0204-078 (BLCK)LICENSED CONTRACTOR DECLARATION
I he.!eby 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. 6a1e.
- �3/�1/Z.�3 t'S3 �7:. `;•€3 ,. /j' � �f/ /171:��AZC
Date Signature of Contractor _
OWNER -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 iMended: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 ATE K:0%fYNHATI Policy No. 0460006168-09
(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 wit0hose provisions
Date: �! CIZ Applicants-��"
i
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject. to the conditions and restrictions set forth on his
application. ti
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and}state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property
�for inspection purposes.
Signature (Owner/Agent)--/:�-+. Date
BUILDING PERMIT PERMIT#
DATE VALUATION LOT TRACT
JOB SITE g�p APN
ADDRESSw�Alr+>11E
OWNER CONTRACTOR / DESIGNER / EN (NEER
C 81MT 'C'AT U.tC3;!?.MA:Ci'OOLS & ST'AO("i IP MAU CC) RP
55.1 Z28 PAILMD 79RM-11 74 7 23 YORLDRIVE, ZYMM..-OA,
1A C21 .WrA CA 92233 PALM DENVIRI ° cA 91260
(760)340-9000 e.3 4 0055
USE OF PERMIT
V%i� '('�
GINE-RAL T3 MM40
M LF. X 6' 3LtiC '.1VALL, ORS.'fri STANDt�FUD
6 FT . WALL JAN LF
,PJ!1,W1rjVFW SUMMARY
CONS`i'I211MC0 FEF i 01.0-00-11 B-000 W3.00
r"
Y
CIy OF jLAQ01KTA
;3T%f-7O"►"N;i CCMUCTIONAM.)kLAYMWCV..
QLym'.O4^PxID F�hqJ `.�$`a0�..a01LJ
TMAL'ff,"UT PEEN DUE ATOW WAX)
1
RECEIPT DATE BY DATEfINAI,1ED INSPECT0
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 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
steel
POOLS - SPAS
Set Backs
Electric Bond
Footings-
Main Drain
Bond Beam
CtL «
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final 1''i
01
Gas Piping
PLUMBING APPROVALO
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:
EXISTING GOLF —COURSE,- PY-10 NOTES CRADINC NOTES
R 800.00*
it--= 0 1 * 5 2'42 0
R 600,00' L _44�5!— 1. EQUIPMEATT MAINTENANCE AND CALIBRATION SHOULD BE CONDUCTED IN ACCORDANCE WITH
MANUFACTURER AND RECULATORY REQUIREMENTS. -
2. SITE WATERING SHALL BE DONE BY AGRI-TYPF WATER SYSTEM PRIOR TO BEGINNING MASS 1. AU Grading sh, -r) Building Cocle, chapter 3 1 3, as amencled by Ordinar e
0 GRADING 0PERATIONS. REQUIRED DEPTH OF WATER PENETRATION TO BE DETERMINED BY 011 cOnFOrm to the Unifor c 457
GRADING iCONTRACTOR'S 'FIELD SUPERINTENDENT AND SOILS ENGINEER. 2. Minimurr buit6ing pod and drainage swate slope shalt be = 1% if cut or' Fitt is less thain 10', 2% if'
51B 3. SITE WATERING SHALL BE DONE BY WATER TRUCKS UNTIL COMPLETION OF MASS GRADING, cut or -�ilt is greoter than 10'. Droinage swotes shalt be a minimum, of 0.2' deep and i)p
70 THIS WATERING SHALL BE DONE AS NECESSARY (DEPENDENT UPON CONSTRUCTION TRAFFIC, Constru-tE>6 A r'lr)ir)ur I n io� 2' from the top of cut or, fill slopes,
HUMIDITY' AND WIND VELOCITY).
