0310-060 (BLCK)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
Signature of Contractor�� "°� �'^=''* �^^•�'
OWN ER-BUILDER,DECLARATION
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.
(J) 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.
STAEr�f1�•traota3
(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-shall forthwith comply with those provisions.
Date: ��<; ,.. Applicant ~.:t,�. r.F�G.' d✓s' rr f `
` 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 representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) e'arC.1'! o `f�'"'' Date
BUILDINGPERMIT •. PERMIT#
DATE V'`UATION LOT _060 TRACT
JOB E �uA2a
d7V �5 �ANGI-i 9 �C/�j
ADDRESS /
ADDRESS l
cis ..r Et,,-�•-�--rr - /G
OWNER
C¢NTRACTOR / DESIGNER / EN (NEER
. �EJl^dS.T�. Ji .liC'9lLY�`.�.iaLr�.N. _
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1' Q2 ARRYI LWi:
81111r::C7M) !'s1TENME
T A. ()%r`�� 3'A C 922 v
'CjPl:,t.' C—,\ 91186
USE OF r'ERMIT
OEWI RAY, L MIT-VIKI
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61 1..7, 6' OARDON WALL, i::1T35-TANDARD
6 Fi.'64fAILL 61,^0C U . .
V10,00TAYOVON PRE Q) _000-41 8_0010
OCT 0�6 2003
CITY OF LA C UINTA
FINANCE DDEPT. p .y AM
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RECEIPT
DATE
BY
DATE FINALED
INSPECTOR i
;.i:
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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 Wali 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 i
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric' Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
PL*-''abing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Se, 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:
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GENERAL MOTES
1. ALL WORK SHALL BE DONE IN ACCORDANCE WITH THE STANDARD PLANS OF THE CITY OF LA QUINTA AND
THE STANDARD SPECIFICATIONS FOR PUBLIC WORKS CONSTRUCTION, LATEST EDITION, AND RIVERSIDE COUNTY
STANDARDS AND SPECIFICATIONS ORDINANCE NO. 461, LATEST EDITION.
2. THE CONTRACTOR SHALL OBTAIN ALL PERMITS AS REQUIRED BY THE CITY OF LA QUINTA OR OTHER
GOVERNING AGENCIES.
3. THE LOCATIONS OF EXISTING UNDERGROUND UTILITIES ARE SHOWN IN AN APPROXIMATE WAY ONLY. THE
CONTRACTOR SHALL DETERMINE THE EXACT LOCATION OF ALL EXISTING UTILITIES BEFORE COMMENCING WORK.
HE AGREES TO BE FULLY RESPONSIBLE FOR ANY AND ALL DAMAGES WHICH MIGHT BE OCCASIONED BY HIS
FAILURE TO EXACTLY LOCATE AND PRESERVE ANY AND ALL UNDERGROUND UTILITIES.
4. THE CONTRACTOR SHALL BE RESPONSIBLE FOR THE REMOVAL, REPLACEMENT OR RELOCATION OF ALL
REGULATORY, WARNING AND GUIDE SIGNS.
5. STREET NAME SIGNS AND TRAFFIC CONTROL SIGNS, TYPE AND LOCATION SHALL BE APPROVED BY THE CITY
ENGINEER. TRAFFIC STRIPING, LEGENDS AND PAVEMENT MARKERS, TYPE AND LOCATIONS SHALL BE APPROVED BY
THE CITY ENGINEER.
6. THE CONTRACTOR SHALL NOT DISTURB EXISTING SURVEY MONUMENTS OR BENCH MARKS NOTED ON THE w•
PLANS, OR FOUND DURING CONSTRUCTION. REMOVAL AND REPLACEMENT SHALL BE DONE BY A REGISTERED
CIVIL ENGINEER WITH AN R.C.E. NUMBER BELOW 33966, OR A LICENSED LAND SURVEYOR ONLY.
