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SOTB (05-3109)P.O. BOX 1504 ^' VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 7/21/05 Application Number: 05-00003109 Owner: Property Address: 81245 MUIRFIELD VILLAGE TERRY, DAVID APN: 762-410-012- - - O81-245 MUIRFIELD VILLAGE Application description: STRUCTURES OTHER THAN BUILDINGS LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 5000 ✓�� O ontractor: Applicant: Architect or Engineer: Cary �� ALDERETE POOLS I I , INC. l�jNq R� OS WCC: STATE FUND WC: 1744999-2004 12/01/05 Clo /V ^ C, --0� ��FpTTq CSLB: 828284 12/31/05 LICENSED CONTRACTOR'S 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 Class:�J-License No.: / ,,d-a,e: ontractor: f-%�L GLf' f0e90 ( s OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he.or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she 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, 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 and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the 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 or she did not build or improve for the purpose of sale.). 1 _ 1 1, as owner of, the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044,. Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon,, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMLT 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 and policy number are: Carrier C53 Policy Number - - - - - - - - - - - - - - - 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 700 of the Labor Co/de, I shall forth_wiiNthhlgompl �,wiitthh those provisions. ate: Applicant:./ ��VIJ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. APPLICANT ACKNOWLEDGEMENT .IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this 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 application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 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 county ordinances and state laws relating to building cons ruction, and here y auth 2e representatives of this un)y to enter upon the above-mentioned property for i actio u se D 42���Signature (Applica t —.1 494" Application Number . . . 05-00003109 Permit BUILDING PERMIT Additional desc . Permit Fee . . . . 72.00 Plan Check Fee 46.80 Issue Date . . . . Valuation . . . . 5000 Expiration Date 1/17/06 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 9.0000 --------------------------------------------------"-------------------------- THOU BLDG 2,001-25,000 27.00 Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee . . . . 15.90 Plan Check Fee 3.98 Issue Date . . . .' Valuation . . . . 0 Expiration Date . . 1/17/06 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 .4500 ---------------------------------------------------------------------------- EA ELEC DEVICE/FIXTURE >20 .90 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 21.00 Plan Check Fee 5.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/17/06 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 6.00 -----------------------------------7---------------------------------------- Special Notes and Comments GAS BARBEQUE AND GAS FIREPLACE ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 4.68 Fee summary Charged --------------------------- ---------- Paid Credited -------------------- Due Permit Fee Total 108.90 .00 .00 108.90 Plan Check Total 56.03 .00 .00 56.03 Other Fee Total 4.68 .00 .00 4.68 Grand Total 169.61 .00 .00 169.61 LQPERMIT Total Permit Fees din,/ City of La Quints.' Pefinit # Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quints, CA 92253 - (760) 777-7012 Project Building Perm it APPlication and Tracking Sheet Address: 2.��- ;A ,t � - A. P: Number. r V" f v , l( ' Owner's N ame:J d l -e/� ✓L Legal Description:` Address: g f - Contractor: �D Cih'. ST, Zip: L44- iN i Z Z (4?Addr ess: D �n7 Telephone: �l Ciq•, ST, Zip: (� Z 9 Project Description: Telephone: S S -t. $3 . Sts State Lic.