BWFE2016-0205Applicant: r Contractor:
HECSTOR GARCIA RENTERIA OWNER BUILDER
51945 ASVEN IDA RAMIREZ D
LA QUINTA, CA 92253 ( 20,E
,
u %I N gkI E0
Llc. No.:
,nv DEVELC
-----------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjurythat I am,licensed under provisions of Chapter
9 {commencing with Section 7000} of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: License No.:
Date: Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct,alter,.improve, demolish, or repair
any structure, prior to its.issuance, also requires'the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9.(conimencing with Section'7000) of Division
3 of the Business and Professions Code) or3hat,he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
6M -P, as owner of the property, ormy employees with wages as their sole
compensation, will do the work, anclihe structure is not intended or offered for sale.
(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 does,.the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building 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.).
�) I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project. (Sec. 7044, Business and Professions'Code: The Contractors'
State License Law does not apply to a`n owner.of property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
I am exempt under Sec. B.&P.C. for this reason
Da e7 �'
O� wner'1 Ct
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ, C.).
Lender's Name:
Lender's
WORKER'S COMPENSATION DECLARATION
I herebyaffirm 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 and policy number are:
Carrier:_ .Policy,Number:_
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
ONE HUNDRED THOUSAND DOLLARS ($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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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 of,this 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 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 county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Dater Signature (Applicant or Agent):&Ia
VOICE (760) 777-7125
78-495 CALLE TAMPICOall
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/19/2016
Application Number:
BWFE2016-0205
Owner:
Property Address:
51945 AVENIDA RAMIREZ
HECTOR RENTERIA
APN:
773165022
51945 AVENIDA RAMIREZ
Application Description:
HECTOR GARCIA RENTERIA
/.BLOCK WALL
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$2,560.00
Applicant: r Contractor:
HECSTOR GARCIA RENTERIA OWNER BUILDER
51945 ASVEN IDA RAMIREZ D
LA QUINTA, CA 92253 ( 20,E
,
u %I N gkI E0
Llc. No.:
,nv DEVELC
-----------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjurythat I am,licensed under provisions of Chapter
9 {commencing with Section 7000} of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: License No.:
Date: Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct,alter,.improve, demolish, or repair
any structure, prior to its.issuance, also requires'the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9.(conimencing with Section'7000) of Division
3 of the Business and Professions Code) or3hat,he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
6M -P, as owner of the property, ormy employees with wages as their sole
compensation, will do the work, anclihe structure is not intended or offered for sale.
(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 does,.the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building 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.).
�) I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project. (Sec. 7044, Business and Professions'Code: The Contractors'
State License Law does not apply to a`n owner.of property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
I am exempt under Sec. B.&P.C. for this reason
Da e7 �'
O� wner'1 Ct
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ, C.).
Lender's Name:
Lender's
WORKER'S COMPENSATION DECLARATION
I herebyaffirm 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 and policy number are:
Carrier:_ .Policy,Number:_
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
ONE HUNDRED THOUSAND DOLLARS ($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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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 of,this 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 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 county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Dater Signature (Applicant or Agent):&Ia
Application Number: BWFE2016-0205
Property Address: 51945 AVENIDA RAMIREZ
APN: 773165022
Application Description: HECTOR GARCIA RENTERIA / BLOCK WALL
Property Zoning:
Application Valuation: $2,560.00
Applicant:
HECSTOR GARCIA RENTERIA
51945 ASVENIDA RAMIREZ
LA QUINTA, CA 92253
Owner:
HECTOR RENTERIA
51945 AVENIDA RAMIREZ
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
Date: 9/19/2016
LIC. No.:
---------------------------------------------------------------------------------------------
Detail: 701-F OF 6' GARDEN WALL SIDE YARD [PROTO 2 SPECIFICATIONS]. PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR'
TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES.
m R.W , .rn
r
DESCRIPTION
ACCOUNT 4
CITY
AMOUNT
BSAS SB1473 FEE
101=0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNTQTY
AMOUNT
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.86
DESCRIPTION , •'
ACCOUNT,,
CITY
AMOUNT
WALL/FENCE -FIRST 100 LF PC
101-0000-42600
0
$60.91
-tTotal Paid for FENCE OR FREESTANDING. WALL:
$108.77
r
6" i6'-0 TO V-81 PROTO II - EXPOSURE C - TRENCH FOOTING
DESIGN CRITERIA (PER 2013 CBC):
- ..-CAP. BLOCK PER SHEET C i. ALLOWABLE SOIL BEARING
PRESSURE = 1000 PSF MIN.