7. GRADING SHALL BE IN ACCORDANCE WITH THE ENGINEERED GRADING REQUIREMENTS OF THE UNIFORM
BUILDING CODE, LATEST EDITION, AND
SOILS REPORT N0. 544-7042 ,f' -'-
DATED,
REPAREDBY SLAWEN ENGIN NG
TELEPHONE 60 772-3893 I
8. THE CONTRACTOR SHALL NOTIFY THE CITY PUBLIC :WORKS DEPARTMENT 48 HOURS PRIOR TO ANY GRADING,
BRUSHING OR CLEARING AND EACH PHASE OF CONSTRUCTION AT (619) 777-7075, AND 48 HOURS PRIOR TO
REQUIRING INSPECTIONS.
9. DURING ROUGH GRADING OPERATIONS AND PRIOR TO CONSTRUCTION OF PERMANENT DRAINAGE STRUCTURES,
TEMPORARY DRAINAGE CONTROL SHALL BE PROVIDED TO PREVENT PONDING WATER AND DAMAGE TO ADJACENT , $f
PROPERTY.
10. CONSTRUCTION OPERATIONS AND MAINTENANCE OF EQUIPMENT WITHIN ONE HALF MILE OF HUMAN OCCUPANC + `lt
SHALL BE PERFORMED ONLY DURING THE TIME PERIODS AS FOLLOWS:
OCTOBER 1ST TO APRIL 30TH: MONDAY -FRIDAY 7:00 AM TO 5:30 PM
SATURDAY 8:00 AM TO 5:00 PM
MAY 1ST TO SEPTEMBER 30TH: MONDAY -FRIDAY 6:00 AM TO 7:00 PM - a < ti
SATURDAY 8:00 AM TO 5:00 PM i �' ; , ✓r
WORK SHALL BE PROHIBITED ANY TIME ON SUNDAY OR FEDERAL HOLIDAY. }
11. AFTER CLEARING EXISTING GROUND SHALL BE SCARIFIED TO A MINIMUM OF 6" ON THE ENTIRE SITE OR I ,
AS RECOMMENDED BY SOILS REPORT.
12. MAXIMUM CUT AND FILL SLOPES = 2:1.
13. PADS SHALL BE COMPACTED TO A MINIMUM OF 90% RELATIVE DENSITY PER A.S.T.M. SPECIFICATIONS AND Ix
' ! I
ABOVE MENTIONED SOILS REPORT.
14. MINIMUM BUILDING PAD DRAINAGE SHALL BE 2%. DRAINAGE SWALES SHALL BE A MINIMUM OF 0.3' DEEP
AND BE CONSTRUCTED A MINIMUM OF 2' FROM THE TOP OF CUT OR FILL SLOPES. MINIMUM SLOPE OF SWALES I
SHALL BE 0.50%. I O
15. ALL FILLS SHALL BE COMPACTED TO A MINIMUM OF NINETY (90) PERCENT OF MAXIMUM DENSITY AS
DETERMINED BY UNIFORM BUILDING CODE SEC. 7010 OR EQUIVALENT AS APPROVED BY THE CITY ENGINEER.
FIELD DENSITY SHALL BE DETERMINED IN ACCORDANCE WITH THE UNIFORM BUILDING CODE SEC. 7002 OR
EQUIVALENT, AS DETERMINED BY THE CITY ENGINEER.
16. ALL STREET SECTIONS ARE TENTATIVE, THE MINIMUM SECTION IS T A.0/4.5" CRUSHED AGGREGATE
OR CRUSHED MISCELLANEOUS BASE ADDITIONAL SOIL TEST MAY BE REQUIRED AFTER ROUGH GRADING TO
DETERMINE EXACT SECTION REQUIREMENTS. CITY ENGINEER TO APPROVE FINAL SECTION.
17. LOCATIONS OF FIELD DENSITY TEST SHALL BE DETERMINED BY THE SOIL ENGINEER OR APPROVED
TESTING AGENCY AND SHALL BE SUFFICIENT IN BOTH HORIZONTAL AND VERTICAL PLACEMENT TO PROVIDE I
REPRESENTATIVE TESTING OF ALL FILL PLACED. TESTING IN AREAS OF A CRITICAL NATURE OF SPECIAL
EMPHASIS SHALL BE IN ADDITION TO THE NORMAL REPRESENTATIVE SAMPLINGS.
