05-2916 (RER)PA BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
& SAFETY DEPARTMENT
VOICE (760) 777-7012
FAX (760) 777-1011
INSPECTIONS (760) 777-7153
Owner:
JOSH LYNBERG
52640 AVENIDA RUBIO
LA QUINTA, CA 92253
Other struct info . . . C
Contractor:
Owner
Date: 7/13/05
--------------------=---------------------------------------------------------------------------—
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm underpenalty of perjury that I amlicensed under provisions.of,Chapter9-(commencing with _ I hereby affirm under penalty of perjury one of the following declarations: -
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation,. as provided
License Class: License No.. for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: Contractor: 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
' - OWNER -BUILDER -'DECLARATION 1 - 'insurance carrier and policy number are:
[.hereby affirmunder penalty of perjury that 1. am exempvfrom the Contractor's. State License Laws for the - Carrier - - - - - - - - - - - - - - - - - - - - - - - Policy Number -
following.reasori (Sec:. 7031:5, Busiriess and Professiorts;Code: � Any.city'or county, that requires"a,permit to.. I certify. that; in the performance of the work for which this permit is issued, I shall not employ any
construc[,•alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the 'person in any manne�to a subject to the workers' compensation laws of California,
permit 3o file' a,signed. statement that he.or. she is licensed 06rsuant'to the provisions' of the Contractor's State and -agree that, if I.s_ject to the workers' compensation provisions of Section
Licen6'1Law (Chapter 9 (commencingwith Section 7000)-of,Division3 oUihe Business and Professions Code) or 3700 of the Lab with comply with those provisions.,
that he orshe is exempttherefrom and the basis for the alleged exemption.`: Any violation of Section 7031:5 by -
any. applican£for a permit subjects the applicant to a civil.penalty of not more than five hundred dollars ($500).:
1 _ 1 I,•as.ownerof 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,,86si6ess 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 workfiimself or herself through his or her -own employees,'provided-that the
.:improvements are not: intended or offeied for sale. If, however, the builtling;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 I; as owner of the propertVam 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 coritractor(s) licensed
pursuant to the Contractors' State License La .I.
I—) I am exempt under Sec. B.& . for 's reason
Date:
JCNNS. UCT� LENDING AGENCY
I hereby affirm under penalty of perjury that t re i, constr ion lending agency for the performance of the
work for which this permit is issued (Sec. 309 iv. C.). -
Lender's Name:
Lender's Address: 7�
LQPERAI T
WARNING: FAILURE TO SECURE WO,N
RS' C PEN_ TION COVERAGE IS UNLAWFUL, AND. SHALL
SUBJECT AN EMPLOYER TO CRIMIENAL ES' D CIVIL FINES UP -TO, ONE HUNDRED THOUSAND
DOLLARS 14100,000)..IN ADDITIOTHE C ST F., OMPENSATION; DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR COTERE D TTORNEY'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 ofthis 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 permi6ssued as a result of this application becomes null and void if work is not commenced
within 180 days from date bf 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 thatbove information is correct. I agree to comply with all
city and county ordinances and state laws relating to buil ing tiorAnd hereby authorize representatives
of -this county to enter upon the a-bove-mentioned prop y or in tion as.
a a e: 3 & urer2f (Applicant or Agent):
G PERMIT
Application Number:
05-0'0002916Property
Address:
52640 AVENIDA RUBIOAPN:
"CE
773-283-028-17 -000Application
description:
REMODEL - RESIDENTIAT.
