
(760)771-2567 CB 4 54(n
USE OF PERMIT
'L :C] Ci71 TC1
INSTALLATION OF 900 CIALLOW CREASE INTA PIRCE.PTOR AT SUITE 102
PER PLAN AND HKALTH DEPT APPROVAU
VALUATION 11300,00 L:1
1` RITMArED COST OF CONSTMIe,JC' ON
1„ 00.W
PFIRKUI'FV K HITIVUSARX
FLUMBIHO "19 101-000-419-000 117,00
8TJ'B-•1Y?fAL CCs)49TRCTC'r014 ,A.bM 11,11-01 (':.HECK
$217.00
L&IS E'I g.PAW F HII*'
x.00
D °
't3T A, Xy17Lr N ow
S2 7.00
MAR 16 2004
CITY OF LA QUINTA
FINANCE DEPT.
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
IL
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION j
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 - IM. 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
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
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
J
SFE 7POTE 3
1 FITTIMG SEAL.
SEE SPEC SHEET
NO. S-250
mi
C
INLET
1 1Q VIEW
SEE NOTE 2
A
CQE
L
TIOIT hMmm WATER Rf51S LMr
RAIIE AND COVER
1. REFER TO S?EancAnONS SHEET Nd: S-2.12
2. REFER TO SPMFiCAT10NS SHEET NO S-252
OuREr t 3. REFER TO SPECIF1CA1IONS SHEET NO, S-251
OUTLET
0
I j V LE TO
GRADE 04
I 6- GCREHEHTS
lr'
_ 1 T/4- TYPICAL
WALL
SSIDE51
1
RECESS
I
_-- 4 3/4' IYWC&
f110 k SIOE
MALLS
OUTLET a
END \4
GREASE INTERCEPTOR '►M11H SAMPLE BOX
TWO MANHOLES EXTENLED TO GRADE
DESIGNED FOR DIRECT H-20 LOADING
OF MANHOLE EXTENSIONS
75D THRU 1500 GALLONS
EXCAVATION SHCIFICATIONS 4mw IADDEL 0-750 G -100D 0-1200 G-1500
L04CTH 12'-0" 12'-O" 12'-0" i2' -Q" P.O. BOX 6D2
VADh! B'-0" B' -Q"' 1 ..'B'-0" 9'-0" HIGHLAND. CA 92346
909 793-7602 800 945-8265
BELOW INLET 3'-4" 4'-2" 4'-11" 5'-2 1/2" Fox: 909 793-1283 -
TANK HEIGHT 4'-7" 5'-5" 6'-2" 6'-5 1/2" 10-1-01 8. BRAKE 1 11 = 1' I Ia044
ALL
DQAEN90NS IN
INCHES
NOAEL
A B
C
0
£
F
C
N
PC G-750
40 38
55
74
74
19 3/4
4 I/2
31 1/2
PC G -100D
50 48
65
74
74
24 3/4
4 1/2
41 1/2
PC 0-1200
59 57
74
74
74
29 1/4
4 I/2
50 1/2
PC G-i OD
G2 t/2 60 1/2 77 1/2 1
85
1 5
30 3/4
5
53 1/2
1. REFER TO S?EancAnONS SHEET Nd: S-2.12
2. REFER TO SPMFiCAT10NS SHEET NO S-252
OuREr t 3. REFER TO SPECIF1CA1IONS SHEET NO, S-251
OUTLET
0
I j V LE TO
GRADE 04
I 6- GCREHEHTS
lr'
_ 1 T/4- TYPICAL
WALL
SSIDE51
1
RECESS
I
_-- 4 3/4' IYWC&
f110 k SIOE
MALLS
OUTLET a
END \4
GREASE INTERCEPTOR '►M11H SAMPLE BOX
TWO MANHOLES EXTENLED TO GRADE
DESIGNED FOR DIRECT H-20 LOADING
