0009-226 (BLCK)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Cpgipter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my.License is in full force and effect.
Licensg # Lic. Class Exp. Date
W, 141188
Dat?41 Zj.W., Signature of Contractor �f
F OWNER -BUILDER DECLARATIO 7
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.
MILDEW RAOLMNS. 'JJW(' $44 -01
(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 sh ll forthwith comply with those.pPovisioni.
' Date: :1/2 �<;, Applicant
',. �''V -- e
°--
Warning: allure to secure Workers' Compen a on 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 representatives of this.City to enter upon
the above-mentioned property for ''aspect'' n purposes.
Signature (Owner/Agent) .� e Die
.f- i -• w
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 0W_ TRACT
$72040 9 23773-4
JOB SITE ! ` `
APN
ADDRESS
4?4-• S P111SC S MTt2M,
t-�ii?••1�t6
OWNER
CONTRACTOR / DESIGNER / EN (NEER
ummay mCiwlX., COM3i1U3+3 113MI
CEMURY CROWELL CC7A W`al;1'3
1535 SO. "IY U.T,f2F;l "i', hM4200
1535 oo. °3•'R ei17iTxr, = #200
SAN :1 VERNAR1190 CA 9240E
BAN %i�t�TARD113�v CA 92408
;
(909)381.6007 OU -4!
USE OF PERMIT
T- 4'x45 IY ktETAiNINO WAl,I, AS PER .+4PPRM ED 0401NIVIVIPIEZ
MANS, WI T 9,
/ 4 Ft W,j,LI., 4196 JS
29MM.I.'. D COST OF CONS :UMM)n
770.W
t;'OAj'S'!"RUCT'li; N I 101.0.00.4180X) �2�.oltl
'
y.B—ryryggyyYY
U♦.i{c�yTV'AND PLAN
ZFL bECHC
$21.00 .00
LESS PRE-1'AYDMW
$0,00
T03'.1�A YEEN 1b4TX ROW
$21 100
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
p}
1
S C) U
R za.+
INSPECTION RECORD
eOPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BL,OCKWALL APPROVALS
steel
Set Backs
(� `-'�
Electric Bond
Footings ' i
ittri$ po
Main Drain
Bond Beam
��.� IOC t
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
f (o (�p�
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)
few
RETAINING WALLS
Cantilever Retaining Wall with Footing Away from Fill
Max. 2
slope Grade sloping
I or level
u4 Cont. ' Max.
slope 2 Grade
sloping or
t
2'Cli + I level
' 8t' Conc. filk
++4 @ 48" o.q Y bars'`, 14 Cont.
a
continuout 2" Cir.
H 14 r 48" o.c.
2" Clr.• 1 continuous Y bars
� 1 8" Conc. blk. .
X bars H
Omit head 6" X bars
join Omit head
I 12 Conc. blk. joints
++4 Cont. 2„ L
2"
H, 2" Clr. _ u4 r 24"
94 @ 24" _ _ Omit if no key
J. Omit if'no key 12" , +.
1L Ae4 Ccnt.
4 Cont.
• � . ' D if Cont. Omit
•6" Hook 04 Cont. if no key
D 3" Cir. J Omit if no key 3" Clr. 6•+ Hook
y� 04 12" 2„
94 3" Cir. 12"QpESS/ Cont.
2" QA O�✓,�''�,
B
Cont.B 3.
tI No. 24069 Section B
Section A,
in .12,31-2009 •
TA nx Ti 1 !.A ni'crr_N nFTAn C AND STEEL REOUIREMENTS ;
"Lap splice may be omitted and reinforcing made one piece trust touting to top o, wall.
Section
H
H,
B
D
X bars
Y bars
L
Grade sloping
maximum 2:1
A
8'0"
2'8"'
5'0"
1' 9"
-5 @ 8"
k5 @ 16"
—
A 7'4" 2'0" 4'8„ 1' 6" # 4 @ 8'+ x5 @ 16"
—
A 618" 1'4" 4'2" 1' 3" w5 @ 16" :95 @ 16"
—
q 6'0" 1'4" 3'8"• 1' 0" -94 @ 16" =4 @ 16"
—
B 5'4„ — 3'6" 9" w5 @ 16" 4 @ 16"
2'6"
behind wall
B
4'8"
—
3'0"
b"
-lt4 @ 16"
4 @ 16"
1 2'0"'
B
4'0"
—
2'6"
3"
-t4 @ 24"
-#4 @ 24"
2'0";
B
3'4"
_
2'2"
—
#4 @ 32"
4 @ 32"
2'01'.