Property Zoning:
COVE RESIDENTIAL
Application valuation:
1000
4 Applicant:
Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-1011
INSPECTIONS (760) 777-7153
Owner:
JOSH LYNBERG
52640 AVENIDA RUBIO
LA QUINTA, CA 92253
Other struct info . . . C
Contractor:
Owner
Date: 7/13/05
--------------------=---------------------------------------------------------------------------—
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm underpenalty of perjury that I amlicensed under provisions.of,Chapter9-(commencing with _ I hereby affirm under penalty of perjury one of the following declarations: -
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation,. as provided
License Class: License No.. for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: Contractor: 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
' - OWNER -BUILDER -'DECLARATION 1 - 'insurance carrier and policy number are:
[.hereby affirmunder penalty of perjury that 1. am exempvfrom the Contractor's. State License Laws for the - Carrier - - - - - - - - - - - - - - - - - - - - - - - Policy Number -
following.reasori (Sec:. 7031:5, Busiriess and Professiorts;Code: � Any.city'or county, that requires"a,permit to.. I certify. that; in the performance of the work for which this permit is issued, I shall not employ any
construc[,•alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the 'person in any manne�to a subject to the workers' compensation laws of California,
permit 3o file' a,signed. statement that he.or. she is licensed 06rsuant'to the provisions' of the Contractor's State and -agree that, if I.s_ject to the workers' compensation provisions of Section
Licen6'1Law (Chapter 9 (commencingwith Section 7000)-of,Division3 oUihe Business and Professions Code) or 3700 of the Lab with comply with those provisions.,
that he orshe is exempttherefrom and the basis for the alleged exemption.`: Any violation of Section 7031:5 by -
any. applican£for a permit subjects the applicant to a civil.penalty of not more than five hundred dollars ($500).:
1 _ 1 I,•as.ownerof 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,,86si6ess 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 workfiimself or herself through his or her -own employees,'provided-that the
.:improvements are not: intended or offeied for sale. If, however, the builtling;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 I; as owner of the propertVam 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 coritractor(s) licensed
pursuant to the Contractors' State License La .I.
I—) I am exempt under Sec. B.& . for 's reason
Date:
JCNNS. UCT� LENDING AGENCY
I hereby affirm under penalty of perjury that t re i, constr ion lending agency for the performance of the
work for which this permit is issued (Sec. 309 iv. C.). -
Lender's Name:
Lender's Address: 7�
LQPERAI T
WARNING: FAILURE TO SECURE WO,N
RS' C PEN_ TION COVERAGE IS UNLAWFUL, AND. SHALL
SUBJECT AN EMPLOYER TO CRIMIENAL ES' D CIVIL FINES UP -TO, ONE HUNDRED THOUSAND
DOLLARS 14100,000)..IN ADDITIOTHE C ST F., OMPENSATION; DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR COTERE D TTORNEY'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 ofthis 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 permi6ssued as a result of this application becomes null and void if work is not commenced
within 180 days from date bf 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 thatbove information is correct. I agree to comply with all
city and county ordinances and state laws relating to buil ing tiorAnd hereby authorize representatives
of -this county to enter upon the a-bove-mentioned prop y or in tion as.
a a e: 3 & urer2f (Applicant or Agent):
LQPERMU
Application Number 05-00002916
Permit . . . . . . ELECT - ADD/ALT/REM
Additional desc
Permit'Fee . . . . 16.35 Plan Check Fee .00
IssueDateValuation . . . . 0
Expiration Date 1/09/06
Qty Unit Charge Per Extension
BASE FEE 15.00
3.00. .4500 EA ELEC DEVICE/FIXTURE >20 1.35
----------------------------------------------------------- 7 -----------------
Permit PLUMBING
Additional desc
Permit.Fee . . . . 21.00 .,Plan Check Fee .00
Issue Date Valuation 0
Expiration Date 1/09/06
Qty Unit Charge Per, Extension
'BASE FEE 15.00
1.00, 6,.6.000 -EA PLB. FIXTURE -.--6.00
-----------------------------------------_----
Special Notes and Comments.
NEW GAS LINE'TO:,_APPROVED.FIREPIt/3
ELECTRICAL OUTLETS/
summary -Paid" Credited Du'e,
Fee Charged,
------ ----------
7-7-7
*Permit, Fee Total 37.35; _00 3.7 .3 5
Plki- the'6k Total .0 00
0.0 00 0,0
Grand. Total 37.3-5 .00 O'd 37.35
rcow4.6c_Tvz�o To
jo co�j
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Tbinn .
NEW
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CIT _-._'LA OUINTA
BUIL E,33AFETY DEPT.
FL. 3i",` , a RUCTION
DATE
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SCALE: APPROVED BY: 0=N BY4
REVISED
DATE: (3/-Z/%)c>5 I I
DRAWING NUMBER
LA QUINTA,, CA 92253
APN #773-283-028-0
NEW GAS USAGE AND BTU CONSUMPTION PER APPLIANCE
GAS STOVE = 75,000 BTU
" GAS FURNACE = 50,000 BTU
WATER HEATER = 34,000 BTU
NEW GAS FIRE PIT = 124,000 BTU
TOTAL BTU = 283,000 BTU
PROPANE TANK OUTPUT
300,000 BTU
BTU DIFFERENTIAL IN TOTAL TANK OUTPUT LESS TOTAL USAGE
300,000 - 283,000 = 17,000 BTU OVERAGE
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FIRE RING INSTALLATION INFORMATION
Empire Products, Inca
5061 Brooks St.
Montclair, CA 91763
18001-527-4790
STANDARD MASONRY HHL Hi I
Empire Products, Inc.