OF MANHOLE EXTENSIONS
75D THRU 1500 GALLONS
EXCAVATION SHCIFICATIONS 4mw IADDEL 0-750 G -100D 0-1200 G-1500
L04CTH 12'-0" 12'-O" 12'-0" i2' -Q" P.O. BOX 6D2
VADh! B'-0" B' -Q"' 1 ..'B'-0" 9'-0" HIGHLAND. CA 92346
909 793-7602 800 945-8265
BELOW INLET 3'-4" 4'-2" 4'-11" 5'-2 1/2" Fox: 909 793-1283 -
TANK HEIGHT 4'-7" 5'-5" 6'-2" 6'-5 1/2" 10-1-01 8. BRAKE 1 11 = 1' I Ia044
-,"'FUTURE
\
BLDG. •D•
FF -42.50 2 TCO 41.90
PE -42.00 CO INV 34.01 \
t i✓ i .,
y,t
l
t
\ 12+31.03
M Fi ND• 3 -___
TMH 42.18
IN INV 36.64
OUT INV 36.54
IN LAILRAL INV. IN 0 CO INV 38.80 2
INV. 38.60 MAIN 36.73 LATERAL INV. 0
OUT TCO 42.30 OLR INV. 38.6 MAIN 36.96
INV. 38.43 CO INV 3TCO
1LL 2 INV. 38.43 CO INV 38.80 2
1 7 1 M AIE 6.80 ,® 1 II 7 1 LATERAL
INV, 0
In 42.02 N TP 42.34
8 101 O O 0 - 12 0
1 0 1
S=0.339 10 12 8
S=O.
5 10
12 5 10
00 a00. 12
h, Cl o ti
Ln
L34 • . 1 7 II 0
2 TCO 42.60 / 1 7 1
T IH 41.10 AATJJ N
39.10 2 TCO 42.60
IINV INV 35.91 L Imo• 0 CO INV 39.10 2
UT INV 35.816.79 LATERAL INV. 0
ER V0 MAIN 36.85
IMPROVEMENTS
OVEMENTS PLANS.CO INV _ 00 2 PROP. BLDG. •A•
. FF 43.20
PE -42.70
,_: - ' +• , i .- PROP. 6' .....=... -
TCO 42.60 2
0 CO INV 39.10
LATERAL INV. 0
95 00 2 MAIN 36.97 2 TC
o-
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17
I-
F
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5 4-114ZA( 5
PROP. BLDG. 'C
FF -42.80
PE -42.30
L.wV/1JtMtN I rtm LVWU UWG 5-46
L22
N
89'50'47' E
10 -FEET EACH
WAY OF PROP. WATER MAIN
L23
N
00.09'13" W
1916
13.39
CONSTRUCT
fi"
SDR 35 VENT LINE
L24
N
00.06'13" w
7.29'
CONSTRUCT
8"
SDR 35 SEWER MAIN
L25
N
00.06'13" w
12.77
CONSTRUCT
48" SEWER MANHOLE PER CVWD DWG S-5
L26
L27
N
N
00'09'13' W
00.06'13" w
5,69'
25.46'
CONSTRUCT
8"
X 6" PVC WYE
08
N
00.09'13" w
13.52'
CONSTRUCT
8"
X 6" PVC REDUCER
730
w
8 62'
rr
PROP.
N
00.09'13"
CONSTRUCT
6"
X 90' PVC BEND
L31
N
00.09'13" W
113 39'
-,"'FUTURE
\
BLDG. •D•
FF -42.50 2 TCO 41.90
PE -42.00 CO INV 34.01 \
t i✓ i .,
y,t
l
t
\ 12+31.03
M Fi ND• 3 -___
TMH 42.18
IN INV 36.64
OUT INV 36.54
IN LAILRAL INV. IN 0 CO INV 38.80 2
INV. 38.60 MAIN 36.73 LATERAL INV. 0
OUT TCO 42.30 OLR INV. 38.6 MAIN 36.96
INV. 38.43 CO INV 3TCO
1LL 2 INV. 38.43 CO INV 38.80 2
1 7 1 M AIE 6.80 ,® 1 II 7 1 LATERAL
INV, 0
In 42.02 N TP 42.34
8 101 O O 0 - 12 0
1 0 1
S=0.339 10 12 8
S=O.