#: �2 G' I �S ��� v -e— A eLc City Lic. #: - Arch., Engr., Designer: . Address: - City, ST, Zip: Telephone: Statc Lic. #: Construction Type: Occu an 1:v: p Name of Contact Person: Project type (circle one):. Nc%% Add'n Alter Repair Demo Telephone # of Contact Person: '1'St.one $ # Units- Estimated Value of Project: �S # opo APPLICANT: DO NOT WRITE BELOW THIS LINE Submittal Rc9'd Recd Plan Sets TRACKING* PERMIT FEES Plan Check submitted Structural Calcs. Reviewed, ready for corrections 1i/ V Item Amounl Truss'Calcs. Plat, Check Deposit .Called Contact Person Title 24 Calcs: flan Check Balance Flood plain plan Plans picked up Construction >t 30T18 Plans resubmitted Grading plan Mechanical -F Subcontactor List 2" Revicw, ready for corrections/issue Called Flectrical Z 4:1gve4_ Contact Person Grant Deed Plans picked up Plumbing1(�gS - D JTti7S . II.O.A. Aptiroval S.M.I. Plans. resubmitted' INI(OUSE:- Grading PfanningApproval Revien• eddy for corrections/issue Developer Impact Fee Called Contact Person Pub. INT's. Appr [ A.I.P.['. Date of permit issue School Fees Total Permit Fees ,/—STACX STONE SlOrt MEW GRASS POOL GRASS SPA POURED STIEP STONES B.S.O. EXISTING RESIOENCE 0 _0 ClW OF LA QUI TA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE SJ-01� BY 6 I CENERALSPECInCATIONS I I KW CAPACI tV I-7 n Vpr5- joiETS/p LTi EA LOWER Address:.18 P, ALDrRFTE POOLS M INC POO L-&SPAS-LANUSCAt% . u CbNsr- A 828264.' P.O. Box 5219 - (760) 773-3291 offloe LaQuirtta',CA92248 (760) 275-5793 cell r.. extend your lining space to the outdoors with... Oo OUTDOOR LIVING PRODUCTS.M Create the outdoor living space you have always dreamed of with _ Outdoor Living Products (OLP). .4, — Gather outdoors around the new centerpiece in your outdoor living room. Choose from a variety of colors to complement the appearance of your home. www.bolp.com 1 -800 -916 -BO LP LOG SET NOT INCLUDED r - SOUTDOOR LIVING PRODUCTS.. Envision the beauty and charm of an outdoor fireplace. • Outdoor Living Products are hand crafted to last a lifetime. • OLP model 300 fireplace is portable and can be moved to a new location at a later date. • All fireplaces are available in four colors to complement the appearance of your home. • OLP's Patent -pending design and assembly allows for installation in 30 minutes in most cases. • All of our fireplaces feature an attractive mantel to display decorative items. • OLP's firebox measures 30"x 30". • A traditional running bond pattern in all fireboxes is standard. OLP-model 300N Outdoor Living Products (OLP) are manufactured with Glass Fiber Reinforced Concrete (G.FR.C.). This mixture of cement, fiberglass strands, sand, and acrylic allows our line of products to be manufactured thinner which reduces the weight and increases the strength without the same cracking you would experience with regular concrete. The G.FR.C. formula has been used on exterior building systems for years and has proven to be a time tested winner. Our team at OLP has four generations of experience with building and designing outdoor living spaces in the western United States. We take pride in knowing the hardscapes we have designed and built have been enjoyed for many years and will continue to last for years to come. We have developed our exclusive manufacturing process with the same philosophy that has served our hardscape business for generations, Quality -Service -Innovation -Pride. See Warranty Card* Gas requirements 1. Fitted with 1/2" male adapter for your gas line. Fireplace placement Do not place OLP model 300 under overhead combustible areas. Maintain adequate clearances over the OLP model 300 at all times. Use only in well ventilated areas. This product is for outdoor use only. *Cracking and damage to exterior surface and color due to improper use are not covered in this warranty Dealer Information "Be An Outdoor (icing Products Bee%r" 62.5" 44" 56" 60" BROWN 49TAN; `.