r -n 1 3. moximum cut nnb fill slope = 2:1
4. SITE WATERING SHALL BE UTILIZED ON BUILDING PADS, STREETS AND LANDSCAPED AREAS AFTER
-ovide 5' wide by 1' hig along the top of t f, 5' high,
MASS GRADING IS COMPLETED. THIS WATERING IS TO BE DONE AS NECESSARY (DEPENDENT UPON 4, P,
equi slo e
x h berm or
p s over
H
CONSTRUC'TION TRAFFIC, UMIDITY AND WIND VELOCITY). SITE WATERING MAY BE TERMINATED 5. Ail groding s1holt lop clone under the supervision of a competent soils engir)eer who shot( certify
70 UPON SOIL STABILIZATION. (PERMANENT AUTOMATIC IRRIGATION OR COMPLETED IMPROVEMENTS.)
5.- GRADING ACTIVITY SHALL BE SUSPENDED WHEN LOCAL WINDS EXCEED 25 MPH AND DURING 1ST -)os been propL
that att �it� -r y placed and who shalt submit cL final compaction report For at[ Fills.
AND 2ND STAGE SMOG ALERTS OR WATER SHALL BE APPLIED TO SOILS NOT MORE THAN 15
MINUTES PRIOR TO MOVING SUCH SOILS. 6 A Pegistereo �Civil Engineer shalt submit to the Building & Sctf:'e� Department written certification
x" 4, of comptetiow of' rouo�� grading in otc-corclan, e with the
6. SOIL STOCK PILE AREAS SHALL BE WATERED AND COMPACTED TO ALLOW A CRUST TO FORM g
OPPrcved grading plan prior to issuance
UNTIL SOffL STABILIZER IS APPLIED. 04�' ti -)e Builoing Permit, Certification shalt be to tire, grolde, elevation and tocotior of' cut or
x
Fill Slopes,
4<
7
X,
7.
-Ow ditch, designed to handle 100 year 'q' storm flows along top of cut stop s,
A, PrOVIC'e 0 10"' e
Final Compact;or) Report wilt be rc-quired for ok Fills greater than one 4�00t.
X�.
-ig shall be done in conformonce with recornmenda t ions of' the preliminary soils investigation
9 All grodir
o
by , dated sets of the Finat compaction report
:Two
%
5'
shalt be subritted to the Building ord Sc�ety Dept. which shalt include foundotion design
__j r.ecommeroatio certi47'lcotior that grading has been done in confor once with th
n s and
< V >, ROOF OVERI-4 < recomrner6o,i s of the pretiminory soils report.
or)
5 7 The Cont-('
< v 10 r I c Pr IS 0
no i Y the Distr-ict Building ard Safety Department a( teost 24 hours in
BSB o'cl v o nic e (-)� r-'equesting �injsh lot grade and droinage Inspectior), This inspection must be opprove�d
FF x
Prior
+0 8jilding Per,rit final inspection For, eoch tot.
LO
Cut slopes equol to or g�-elotpr than 3' in verticot heigh
_j z than 3' in ver---ccil height shall be planted with gro, t and fill stopes equot to c)r greater
C�f
ss or ground cover to protect -the slope
L�J!
From er-osion u,-6 instobiIity in accor-dorce with ordinance no, 457 prior- to the opprovc.l of
X
Pino! irs")ectior-,
C
12. No Fi(t sholl 0�
�-)triced or) Pxisting ground until the ground has been cleared of weecls, debris,
deleterious mater-jat.