2. ALLOWABLE' SOIL PASSIVE
PRESSURE = 150 PCF MIN.
:STEEL PLATE TO BEAR FULLY 3. SEE SHEET B AND SHEET C
ON CENTER WEB:OR END PRIOR TO START OF
FACE SHELL- SIZE PER CONSTRUCTION.
SHEET C
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-REINFORCING TOP 2 COURSES
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/;,POST TENSION (PT) ROD SEE
SHEET B FOR ROD. SPECS -
CENTER IN WALL
. PROTO II FENCE WALL
SETBACK
PER
,--:.FINISHED GRADE
�-:#4 CONTINUOUS
AT HOOK
dONTINUOI
CONCRETE
TRENCH
FOR SIDEYARD RETURN WALLS'
WHERE DRAINAGE SWALE
OCCURS; INSTALL DRAINAGE
BLOCK:..AT SWALE AT GRADE.
FENCE
WALL SCHEDULE
AT LEVEL SOIL
H'
DESIGN WIND
PT ROD
_:MAX....:::::.:....:::....EXP.:MPH::,:::..:....
SPACING..:.:;...........:MIN...............:
...........
..:.. _
C...AT-100._
-BUILDING 3, SAFETY DEPT.
C AT 110.
C..AT..120, ......
-:
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6'-8"
! C AT 110
-
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--
FOOTING
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CITY OF LA QUINTA :
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-BUILDING 3, SAFETY DEPT.
DAYLIGHT MIN-.
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DATE
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THESE DRAWINCS/CALCUTATIONS ARE CONSIDERED PRELIMINARY -NOT FOR CONSTRUCTION
OR RECORDING
UNLESS THE STRUCTURAL ENGINEER OF RECORD'S SEAL IS AFFIXED WITH WRITTEN SIGNATURE.
J
GENERAL STRUCTURAL NOTES:
1. SOIL SHALL .BE FIRM AND COMPACTED PRIOR TO PLACEMENT OF CONCRETE. PRIOR TO FOUNDATION EXCAVATION, USER SHALL
VERIFY THAT SITE SOILS CONDITIONS MEET OR EXCEED AN ALLOWABLE PASSIVE BEARING PRESSURE OF 150 PSF/FT (SOIL
CLASS 4 OR BETTER AS DEFINED BY THE CBC) STARTING AT THE TOP OF GRADE(I.E. NO TOP SOILS ARE NEGLECTED FOR
PASSIVE) AND A MINIMUM ALLOWABLE BEARING PRESSURE OF 1000 PSF,
2. FOOTINGS TO BE LEVEL. IF GROUND SLOPES THE FOOTING SHALL BE STEPPED. EACH STEP SHOULD BE PROPER HEIGHT TO
FIT BLOCK TYPE USED. ALL EXCAVATIONS SHOULD BE 'CLEAN AND CONTAIN NO LOOSE EARTH OR FOREIGN MATTER.
3. SEE SHEET A FOR EXPOSURE, WIND SPEED, POST TENSIONED ROD SPACING, FOOTING SIZES, ETC. USER IS RESPONSIBLE TO
VERIFY REQUIREMENTS WITH BUILDING DEPARTMENT AND OWNER. ALL WORK IS TO BE PERFORMED IN ACCORDANCE NTH THE
APPROVED SITE PLAN' AND APPLICABLE CODE OR JURISDICTION REQUIREMENTS.
4, SOIL BELOW FOUNDATIONS SHALL BE WELL DRAINED AND NON -EXPANSIVE. USE CONCRETE WITH A MIN. STRENGTH OF 2,500
PSI - TYPE 11 CEMENT (TYPE V WHERE REQUIRED BY OWNER, SOILS ENGINEER OR JURISDICTION). CONCRETE SHALL BE A MIN.
OF 48 HOURS OLD PRIOR TO FINAL .TENSIONING. ALL CONCRETE SHALL BE THOROUGHLY CONSOLIDATED BY SUITABLE MEANS
DURING PLACEMENT.
