0002-280 (CONR)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 and effect.
License # Lic. Class Exp. Date
Date 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 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 Policy No.
(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 shall forthwith comply with those provisions.
Date: Applicant
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 purposes.
Signature (Owner/Agent) Date
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 2-26 TRACT
w.�ctDt,5Q4$0
JOB SITE
ADDRESS�}
_,TCM ,� C�'Z�W_r
APN
OWNER
CONTRACTOR/DESIGNER/ENGINEER
WOKTOP lti!tCGONUC 11W*
xWXS'MT',): OUMM a1c
`750141MM
?6-401 Y:E 0,14W.YY I I I
S.A14 VIRGO QA 92101
L& QtiWA C& 9.22,53
(760)771.3363 363 G73Y o
USE OF PERMIT
2SI15.1+. C{?MN9Oip ATZA..A PQOI,�T� .R� 00
" ALUAT104
EMMA D COST OF CC-WERtTC'1` M
SAMM
k'. IMMM sumany
PLAN CHIRCK M $52,65
CONSTRUCTION ION semE 101,:000-418-000 $81.00
Ml?t',4AMIC.AL IFFE 101-000.421.000 $X50
ELECTRIC A1,PEE 101-000.420-000 $70.16
PLUMBING iTSR 101.000-419000 $99.00
QTL.Q.CiI? fli i ? 101-000,423-000 $20.00
' � e. ; .•
STRONG Mid TM FEE - COMM 10040004.141.000 $1.06
= _J
,14 - t'
KM -TOTAL COWLT k2TJCT10 AM KM CMM �
� $308,37
= S
RE PAM FMS
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sky
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RECEIPT
DATE
BY
DATE I ALD
I 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
Q
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 Firewatl
Exterior Lath
Drywall - Int. Lath
/ pD
i
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
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
$ jj
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:
Bin. -#'City of La Quinta
Building 81 Safery Division
P.O. Box 1504
'Pew # 78-495 Calle Tampico
La Quinta, CA 92253
Building Permit Application and Tracking Sheet,
Project Address: K C Owner's Name:x
A. P. Number: x Address: e-
Legal Description: City,ST, Zip: S C"
Cotitractor:x un5 l S� .ccgjvt Telephone: 6
Address: 'l < 11 54- 3 %qD Project Description:���,�-�„
Cit) -.ST. Zip: iLAoe
D
Telephone: --
e 7
G � sem' ?,i
State Lic. 70 10 3
City Lic. #:
Arch.. Engr.. Designer:
Address:
City. ST. Zip:
Telephone:
State Lic.
Name of Contact Person:
Telephone = of Contact Person:
6M
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Construction Type: Occupancy:
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Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: TO Units:
Estimated Value of Project: O _ o IF; 7
I I r
t'I!eb 012 00 12:51p Earth Systems Consultants 7GO 345-7315
Earth Systems Consultants
Southwest 79-J 1 113 Country Club Drive
L;clmuda Llunrs, CA 91 01
(760) W4 I i\S
(800)924.7Q15
I'.'AX (760) 345-'315
FACSIMILE MEMORANDUM
Page: 1 of 1
To: Bob Haig cc: Mark Swanson
Company: Trans West Housing, Inc. Swanson & Asociates
Fax #: (619) 696-6949 (858) 576-3264
From: Shelton L. Stringer, GE
Date: 02/02/00
Project: PGA West -Augusta Phase IV, Tracts 28410-1&-2, La Q6inta, CA
ESCSW Project No: 06372-01 Document No: 00-02-703
1997 UNIFORM BUILDING CODE (UBC) SEISMIC PARAMETERS, Chapter 16
Seismic Zone.- 4
Seismic Zone Factor, Z: 0.4
Soil Profile Type- S p
Seismic Source Type:
A
Closest Distance to Known Seismic Source:
12.5
Near Source Factor, Na:
1.00
Near Source Factor, Nv:
1.10
Seismic Coefficient, Ca:
0.44
Seismic Coefficient, Cv:
0.70
Reference
Figure 16-2
Table 16-1
Table 16-J
Table 16-U
km = 7.8 miles ** San Andreas Fault
Table 16-S
Table 16-T
= 0.44Na Table 16-Q
= 0.64Nv Table 16-R
** Note: actual distances for each lot vary by about 0.1 km, but do not change the seismic
coeficients values
Respectfully yours,
Shelton L. Stringer, GE
Vice President
?r
UJ Ift2
Ca
F�1FCli'M aP�f
\�9TFOF CP.I�Fi�f
3914 Murphy Canyon Rd.
Suite A-130
San Diego. CA 92123
Phone (858) 5763260
Fax (858) 5763264
March 24, 2000
City of La Quinta Building Department, c / o
TransWest Housing at Plaza La Quinta
78-401F
Highway 111
La Quinta, CA 92253
Attn: Mr. Bo Kuo
Subj: Accessory Building @ PGA West
Attn.: CITY BUILDING OFFICIAL
Subject: PGA West
This is in response to your request to review the factory roof truss by Spates Fabricators and
verify that the design engineer of record for the roof truss components has incorporated the design
forces specified by my building design.
The following language should serve as satisfying your requirement, as recommended by the
California Board for Professional Engineers;
The Engineer of Record (EOR) has reviewed the building components engineered by others in
these truss calculations and drawings for compliance with the project spec cations. The
interface between these components and the project has been reviewed for conformance with
the appropriate building codes. The EOR was not in responsible charge for the design but did
provide the specifications and design criteria to which these components were designed and
reviewed.
Thank you,
Mark 0rson