0004-298 (SFD)U
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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
Professional#Code, and my License is in full force and effect.
License
.y#i r .y / CCt�Lic.. Cla s.,,, Exp. Date y 9
r�y'41174 ,/ Jed !� 07Pt3�Q'6'
Date 5 �� �.fi '/ Signature of Contractor 7
M,,.:«mow^•'..^"'.'".`_ . .
�,: --"" OWNER -BUILDER DECLARATION
1 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.
STATE FOD 0416_00DVA
(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 99 ornia, an�g ere that if I should become
subject to the workers' compen'satio provisions off Section 3700 of the Labor
Code, I shill for{hwith comply with th,Jse provisions
Date:,' X>' /"Q A 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 represehf°tives of this City to enter upon
the above -mention � $ropert)efor inspection p rposes.
,�l c'
W �_. - ate 4lr�
Signature' (Owne'r/Agent) -
BUILDING PERMIT PERMIT#
DATE VALUATION LOT TRACT
26*524
JOB SITES APN
ADDRESS
OWNER ; CONTRACTOR/DESIGNER/EN &NEER
79.480YWARMOD 79x295li:P►NCTIO`rteQURTWDIR.
LA QUWTA CA 92253 !A f. tW- A Mk 9.225.3
060)771-1941 CD10 2996
USE OF PERMIT
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W`isi3419,;�tdf'I' 3:x' OMS 4iOT N ' JOE SP1,/i.Fp✓f.1 BrY. LLIPk.+LB.U.S'i` h f.,Jl4�+JYi'.11� AC -1'A
TRACT CONSTRUCTION 4;310.00 SF
i•'t:'3RCHIPA IO.' 112.00 SF
,�bVF,,t7A�.A.� D COFT �i,`1 Y 'bryJ'7�a�� nU'4.A.1�.✓1�"1
smvawz 1c
M.401 T SUCTION ME
101.000-4.38.000
slj- oo
^Pi;.:aAXCHECK Fr&
101-000-439-319
$1,331.69
PER r<?Ef.'COMT
1011.000439-318
-SB .00
Ar1=t-3A:N?C°..drs1.. PR'u;
1121 -?SCA -x.21 -coo
JSi,6300
VIECT?ICA10 VU,
1€1.000.42 0-000
$231,47
1'Tn..�i'1��1�#�D`s�YC4 FES
101:Qy/0��k�pi-4�]{�'-C °y��s
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STROW W ThAR,rc�:',S.O Y 3'r�: - REQ PID
101 "l?FP6J-,41 '
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1401-�000•.�123-'
A= '94 P U B LlC PLACFO n PIESIr 701-ONu -7,53- 'M I MAY PT 100
CITY OF LA OUINTA
STFB `.,r0ULCONMALIC`MNA L`"' 03Pkh1WEDEPT
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RECEIPT I DATE r / I BY
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
'S,, acks
Forms & Footings
Slab Grade
p _
C/ _ _
_ _ _
Underground Ducts
Ducts
Return Air
Steel
_
Combustion Air
Roof Deck
/ d
Exhaust Fans
O.K. to Wrap
Framing
_
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F.A.U.
Compressor
_
Insulation'��
/ p? ��L
Vents
_
Fireplace P.L.
(
Grills
-
Fireplace T.O.