5. LAP REINFORCING STEEL: LAP = 32" FOR a4 BARS IN CONCRETE.
6. CONCRETE MASONRY UNITS SHALL COMPLY WITH ASTM C-90 AND BE 2,000 PSI MIN. (F -M DESIGN CRITERIA FOR BLOCK IS
BASED ON 2000 PSI), BLOCK SHALL- BE A MIN OF 7 DAYS OLD PRIOR TO ROD TENSIONING. STANDARD HEAD AND BED JOINT
BLOCKS WITH MORTAR MAY BE USED OR INTERLOCKING BLOCKS MAY BE USED. BLOCKS SHALL BE LAID IN RUNNING BOND.
7-, • . MORTAR SHALL BE TYPE S. 2000 PSI MIN. MORTAR MUST BE. A MIN. OF 4 HOURS OLD PRIOR TO INITIAL TENSIONING AND 24 .
HOURS OLD I-RiOR TO FINAL ii LSiOIviNG.
8. FIRST MASONRY COURSE MAY BE SET IN FRESH CONCRETE FOOTING.
9. REINFORCING REBAR SHALL CONFORM TO ASTM A641; Fy = 60,000 PSI.
10. PROTO-11 HARDWARE IS DEFINED AS: TENSION RODS, BEARING PLATES, COUPLERS, NUTS, ALL THREADS, DIRECT TENSION
INDICATORS (A DIRECT TENSION INDICATOR (DTI) IS A COMPRESSIBLE WASHER) AND PLASTIC SADDLES.'ALL OF THIS HARDWARE
SHALL BE SUPPLIED BY ONLY AN APPROVED PROTO-11 LICENSEE TO THE CERTIFIED INSTALLER. POST TENSION RODS SHALL BE
7/16" DIAMETER WITH 1/2" ROLL THREADS CONFORMING TO ASTM A641 (FY = 60000 PSI) AND HAVE STEEL CHEMISTRY SO
THAT BENDING AND THREADING CAN BE ACCOMPLISHED WITHOUT DAMAGE TO THE POST TENSION ROD, AREA OF POST TENSION
ROD = .1503 SQUARE INCHES. BEARING PLATES ARE 1/4" THICK (Fy=50 KSI) SEE SHEET C FOR DIMENSIONS. 1/2" COUPLERS
PER ASTM A563 GRADE A, AND THE COUPLER MUST FULLY ENGAGE THE UPPER AND LOWER ROD, FULLY ENGAGED IS DEFINED
AS 1/2" MIN. INTO COUPLER: 1/2" NUTS ARE TO BE GRADE 8, PER ASTM A325. 1/2" ALL THREADS PER ASTM A307, GRADE
60. DIRECT TENSION INDICATOR (OTI - COMPRESSIBLE WASHER) IS MANUFACTURED PER ASTM F959. PLASTIC REBAR SADDLES
ARE NON-STRUCTURAL.
11. HORIZONTAL -JOINT REINFORCING SHALL BE 9 GAGE DIAMETER WIRE AND PLACED PER SHEET A AND CONFORM TO ASTM A82
LADDER TYPE, 9 GAGE DIAMETER. LAP JOINT REINFORCING ONE FULL CROSS SQUARE (6" MINIMUM LAP).
12. IN LIEU OF FULL HEIGHT RODS, CONTRACTOR MAY USE SHORTER RODS, 1/2" COUPLERS AND STRAIGHT RODS THREADED BOTH
ENDS FOR ADDITIONAL LIFTS, RODS SHALL HAVE A RODS SHALL HAVE A MIN. OF 3" 'L' HOOK, WITH 1/2" NUT AT END OF
TENSION ROD WHERE EMBEDDED IN FOOTING.
13. VERTICAL CONTROL JOINTS TO BE PLACED AT MAX. 36' O.C. IN ALL NON -STUCCOED WALLS AND 20' ON CENTER IN STUCCOED
WALLS WITH CLEAN VERTICAL BREAK OF ALL MATERIALS. POST TENSION ROD SHALL OCCUR WITHIN 12" OF END OF WALL AND
12" EACH SIDE OF CONTROL JOINT.
14. NO COUPLERS MAY OCCUR DIRECTLY BELOW AND IN CONTACT WITH THE BEARING PLATE. NO BOND BEAM BLOCK MAY BE
USED AT PLATE/TENSION LOCATION.