5 10
12 5 10
00 a00. 12
h, Cl o ti
Ln
L34 • . 1 7 II 0
2 TCO 42.60 / 1 7 1
T IH 41.10 AATJJ N
39.10 2 TCO 42.60
IINV INV 35.91 L Imo• 0 CO INV 39.10 2
UT INV 35.816.79 LATERAL INV. 0
ER V0 MAIN 36.85
IMPROVEMENTS
OVEMENTS PLANS.CO INV _ 00 2 PROP. BLDG. •A•
. FF 43.20
PE -42.70
,_: - ' +• , i .- PROP. 6' .....=... -
TCO 42.60 2
0 CO INV 39.10
LATERAL INV. 0
95 00 2 MAIN 36.97 2 TC
o-
M ArIL(
17
I-
F
MA
V
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1
/
5 4-114ZA( 5
PROP. BLDG. 'C
FF -42.80
PE -42.30
L32
N
00'09' 13" W
7,29'
L33
. N
00.09' 13' W
13.40'
734
N
00'09' 13" W
12,82'
L35
N
-N-F070-911
00'09' 13" W
25.44'
L36
3" W
25.44'
7
N
00'00'00" W
52.66'
L38
N
00' 18' 7' W
19 97'
L39
9' 1 W
18 45'
rr
PROP.
BLDG.
•B•
FF -42.90
CO 42.30 2
PE
-42.40
TC
O38
1NV. 0
ccATERAL
-,"'FUTURE
\
BLDG. •D•
FF -42.50 2 TCO 41.90
PE -42.00 CO INV 34.01 \
t i✓ i .,
y,t
l
t
\ 12+31.03
M Fi ND• 3 -___
TMH 42.18
IN INV 36.64
OUT INV 36.54
IN LAILRAL INV. IN 0 CO INV 38.80 2
INV. 38.60 MAIN 36.73 LATERAL INV. 0
OUT TCO 42.30 OLR INV. 38.6 MAIN 36.96
INV. 38.43 CO INV 3TCO
1LL 2 INV. 38.43 CO INV 38.80 2
1 7 1 M AIE 6.80 ,® 1 II 7 1 LATERAL
INV, 0
In 42.02 N TP 42.34
8 101 O O 0 - 12 0
1 0 1
S=0.339 10 12 8
S=O.
5 10
12 5 10
00 a00. 12
h, Cl o ti
Ln
L34 • . 1 7 II 0
2 TCO 42.60 / 1 7 1
T IH 41.10 AATJJ N
39.10 2 TCO 42.60
IINV INV 35.91 L Imo• 0 CO INV 39.10 2
UT INV 35.816.79 LATERAL INV. 0
ER V0 MAIN 36.85
IMPROVEMENTS
OVEMENTS PLANS.CO INV _ 00 2 PROP. BLDG. •A•
. FF 43.20
PE -42.70
,_: - ' +• , i .- PROP. 6' .....=... -
TCO 42.60 2
0 CO INV 39.10
LATERAL INV. 0
95 00 2 MAIN 36.97 2 TC
o-
M ArIL(
17
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MA
V
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1
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5 4-114ZA( 5
PROP. BLDG. 'C
FF -42.80
PE -42.30
I
SGPA ARCHITECTURE o PLANNING ` ' _ SAN DIEGO s SAN FRANCISCO
TRANSMITTAL
DATE January 22, 2003
TO Mr. Brian Monroe
Marvin Investments, Inc.
