0209-118 (BLCK)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:
(f,,) 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
c
Date . �' Signature of Owner* l;°✓rc-' -1 r'� ..
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 work ers'.
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�-• L__5 0_2_ 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 i
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. t.
Signature (Owne'r/Agent) •��'F�" �?F -v' *�"%' Date ` � 'V
BUILDING PERMIT PERMI
t
LOT . TRACT
DATE VALUATION
cif 7t2ot
JOB SITE
ADDRESS
APN
OWNER
CONTRACTOR/DESIGNER/EN INEER
17.ICHN(W ROC"C; TO
OV,iNER E3tJil D ,i2
7.'k QU 'A CA 9225:
USE OF PERMIT
GINE-0�t.AI..
50 f. V 6r' f~t:A.lU]M° WkiIJ.. C;TY STA14riAP.0
0 FT. t7V.Ft.LL 10.09 L
XSMMII COST OFCO9S7KIi"Lo:7
FF.RkKysyWLTIt
C(XI45 RUC7`ION RR 101-000.419.000 $31,00
_ ��� S-".tYJ'�.'AL 0
WS DPIANTO TTECK
1W
$31,00
D�: MJ1 TYRE -P -AI � �a�:lWmoi
AP 0,00
`7 U2
CITY OF LAQUINTA
FINANCE DEPT.
RECEIPT
DATE '
�.
BY%
DATE FINALED
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
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 Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backsy _
Footings �O
Electric Bond
Main Drain
Bond Beam �Z_
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Wq!ar Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
I, Shower Pans
O.K. for Finish Plaster
sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
L
( l Gl
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)
ESSI SHAHANDEH,P.E.
CIVIL ENGINEER
45175 PANORAMA DRIVE, SUITE A-1
PALM DESERT, CA. 92260
(760) 34O,9597
Retained Height -
4.00 ft
Wall height above soil =
6.00 ft
Slope Behind Wall =
0.00:1
Height of Soil over Toe =
1200 in
Soil Density =
110.00 pcf
Using AASHTO Concrete Load Fac
Wind on Stem =
16.0 psf
Title RICHARD RESIDENCE
Job # 999.04 Dsgnr: ESSI Date: SEP 27,2002
Description....
6 GARDEN WALL ON 4 RET. WALL
This Wall in File: C:\CIVIL\STRUCTURE\RICHARD\M9.RP5
Cantilevered Retaining Wall Design RetainPro Professional 5.0.7,8 -Jul -99, (c) 198999
Soil Data
Allow Soil Bearing
= 1,500.0 psf
Equivalent Fluid Pressure Method
Heel Active Pressure
= 30.0 psf/ft
Toe Active Pressure
= 30.0 psf/ft
Passive Pressure
= 375.0 psf/ft
Water height over heel
= 0.0 ft
FootingIlSoil Friction = 0.400
Soil height to ignore
for passive pressure = 1200 in
Seismic Load Kae for seismic earth pressure = 0.575
Ground Acceleration = 0.7g Ka for static earth pressure = . 0.236
Footing Strengths & Dimensions
fc = 3,000 psi
Fy = 60,000 psi
Min. As %
= 0.0018
Toe Width
= 3.00 ft
Heel Width
= 1.33
Total Footing Width
= 4.33
Footing Thickness
- 1200 in
Key Width
= 6.00 in
Key Depth
= 3.00 in
Key Distance from Toe
= 0.00 ft
Cover @ Top = 200 in
@ Btm.= 3.DD in
Added seismic base force
465.2 lbs
Sliding Calcs (Vertical Component Used) Bar Lap/Hook BELOW Ht. in = 24.00 6.00
Lateral Sliding Force = 876.2 lbs Wall Weight psf = 58.0 98.0
less 10006 Passive Force = - 761.7 lbs Rebar Depth 'd' in = 275 7.25
less 100% Friction Force = - 741.2 lbs Masonry Data
Added Force Req'd
= 0.0 lbs OK
Difference: Kae - Ka
=
0.338
'
Using Mononobe-bkabe / Seed -Whitman procedure
=
Toe
Heel
Factored Pressure
Design Summary
0 psf
Mu': Upward
Stem Construction
1 ft-#
Mu': Downward
Top Stem
2nd
Mu: Design
= 528
411 ft-#
Actual 1 -Way Shear
= 9.25
7.25 psi
Stem OK
Stem OK
Total Bearing Load = .
1,853 lbs
Design height
ft =
4.00
3.75
...resultant ecc. =
10.40 in
Wall Matcriai Above "Fit"
=
Masonry
Masonry
Soil Pressure @ Toe =
952 psf OK
Thickness
Rebar Size
=
=
6.00
# 4
10.00
# 4
Soil Pressure @ Heel =
0 psf OK
Rebar Spacing
3200
32.00
Allowable = 1,500 psf
Soil Pressure Less Than Allowable
Rebar Placed at
-
Edge
Edge
Design Data
ACI Factored @ Toe =
1,081 psf
fb/FB + fa/Fa
_
_
0.773
0.307
ACI Factored @ Heel =
0 psf
Total Force @ Section
lbs =
.96.0
99.5
Footing Shear @ Toe =
9.2 psi OK
Moment.... Actual
ft-# =
288.0
3125
Footing Shear @Heel =
7.2 psi OK
Moment..... Allowable
ftp=
3728
1,018,7
Allowable =
93.1 psi
Shear..... Actual
psi =
3.2
1.2
Wali Stability Ratios
Overturning =
1.88 OK
Shear..... Allowable
psi =
38.7
38.7
Sliding =
1.61 OK
Bar Develop ABOVE Ht.
