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LICENSED CONTRACTOR DECLARATION
I hereby affirm 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.7407+ 13
License #t / Lic. Class - �Exa. Date .✓"''+
Date{.:i.f !.�^ -- SignatureofContractor
OWNER -BUILDER DECLARATION
I hereby affirm 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 secti�oP �,:.gq,ltJ y completed if the permit valuatiop i�S1f .lot 0.00 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 Se6tion 3700 of the Labor
Code, I, shall forthwith comply with those�jprovisl6`ns.
Date: l f ' 6, 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 application agrees to, & shall, indemnify
& hold harmless the City of Indian Wells, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and voidli
work is not commenced within 180 days from date of issuance of suc
permit, or cessation of work for 180 days.will subject permit to cancelli i6
F certify that I have read this application and state that the above inform' it
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 forr inspectioppurpgses.
Signature (Owner/Agan
Date IA ? f 4
ALC '
BUILDING PERMIT
PERMITS
96419d1.7d1
DATE,.
VALUATION uP+.Si� LOT{ TRACT 2.7840
JOB SITE ADDRESS
48.520 i",.t�;P I.V�'JE�'il�i�FJr �'Vt��'
APN
646-39W020
OWNER p
! ' .
CONTRACTOR
;SP.A.R1KS I�1STitfJ T-.0
��.: � airy .0 ► t;
'V 295.1 ICHO LA QU11 1A."A..
[�.t .130 1726.
LA QtJ',1�"rA . 922.53
LA ()LFMA C;A. 9W13
(6t9)771-1941 E;13t:# 2W6
DESIGNER/ENGINEER
;�i}r-1941
USE OFPERMIay1i41 '.,I1'A1MILYDWELLING
RANCHO LA QU9Ni'A _ -
'WR1iA'C.A PLAN 1
FEE DESCRIPTION
= FEES
' l
i
CU3'.fG-N1 C(. N1 STRL1CF10N 2,a3I,00 LF
POPICH/pATt0 170.00 S -
C►FiRAGEICARPOR.T 486,00 SE . �Y
i
ESTIMATE COST OF CONSTRUCTION
T1��,5N4.if!
PKRM F FF,C. SiJt 41.4,RY
SIL AN CW.CK T'F?E l O T -0(94'539-3? E1 $774.34
C0f4STRUCrf0T4FEE 101-000-4.11100 $940.50
a
N.IEG1-IAWCAL FCE 10.1-)00.41,1-060 $98.50
1RL"•C7T12TCAL FEE 101 -000 -420 -OW
PLUNIBTNO FEE 101-0004 9-000
STONG MOTRYN Flus - FtESID 100-000-211-000 $18.56
GRA13l.NG FE 1.01-()00-423-000 $20.0
1NT?'IiATfARUCTURE Wil; 225-000-443-342 $4,124.71
ATtT 04 PUBLIC PT, ACES-,REZH; 701-0R0-255-000 $217.95
SUB -TOTAL CC3NST1tt..TCTiON AND PLAN CHEC.TC:
$6,500.57
,1
LESS PRE -PAID F9ES
$0.00
2 3 79 %l TOTAL PERMIT FEES VIVE OW
$6,400.57
96
\
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
I
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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
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)
COMMENTS:
c
1
ArnbroseEngineeeing, Inc.
A Professional Corporation
Max Point Load Typical Footing
*Assume Cantilever Footing Ma = ¢M„ = 0.4j, (d - /)
where... a = A'j'' 0 = 0.9
- -' 1.7tooLL2
-------
MM" (Fixed -Guided) — _ 3 .
L'= Length at which footing so... L'= 3Ma -- P.. = 2w L L'
eliminates downward load 1.7(oDL
Le( Fb(ar(aw) - Fb
"Weight of Ftg. approx. bA
replacing the weight of soil removed F L'
V. = 2b b d V,, 0 j,
A ns
finally : P_ = Fb(atlow)(2L )bf,c
width 12 in
height 12 in
width
f'� 2500 psi
depth
Fl, 1500 psf
"`°°""
Reinforcing steel
fy
(1) #4T&B
V
0.20 int
❑ TWO Story
1.00 felft
WDL(PSQ WLL(Ps�
Trib (ft)
WDLRoof
24 20
15.
W DL Wall
10 0
b
W DL 2nd Flr.
O O
0
pnv;yFi;;#rtVi��. ;..^
a
width
12 in
depth
9 in
f',,
2.5 ksi
fy
40 ksi
A.
0.20 int
AFtg
1.00 felft
Fb
1500 psf
Dead Loads
Roof
660 plf.
Wall
60 plf
2nd Flr
O plf
Mg.
n/a pif
slab
50 plf
Sum
770 plf
v
a
0.514 in
M„
5.306 k -ft
L'
5.49 ft
Fb(auow)
750 psf
V,
256, psi
V„
85.0 psi
MOO
Pmax . 5,091 lbs
FLEXURE 60VERNED
Desert Sands Unified School District
Notice: 82-879 Highway 111
Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
CERTIFICATE OF COMPLIANCE
Date 2/13/96
No. 14155
Owner Name T.D. Desert Development
No. 48520
Cit, La Quinta
Street Capistrano Way
Tract # 27840 Lot # 128
Type of Development Single Family Residence
Comments
APN # 646-390-020
Jurisdiction La Quinta
zip 92253
Permit #
Log #
Study Area 123
Square Footage 2231
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 1.72 x 2,231 or $ 3,837.32
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.
Fees Paid By' T.D. Desert Development " Telep4one";,771-1-941
Name on the check
By Dolores A. Ballesteros
Superintendent
Fee collected /exempted by Pauline Pearson Payment Received $3,837.32
Signature Pf�, AA-�
Check No. 7881
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
_ CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
777-7012
�.`.; INSPECTION REQUEST LINE
C , �' 777-7153
Owner" ' T.D. DESERT DEVELOPMENT
Contractor SPARKS CONSTRUCTION
Permit Number 9601-170
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 48-520 CAPISTRANO WAY
SFD PLAN 1 LOT 128
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT -A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING -
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH t
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK 7
FINALS
ELECTRICAL - `%y
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY RUILDING
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