78-080 Calle Estado, Suite 201
La Quinta, CA 92253
FROM Michael Cather
VIA Fax: (760) 771-5057
PROJECT Old Town La Quinta
La Quinta, California
PROJECT NO 20210-D-01
DESCRIPTION
Enclosed please find proposed grease interceptor schedule for buildings A, B & C
COPY TO File
FA2002\20210\D01 \Con•Xmt\Client\BriaWonroe.rmt.doc
1545 Hotel Circle South, Studio 200, Son Diego, California 92108 David Reinker, AIA. President 619.297.0131 (p). 619.294.9534 (i) www.sgpn.com
OLD TOWN LA QUINTA
GREASE INTERCEPTOR SCHEDULE
BUILDING A
January 22, 2003
Suite Square 1
Number
Waste
I ]hterceptor
(
Interceptor
No. Footage
of meal
X
Flow X
Retention X
Storage
=
size
per
Ratio
Time
Factor
peak
(Liquid
peak
capacity)
Interceptor
hour
Footage
capacity)
X
hour
X
B-100 1,899
30
X
6
1 X
A-100 3,089
40
X
6 X
2.5 X
2
=
1200
A-109 1,199
60
X
6 X
2.5 X
1
=
900
A-111 1,225
40
X
6 X
2.5 X
2
=
1200
BUILDING B
Suite Square
Number
Waste
I ]hterceptor
(
No. Footage
of meal
X
Flow
'X
Retention X
Storage = size
per
Ratio
Time
Factor I (Liquid
Number
peak
Waste
capacity)
Interceptor
hour
Footage
of meal
X
Flow
X
B-100 1,899
30
X
6
1 X
2.5 X
2 = 900
B-102 905
1 50
1 X
1 b
1 X
2.5 X
1 = 750
BUILDING C
Suite
Square
Number
Waste
Interceptor
No.
Footage
of meal
X
Flow
X
Retention
X
Storage
= size
per
Ratio
Time
Factor
(Liquid
peak
capacity)
hour
C-100
12,162
1 35
X-1
6
X
2.5
X
2 1=
j 1050
C-102
1,189-1
60
X
1 6
X
2.5 f
X
1
= 900
C-104
1,458
40
=6
X
2.5
X
2
= 1200
C-200
13,026
100
X
1 6
X
2.5
X
2_
3000
Ja1-30-0? 09:26am Fro -WATER DISTRICT/C'JAC!IE!LA VALLEY +11693983T11 T-013 P.02/03 F-420
_ - -- ASSESSQR S PARCEL 04 BER
)UN,I,y IVFR (Gt COCYtfyIUNtTT AaALTH AGENCY_
PAKVU-NT OF ENVIRONMENTAL HEALTH
'10PL1CATION FOR WASTE WATER DISPOSAL APPROVAL
'PUGO+ ;; uo:r•..t tnia lour four (+op'0° or o SGA'' -60V01 Flan (1"+20' w 1`^-10' SCALCI O-a'n :c C"f'ly ;Pe 6teUCn e91n0' tal d On me TtaN d(1
s:n 5a'. A nOn rfil,.oj* Glity ice is regdlts4 .roan ro :pylrcei.on o :vDm:ttad. t n¢cit rtu: be r a0o pOYaCln :o ilia Count R verbi00. AWrovar of irb0
.pnn,riam bn Flt remain .lily fo: a Denod net to ex -0 one -,Mw :TOM oald of Ga)ntn11 i
_
AyEni <;pnlyd4:4f, ,CenldGf PsfeOn
"v mar
L!a•ii ?