GENERAL INFORMATION - OUTUUUM I -Wr-i-I1 J
1.2005
Fax (800)-758-2929
Outdoor firepits are constructed of standard masonry materials including firebrick, poured in place concrete, or various
other natural non-combustible materials. Use care when selecting the materials to assure any materials that may come in
contact with the flame area will not cause cracking or expansion. Check with your local material yard for best materials.
All fire rings are CSA certified and pipe threads comply with ANSI 132-1.
GAS PIPING AND CONSTRUCTION
Basic pipe installation requires a natural gas supply pipe to be buried in accordance with local codes and attached to an
approved shut off valve. The pipe is brought vertical into the center of a firepit. Most pits are round however any shape can
be used. The bottom of the pit is open to soil for water drainage while the sides are firebrick. The overall depth can varie
however the basic dimensions are shown in Figure 1. Remember to place your pit from combustible construction. Use the
chart below to estimate BTU and gas pipe requirements.
BTU BURN RATE FOR NATURAL GAS BASED ON INLET PRESSURE W/C.
DESCRIPTION P/N 4.0IN.W.0 5.0IN.W.0
12" FIRE RING - SINGLE RING 10839 71,401 80,838
18" FIRE RING - SINGLE RING 10840 80,278 90,888
22" FIRE RING-- DOUBLE (12" INNER) 10841 90,496 102,457
24" FIRE RING - DOUBLE (12" INNER) 10842 104,083 117,840
130" FIRE RING - DOUBLE (18" INNER) 10843 124,020 - - -- - 2
36" FIRE RING - DOUBLE (18" INNER) 10844 136,095 154,082
NOTE: RATES 12 ;18",22"BASED ON W RIDGED SUPPLY PIPING 30' FROM SOURCE
RATES 24",30",36- BASED ON 3/4 RIDGED SUPPLY PIPING 30' FROM SOURCE
ALL RATES BASED ON 2" SAND COVERED BURNER
6.0 IN.W.0 7.0 /N.W.0
INSTALLATION
Fire -ring is installed with the port holes down. Fill bottom of pit with pea gravel to within several inches of the burner. Cover
burner with about 2" silica sand. The sand disperses the gas and allows for a large area burn. Top sand with volcanic rock
and/or EPI's Sierra Campfire Logs available through your local dealer. For further information please contact Customer
Service at (800)-527-4790, Monday thru Friday 8am-4:30pm PST.
FIREPIT INSTALLATION
J
"87,98094,5411541,294,850,814,212,199
INSTALLATION
Fire -ring is installed with the port holes down. Fill bottom of pit with pea gravel to within several inches of the burner. Cover
burner with about 2" silica sand. The sand disperses the gas and allows for a large area burn. Top sand with volcanic rock
and/or EPI's Sierra Campfire Logs available through your local dealer. For further information please contact Customer
Service at (800)-527-4790, Monday thru Friday 8am-4:30pm PST.
FIREPIT INSTALLATION
J
LOG LIGHTER VALVES
Features and instructionsIU> NIAMILUE
Model R633 Model R634
1
Angle pattern
Straight pattern Quarter turn
Quarter turn
i
f3 ,
Characteristics:
Characteristics: T�
Female x Female 1/2" size
I Female x Female 1/2" size
Pipe threads comply with ANSI 62.1 Pipe threads comply with ANSI B2.1
_ y 7
�_-� Adjustable height flange k�l
Adjustable height flange; — �.
I 1"'���""�—'✓"– CSA Certified
CSA Certified Meavy forged brass construction -a1
Heavy forged brass construction �_ ,
1/4" turn operation
1/4" turn operation
a After installation of the valve (pipe threads 1/2" NPT) adjustablf escutcheon shall be fitted to the upper part of the
valve body, until the top flange flushed the wall surface.
By using the special Key (8) enclosed in the package, turn the stem to open or close, following the arrows stamped
on the top surface. 047U23218
4