0102-157 (PAT)W
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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
769495 BMW
7 ^j sw ISignature of Contractor
OWNER -BUILDER DEC,L_ARATION_-•---
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 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 agre@_th,.at if I should become
subject to the workers' compensation provisions of _r 6,
of the Labor
Code, I shall forthwith comply with those- provisions` "
p' Date:'" r.•rx r Applicant—
Warning:
pplicant Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to,6rriminal'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.
F
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 15 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, indemntft,R.f
& hold harmless the City of La Quinta, its officers, agents and employees' r
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 certifyrthat I have read this application and state that the above information is
' correc4. I agree to comply with all City, and State laws relating to the building
c9ris66ction, and hereby authorize representatives of this City to enter upon
4'tiie above mentioned property for inspectiopurposes,'-
C Signature•(Owner/Agent),�'•�%^�'>^ +"" "� Date � ��'� _•�.�
BUILDING PERMIT PERMIT#
DATE -y /f VALUATION LOT 01021-1,5 j TRACT
.✓ ! f� f i i j !�
JOB SITE
APN
ADDRESS
OWNER
CONTRACTOR/DESIGNER/ENGINEER
EMM UK MAE
Y LI.L, iYC!IU-)111 JQ-4 & IJIfe� Gt,7
4J5_8>�TF .39
1i7;�c�r��'�i'�.ti� ��Pk
L tL QUKrA CA rJ° 225
MMC3NG0 VAi.:€ EY CA 92256
(760)363-62..39 CBIX 02566
USE OF PERMIT
Twrno
tatb.0o Xt
PL&I CHPWIC .LrZE 10 1 - 010 -43.9-`I3 8 $22,76
(10)g111TRCSO'410H ripli; 101 -000-4i6-OQe $35.00
SEM- TMAL, W.YMMUC�`�`IM SND PLAN Mif-T.'
$37:15
ONO TOTAI,w.
FEB 2 0 2001
ATY UF LA UUiW
RECEIPT
DATEf
BY
D T INAL m
[
INSPECTOR
17
V
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR ,
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings
_ _
$�6�Q
Underground Ducts
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
/
F.A.U.
Framing
�// l
Compressor
Insulation
`
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines .
Party Wall Firewall
Exterior Lath
Drywall -Int. Lath
Final
BLOCKWALL APPROV �C_s
Final
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
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
COMMENTS:
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)
_ All GOUVIS ENGINEERING
• C A L I F O R N' I A•
E-MAIL TO • SUPPORT@GOUVISGROUP.COM • SALES@GOUVISGROUP.COM
CALIFORNIA
October 10, 2000
J.B.L. Building & Design
1243 S. Gene Autry Trail, Suite B
Palm Springs, CA 92264
Attn: James B. Linzner
Re: Okelly Remodel
Trellis and Fire Place Design
GEC Job No.: 21201
Dear Mr. Linzner
Pursuant to your request regarding the above captioned project, we submit the following:
Follow the attached plan and cross section I and II for the free standing fireplace. Also
follow the plan and details "A", `B" and "C" for the added trellis.
Note: Please verify the above with the building department prior to construction.
If you have any questions, please do not hesitate to contact this office.
Sincerely,
GOUVIS ENG
SJB:cb -
Attachments: (16)
21201
GOUVIS ENGINEERING GROUP OF COMPANIES WITH OFFICES IN:
4400 CAMPUS DRIVE, SUITE A * NEWPORT BEACH, CALIFORNIA 9266
2150 EAST TAHQUITZ CANYON, SUITE 9 * PALM SPRINGS, CALIFORNIA 92262
FIELD OFFICES * SAN DIEGO * PLEASANTON
WEB -SITE: WWW-GOUVISGROUP.COM
0 * (949) 752-1612 * .FAX (949) 752-5321
* (760) 323-5090 * FAX (760) 325-2863
INTERNATIONAL OFFICE: VIETNAM
0
.FAIRWAYS ASSOCIATION
July 11, 2000
Mr. and Mrs, Edwin O'Kelly
RE: Architectural Change Request
-mar Mr.-&-Mra.-AD'Kelly: - -
The Architectural Committee of the PGA WEST Fairways Association has
reviewed the plans submitted for a kiva and trellis at your new PCA WEST home.