15. TENSION RODS MAY BE STABBED INTO WET CONCRETE OR TIED IN PLACE AT CONTRACTOR OPTION,
16. A PROTO-11 DTI (COMPRESSIBLE WASHER) SHALL BE INSTALLED AT EVERY TENSION ROD BETWEEN THE BEARING PLATE AND
NUT WITH THE OTI "TABS" FACING UP AGAINST THE BOTTOM OF THE NUT. THE SPECIAL DEPUTY INSPECTION REQUIRED AT
TIME OF FINAL TENSIONING BY A DEPUTY INSPECTOR SHALL VERIFY FINAL TENSIONING TO 6,000 POUNDS BY 1 OF 2 METHODS;
METHOD 1; • VISUAL INSPECTION OF DIRECT TENSION INDICATOR (DTI), TABS -FACING UP AND COLLAPSED AGAINST NUT WITH NO
LIGHT LEAKAGE BETWEEN THE PROTO-11 DTI AND BOTTOM OF NUT. METHOD 2: USE OF A CALIBRATED TORQUE WRENCH
TORQUED TO 55 FT -LBS: (DTI MUST STILL BE PLACED WITH METHOD 2. NO VISUAL INSPECTION OF DTI REQUIRED WHEN USING
METHOD 2). INSPECTOR SHALL OBSERVE THE USE OF THREAD LUBRICANT, THE POSITION OF PLATE ON BLOCK, AND INTEGRITY
OF MORTAR JOINTS, AND PROVIDE A SIGNED REPORT TO ALL REQUIRED PARTIES. PROTO II MASONRY DESIGN IS BASED ON
THIS SPECIAL INSPECTION.
17. POST TENSION ROD SPACING TOLERANCE IS t8" BUT THE NUMBER OF RODS FOR A GIVEN LENGTH OF WALL MUST REMAIN
THE SAME.
18.. SEISMIC DESIGN CRITERIA: Ss=2.0 Si=0.749, SOIL CLASS=D(ASSUMED), RISK CATEGORY I.
19. FOUNDATION INSPECTION PRIOR TO PLACEMENT OF CONCRETE INCLU,
AND SIZE/DEPTH AND CLEANLINESS OF FOUNDATION. ADDITIONAL .. EC 1N'S Tf A
BY JURISDICTION. /} �� BUILDING 8� SAFETY DEPT.
A? P R OV E D PROtO II STANDARD
FOR CONTRUCTIO .A OU! TA, CA
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4'; C. AND A• THICK POST-TENSIONEO MASONRY WALLS
£ THESE DRAWINGS/CALCULATIONS ARE CONSIDERED PRELIMINARY -NOT FOR
CONSTRUCTION OR RECORDING
UNLESS THE STRUCTURAL ENGINEER OF RECDRD'S SEAL IS AFFIXED WITH WRITTEN SIGNATURE.
TOP OF PROTO 11 WALL
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KEY NOTES:
1, POST TENSION ROD:
2.. NUT.
3. DIRECT TENSION INDICATOR (DTI).
4. BEARING TOP PLATE.
5. COLLAPSIBLE TABS.
6. MINIMUM TENSION TO BE 6,000 LBS LOAD AND
CONFIRMED BY ONE OF TWO METHODS PER
NOTES "B" & "C" BELOW.
7. FILL CAP BLOCK WITH MORTAR. IMMEDIATELY
"FLIP" ONTO ROD. COMPLETELY COVER NUT, ROD
AND PLATE WITH MORTAR.
8. CAP BLOCK Of SUFFICIENT SIZE TO COVER
PLATE AND ROD.
9: CONTINUOUS HORIZONTAL JOINT REINFORCING.
10. CENTER WEB OR ENO FACE SHELL BELOW.
1:1. STEEL PLATE SIZES:
A. 4" PROTO 11::1/4"x3".x6"
B. 4" SLUMP:PRO.TO 111/.4"x2'7/2'x* :.,
C. 6" PROTO 11:1/4"x4 1/2"x6"
D. 6 SLUMP PROTO 11:1/4"x4"x6"
STEEL PLATES TO BE PLACED AT THE EDGE OF
THE CELL SO THAT THE PLATE BEARS FULLY ON
THREE SIDES.
12. 00 NOT USE BOND BEAM BLOCK AT BEARING
PLATE LOCATIONS.
TIONS ARE CONSIDERED PRELIMINARY -NOT FOR CONSTRUCTION OR'RECORDINC UNLESS THE STRUCTURAL ENGINEER OF RECORD'S.SEAL IS AFFIXED WITH WRITTEN SIGNATURE.
