0006-034 (RPL)LICENSED CONTRACTOR DECLARATION
Ihereby affirm under penalty of perjury that .1 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
4
692059 C-53 (1713112(
Date t 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 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 amexempt 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 certificate of consent to self -insure :for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the
performance ofthe.work.for which this permit is issued.
&) I have•and vrill 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 F'RL1MC_,N1' COMP 1'ht5 Policy No.
(This section need not be completed: if°the permit'valuation is for $100.00 or less).
O 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: i } �!" (. Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subjectan 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 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) 7 Date t
BUILDING PERMIT PERMIT#
DATA/4 VALUATION LOT<1 TRACT X/C
JOB SITE
APN
ADDRESS $2410 DFL C;iATO DIUVE
_
OWNER
CONTRACTOR / DESIGNER / EN (NEER
MW ph—MRSON
CAMILLA POOL CONMR.UC170N, INC'..
52-410'UM, GATO DFJn
78 -710 LA PALMA FSR,, T A QUWf 1,
LA. QIMITA ,'- CA 92253
PALM DEM;t ' CA 92261
(760)37 0t 6602 C IR 1844
USE OF PERMIT
POOL AND/OR fRP.A.
pum, & 9PA (I) wA'P m PX&TURX 0NLY-ALAXMWHARRI1rRS SHALL.. BE
TH PL AU AT PRE PLASTER THSPEC1`IaN, POOL SQUtPId AIS' h.AfCLOSUR
18 NOT INCLUDED
POOL ANLVOR SPA 50,000,00 LIS
R18"17MATn) C09r OF 00.1519 UCPIOI<1
l�d141(1.Qti?
1PERRUr FRE StIMAURY
PLAN CHECK F FIF 101-0100.439-318 $249,43; '
CONSTRUCTION FEF 101.000-418-000 $414.50
MECHANICAL ".B -- P001. 101.000.421.-000 $:4.00
t:I,ECTPJCAL_FBI, - POOL 101-000-420-000 &15.00
PLUM1111410 WE -- POOL 101.000.419.000
ffllk-TtJ'rAf, AND PLAN C}- KKK
IV779.93
U. 331 P'RT14-11AID 1-IFES
0U
IrOTAT, PIPPdV rl.' MS DVE NOW
X779.93
w
RECEIPT
DA E /, j`
BYDATE:FINALED
INSPECTOR
i!
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
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
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
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:
Yo,T9 Eniginooring 5orvires Job No.
4*1-154 Youngs Lane Shoot No. � Of
Indio, CA Calculated By "Pate
92261 -Date .
. . .. .....
Phones('160) 542-4214
. .. . . . ... . . . . . . . . . . . ...
OLIU
T;j --- •--
I...
--
I...
Is
w
�7 zoo/1
LL,
17 . . . . . . . . . . . .. . . . .. . .
r• r
. . . . . . . . . . . . .. . . . . .
. . . . . . . . . . . . . . .
00
. . . . . . . . . . .. . . . . . . .
. . . . . . . . . . . . . . . . . .. . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . .. . . . . .
. . . .. . . . . . . . .. . . . . . . . . . . . . . . .
. . . . .. .. . . .. . . . . . . . . . . . .
34- 4
. . . . . . . . . . . . . . . . . . .. . . . . . . . .
�To s�cify your title block on � __ _.._ Title-: PETERS.ORRESIOENCE _. _._ Job #00-1408-21
these -five lines, use the SETTINGS Osgnr: pate: 1,1:0413M, 27 JAN 00
Description : LOT B�I;IA:OUtNTA;CA
main menu selection, choose the KRISTI HANSON ARCHITECT
Printing & Title Block tab, and ent Scope:
yourtitle block information. _
U/F:KW+17K VMS. 1.3.2LaH999/Wulf Multi -Span. Timber Beata
k/ 19dLW FJIFAI,AId' e:kc5%PC1d50..--BEAMS
Description BEAM 3 at -1 V7 -
General Information
2400
Spans. Considered Continuous Over Support
Timber Member information
Fb : Basic Allow 2,400:0 pal
Fv : Basic Allow ' 165.0 psi.
Calculation's are designed
Description
Yes "
180:00
180.00
SPANI
-
SPAN 2
SPAN 3
Span
It
6.75
9.83
...7:25
Timber Section
11.5
5.125x24:0
5.125x24:0
5:125x24.0
Beam Width
in
5.125
5.125
&125
Beam Depth
in
24.000
24:000
24:000
End Fbdly
-31.:1
Pin - Pin
Cin - Pin.