Based on its review the committee has approved the pians as submitted with the
following condition;
1. The colors to match existing surroundings.
Please contact me at (760) 564-3868 if you should have any questions.
„� Sincerely,
For the Architectural Committee
n J. Mon
Association Manager
P.O. Box 13710 • PALM DESERT, CALIFORNIA 92255 - Tel. (760) 776-5100 • Fax (760) 776 -Sul
emalh pgawest@monarchgrp.tom
IGO UVIS
I * C A L
CA VAII
TO J.B.L.UILDING & DESIGN
1243 G AUTRY TRAIL SUITE B
PALM SP INGS, CA 92264
Phone ( 60)322-3502 /1
ATTN: JAMES LfNZNER (�
RE OKELLEY,ADDITION
ENGINEERING
I F O R N I A
GEC JOB NO: 21201
DATE 9/13/ 000
DATE FAXED: gyp/
TIME ;�
BY
PLEASE VERIFY ILL INFORMATION LISTED BELOW. IF CORRECTIONS ARE REQUIRED PLEASE FAX THE
CORRECTED SHEEI TO OUR PALM SPRINGS OFFICE AT (760)325-2863. THIS INFORMATION IS VITAL
AS WE USE IT TC PERFORM OUR ENGINEERING DESIGN AND ANALYSIS. ITEMS THAT ARE MARKED WITH
DASHES ( ----) bEED YOUR IMMEDIATE ATTENTION. EXTRA CHARGES MAY APPLY IF INFORMATION IS
CHANGED AFTER ENGINEERING BEGINS.
ARCHITECT JOB#
OWNER N/A
PROJECT NAME OKELLEY ADDITION
DESCRIPTION ADDITION
ADDRESS 55-839 BRAEBURN
LOCATION LA QUINTA, CA
PLAN NUMBERS
BILL TO I: J.B.L. BUILDING & DESIGN
SCOPE OF WORK {: ENGINEERING FOR STRUCTURAL CALCULATIONS & DRAFTING
COMMENT
CODE : 1997 jUBC
5KC:
LA WUINTA CITY BUJU.
IJEFT.
STANDAKD
SEISMIC ZONE
:4
SRC:
LA QUINTA CITY BLDG.
DEPT.
STANDARD
EXPOSURE ;
C
SRC:
LA QUINTA CITY BLDG.
DEPT.
STANDARD
WIND SPEED
70 MPH
SRC:
LA QUINTA CITY BLDG.
DEPT.
STANDARD
SNOW LOAD
0 PSF
SRC:
LA QUINTA CITY BLDG.
DEPT.
STANDARD
SOIL BEARING PtESS. : 1000 PSF
SOILS REPORT ��yy
FOUNDATION : CONVENTIONAL MONO -POUR FOUNDATION SYSTEM
SPEC. FOUND. IT. :
FOOTING REIN CING: ONE #4 TOP AND ONE #4 BOTTOM
ROOFING : N/A
ROOF FRAMING : CONVENTIONAL
FLOOR FRAMING :N/A
LIGHT WEIGHT NC. : NO
EXTERIOR FINI H :7/8 INCH STUCCO
CONCRETE STRENGTH :2500 PSI
WOOD SPECIES: DOUGLAS FIR LARCH WITH MAX. 19% MOISTURE CONTENT PRIOR
TO INSTALLATI N OF FINISH MATERIAL
4X MEMBERS NO 2 OR BETTER
6X, 8X BEAMS HEADERS NO. 1 OR BETTER
2X JOISTS & ERS NO. 2 OR BETTER
PLATES AND B CKING STUD GRADE OR BETTER
STUDS STUD G E OR BETTER
E SUR
MUD SILLS PRE TREATED UTILITY GRADE OR BETTER
(Page 1 Of 1)
GOUVISENGINEE&WGG UP OFCOMPANMSWl1HOFFICESIN: WEB-=: WWW.GOUVLSGROUP.COM
4400 CAMPUS DRIi� UnEA. NEWPORTBEACH, CAIIFORN M 92660 • (919)752-1612 • Faz(949)752-3321
2150 !" TAHQUIIZ C ON SU17k 9, PALMSPRINGS� CALFORNIA 94262 • (760)323-5090 • Faz(760)325 2863
FIELD OFFICES • ANDIEGO • PLFASAN70M • • IN7ERNA770NALOFFICE: VIETNAM