in=
24.00
24.00
Sliding Calcs (Vertical Component Used) Bar Lap/Hook BELOW Ht. in = 24.00 6.00
Lateral Sliding Force = 876.2 lbs Wall Weight psf = 58.0 98.0
less 10006 Passive Force = - 761.7 lbs Rebar Depth 'd' in = 275 7.25
less 100% Friction Force = - 741.2 lbs Masonry Data
Added Force Req'd
= 0.0 lbs OK
....for 1.5: 1 Stability
= 0.0
lbs OK
Footing Design Results
Solid Grouting
=
Toe
Heel
Factored Pressure
= 1,061
0 psf
Mu': Upward
=. 0
1 ft-#
Mu': Downward
= 0
412 ft-#
Mu: Design
= 528
411 ft-#
Actual 1 -Way Shear
= 9.25
7.25 psi
Allow 1 -Way Shear
= 93.11
93.11 psi
Toe Reinforcing
= # 4 @ 18.00 in
psi =
Heel Reinforcing
= # 4 @ 18.00 in
Key Reinforcing
= # 4 @ 2225 in
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE.�,;��BY
fm
psi =
1,500
Fs
psi =
24,000
Solid Grouting
=
Yes
Special Inspection
=
Yes
Modular Ratio'n'
=
25.78
Short Term Factor
=
1.000
Equiv. Solid Thick
in=
5.60
Masonry Block Type =
Medium Weight
Concrete Data
fc
psi =
Fy
psi =
Other Acceptable Sizes & Spacings
Toe: Not req'd, Mu < S' Fr
Heel: Not req'd, Mu < S : Fr
Key. Not req'd, Mu < S ` Fr
1,500
24,000
Yes
Yes
25.78
1.000
9.60
�Q4pFESSd0/y4
�Q�O Q\PR S H4i
Q- a
W "' No.47834 `"
a` Exp. 93
ESSI SHAHANDEH,P.E.
Title RICHARD RESIDENCE
CIVIL ENGINEER
Job # 969.04
Dsgnr: ESSI Date:
SEP 27,2002
45175 PANORAMA DRIVE, SUITE A-1
Description....
PALM DESERT, CA, 92260
5 GARDEN WALL ON 4 RET. WALL
(760) 340,5697
This Wall in File: C:\CIVIL\STRUCTURE\RICHARDVc99.RP5
Cantilevered Retaining Wall Design RetainPro Professional 5.0.7,8-Jul-9'9, (c)1989.96
Summa of Overturning & Resisting Forces & Moments
y
.....OVERTURNING.....
.....RESISTING.....
Force Distance Moment
Force Distance
Moment
Rem lbs ft ft-#
lbs ft
ft-#
Heel Active Pressure = 375.0 1.67 625.0
Soil Over Heel =
218.5 4.08
8920
Toe Active Pressure = -00.0 0.67 -40.0
Sloped Soil Over Heel =
Surcharge Over Toe =
Surcharge Over Heel =
Adjacent Footing Load =
Adjacent Footing Load =
Added Lateral Load =
Apal Dead Load on Stem =
0.00
Load @ Stem Above Soil = 98.0 8.00 768.0
Soil Over Toe =
330.0 1.50
495.0
SeismicLoad = 4f.2 3.00 1,395.7
Surcharge Over Toe =
Stem Weight(s)
3725 3.26
1,214.7
Total = 876.2 O.T.M. = 2,748.7
Earth @ Stem Transitions =
ResistingfOverhirning Ratio = 1.88
Footing Weight =
649.5 217
1,406.2
Vertical Loads used for Soil Pressure = 1,853.0 lbs
Key Weigh =
18.7 0.25
4.7
Vert. Component =
253.7 4.33
1,141.9
Vertical component of active pressure used for soil pressure
Total =
1,853.0 lbs R.M = `
5,154.4
16
Pp= 761.72# — 375.#
951.51psf
CHANGE IN MAT'L SPEC. OR BAR SIZE/SPACING
6' C.M.U., SLD, GROUT, SP. -INSP. ` —
f'm= 1500. psl, - Fy= 60000. psi
#4 @ 32.' Vert @ Edge
#4 @ 24' Horiz
3 1/4'
10'
C.M.U.,
SLD. GROUT, SP. INSP,
f'm= 1500.
psi, Fy= 60000; psi
M
#4
@ 32.'
Vert @ Edge X-0:
o
#4
@ 24'
Horiz2
Nit
3/4'
(U I -
?U
HEEL
(top)
#4 @ 18.' o.c.
' - -.:.::.•"-
#4 H❑RIZ.
AS SHOWN
I I
I
it
—1 no
3'-10'
A'—A&
RETAINING WALL
NTS
09/24/2002 14:24 7603197410 AMIR ENGINEERING PACE 01
j
r----� �� -Z-) 1-71 L
*71
U
lily i f 1
CORE DRILL ANIi EPOS
#4 ! 32' D.C. R NEW
EXTENTIDN LOCA TION
I I
PROPOSED I L. --EXISTING WALL,
FOOTING _ _ J FOOTING
8`
6'
CORE DRILL AND EPDXY
04 ! I8' QC, a NEW FOOTING
EXTENTION LOCATION --�--
IIS aw
W VAp
FOOTING DESA L
NOT TO SCALE
HI i t11 la-•;
I,"= �t � o..tan
&M "O4 a�1g1 06 s
£0'd TZTTOb£094 H3QNVHVHS ISS3 WV L0:TT ZOOZ-ZO-100
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may. be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under Stair
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7012
FAX' ( 60) 777-701
OWNE SI ATURE/DATE
PROPERTY ADDRESS
0 _ zz
r PERMIT NUMB R(s)