18. ALL UNDERGROUND FACILITIES, WITH LATERALS, SHALL BE IN PLACE AND INSPECTED PRIOR TO PAVING.
INCLUDING, BUT NO LIMITED TO THE FOLLOWING: SEWER, WATER, ELECTRIC, GAS AND DRAINAGE. I _
19. THE FINAL UTILITY UNE BACKFILL REPORT FROM THE PROJECT SOIL ENGINEER SHALL INCLUDE AN I I
APPROVAL STATEMENT THAT THE BACKFILL IS SUITABLE FOR THE INTENDED USE. I I
20. THE FINAL COMPACTION REPORT AND APPROVAL FROM THE SOILS ENGINEER SHALL CONTAIN THE I I
TYPE OF FIELD TESTING PERFORMED. EACH TEST SHALL BE IDENTIFIED WITH THE METHOD OF OBTAINING
THE IN-PLACE DENSITY, WHETHER SAND CONE OR DRIVE RING AND SHALL BE SO NOTED FOR EACH TEST. I ;
SUFFICIENT MAXIMUM DENSITY DETERMINATION SHALL BE PERFORMED TO VERIFY THE ACCURACY OF THE I I 1
MAXIMUM DENSITY CURVES USED BY THE FIELD TECHNICIAN. I
21. ALL TRAVELED WAYS MUST BE CLEANED .DAILY OF ALL DIRT, MUD AND DEBRIS DEPOSITED ON THEM I I
AS A RESULT OF THE GRADING OPERATION. CLEANING IS TO BE DONE TO THE SATISFACTION OF THE I I
CITY ENGINEER.
22. BLOCK WALLS ARE NOT PART OF THE GRADING PERMIT. SUBMIT FOR SEPARATE BUILDING PERMIT. '
23. ALL CONSTRUCTION AREAS SHALL BE PROPERLY POSTED AND LIGHTED IN CONFORMANCE WITH THE
t
STATE MANUAL OF WARNING SIGNS, LIGHTS AND DEVICES FOR USE IN THE PERFORMANCE OF WORK UPON
HIGHWAYS, IN ORDER TO ELIMINATE ANY HAZARDS.
i
24. THE SOILS ENGINEER AND ENGINEERING GEOLOGIST SHALL EXERCISE SUFFICIENT SUPERVISORY CONTROL I ;+
DURING GRADING TO INSURE COMPLIANCE WITH THE PLANS, SPECIFICATIONS, AND CODES WITHIN THEIR
PURVIEW. 'f f
25. THE DESIGN CIVIL ENGINEER SHALL EXERCISE SUFFICIENT CONTROL DURING GRADING AND CONSTRUCTION
CONSTRUCTION TO INSURE COMPLIANCE WITH THE PLANS, SPECIFICATIONS, AND CODE WITHIN HIS PURVIEW.
26 THE CITY ENGINEER WILL REVIEW FOR APPROVAL THE FINAL STREET SECTIONS `
AFTER SUBMITTAL OF "R" VALUE TESTS FOR ROADWAY SUBBASE.r
27. THE CONTRACTOR IS RESPONSIBLE TO PREVENT SILT CONTAMINATION OF STORM WATER INFILTRATION
FACILITIES DURING CONSTRUCTION OF SUBSEQUENT IMPROVEMENTS BY THE CONTRACTOR. IMMEDIATELY
PRIOR TO FINAL ACCEPTANCE OF STORM DRAINAGE RETENTION/INFILTRATION FACILITIES, THE CONTRACTOR
SHALL CONDUCT, IN THE PRESENCE OF THE CITY INSPECTOR, A PERFORMANCE TEST DESIGNED TO CLEARLY \
DEMONSTRATE THE FUNCTIONAL ADEQUACY OF THE FACILITIES.....
28. THE CONTRACTOR SHALL PROVIDE WIND EROSION AND DUST CONTROL MEASURE AS REQUIRED BY THE
FUGITIVE DUST CONTROL PLAN APPROVED FOR THIS PROJECT.
