9801-135 (RR)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Fes— ' Chapt6r 9 (commencing with Section 7000) of Division 3 of the Business and
04 W Professionals Code, and my License is in full force and effect.
O =) M License # Lic. Class Exp. Date
r, -Q U.)' W
t`
oZ r,_ Date Signature of Contractor
�O�
J U C> OWNER -BUILDER DECLARATION
W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's
~ tl License Law for the following reason:
Z_ (t/ 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 (Seca 7044, Business & Professionals
Code).
c'`) () I am exempt under Section , B&P.C. for this reason
LO
O N /Date / - ? 2 C, ,�� Signature of Ownerj , � �1 .+
_. / �.
a Q WORKER'S COMPENSATION DECLARATION
p � I hereby affirm under penalty of perjury one of the following declarations:
U-) 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 � Q performance of the work for which this permit is issued.
C0 Q I have and will maintain workers' compensation insurance, as required by
p U QSectjon 3700 of the Labor Code, for the performance of the work for which this
0- rn 1 --permit is issued. My workers' compensation insurance carrier & policy no. are:
NJ- Z Carrier Policy No.
o
�a
Q (This section need not be completed if the permit valuation is for $100.00 or less).
( ,4 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. A-:7
Date: �_� 4 Applicant 4�4A 1
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
11110 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 purposes.
Signature (Owner/Agent) ✓ 4,,+1.t . V Date A..)
BUILDINGPERMIT
PERMIT#
CONNTTTR/wO��L#
DATE VALUATION LOT
"x3� TRACT
c V V 5 O
1/23/98 $3,500.00
JOB SITE
ADDRESS
APN
52-60 ANTNIDA CAR AWA
773-291-0@$
OWNER
CONTRACTOR/DESIGNER/ENGINEER
TERRIE UNNL`IT
OWNER / BUILDER
526x,0 AVENIDA CARRANZA
€ A QUINTAL CA 92253
�)�L#
USE OF PERMIT
Fit it , ll c.
%c.t�ifWE %XISUNG CRAWL R00FTNG ANL► .WTLACE TAMP' (ICBM
ti4W*), CT;ASS W ROOF 1'RX.
RER00F
3,500.00 LS
b;S'i"INIA'1'ED COST
OF CONS'1"RITUCI(ON
3, t#I.tNt
PERMIT FEE SUNI.14AfCY
REP10017 FEF I ti l. -()UO -•t I R�{)t)
530,t eu
PAID
JAN 2 3 799
C'17 -Y OF: LA
QU
rk�i'a
t
SCTI3-'I1Tr11 CC}WIRUMON
AN]) PLAN CHECK
�:att LNt
LESS PRE -PAID FEES
ULD()
TOTAL PERMIT FEES DLTE NOW
S30.D0
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
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 APPROV LS
POOLS - SPAS
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
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:
OWNER / BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/ Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his.or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law; contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who."are not licensed contractors are allowed to perform their
work personally or through their own employees, withouva licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing'to tie contractors is to secure an "Owner/ Builder" building
permit, erroneously implying that the property owner is.providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing "their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quints, CA 92253
(760)777-7012
FAX: (760) 777-7011
f 23-9�1`
T-'
OWNER'S SIGNATURE/DATE
PROPERTY ADDRESS
qoo L - 13
PERMIT NUMBER(s)
15-5,, Wish PF
December 18, 1997
Mr. Mark Harrold
City of La Quinta
Department of Building and Safety
78-495 Calle Tampico
La Quinta, California 92253
STRUCTURAL ENGINEERING CONSULTANT
54625 AVENIDA BERMUDAS. LA QUINTA CALIFORNIA 92253
Regarding: Bennett Residence Roof Report — 52660 Carranza, La Quinta
Dear Mark:
760.564.0884 PHONE 111 760.771.3606 FAX •
WISH@CYBERG8T.COM
I performed a roof inspection on the residence located at 52660 Carranza on Friday, December 12. The home is approximately twenty
years old and is constructed with 2x4 plated roof trusses. The connections are made with a proprietary, light -gauge steel side plate that
is connected to the wood with nails. The plates predate those used by the local truss companies. This makes it difficult to verify the
load capacity for each member without extensive analysis.
The existing roofing materials consist of:
Roof Materials
Dead Load in PSF
Composition Roofing with Rock Finish
6.0 psf
1/2" Plywood Sheathing
1.5 psf
2x4 Trusses at 24" o%
2.5 psf
I/z" Gypsum Ceiling
3.0 psf
R30 or equivalent Blown -in Insulation
2.0 psf
Miscellaneous loads not accounted for
1 1.0
sf
Total Roof Dead Load
16.0
psf
The existing structural framing is very good with no noticeable signs of deflection. The length of the eaves that compensate for .
possible top chord deflections helps this. The span of the trusses does not exceed 30'-0" (+/-) and the top chord of the truss is braced
by a compression strut located symmetrical at each side of the ridge. This appears to be placed at or near locations of interior partitions
which help brace the upper chord from deflection.