��/
Fans & Controls
_
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
_
Drywall - Int. Lath
Final
3 /Q— �- L
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Waste LinesS Z/ O
Water Piping
Electric Final
Heater Final
Plumbing Final
Plumbing Top Out
_
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer Connection
Conn
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Pool Cover
Encapsulation
Gas Piping _
Gas Test
Appliances
_
Final
COMMENTS:
Final
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Utility Notice (Gas)
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ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
-�y--=
Low Voltage Wiring
Fixtures
_
Main Service
Sub Panels
_
e
Exterior Receptacles
_
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)®- L
Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated 760-771-8515
CERTIFICATE OF COMPLIANCE
Date 5/8/01
No. 21989
Owner NameLa Quinta Orchard Partners
No. 79-480 Street Briarwood
city La Quinta
Tract #
Lot # 3
Type of Development Single Family Residence
Comments
APN # 769-760-004
Jurisdiction La Quinta
Permit # 0004-298
Log #
zip 92253 Study Area
Square Footage 4,310
No. of Units 1
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered
patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It
has been determined the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of
2.05 X 4,310 or $ 8,835.50 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
L d
Fees Paid By CC/ Eldorado Bank - Judy Halpain Telephone,
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Paula Ruiz Payment Received $83835.50
Signature
Check No. 352472739
40TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
rbove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
:ollect them on the District(s)(s) behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
06/08/2001 11:56
June 8, 2001
7603252863 GOUVIS PS
c) -n
T.D. Desert Development c/o Sparks Construction
79295 Rancho La Quinta
La Quinta, CA 92253
Attn: Nolan Sparks
Re: Estancias Lot 3
Kitchen remodel
G.B.C. Job No. 20980
Dear Mr. Sparks:
Pursuant to your request regarding the above captioned project, per our phone
conversation on 6/7/01, we subunit the following:
Follow the attached partial framing and foundation plans for the omitted walls and added
ceiling beam at left of the kitchen to support the roof.
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 ENGINEERING CALIFORNIA
Saeed J. Bekam
President
Attachments (5)
Cc: Stormy Dayton
SB:RF;ig
20980.doc
Raymond B. Frangie
Project Manager
z
PAGE 01
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06/0B/2001 11:56 7603252B63 GOUVIS PS
.GOUVIS ENGINEERING CALIFORNIA
--------------------------SHEET
JOB •
CLIENT .-
PLAN NO.:�
DATE 6- 8-2001
A FLUSH CEILING BM. LEFT OF KITCHEN
OVER-ALL LENGTH: :19.50 RCTS AT: .00 19.50
APPLIED LOAD DOWN +)
4500 T 14/� ,t �c CON LOAD ,
30 1 1 UNIF LOAD #/LF
REA TIONS ( UP
LEFT: 1561.7 RIGHT: 3523.3
****** A*0119F
USE 24F GLH 5.125X 13.5
A= 69.188 S=-155.672 I= 1050.785
FV=165. - E=1800000. DF=1.00
CRIT SHEAR = 3490. AT 18.38 1.5*V/(A*FV*DF) = .46
SPAN MAX MOM= 18924. FT.LBS AT 14.00
FB=2369. M/(FB*S*DF)= .62
DEFL= -.54 AT' 10.67 L/240.= .98
"loll
0
56t!) lb bM�'r4-
06/08/2001 11:56 7603252863
GOUVIS PS
GOUVIS ENGINEERINO CALIFORNIA
(UHC 97)
SHEET : tp
JOB NO. : 20980-111
CLIENT : T.D.DESERT
PLAN NO.: LOT 3
DATE : 02/01/2000
ENGINEER: RAYMOND(VER5.60)
BEAM HUMBER: 14 DROP BM. AT BREAKFAST
PAGE 06
OVER-ALL LENGTH (FT): 19.50 REACTION AT: 0.00 , 19.50
LOADS (DOWNWARD +)
BEAM WEIGHT : 30.0 PLF FROM 0.0' TO 19.5'
PRIMARY ROOF : 472 PLF=23.0*(21+20)/2 FROM 0.00' TO 19.50'
PRIMARY ROOF 82 PLF= 4.0*(21+20)/2 FROM 0.00' TO 19.50'
POINT LOAD @17,.2(G= 3500 )
REACTIONS .(LBS) LEFT RIGHT
DOWNWARD(DL+LL/MAX.) 5670/5670 8189/8189
UPLIFT (DL+LL/MAX.) 0/0 0/0
*** USE OLE 24F V4 5 1/8 x 16 1/2 DROP BM/HDR ***
*** W/ LEFT: 2-2x6 TRIMMER/STUD RIGHT: 2-2x6 TRIMMER/STUD
***0.375" CAMBER UP @ SPAN( 9.9')
CRIT MOMENT = 29616 LB*FT @ 10.42' RATIO=0.544(Fb= 2810 S= 232.55)
CRIT DEFLTN = -0.598 INCH @ 9.92' BASED ON (L/ 240)= 0.975
CRIT SHEAR = 7375 LB @ 18.00' 1.5*SHEAR/FV*A=0.436(FV=300 A= 84.56)
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06/08/2001 11:56
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GOWIS P5 PAGE 03
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