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9712-044 (BLCK)LICENSED CONTRACTOR DECLARATION `. I hereby affirm under penalty of perjury that I am licensed under provisions of H i Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 04 W f Professionals Code, and my License is in full force and effect. ch License # . Lic. Class Exp., Date Ln'. U.I oZ r— Date Signature of Contractor to O� U OWNER -BUILDER DECLARATION Wa I hereby affirm under penalty of perjury that I am exempt from the Contractor's U) License Law for the following reason: Z_ ( ) 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).- r � ( ),.,I am exempt under Section B&P.C./for�tfis reason O N VDate rl y ' G , G 7 Signature of Owner U 101- Q WORKER'S COMPENSATION DECLARATION p Ir 2I hereby affirm under penalty of perjury onerof the following declarations: Lo H p () 1 have and will maintain a certificate of consent to self -insure for workers' X W compensation, as provided for by Section 3700 of the Labor Code, for the O J Q performance of the work for which this permit is issued. m Q (� ( ) I have and will maintain workers' compensation insurance, as required by O C) Q Section 3700 of the Labor Code, for the performance of the work for which this a LO Z permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. oo 5 0 r J (This s 'tion need not be completed if the permit valuation is for $100.00 or less). ( t)"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 3 Code, I shall forthwith comply with thoseprovisions.-•"•`v VDate: '§ ` U —,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 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 representative"Of this City to enter upon the above-mentioned property X in�spec�tion purposes. Signature (Owner/Agent) f - ����"'Date ' BUILDING PERMIT PERM'f# . -�_ .�, CONTROL# DATE 1,219197 VALUATION S1,77,S 0+) LOT TRACT A 7 VVVV. 111 JOB SITE n► �q �Y r ADDRESS !}5"�+'�4,1'..��O0 *�.tr�.��i..C�.RE S11 DRIVE' OWN�JER� CONTRA(C/T�O�R7/tDESIGNER /ENGINEER �[t�y�r +5y�8ll��d�{y-,+Ery_Yr3�i•7Y.f�1t5�.`V�t�Yy�ySl�o`i it LA E?i iNrf'A CA 9225; C" lup f USE OF PERMIT �i.fli�i3j�i>.� • DEC 0 91997 Cf'iY O � NTA 6 rr. WALL 71- ,k { ;b MIFILIVIATI.E.Dt 'h"1031' 01? CON'S"IRRUM11UN �; �+?��: f'i�� ts� 3YC>t�i t� �i� � l.7I ��-,q { ii•tH1f3 �•f; :t..€Nt �- �f,fi�t.Tt"1�#���)'.. �`c-3�v�r'�f 1f;;t�1f�R1 ��Nf;ti s�t.a�rJ �:ja.l.?r•77� t L $0.11 (v '.1'OT!A1, P14,kj4 IT fet,F-S 0 t E, t'k!)W RECEIPT DAT � �� «�� �� BY-" `� p DATE FI ALE � 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 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 APPROVAL 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 Fcdures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: .'I 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 Stare 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: (760)(7,77 701 OWNER'S f IIGNATURE /DATE PROPERTY ADDRESS q -)la - 61 PERMIT NUMBER(s) SPECIES 4 GRADE MAX. 0/A SPANS WEB BRACING RLOUIREHENTS NOIL+ 1X1 CONIIN1111115 LNILWIL ORHCINI: hl(11Cr1- 2X4 T/C 2X4 B/C NCD HER RED MAXIIIHM SPINI Nn DNF EO III TIIE MIUPnINi OF NCO H{lll 1N BO _---------- . 'SIZE DI(AUC OF .HUBS WITH: BknCC ORIICE NIIILS HHERL• INUICHILD UY I.). -------------------------- 2 2x 1 .3/Si .3/STUD S -P -F 27' 1. 32' 0' NOTE+ LOCATE INTER -PANEL' SPLICES D O U G L A S F I R- L R R C H AT 1/4 PANEL LENGTH ./- 12'. ------------------------------------- TOP CHORD SPLICES: NOTEt PROVISION MUST BE MADE 1N THE DESIGN D•5•STR• MC -15 31'- 3' 32 - D" IS�1 (IF TIIE HnLLS (BY 0111FRSI In ACCIIIIHO- 0.5 -SIR • 30'- 7' 32'- 0' 2445 TO 32'- 0- OAIE LAILRHL DISPLACEMENT [HORIZONTAL THRUST[. SEL •STR• HC -15 30'- I' 32'- 0' •l DENSE HC -15 30'- 6' 32'- 0" SEL•STR• 29'- 4' 32'- 0" at DENSE ■1 MC -15 ■2 DENSE HC -15 29'- B' 32'- 29•- 2" 32'- 28'- 7" 32'- 0' 0" 0' Tpollssro,E( }o�s«".