ENGINEER'S NOTE
THE EXISTENCE AND LOCATION OF ANY UNDERGROUND UTILITY PIPES OR STRUCTURES SHOWN ON THESE
PLANS WERE OBTAINED BY A SEARCH OF AVAILABLE RECORDS. THESE LOCATIONS ARE APPROXIMATE. IT
SHALL BE THE CONTRACTOR'S RESPONSIBILITY TO VERIFY THE LOCATION OF ALL UTILITIES OR STRUCTURES ` `T
f.
ABOVE OR BELOW GROUND, SHOWN OR NOT SHOWN ON THESE PLANS THE ENGINEER IS TO BE NOTIFIED OF
ANY DISCREPANCIES SO THAT ANY NECESSARY ADJUSTMENT CAN BE MADE IN THE ALIGNMENT AND/OR GRADE;t ,,x*
OF THE PROPOSED IMPROVEMENTS. THE CONTRACTOR IS REQUIRED TO TAKE PRECAUTIONARY MEASURES TO
PROTECT ANY UTILITY LINES SHOWN, AND ANY OTHER LINES NOT OF RECORD, AND/OR NOT SHOWN ON THESE `
PLANS. THE CONTRACTOR WILL BE HELD RESPONSIBLE FOR ALL DAMAGE TO ANY UTILITIES OR STRUCTURES ,p
CAUSED BY HIS OPERATION. _
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IN THE CITY OF LA QUINTA,
STATE OF CALIFORNIA
]P
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PAnC MAP Dq00.219164
--LOCATED IN A PORTION OF THE NE 1/4 OF SECTION 29, T. 6 S. R. 7 E. S.B.M.
19.OFL w'
... 1.
EXIST. TENNIS COURT/
RETENTION BASIN
i
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PGAWEST
LAKE CAHUILLA AVE 58
1
QUARRY
PROJECT AVE 62
LOCATION
VICINITY LDAP
NO SCALE
BASIS OF BEARINGS:
THE BEARINGS SHOWN HEREON ARE BASED UPON THE NORTH LINE OF LOT 'F' AS IT'S THE LAW! CALL AT LEAST TWO
SHOWN ON TRACT NO. 27728, M.B. 249/1-13. RECORDS OF RIVERSIDE COUNTY, DIAL BEFORE WORKING DAYS PRIOR
STATE OF CALIFORNIA, SHOWN AS: YOU DIGI TO EXCAVATING
N00020' 13" W( 1-800-227-2600
BENCHMARK: 41t UNDERGROUND SERVICE ALERT
#466 USBR (29th ENGRS 1941 RIVERSIDE COUNTY) OF SOUTHERN CAUFORNIA
AUSBR DISC SET IN A CONCRETE POST (NOT STAMPED) AT THE S.W. CORNER OF
MONROE STREET AND 58th AVENUE BEFORE EXCAVATING, THE CONTRACTOR SHALL VERIFY THE
LOCATION OF UNDERGROUND UTILITIES BY CONTACTING
ELEVATION: -64.955 UTILITY UNDERGROUND SERVICE ALERT AT 1-800-227-2600 NO. INIT.
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6. OTF
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BY A MINIMUM OF 12" THICK.
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APPROVED FOR PERMIT. PLANNING AND ZONING COMPLIANCE:
TOM HARTUNG DATE JERRY HERMAN DATE
BUILDING AND SAFETY DIRECTOR COMMUNITY DEVELOPMENT DIRECTOR, LA QUINTA
LEGEND AND ABBREVIATIONS
TOP OF CURB .......... TC
FLOWLINE ..............
FL
FINISHED SURFACE ........
FS
FINISHED GRADE ........
t'1
I
HP
LOW POINT ...... ......
LP
GRADE BREAK ..........
GB
INVERT ..............
INV
RIGHT OF WAY .........
R/W
PROPERTY LINE .........
PL
TYPICAL .............
TYP
EXISTING CONTOURS .......
----50
PROPOSED CONTOURS .......
---
PROPERTY UNE ......... .
PROPERTY
FLOW GRADE ............
_.027.
EXISTING SEWER LINE ........._,.IS_.,_...
i
EXISTING WATER LINE .......
PLANTER AREA ..........
C)
WATER VALVE ...........
WV
MANHOLE ..............
MH
L0
o Ln
#
TG
SEWER CLEAN OUT .........