The slope of the roof appears to be approximately 4:12, which reduces the live load to 16 psf per code. I would not expect ponding or
deflection to be a problem on this residence. The roof framing above the garage door is parallel to the door header. Therefore, the
chapge in roofing materials will have no noticeable affect upon the existing header.
The client has purchased an Eagle Brand lightweight the that does not exceed 6.0 pounds per square foot. This is comparable to the
weight of the existing composition roof (approximately 4.5 psf) and the additional white rock finish (approximately 1.5 psf). It is
therefore my professional opinion that this roof is capable of accepting the change to lightweight Eagle Tiles.
Tho owner / builder will provide the city building official with the ICBG number and material specification from Eagle Tile before
loading the roof. The owner / builder will also take precautions as noted in the stacking and distribution of the roof tiles. The client
shall notify my office immediately at any time a deflection or bending becomes noticeable at the eaves or in any structural header
throughout the home. The engineer shall determine the cause and provide additional restraint to correct the problem before installation
STRUCTURAL ENGINEERING FOR - CUSTOM HOMES - REMODEL - COMMERCIAL - LIGHT INDUSTRIAL.- SEISMIC RETROFIT &. REPAIR - UNREINFORCED MASONRY - RETAINING WALLS & FOUNDATION - REPORTS:
DAMAGE ASSESSMENT - NEW ROOF - INSURANCE CLAIM - DENNIS S. WISH P.E. HAS BEEN A MEMBER OF THE STRUCTURAL ENGINEERS ASSOCIATION OF SOUTHERN CALIFORNIA SINCE 1983
4 -
of the tiles can proceed.
Conclusion:
Page 2 of 2
It is myprofessional opinion that the roof be restricted to lightweight tiles not to exceed 6.0 pounds per square foot. The following
cautions shall be adhered to and the engineer notified of any deviations noticed during construction.
CAUTION:
1. Extreme caution should be practiced applying loads to the roof, which match or exceed the approximated weight of the existing
materials. A different dead load value may have been assumed by the original truss manufacture that is no longer available for
comparison.
2. The contractor shall not load or stack roof tiles above or behind any long span headers or beams. This includes, but is not limited
to, garage header, beams above sliding glass patio doors, intermediate beams such as those in the living -room, or any opening
exceeding 4'-0" in width. All materials shall be located above solid bearing walls that can transfer the stacked weight to a
foundation.
3. The contractor (owner -builder) shall be aware of all changes to structural members including beams and joists. Changes such as
difficulty closing doors and windows shall be reported to the engineer of record for possible remedial work-
4.
ork
4. The contractor shall look for damaged joists or rafters prior to loading the roof. Joist with imperfections or knots located in the
middle half of the beam on or near the bottom edge of joist that may fail during loading. These joists are to be replaced or a new
joist may be sistered to the existing to compensate for the imperfection. This report can not guarantee the uniform quality of the
existing materials and special• caution should be exercised to prevent possible damage.
The difference in weight of the existing roofing and new tile may have an effect upon deflection at the roof eave. Truss tails are
assumed to be continuous. Where excessive or noticeable deflections occur at extended eave, the engineer shall be notified to
determine the cause and to provide remedial measures.
6. It is outside of the scope of this report to redesign the lateral system of the home based upon the additional materials applied. A
general comparative analysis of wind and seismic forces generally concludes that the design of lightweight wood structures such
as this are governed by wind loads in their weak direction (least depth diaphragm). Therefore it is safe to assume that the
difference in the weight of lightweight tile compared to composition roofing and rock will result in no change or very negligible
changes to the lateral load applied to the building.
Please n me at your earliest convenience should you require any additional information for acceptance of this material.
O??,Of ESS/pN
Since � �F2
DENNIs & WISH
NO. C-wi b0
De s S. Wish PE �j .1 ' g
Structural Engineering Consultant
Notice
1
This review or inspection is limited in scope. We have made a visual inspection or reviewed existing framing plans of the building. Because many structural conditions
cannot be verified, certain assumptions have been made. These assumptions, which include facts relating to the original design, the structural properties of building
mat rials and actual construction practices, cannot easily be verified without destructive testing or exposure of the structural framing. Verification, if possible, would
entail considerable effort and expense and is beyond the scope of this project. Any conclusions or recommendations included in our report may therefore be based on
professional opinion and experience rather than known conditions. This report is not intended to cover mechanical, electrical, architectural, geologic or other features
not specifically noted.
STRUCTURAL ENGINEERING FOR • CUSTOM HOMES • REMODEL • COMMERCIAL .• LIGHT INDUSTRIAL • SEISMIC RETROFIT & REPAIR • UNREINFORCED MASONRY • RETAINING WALLS.&.FOUNDATION.• REPORTS:
DAMAGE ASSESSMENT • NEW ROOF • INSURANCE CLAIM • DENNIS S. WISH P.E. HAS BEEN A MEMBER OF THE STRUCTURAL ENGINEERS ASSOCIATION OF SOUTHERN CALIFORNIA SINCE 1983'