9609-099 (RR)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
' 621136 t3 til' '`�i'
Date 497 „� Signature of Contractor y%
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 Sss ye�d M�wkers' compensation insurance carer& Bohfygno: 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 3790 of the. Labor
Code, I shall forthwith comply with thos provisions. .j{
Date: ? Applicant—' .v _* -4/�, }J
Warning: Failure to secure Work ers rCompe sation covers a 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 agreeto"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 spection purposes.
Signature (Owner/Agent) ��*tt a � - Date Q 12-6i'l
PERMIT # CONTROL #
BUILDING PERMIT
9609A)94) 4022
DATE 9/ ()1% VALUATION $4990000t LOT, TRACT
JOB SITE
ADDRESS '77-94 / LAC -0 R.f) . -
APN
OWNER
CONTRACTOR / DESIGNER / ENGINEER
JIL IMU,<;.VITY
f i s1;+2 t"i' oz.srplfic 'JON
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S=iit05.AV8 C:�`►fCltfcNZA
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LA Q TNI' A. CA. Q:!'2. is
CBL# 2968
USE OF PERMIT
Ott^' at e:N'A`I/41.:.E2EMIOIX3,-,
KiTISAITH ROWAX11 y
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.
PL 01 C;$IRC'k1: '40t -OW -439-318 5155. f1
C01wr}?;ti.r"'€'40'N FRIU: 10.1-000-4:1,34)00 $408.00
EJ>i~C"l (CAL t iOi Q([ia4 0 c"lOt? $2f.7y
4
CO
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crD
Ltf
SUO=TOTAL C0N3TkUCT%0N AN0 PLAN CFMCK
$697.95
LES `P+R .',P IDFEIRS
40.00
TZ IYUr
TOTAL -PE RAW FIG, jNOW
RECEIPT
DATE
BY.
DATE FINALED
INSPECTOR
. r- —
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 Q
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 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 I
Gas Piping
PLUMBING APPROVALS
If
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:
GOUVIS ENGINEERING
• C A L 1 F O R N I A •
August 30, 1996
Integrity Construction
P.O. Box 98
La Quinta, CA 92253
Attn: Terry Smith
Re: Murphy Remodel
77947 Lago Road in La Quinta, CA
- Remove wall at side of kitchen
G.E.C. Job No. 20038
Dear Terry:
Pursuant to your request regarding the above captioned
project, we submit the following:
In order to remove the wall at side of the kitchen add a
5-1/8" x 15" glu-lam flush beam and replace the existing
4x10 header at rear of the kitchen wi-th'a•3-1/2" x 9-1/2"
paralam header per the attached partial framing plan and
details A, B and C.
Note: Please verify the above with building department
prior to construction.
If you have any questions, please do not hesitate to
contact this office.
Sincerely,
GOUVIS ENGINEERING
'1
ee m
President QROFE Oti Pr
SJB;ig
20038232.1tr
attachments (6)
Cl) (,1
UJ No. C 38276 z
Cem
m
Exp. 3/31/97
97F CIVIC 9 -
OF CA0
rangie
je t Manager
GOUVIS ENGINEERING GROUP OF COMPANIES WITH OFFICES IN.•
4400 CAMPUS DRIVE, SUITE • NEWPORT BEACH, CALIFORNIA 92660 • (714) 752-1612 • FAX (714) 752-5321
2150 EAST TAHOUITZ CANYON, SUITE 9 • PALM SPRINGS, CALIFORNIA 92262 :C(619).323 -5090
_,,.O FAX (619) 325-2863
5465.MOREHOUSE DR/ VE, SUITE 100 SAN DIEGO, CALIFORAL4 92121 41 -FAX(619)6-23-0278
FIELD OFFICES : LAS VEGAS (702) 597-2005 • FAX (702) 597-0905 • MILPITAS (408)263-3016* FAX(408)263-3714
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SHEET
JOB NO.
PLANNNO .:Mut
DATE . 4�_y 3& !lD
NEW CEILING BM. AT SIDE OF KITCHEN
OVER-ALL LENGTH: 22.00 RCTS AT: .00 22.00
APPLIED LOADS (DOWN +)
265 FROM 0 TO 12 -45A14/t-4"_ TL LOAD #/LF
20 FROM - 12 0 22 0,1. * P'TL LOAD #/LF
2120 AT 0.5 CONC LOAD #
3202.5 AT 6.25 e GE!`,h 5m CONC LOAD #
2120 AT 12 CONC LOAD #
REACTIONS (UP +):
LEFT: 7686.3 RIGHT: 3136.2
****** USE 24F GLB 5.125X 15.0 *****
A= 76.875 S= 192.188 I= 1441.406
FV=165. E=1800000. - DF=1.25
CRIT SHEAR = 5235., AT 1.25 1.5*V/(A*FV*DF) _ .50
SPAN MAX MOM = 31618. FT.LBS AT 8.92
FB=2341. M/(FB*S*DF)=: .67
DEFL=-1.02 AT 10.50 L/240.= 1.10
f
SHEET :
JOB NO. :
CLIENT :trtz'i-�
PLAN NO.:
1�Ylt�
DATE q�
HDR AT REAR OF NOOK
OVER-ALL LENGTH: 10.25 RCTS AT: .00 10.25
APPLIED LOADS (DOWN +) 0
3136 AT 7.5 gal L G FSM CONC LOAD #
265 l4%(., UNIF LOAD #/LF
REACTIONS (UP +):I/
LEFT: 2199.5 RIGHT: 3652.8
USE
/2
****** USE 24F GLB 3.125X 9.0 ****** A
A= 28.125 S= 42.188 I= 189.844 4
FV=165. E=1800000. -DF=1.25
CRIT SHEAR = 3454. AT 9.50 1.5*V/(A*FV*DF) _ .89
SPAN. MAX MOM = 9043. FT.LBS AT 7.50
FB=2400. M/(FB*S*DF)= .86
DEFL= -.45 AT 5.42 L/240.= .51