NOTES:
A.
PROTO.II DTI TO BE USED AT EACH TENSION ROD.
TABS FOR DTI SHOULD FACE UP AGAINST BOTTOM
OF NUT. TABS WILU.COLLAPSE (NO LIGHT PASSES
BETWEEN BOTTOM OF NUT AND DTI) WHEN PROPER
TORQUE' OF NUT HAS BEEN ACHIEVED.
B.
AS ALTERNATE TO. VISUAL INSPECTION OF TABS,
INSPECTION OF NUT TORQUE MAY BE ACHIEVED BY
USE OF A CALIBRATED TORQUE WRENCH. TORQUE
NUTS TO 55 FT -LBS. DTI STILL MUST BE PLACED ON
ROD IF USING TORQUE WRENCH.METHOD. SEE
GENERAL NOTE ON SHEET B.
C.
SPECIAL DEPUTY INSPECTOR WILL PERFORM A .
VISUAL INSPECTION :WHEN USING THE DTI METHOD TO
CONFIRM THE DTI IS COLLAPSED WITH NO LIGHT
LEAKS K-TWEEN THE TABS AND BOTTOM OF NUT..
IF, USING TOROUE ;WRENCH METHOD, DEPUTY
INSPECTOR' WILL CONFIRM WALL IS TORQUED TO. 55
-FT-LBS. NO VISUAL INSPECTION OF DTI IS REQUIRED.
D.
INSTALLER MUST HAVE SPECIAL DEPUTY INSPECTION
OF TENSIONING PERFORMED BY ONE OF THE TWO
METHODS NOTED ABOVE. SPECIAL DEPUTY INSPECTOR
TO.PROVIDE.A COMPLETED REPORT TO LISTED
PARTIES.
TIONS ARE CONSIDERED PRELIMINARY -NOT FOR CONSTRUCTION OR'RECORDINC UNLESS THE STRUCTURAL ENGINEER OF RECORD'S.SEAL IS AFFIXED WITH WRITTEN SIGNATURE.
Bll1 #
Permit ,f
F J :1076
TP�roJcct:A"88ress;"^�L
_ Qty a1 /HCl QUinta
Building 8i- Safety Division
78-495 Calle Tampico:
La Quinta; CA 92253 - (760) 777-701,2
Building Perrnii Application "and Tracking -Sheet
.�Owncr�s Name' "
.. • if
—�
A. P. Number:
;
Add"resss, =a� AR.v e
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Legal Description:
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State Lic. # :
City t ic: f!;
Arch., Engr., Designer:
Address:
City, ST, Zip:
Occu
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# Stories:
# Units:
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APPLICANT: DO NOT WRITE BELOW. THff.-ONE
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Submittal
Req'd
"Reed
TRACKING
PERMIT FEES
Plan Sets.
Plan'Check submitted
Item
Amount
Structural Calcs.
Revicwed; ready for corrections
1PW5eek'Deposit
Truss Calcs.
i
Called ContaetPcrsonn
Clieck Balance.
Title 24 Calcs.
Plans picked up10
4�
Construction '
Flood plain plan
Plans resubmittedMechanical
.
Grading plan
2"" Review,,ready foac�ctions/issue
Electrical
Subcontactor List
Call�ed�C�ontacrson
Plumbing
Grant Deed
%I;1iis picked up
j
S•M•I.
H.O.A. Approvalate'
.Plans resubniitted'
Grading
IN ]iOUSE.:-
''� Reyicw, ready for corrections/issue
Developer'Inipact Fee
Planning Appro'va•l
Called Contact Person
A.I.P.P.
Pub. 1V�..�Apprpr
Date of permit issue
SrSdro�Fecs
Total Permit Fees
P.O. Box 1504
LA QUINTA, CALIFORNIA M47-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tom:
BUILDING & SAFETY DEPARTMENT
' S PACKAGE
(760)777-7012
FAX (760) 777-7011
Disclosures .& Forms for Owner -Builders Applying for Construction Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit s been subrriitte in your name fisting ourself as the builder of the property
improvements specified at.