CO
C14
C-4
EXISTING ELEVATION .......
OL
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6. OTF
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D ROCK
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BY A MINIMUM OF 12" THICK.
TYPICAL BUBBLER. BO)o
X=SECTION
NO SCALE
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APPROVED FOR PERMIT. PLANNING AND ZONING COMPLIANCE:
TOM HARTUNG DATE JERRY HERMAN DATE
BUILDING AND SAFETY DIRECTOR COMMUNITY DEVELOPMENT DIRECTOR, LA QUINTA
LEGEND AND ABBREVIATIONS
TOP OF CURB .......... TC
FLOWLINE ..............
FL
FINISHED SURFACE ........
FS
FINISHED GRADE ........
FG
HIGH POINT ............
HP
LOW POINT ...... ......
LP
GRADE BREAK ..........
GB
INVERT ..............
INV
RIGHT OF WAY .........
R/W
PROPERTY LINE .........
PL
TYPICAL .............
TYP
EXISTING CONTOURS .......
----50
PROPOSED CONTOURS .......
---
PROPERTY UNE ......... .
PROPERTY
FLOW GRADE ............
_.027.
EXISTING SEWER LINE ........._,.IS_.,_...
.
EXISTING WATER LINE .......
PLANTER AREA ..........
PA
WATER VALVE ...........
WV
MANHOLE ..............
MH
BLOW OFF ..........:...
BO
TOP GRATE .............
TG
SEWER CLEAN OUT .........
CO
SEWER MANHOLE ..........
SMH
EXISTING ELEVATION .......
(XX.XX)
EXISTING LOT LINE PER PARCEL MAP 29164 (XXXX XXX.XX')
PROPOSED LOT LINE PER TENTATIVE TRACT MAP 30651 [XXXX XXX.XX']
GARDEN WALL ......... .
RETAINING WALL ......... .
CONSTRUCTION NOTES
1O CONSTRUCT YARD DRAIN. NYLOPLAST 12" DRAIN BASIN
OR EQUIVALENT. ' -
CONSTRUCT 6" PVC PIPE, (SDR -35) AT 1.0% UNLESS
NOTED OTHERWISE ON THE PLANS.
CONSTRUCT T CLEANOUT, WYE. NYLOPLAST T DRAIN OR
EQUIVALENT. SET FLUSH WITH FINISHED GRADE.
® CONSTRUCT BUBBLER BOX WITH GRATE TOP. NYLOPLAST 12"
DRAIN BASIN OR EQUIVALENT.
50 CONSTRUCT SLOTTED DRAIN. ALHAMBRA FOUNDRY A-2421
OR EQUIVALENT.
CONSTRUCT GARDEN WALL PER SEPARATE PLAN AND PERMIT.
HEIGHT AS SHOWN ON PLAN.
O7 CONSTRUCT RETAINING WALL PER SEPARATE PLAN AND PERMIT.
HEIGHT AS SHOWN ON PLAN.
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OETY OF LA QUINTA
BUILU(NG & SA �®
A OV
FOR CONSTRUCT1
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jol!PREPARED UNDER THE SUPERVISION OF: Cl"ImY L
A QU10"" 14
APPROVED BY CITY OF LA QUINTA: SHEET N0.
QRpFESS/0
oo CITY ENGINEER PRECISE GRADING PLANS No
No. C54559 N m
DANIEL R. RUIZ DATE
Exp. 12/31/03 } R.C.E. NO. C54559, EXP. 12/31/03
CIVIL
qTF OF CAL�FDRAWN BY: CHECKED BY: DATE:
The Keith Companies
41-865 Boardwalk, Suite 101, Palm Desert, CA 92211 (760) 346-9844
P C ESI, M AP a *5 OF-1
PARCEL 3 FILE: PG733001
TIMOTHY R. JONASSON, P.E. DATE LOCATED IN A PORTION OF THE NE 1/4 OF SECTION 29, TOWNSHIP 6 SOUTH, RANGE 7 EAST, SBM DRAWING NO:
PUBLIC WORKS DIRECTOR/CITY ENGINEER
RCE NO. 45843 EXP 12/31/02 FOR: QUARRY
RA , C L.L.Cs