Ll LIU to�Dsoit, onoi �:)t� er L
IF steep stcping terrain occu,-s
THE PALMS THE PA LYS _�Don which fill is to be plcr_,,�), It must loe cleared,' keyed, and
z 13
rotir,r-; shot( he approved by n registered
i soils Cngineer- prior- to Placement oP Fill r)ateri(
THE PA1.41S LO T 19 LOT 18 benched r')t,-) �irm roturat soit Por Full support. Prepa
LOT �O EXIST. SFR
FF 59.20 1 F
jr-)g rouQr)
14. Dur gr(,dir-)g operations and pri
VA CA N T FF=(59.50) or to construction c�, per-marent drainage structures,
D (58.7
temporary 6rninoge control sh�'u�rA be provided to prevent poincling water- and c�omog to odjccer)t
PAD=(58.6) L-4 ENP'r _= e
Properties,
0,
ID
1. 1 4��- 15. Dust ShOlt he controlled by wote-;�ng or other approved methods, as cleFired in county ordinance
r
Ell 4E?4.1 and 742 (P I-1 - 1 rj
P
1 16. All existing �r air -age co(_,irses on the Project site must con7inue tn -Ing
function, especio(ty dur
ILI
r storm condi7ions. Protective measures ond temporary
draInGgp �DrQvlsions must be Lased to
8�! V protect ad-10,101eig propert,es during groding operotions,
0 0
17� Stobility c(Alculotion with a Factor of at teast one on five tenths (1,5.) shalt be sobrnitteci by a
5' �_�F QC Encineer, to the BLAiloli-,g ano Scfety Depbrtment �7or Cut OnCl fill slopes over 310' in height,
Is, A Reg)-ste.-ed Civii Eng;neer- or Licensed Lord SLrveyor shalt submit cer-tification of' 10)uitc4ing pod
10
"%> > e(evotion. Wherp -pe-'�Ic elevations (are required, the elevation (with respect to me>ar) sea level)
03
i shalt be given if ar-, elevGtior with respect to adjacent ground surface is required,, the actual
distance obo�e tne odjocent ground shalt be given.
-adf?d Slopes shalt lop ptonteel with rosec, ice plont at 12' or) centers or
Erosion Control: Att gir
> I
x, another approved ground cover.
Slopes over 15' in height, in oddition to grourd co)ver, shalt be
"approved trees shrubs, or- Combination thereof. -ubs s at( be plant at 10' or
planted wit
centers; tre,�,s, Shr In L -Cl
Ca" -0,
711- _'115' Or') cer-iters; combinations, 15' or centers Slopes over 4' in heigtht shot( have
P e r) 0 n G' r) t
Igo lor) systems witl-, IoackFlow prevention devices per U.P.C, Chapter 10 R.
A
20. Finish graJe �-hcdl Ioe sloppd c�woy �'rom '0'(t exterio
0 r wolts at not less than 112, per Foot for a
61� minimum oF 3
12x12 YARD DhAj.
BROOKS, Aff� OA
EQUAL
A-)
6- FLFX PIPE
>
>
6** SDR 15 TEE
Sl)j� 3i P!PE < >
HWY 111
314- CKISHFI-, FO(K
AVE 48
FQ GAR.
J
58,70 2C ---
+
PL
__i�U,�V E D A T A
V
AVE 50
�`ARD DRA IN PIPE
LL 01*22'18"
x",
NO ECALF
R 650.00'
58 15.56'
EY117T, I IN 1P
j 8" STORO DR A LECAL DESCRIPTIOIV.
P
WM
IPE IN EXIST. 10' C�) AVE 5"
f _7 77,
L
x A- 3
EASEK4EN7 0
> LOT 19, TRACT 9898' HE` 285176-82
FLECT Y ILBOX
',A
E_Y�S- CATCH
y. LA_
ASSES,30R P-1 RCH NUMBERL AVE 54
0.157.