Pin - Pin
Le: Unbraced Length
fl
0.00
0.00
0.00
Member Type
3.000.0
GluLam
GluLam
GluLam
Loads
---tive Load Used This Span-?
Dead Load VII
Llve.Load #nt
Yes "
180:00
180.00
" - -- Yes'
180.00
180.00
- Yes.
1.80.00.
180.00.
Results
Morax Cntr
in?k
11.5
20:1
X-
it
2:29
4.85
4.69
Max @ Left End,
in=k
0.0
-31.1
-33:1
Max @ Right, End
in=k
-31.:1
.3 .1
0.0
Ib s Actual
psi
63.3
6 :
67:3
Fb :. Allowable
psi
3.000.0
3 °0
3;000.0
Bending
OK pcndi OK
Banding OK
Shear@ Left
k
0.83
1.75
1.69
Shear @ Right
k
1:
1.79
6.92
W : Actual
psi
.6
.12.9
11.9
FV: Allowable
psi
.3
206.3
206.3
i
r pK
Shcar'OK
%cmr OK
Reactions & Deflectio ..
OL @ Lela
k
0.42
1 B8
1.74
LL @ Left
k
0.42
1:68.
1.74
Total @ Lett
k
0.83
3.35
3.47
DL (4 Right
k
1.68
1.74
0.46
LL @ Ri
k
1.68
1.74
0:46
Total Right
k
3.36
3.47
0:92
Max. flection
in
-0.000
-0.002
-oml
X=
it
2.52
4.85
4.40
Moment in -k O:o =31.1 -33.1
Shear lbs 0.6 1.8 1:7
Deflection in 0.0000 0.0000 0.0000
i Factor
and 1997
1.8W.0 ksl
J3-99 io:oaA
1.997 UN [FORM BUILDING CODE INFORMATION
Recently the International Conference of Building Officials issued tl I it: 1,991 Uniform
Building - Code -ccaltuillillS - -substantial revisions And additions to the earthquake
cligincering'.scetioti in Chapicr 16. NawconceptsCoiAj-iii –Idd . Ili - tile -up . da, code–that Will-
likOy be rcicvnnt to construction or the proposcd:structurcs,ard %umplari7rd below.
Ground shaking is expected to be, the primary hazard Most likely to ;Iff'cct the site, based
upon proximity to significant r.,Iulls paplibic of generating large earthquak-es. Major fauft
,ones, considered to be most likely to. create Strong ground shaking at the _site .are listed
below.
Approximate, Distance FaultType
villill Zone, From sitc� (1 Q
,997 XJB.
San Andreas A
A
'.§aIl Jacinto, k -ni
Based on our, ficidobsurvatiOns and understanding ollocal .scot9gic conditions, the soil
cjudgcd..applicabl
Prolilc ty.ct toll, is site is 81), generally described as stiff or dense soil.
-�
,1*11e site i.% located within U13 I C Seismic. Zone
coefficients and factors relevant to SO-% 4. '11feff-fibillow", hig table-present"dditional--
seismic mitigation flor new construction upon adoption
or the 1997 code.
Near -Source
seismic Acceleration
Factor, Na
San Andreas
reas 1.0
San Jacinto 1.0
.august 3, 1,999
11 . .. . ...... .
Near -Source
Seismic
Seismic
velo.c. ty
C-0-r-Wicient,
CoefficieW
FnctoEl NvCa
- –
— -----------
Cy
0.44
1.0
0.44
0.64 _J
project No. 522-6138
P..02
SPECIAL
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool, Ave..
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE. ❑ STRUCt STEEL ASSEMBLY ❑
O POST TENSIONED CONCRETE ❑ ASPHALT ❑ OTHER
❑ REINFORCED MASONRY ❑ FIRE PROOFING
JOB L-,--> $ O /\ _ I &6� Q� �V `
l~AJC Pvll
`TgulIC1TTURE
REPORT SEQUENCE NO.
TV jr D r /�
CCK.- 1d''n`���
PERMIT NO.
E -L
DAY OF' WEEK
MATERIAL ESC
10
ARCHITECT
1 OR i
HRS. CHARGED
�
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPESUB
DATE CTION
CONTRACTOR OR Lu A 1w "�'� 1 l l CONTRACTOR�-
-�
em Lien coo cr�
gip _
COPY SENT TO CLIENT O
CONTIN D NINEXT PAGE ❑
PAGE OF
CERTIFICATION OF'COMP-LIANCE
1, HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THEAPPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
S GNATU E OF REGISTEREDNSPECTOR
(}U XT6 o 64)--V-S
DAIrE OF REPORT REGISTER NUMBER