Job P;09any A:dlc-
Lot
City
Cil Tp
ol
i)tu or Ferrnd. P/P, SUP. PUP. tue. Legoi Ct:9cciDUoe 06A
oAa:nn . MN Sale prep.. ti::. Id
Date
FOR OFFICE U36 ONLY
C`iFCK BOX lF REQUIRF0
rt any tux it clibac6, (Na application $hdt lae oontlde:eo rejealed unit uta C.1 Detailed Contrive Poi PNni Reauir60 {t to S fp01 interval)
I mr.r'nadon is provl6d and me tae paid. Rolubrnlicari later imam 90 Gays
7pef 3alr. noted Do:ov. tnay rcgvi(o repayrment of Not V OU+er
V U $tJlt HONIng tank Aarc.ame- le Completed .SpeG01'.el Lal lAapeclwn ROrvka0
G .er4fi,:a4on e1 FAnning 5,a. Wilitarn Re1wrod Thomtas e6roa, Page Grid
O WpCB lea ener
1_j Cato La Inap•tcuor, COrrew9d: Inlcials
Rsgwirad
. lA,tath for COH..SAN-007, Santa Ana Region Cnly) Rernarki:
I ;} teat Ps(cm9'lOn Report Raguif66 0 MaintaranaG BOolllet Provided
I Q Faea:owly ba,:f.9 Ropon F60juved I C) Final lmg0 cA b Dapg tmOnt cf Endronincmtal Health '16 IaOuifaO-
i
j TSrevre,v Regl:lmd "two Da'a Please roll 1;4ltovrs FRIDF to a spettion,
liClPf01 a _ _ DBIo
?ercolauon BO"QopoC• By --Palo
-
aN. Map Pa(ie
W Typo —A9provc0 ey DatO
'- No. Owt,ling Unita (111-3-6 9Cw Tenn 5011 Rale Groaid/Sand
i ;:}+rrz: t;•{ No. of ,"lama Type 01 sircmn(e)Gioase {{IntaWL•nl Yrap
U Hdding Tank O Raplasernenl BlINCCT.i. Fiatuf0 Voila t 1 T
C.1 Neer Q AOdldon Qat. Gal.
I U cF'it n9 Connell m 5ewer -
Laach Boo 60 It.
Sq. Fc.
paitani Area
?_ 1 Loacn ii"V
'' ApplicaD e -
F t
1 rJ r ht/ _CI
y
'otel Linear Sidpwall AOowance
n, rock) r nnlllg It. Inaiell Lh e(a) fL loop 9. wide or 8olkm Area
Ir>fat Tocced Depot– -•- Ll NA -0 min lnche: rock Oslew QrairdiMa
Propoaad eoltn+n Tamed Depth w
6Pec:>tit 466i9rr 101 ah+Pal (3) Pit 016Rdter fes. Plls Pit 961av Into
(l31) Sgem Pd a%lrnem OOtCT.
Tota' 09FCt MotA1114*h le
I I )J OIR
Facto+ I ,, 5. . Z5.
IN
Nidi Re"ew RDDr 1ed: _ Data: — --
Gracing Plan APP:ovcd.ae Dale;
Plan Ghdcw on y APPMa zd: amu'
P w. S..
REMARKS: `
wah,r" PprptY4
v
Ynis a;,Dncai,on S APPRO!EKE
Cr the celOQory r} EMO rn diw; syJlarn as i'aloa'ad5e accompanied Netdallrert*f4D :et ICAs m SECTION Fae6RevenueCndelZ abtwo. A building pe(ntil iiUta inalaUOVem of ins 6bJV6• K2.S11 ltl In iFPr dur pli0mrP1 4
yOfR•' 4;GeA-elan 11t,Ly, Cheats A
(?) Sapilc link owsi be too, minimum (rum any walla•
„_ Inti ai
;.) m uo an wens. nelw6lna alrpenGOn oaa
._ .aa.r. I;ne¢,rr.. C6 '00' mlfltty Y
14iI Saw Fr tinea nwt: to 50' rmnlmum RoT cell, wells.
.n 1
(4) `ecpege p.ta rrvrct to t9D' ri.,nirrwm tNm any•vPta. tmwalrtl; s pansbn RIVERStGE: 904-e56-U9t3G
4,QOINDtO: 760-463-7000
SOUTHWEST. 909.600-8100