�. -=: CY 12" i 30" ``• *Sp�- q 949 733 4320 09/25/02 WED 09:19 FAX 949 733 4320 CSA/IAS Irvine t�- CSA INTERNATIONAL Certificate of Compliance Certificate: 1355624 Master Contract: 217348 Project: 1355624 Date Issued: 2002-09-24 Issued to: Grand Effects 10 Argento Dr. , MISSION VIEJO, CA 92692 USA Attention: Mr. Kevin Doud The products listed below are eligible to bear the CSA Mark shown with adjacent indicator 'US' (s ® Issued by: Trinidad o Igo:101'.. US Authorized by: Len Bardsley Operations Manager PRODUCTS 2731-82 x . LIGHTING (GAS) Outdoor Decorative Type Model Number For Use With Natural Gas Illuminating Appliance for Outdoor Installation W Minimum Maximum Input Rating Input Rating Trade name: GRAND EFFECTS 80, APPLICABLE REQUIREMENTS �% ,r- _ OI o O O I.A.S. Requirement 8-96 Gas -Fired Decorative Illu ing pp lanc or ut oor sta anon MARKINGS All markings and printed instructions are in compliance with the above-mentioned requirements. [a 003 The 'US' indicator adjacent to the CSA Mark signifies that the product has been evaluated to the applicable ANSVUL Standards, for use in the U.S.. This 'US' indicator includes products eligible to bear the 'NRTU indicator. NRTI. i.e. National Recognized Testing Laboratory, is a designation granted by the U.S. Occupational Safety and Health Administration (OSHA) to laboratories which have been recognized to perform certification to U.S. Standards. 05/24/2005 09:39 FAX 562 916 7767 SOUTDOOR uvi pRODUC 1 STM OUTDOOR LIVING PRODUCTS Fireplaces TEL# (800) 916-BOLP / FAC# (562)9164767 Barbeques BenchesCON, rIDENTIAL TRANSMITTAL j planters r= COMER LETTER of Pages to Follow EMO: -.1 00-1 21205 No.rwalR eiq. • N-aaaiiaii Gardens, Ch 90716 • lel: 562-916-7755 1 tax; 562.916-7767 05/24/2005 09:39 FAX 562 916 7767 OUTDOOR LIVING PRODUCTS 22 05 !1:190 SA CUSTOMER C311ft-FbUFY FntCrprlSe8 uO N Joy St corkinA CA 92979.1561 us -A Model >\umt�t'r 1'.Og Lighter 711, 712, 302 law 3 C:ertification Record FILE 3371-0 VALVFS (:crjjfit!d to U.S. Stan -duds Refer to Clash Description for program details Tj NO (.-SA lrW-M3jh0.ql A'l oglics wood. Z002 P. Page I of .1 Input Rat! llg. 3U,000 0 WO -33— 3/16/2005 htkpJ!(1ij 05!24/2005 09:40 FAX 562 916 7767 OUTDOOR LIVING PRODUCTS G3A iNIMAt10NAL • Certincate o Compltance* Certwcate: 1064563 (112829-a) Pruject: 1107919 kisuad to: Canterbury Enterprises P.O. Box 16369 Irvine, California 92623 USA Anestim, Lisa Leighton Master W>atract: 188694 Date lmilml. Feh►-aary 22, 2030 !•lie products listed below are ellgPle to bear the CS -4 M4rk show" with adjacent indicators 'C" and 'US' Issued tl}: Bret Ekstrand CK C us Signature: L -f n yp9? �.-M 633771.0# VALVES (GAS) General LJse 3371-98 VALVES (GAS) General Use dotal Number lwct out'ct Sire Ler Use VYiW Natuak MM.,Mirad. L:qucdicdFeaalcuanGaza and LP Cos -Aix raizeurao gaKic ; rade Name. DAN l b l,'2 LLA -2 For Use 1V:tb Ala -'u-* Y-fe , MiwA Ligeef ed Petroieuin Gases anc► L? tins-Ais A4ixturt. 5`tcaight ':tedc Nam: DANTE 1(2 LOL-2 Z003 T!tc Vow US µ,G,�tr ayj>c�t to Q+e CSA Marl: eigM1fiea tut der v odu.e tnt been eva7aabw t the aPplicaMe AWSJ UL aid GSA &at+� goldm eA b3* Me U.S. a ;)S. s.d C&nad& n,6 iddudesr uduets cUole b Sew ft NRTL mdiramr. NRTL, i.e. Natibe *04 dot VD V A.% m :erti0cadva t�.S- Orn WspvR:l SafcO' and Hratb AdimmS 604 MHA/ to :Av4Wvia wS,-k hava Lsac+rerolP PO°t DQD 34TWO 2CCCAWl7--.._..-.r_.. 05.24/2005 09:40 FAY. 562 916 7767 OUTDOOR LIVING PRODUCTS kT004 Fire Place Cnnstruciion SLP mo- Ae1309 n ,) C�CfU:1Y remove all parts from pallet. 2.) Place fireplace hearth in desired location for fireplace. (Do not place under any combustible aaaterial. Keep all combustible materials at least 12 inches from fireplace•) 3.) Place fireplace mid section on top of the hearth• Make sure the back of the hearth and the back of the Haid section are flash. Line up the pre drilled holes inside the raid section with the pre drilled holes on the heartb. 