0005-073 (SFD)F1
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commOicing with Sec.ibn"7000) of Division 3 of the Business and
Psofessiorials Code, and my License is in full force and effect.
tLinse # Lic. Class Exp. Date
4?
. 7 4 A%/14 I88 B
VDte S /-Q Signature of Contractor �` j f
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 C90I.JaI i I:.AOLN DIS, Policy No. NWC,444069-02
(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.
tk,o ate: (2V V Yi`, Applicant a rF V f
4"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
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
We above-mentioned property for,inspection purposes. /
Signature (Owner/Agent) Date
BUILDING PERMITPERMIT#
DATE VALUATION LOT �Y•- \ 0005-073. TRACT
JOB SITE
APN
ADDRESS 79-5Z0 MVINO
76%-4,90-042
OWNER
CONTRACTOR/DESIGNER/ENGINEER
CFNTi RY CROWM L COROAUNI` MS
CEAii'iTRY CI O`V AV1 COMWTNIMS
1535 SO, -D" 9'!__REETT, UTE. 4200
1.535 SO. ".D- MUM, ST& 4200
RAN 73;KRNARDINO CA �J24 0f
SAN r3? i 7?�JTNCy CA 92408
(900381-6007 MLO 2120
USE OF PERMIT
S19MY, 17PA& Y 77`V51 ..T.MG
SYD-IAT I PL 38I2 P1 ;T DOES NOT INCLUDE BLOCK: WALLS OR POOL
75% PIAN CHECK M REDUCTION FOP, MULTIPLE. ISSUANCE OF SAA+4.F
PLA14 TYPE.
CUSTOM CONSTRUCTION -Z815.09 i33I%
PORCHIPATIO 13?.0o sw
0ARACII•ACARPOR'i'
FST1AWrKD COST DIP COY. SIX C"1710N
PERM, FXE SUMMARY
CONSTRUCTION FEE 101-000-418-000 SI,161,59
PLAN CHECK FEE 101-000-439-318 3s'22.47
MECHANICAL FEE 101-000-471.000 x98,$0
Ii 1=TRIG.+P L PEI: 1134 -f2�� x!•2(1-�b0 $i, 2.2I
'; ' •r
FLUMBINO FEE 101.000.419-000 $169,30.
STRONG MOTIOW FEE . M"ID 101-000-241-000 $23.14
� s .
C3R.ADINO FE? 101.000-421-000 $70.00
1 tic,
DEVELOPER IMPACT FLEE
ART IN PUBLIC PLACES - RESI 7 01 -(300 -ass -000 S7S.38`-
1."� wY
SUB -TOTAL CIONVT`ItF, MMON ARD PLAN MIECR
$3,761.70
LESS PR1Ir-PAV3 ,t4J
$0-00
TOTAL FArMWIT FXF0 D'4X 1V()W
&1,761.70
RECEIPT
DATE
BY % t'f
DATE FINALED
INSPECTOR
v
,y.
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
dam/
Return Air
Steel
Combustion Air
Roof Deckwa--ato
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
glsulation
Vents
Fireplace P.L.
Grills
+Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
�Z
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)
N,o 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:',
Jun 1S 00 04:53p
Slodden Engineering
6782 Stanton Ave., Suite E, Buena Park, CA 90621 (562)864-4121, t714')523-0952 Fax(714)523-13 69
39-725 GHrand Ln., 3uite G, Paim Desert, CA 92211 (760)772-3893 Fax (7E0) 772-3895
June 15, 20170
Century Crowell Communities
1535 South "D" Street, Suite 200
Sari Bernardino, California 92408
Attention: Mr. Jack fisher
Project: Tract 28719
Mandarina at the Citrus Course
La Quinta, California
Project No. 544-0049
00-06-259
Ref: Geotechnical Update prepared by Siadden Engineering. dated May 20, 1998, Project
No. 544-8038.
This memo has been prepared it) order to provide formal confirmation of our recent telephone
conversation regarding floor siF.b design for the above referenced project. Specifically;
r(rommendations for floor slab sections and moistureivapor barrier installaticn were. discussed.
As we indicated, a visquccn m..emhrane,`vapor batTier is recommended for areas where moisture
sensitive flooring is-xpecIed. Typically, the membrane is to'be protected with ' inches of sand
above and below to prevent damage during placement and to allow for proper concrete curing.
Because the surfa:x soils on this project,arc generally free of gravel that may result in membrane
damage, it is our opinion that the. 2 inch sand layer underlying the membrane may be emitted.
The rnerabrane may be placed directly upon the native soils and covered with 2 inches cf sand.
If you have questions regarding this letter, please contact the undersigned
RespecAlly submitter:,
SLADDEN ENGIN'EE
'fE'v
7Bron L. Ande soPrincipal Engineer4598911 30.2002
Letter; pc
Copies: 4/Centura! Crowell Communities
p.1
7...
VANVORPE'ttlo J ASSOCIATES, INC.
CONSUL77NLI ENGINEERS
295 N. Rampart Street, Sulte A
Orange, CA WOx6.
Tel: M4) 978-0780 Fax (714) 978-9926
Ann. Jack Fisher
Century Crowell Communities
1535 South D Street, Ste. 200
San Bernardino, CA. 92408
Subject: Mandarina (La Quints; Ca.)
Tract 28179
0
Since 1979.
Facility Planners
Code Consultants.
Structural Engineers
.ire Protection Engineers -
August 15, 2000
Dear .lack,
We have received and reviewed the sk®tch sent to us regarding the shear wall at rear of
dining/den for plan 3. It is acceptable td have a cripple wall over the shear wall with structural
sheathing as shown on the attached skbtch,
If you have any questions, please contiet Steve Trieu of our office.
Very truly yours,
VANDORPE CHOU ASSOCIATES:
�o Qp,Of ESS ptiN.
��elb SNE UNG ,c
yel��Aot15EMIr
'
Robert Chou. S.E.
SP o
Cr. S-003518
Att: Figure I. 03-31'04
FAUr,hP11ee120(XhCCC 1682Ttdd03 (Plan 3 den).wpd ��r£ CTURP��\P
�� CA1.tiF0
Wq
s"(4 I
VANDORPWCMOU ASSOCIATES, INC.
CONSLIOA. �# ENGINEERS
296 N. Rampart Street, Suite A
Orange, CA -02M
Tel: (714) 978.760 Fax (714) 978.9926
Attn. Jack Fisher
Century Crowell Communities
1535 South D Street, Ste. 200
San Bernardino, CA., 92408
Subject: Mandarina (L'aQuintr:k-Ca.)
Tract 28179
Dear Jack,
Since 1979:
Facility Planners
Code Consultants
Structural Engineers
Fire Protection Engineers
August 11, 2000
We have received and reviewed the.sketch sent to us regarding the connection o: cube steel
columns to 6x12 wood beams at the reiw:of plats 3. It is acceptable to omit two 1301ts from the top
of the tube steel to the beam as shown'an the attached sketch.
If you have any questions, please cont Sharad Patel of our office.
Very truly yours,
VA O E CH U IATES: •:
Robert Chou, S.E.
SP
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