`�at/� man µ0A/ try ?� r IIT �`4. /%rf� C4 ■ 1 •2 DENSE 28'- 5' 32 - 27'- 8' 32 '- 0" 0 ' IY/iY i 1� °i 27/x' a> CIVIL�. a a sYnn • ABOUT ■2 HC -'t5 27'- 4' 32'- 0' '?+�„„y�A R2 26'- 1' 32'- 0" ^o. 6310 �'ft Of C;LjW) \' - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - H E H - F [ R - - - - TPo((ssf0,4 L•• o •.........•r .. � •(.`- __•' ��. •.t PIJIC� 3215 10 25'- 6' n• 1015 TO 3. - O ' SEL SIR• 27'- 0' 32 - 0" Ho al�l,y/�� )'/� ?TINT °' - IIM lM e � `•./�Z`%1J�,c /LATE ROTATED 90 DEO. N I 25' - 8' 31 ' - S' / (J'I.:�"T:� ' . ...... .....• J'4/(0(OTI� ------------------------------------ S P R U C E- P I N E- F I R ------------------------------------ - f �•.'n:.�v�� a:�ngq �Ls;lne"` frc �a'luai a vLwigP/o F��� '/ CE 1860610[32'- 0' IS-) NO CE 2116 ToO . 3 322'- o• SEL •STR • 26'- 0" 32'- 0• J ■I 24'-2' 28'- 5' il QIY ■214 _ _ IF,9,1 4,, < _______ --2----4--------7-- iJ'4,, or 100 12 111.' yr41D()S4( M 5 R (FOR SPECIES LISTED ABOVE ONLYI 4C�:-- 240OF-2 OE 32'- 0" 32'- 0' 225OF-1 •9E 31'- 4" 32'- 0" 4375 to 211'-10• 2)OOF-t •BE 30'- 6' 32'- 0" 4890 10 3_'- 0" 1950F-I.7E 29'- 9" 32'- 0" I800F-1-GE 28'-l0' 32'- 0' 165OF-I-SE 28'- 0' 32'- 0" 0830 I50OF-1.4E Ia50F-i 27'- 0' 32'- 26'- 3' 31'- 0' 1' " 2 SIZE HF.'Sf`F 12 O -29 — ci+�tc� •3E 24Vn 23•- F- a,vo�c,<1 ------- _________________________ 3275 S��q/) N E B n E H B E R S (EOUAL OR BETTER) 3290 511- 0' 40.15 32'- O" ------------------------------------- nr-L 2x4: 83/STUD S -P -F '4'/'. ^li'• H• 2490 31'- U• C'�/� 2,,,J'O - csk/,S7 -6 6••b4SdF 3275 32'- D' v OVERALL SPAN 11 1� IH( /EnIVII;IUILIII of DIMERS 10 ASCERIO:N THAI tHE LOBUS UTILIZED Crl IMS LIESICN nEEI OR EXCEED (HE MAX• SPAN CODE SPACING DATE ICI.1AL 01 ND LOADS IMPOSED BI ICAL CLIMATIC RECOROa. 110 RESPOr15l0ILITT THE STRUCTURE AND THELIVE 19 ASSUMED LOACS IMPOSED Of THE LOCAL BUILDING CODE OR HISTOR- FOR OInEN9[OIIRL ACCURRCf. 11ERIFT P.LL DIMENSIONS PRIOR 'IIURLITT LIVE LORD.... 16 -0 32'-0• UBC 24" O.C. 8/22/89 (D FABP.ICRIIDII. FABRICATION I IPI[ RrID INC tR115NRL TRUSCOn SHALL CPLT NITX IME DO CONTPOL MRIIUAL' OF INE 'TRUSS PLATE [NSI ITUTE MANUAL• CONNECTOR PLATES SHOIIH ARE TRUSNAL 16. 16. OR 20 OADE AS SPECIFIED. OERO 10A0..:...7. -- •(]..s.r. T R ' I'L11i ES SHALL BE APPLIED 10 BOTH FACES OF THE TRUSS AT EACH JOINT. ALL TRUSS JOINTS SHALL BE TICMT FITTING U S NRL •1110 R01 PLATES RNRLL BE TIO11 IMOEOOEO. PERSONS ERECIINO TRUSSES ARE CAUTIONED LI SEEM PROFE3SIONAL AREFER wfLARDI NC IEMPORNRI ERECTION BRUCIND Mnl[H 19 Rl.lAiS REOUIRiO TO PREVENT TOPPLING AND '0(RIINOIND". REFER ID 'UkHCINO IRUSSE S: COMMENTARY AHD RE COMnEHONf IONS* [TPI). ONLY IDT ERR[ tlR9CIN0 REOUI RED Of fN0[P(DUAI CEILING 0•L••.,• TOTAL O •Q 33.0 SYSTEMS A T R U S W A L S T A N D A R D In1UD IRUSS nEMeERS IS NOTED ON IIIIS CRIININD. INE TOP CHORD 19 ASSUMED TO BE LATCR:LLT BRACED AT SHEATNINO UNLESS ■ ....r. I(HIANISE TDfE9• IMF' BOTTOM CNfIRO 1! A9 S11MEn f0 BF. LA'ER(ILI.T OWED IF Rim CEIIIND moirkinl 13 At IACHEO ■ 6 P3/ CLILINO 8925 STERLING IAO ST• sc-32-4-12-33X �,• 4 �} u' 'll Y.l Atr IU [III IIIITIIN IHillRD. DIIICNNI'1. 1NI'llk" UNIIf.E Ihl: Nntwii FIumn 111 INtrPY(RH NIIl I-XCIIIIINII IH• -0-. rNNS`19 Ll It ulll U[ 1'l HCl 11 IN INI1 filYlNuriniNl Inst Nlll CIIU:fI MIL nUISIIINC CONIINI IM IOL HUUU IU CXCEEU 19X REO(1CTION TAKEN mU/UN CAU 5E CIIBIIECIUI' PIATE CUNROSIIRI. EIIMUER. NIIICH IS IIOf H 9TkUCTURHI REOUIREnENT OF IME IRU55. MITT HE 254 DURATION FACTOR SUITE 150 . ITIIIFED f0 MAINTRIII UN1FORn CEILING HEIGHT Ano PROPER APPEARANCE. WHEN DESIRED. CnnBEk IS BEST DETERMINED IRVING. TX 75063 ' .If .mpirinus n('PIIOIIIOn of FTPFRIENCE .Alin THEREFORE IS OUTSIOE TIIE SCOPE OF RISPONSIRILIT/ OF TRU7HAL.