4.) Bolt together the mid section and the hearth with the bolts, washers and nuts provided. lPtko eDSiA fkO111 5.) Lay bottom piece of fwebux inside mid sectiorL The groove on the back of bottom piece should be towards the back of the mid section, 6.) Slide the back panel through the top of the mid section and the back panel should rest in the groove on the back of the bottom panel. 7.) Slide the side panel without the hole through the top of the mid section and let it rest in the left or right groove opposite the gas line. �.) Slide the side panel with the hole, through the top of the add section and let it rest on the top of the bottom piece of the firebox. Thread the gas flex line through the hole in the side panel. Now place the side panel in the groove of the bottom piece of the firebox next to the gas line. 9.) Slip the 2 concrete wedges provided, behind the top of the back panel of the firebox to interlock. the Firebox together. (Refer to the firebox detail) ' r 10.) Slide the mantle piece over the mid section so it rests securely. �.) Make sure you hire a licensed contractor to hook up the gas to your new fireplace. -7755 For any questions call (562) 916 . 05./24/2005 09.40 FAX 562 916 7767 OUTDOOR LIVING PRODUCTS MATERIAL SAFETY DATA SHEET UR CAST 27 Page ........ Print Dide .... Revised ...... MSOS No 3. EXPO51JRE CONTROI.JPERSONAL PF?OTF-CV0.N Yentiiation ............... : Pfcvide adeqW4te reran vert'.1lation and kcal venblati--)n to caned mast ander oust levels below the TLV. Z005 3 of 4 January Z9, 1998 September 4, 1997 61000540 P3rsona! .7rojective Eqjjpmq.i! Eves ....... ....... G0qg:e!j . SK -11 .. ................. 1-0 1'. g HdzBrCG 15 ne--cofriDosition Qust Task Glovec 9. PHYSICAL ANO CHEMICAL PROPERTIES soil,nc Point ........... Yapcx P-essure ..... . ... vapor Denssty ............ soluol:i:y in Water ......... Vgl*i:ng P.)i!l* 0?.1 ........... ......... ' `b, STABIL" AND REACTiVrrY hlor Applicallo. Not AprilrabW. Nf)' , Appl:cab!c;. slignt P.0 >270C*F 11 .5 (10% Aqueous Slurry) and pmssurc, ftompalible MAterlals and C,o;jCiijor!; to Avcid ....... N'Ofle, Pj!-.;Meriza-,'on 'Vii! nct HdzBrCG 15 ne--cofriDosition will no; c.ccur, 11. TOXICOLOGICAL_ IN FORMA' 1ION Thers are -,c ',,r.owr, !-ieal!h eler.7. ,iat, -a-1 arlse "rorn 0a arrnanufacIured t -,*R o,'AST 27. There Is no evidence to s�SgeC'hai I..tF' CAST 2';'!isell:s carcir.ogeni4. 12. ECOLOGICAL INFORMATION t; F1 CAST ;-1)7 15 virtually insQ;ublo and immobile old poses, ne tr.rear. is tt-,4L orwironrnant:1 wxident3l(y eleasej on land or into water. 13. DISPOSAL (7-ONSiMPATIONS UR CAST 2, e.s-manufacwreo it not considered a 1" wPWO. L%elCre cestruclion c' the fetra,To .j CUSIV,le"'; a'-�, acWsecl to evaluate any -hangaz to tree Tay =cifr by ilie inpmcucdor. 0` cx;dqicr.s outside ,he :,)r:.,.rc1 of It -.e vfcndor. I? •d 9900 -SCS OTC zj3w.aur 831.Zlod cigs:cu SO , 7 Uer 05/24/2005 09:41 FAIL 562 916 7767 OUTDOOR LIVING PRODUCTS 008 II MATERIAL SAFETY DATA SHEET UR CAST 27 .......... 4 of 4 I. Priam Date ....: January 2g,igga Revised....... September S.1997 II WDS No..—: 61000540 II 14. TRANSPORT INFORMATION L'A CAST 27 is not a DOT Havamous MatGrI&I and contains no DOT :Hazardous oompoments. 15. REGULATORY INFORMATION Saclion 2 lists OSHA expo3vre limits for chemicals considered by OW to be air cc 16. OTHER INFOFIMATIQN Although reasonable care nas been xake:i in The proparallon of Itle information conlaioeiJ herein. `.'he Pryor -Giggey Ccfn,pan,/ exlends no warranties, makes no nsoreserW.0on5 aril assumes no responsibility as io the acc-iracy or sumbifity ct rwc` informaliz for app)icarlcr. W pj)rchQSer1S;nTence0 oqrposaS or tor consequfmces of :t5 5"j 0880 SES 01c a3WSLJM NZILLN04 gigs :cu so 30