A
810"
2'0"
4'2"
10"
-95 @ 16"
=5 @ 16"
—
A 7'4" 1,4" 3'81' 7" -�t4 @ 16" =5 @ 16"
—
A 6'8,. 1'4„ 3'3" 4„ sr4 @ 16" -94 @ 16"
—
level
B
6'0"
—
3'2"
4"
45 @ 16"
z5 @ 16"
2'0'*
G rade
behind wall
B
5'4"
—
2'9"
—
4P4 @ 16"
44 Cl 16"
2'0'*
B
4'8„
—
216"
—4
@ 24"
4 @ 24"
210.,. .
B
4'0"
—
.2'2"
—4
@ 32"
$4 @ 32"
2'0"'
B
3'4"
—
119"
—
04 @ 32"
x4 @ 32"
2'011'
"Lap splice may be omitted and reinforcing made one piece trust touting to top o, wall.
4.8'
a
• X }
Q {-
ZO 1 QTR E�
Pod= 101.8
FG 101.34
qO-
• fox. r� .
rn 33' 90
1. 9g
A�
Af
Pod=97.1 swole
ImaX o SECTION A -A
RETAINING WALLS
2 2 '�\� (BY SEPARATE PERMIT)
N. T. S.
p OV ESS16
No. 24 �.
1.2-39T 009
\��Oti CA��rJP
W
�, -2i-00
t
3-B
RETAINING WALLS
(BY SEPARATE PERMIT)
N. T. S.
V�kOFES
No
--1-200! m
civil*
I t 1C3% A¢ \ r7
F.F. = 98.00 20.00'
PLAN 2A(R) ; --
r�90 I
I c+`1 rc'vp PROP. 6" C do
t/,• � � A ,G I
!p?
10
0-2.6
26' ,cC °
g3 5 \ lc / Fss oa �`,9r 96 JJ
96
=35_6996.4
�- , h
' •_ p•
FL-GEI coo' r------c
0 \ ` �\ i 14:2'
9
6•
.j - ,P-e 09 f1 G 2 10 N qs�\ ,��� i STEP
96 F� CB f 9 56 . D�EPj NG Z - �c `sol FOOTING
g1'S f 00s I
6\ 9�o_ N a �\ f 9s?s g6. i+ 'o
6•
n /�� O
9�f� rF so
CN
o$ o\ o Pad=97.1too t; J
Uoo`O, ! �, F.F.=97.60 S �, o
VAI a)
Wi
I 8' STEPPED GARAGE. hb a °�' `'� °` PLAN 3 B ® 3. 10
-96.42
9s 9 p c�
I ��A� �� G 2g LFRES
r FG 9 5'
00
Pod= 97.1 h g t`�`;o3R;
12.45' F.F. =9 7.6 0 \ ° F� p.5y 1FG%° '��-�'�!1
PLAN 4LB N o
25 ,. 1
96 f� g5 ►RET, WALL Ips S`Nf X03
tip \ StEP NG �. ) 105 10 �kc sp S
o y�° 5 102.62 Fp011 g.6� 1 S FG r,`' ��� J STEP
64) .5� g6,00 \ 10 2- �p?p J
-. A >, °
01 Cil 0 °° 1 103.10
0.5X CN . . . 3 F 3 TO ► t V41-
FC FG 5E
102' 45 L RET' WA �8 2 l: �.0 SSyp'b
n -
LF - 2' TO 3' HL ,��� 1F 100 q(�.5 �. 0.3 CC,
7.
/ RET. WALL c � 0 2;1 !p1 .TJ �
90 fG 2:1 A6•D8. °y,G p1.,0
m
'k
'NO 31 W 66.82' �° TF 1' 2.00 RETAINING WALL
I,n � '' � 102 ti>>
-� ��i05.1p ° Q (BY SEPARATE PERMIT) O
STEP FC V �I'21- v
,. A WING ��