LP PC, A 11"EST
rn 171
70 z
z�l CI)q,VE D,�TA S V H
P, rr) 0
AIRPORT BLVD
LA
L', = 03-26'36- SITE ADDR"QS-
R = 750 CO' <
PALMIS DR
4 0 7' \,J 56228 THE T4LAIS DRIVE
JC, S
J LA QUINTA, CA 92253
7
SI7'F,
CL
I'd 2`
-AD
PREPARED FOR: ASOF�w bPr -t m0CI11 WALLM
10
SCALF-
St7N VISTA DEVELOPMENT
PO BOX 1144 VICINITY' �MAP
0 1 -
10 C) -30 40 LA QUINTA, CA 92253
(760)772-2626 SO SCALE
elk
FFI1
TOTAL L07'�
-AREA. 9098-27 SF
BENCH AIARK- DATE- REVISIONS AP)"APPROVED BY: ESSI S11A HA NDE11 IN THE COUNTY OF RIV'ERSIDE, CALIFORNIA
_F_1RT114i`0RK QUAN71TY R�_71AIATE.- CIVIL FNGINEER HEET
45175 Panora7na Dr., A-1
SITE AND GRADJNG PLAN
)�/, �\NR3t/
Se 7-1" ice Aze rl CUT- 0 CY TILL- 0 Cly PALM DESERT, CA 92260
00514104 Xses I Ole Alcew
No. 47834 Phone: (760) 340-559,, 0F1
1,�31 t�j r"
rn FAX: (760,)340-5597
SOTE THE AEOVF ARE )RAW QUANTITIES FOR THE COVPUTATION S(a AZ S 1PA LMS '71b It 111 LW 0
800- 1<?27_12600 Exp 1*41/3','03
OF �EES ONLY. IT IS THE CONTRACTOR'S RESPONSIBILITY TO
PREPARED UNDER THE SUPEMUEJON OF:
TX0 #'ORKNC RWES' CALCULATE THE EARTHWOjRK HLYSELF AVD BASE HIS CONTRACT ON LO T 19 THE PA LMS sHE
cjv�\� IT- ETS
THOSE VALVEF
`-4
PJ1,10RE 1vot, D10
�:- �� 4-9-01
F C��\
FSFANDIAR SHAHANDEH RCF47834 DATE POR. SEC 22, T -6S., R.7E., SPBM 320
T,
- --------- F_
T
7'
... :A. JON TT
i `•37630`'Medjool' Ave.
Jxalm_Desert, CA 92211
Office (760) .772-7192
• ' • Fax.(760) ` 772-7193
:. - . >;PagerR4(760)'1776-3338
ikEGISTERED INSPECTOR'S`WEEKLY.REPORT" �r °. _ • :
TYPE OF
.REINFORCED CONCRETES '"`' STRUCT. STEEL ASSEMBLY : � ❑
INSPECTION
`.POST.TENSIONED CONCRETE ❑ ASPHALT, •! t OTHER
TA
PERFORMED
REINFORCED MASONRV� O'FIRE PROOFING =i,;`' �L
JOB �LOCAT�ION y�' ; F
REPORT SEOUENCE NO.
TYPEt �S RE' CC �'� - , - r ' "4v. '
PERMIT N0
//T 11
DAY OF WEEK
MATERIAL DESCRIPTION- t
ARCHITECT •., w ;, -' .i
INSP CTOR- - .
HRS. CHARGED
�I� ^
ENGINEER; :rte R *r x= a
ASSISTANTS
HRS. CHARGED
INSPECTION- Y GENERAL -r `Yr ? SUB r '• " .i` r e'!;ry
DATE . , CONTRACTO i_ t' '_CONTRACTOR
_��!
.. ... t .. W'I i"rye- •, j ._ ,� Y t
-_. ... ,
p. ]I A
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•.
K/,VT M y
!
COPY SENT TO CLIENT ❑
O
+ CONTINUED N NE%T PAGE ❑i,,_ :
PAGE OF
CERTIFICATION OF COMPLIANCEK
'I HEREBY CERTIFY.THAT I HAVE- INSPECTED JO THE"BEST-OF.MV , . •'0-ATUR OF REGISTERED INS TOR
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE F %' � . c` � ',
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED s
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS, OF, .THE r
GOVERNING BUILDING LAWS. DATV OF•RE ORT .j• REGISTER NUMBER"
4 K r.