- vt- •. m ,„ E , V�
We are providing you wi an.Owner-Buil- er Acknowledgment an IR'Omlation��rificiWouCh-n rm to make you aware of your
responsibilities and possible'risk you,may incur by having this,peribit issued in your. name :as the
Owner -Builder. We will no'tissue.a.buildme,-permit .uatil you have read, initialed -your understanding of each provision,
signed, and returned.64 form to us at our official address .'indicated. An ageint; of the owner cannot execute this notice
unless you, the property owner, obtain the prior approval of.the permitting authority..
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement beloito signs you understand or verify this information.
. I understand a frequent practice of unlicensed persons ; is to have the property owner obtain an "Owner -Builder"
lbuilding permit that erroneously. implies that the property_ owner is providing his or her own labor and material personally. I, as
an Owner -Builder, may be heldfliable and subject to serious financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property: My homeowner's insurance may not provide coverage for those
injuries. I am willfully acting as an Owner -Builder and am aware of the limits of myinsurance coverage for injuries to workers
onmy property.
Z. I understand building: permits are not required to be signed by property owners unless they are responsible for the
"onstruction and are not hiring a.licensed'Contractor to assume this responsibility.
3. I understand as an"Owner_Builder" I am the responsible party of record on the permit I understand that I may protect
myself from potential financial risk by hiring.a licensed:Contractor and having the permit filed in his or her name instead of my
own.
l' ` 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
,Qar 5. I understand if I employ or otherwise engage any persons, other than California licensed. Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer"
under state and federal law.
6..I understand if I am considered an "employer" under. state and federal law, I must register with the state and federal
government, withhold payroll taxes, "provide workers' compensation disability insurance, and contribute to unemployment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to:serious financial
risk.
7. I understand under.California Contractors' State License Law, an Owner -Builder who builds single-farnily residential
structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed -general building Contractor.
k
I understand as an Owner -Builder if I sell the ,property for which this permit 'is issued, I may be held liable for any
Cfi�r*iancial or personal injuries sustained by any subsequent owner(s) 'that result from any latent construction defects in the
workmanship or materials. 'I.
40 . I understand I may obtain more information regarding myobligations as an "1.employer" from the -Internal Revenue
Service, the United States Small:Business Administration;,the .California Department of Benefit Payments, and the California
Division of Industrial Accidents. I also understand I`may-contact the California Contractors' State License Board (CSLB) at 1-
800-32 1 -CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
0. 1 am aware of and,consent to:an.Owner-Builder building permit applied for. in, my, name, and understand that I am the
` legally: and_f>nan�cially�respnsibleffor ,;proposed conshuction r activityat,;x the?'foZlowin� address:
111. I agree that, as the party legally and financially responsible for'this proposed construction activity, I will abide'by all
applicable laws and requirements.that governbwner-Builders as well as employers.
12. I agree to notify the:issuer of this form immediately of any additions, deletions, or changes to any of the information I
Rave provided on this form Licensed contractors are regulated by laws designed io,protect the public. If you contract with
someone who does not. have a license, the Contractors' State License Board maybe unable to assist'you with any financial loss.
youmay sustain as a result of a corrolaint. Your only. remedy against unlicensed Contractor`s may be in civil court. It is also
important for you to understand.thaf if an-unlicensed_Contractor or employee of that individual or firm is injured while working
on your property, .you may. be 1eld.liable-for. damages, If you obtain a ,permit as Owner -Builder and. wish to hire Contractors,
you will be responsible for .verifying whether or not those Contractors are properly licensed-and'the status of their workers'
.compensation insurance coverage.
Before a building .permit can be issued, this forin must he completed and. signed by the property owner and returned to
the agency responsible for issuing the permit. Note: 'A' copy of the property owner's driver's license, form -notarization, or
other verification . acceptable: to, the agency is required .to be presented when the permit is issuedto verify the property
owner's signature.
ignatiue of property owner,.,D,cate:
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a :construction permit for the Owner -Builder. j
Excluding the. Notice to Property Owner, the execution'o1
the following persons) to act as my agent(s) t6 -,a' *ppy foi,
Permit for my project.
Scope of Construction.Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
h1 understand is my personal responsibility; I hereby authorize
and file the, documents necessary to obtain an Owner -Builder
Tel No
I declare under penalty of perjury that I am. the property owner for the address listed above an&,I personally filled out the above
information and certify its accuracy. Note: A copy of theowner's driver's license, form notarization, or other verification
acceptable to the agency is required io be presented when the -permit is issued to verify the property' owners signature.
Property Owner's Signature:
Date: