0307-070 (SFD)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
two
Date/ r : 7 `i0�. 5 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).
-O I am exempt under Section B&PC. for,this reason
r i
Date Signature of Owngr.:*sp ..�� + . /tea .•
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 permitisissued.
( ) 1 -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
perrnit 'iso issued. My workers' compensation insurance carrier & policy no. are:
Carrier ` Policy NO.
(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 withjhose`provisions.
Date:%.'' 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, interestand attorney's fees.
IMPORTANT Application s 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•)° ..r.?xs' -sem Date��'�%
...BUILDING PERMIT PERMIT 1l
DATE VALUATION LOT T9a�tC1"�_ (i6 t TRACT
RILK 183
JOB SITE
APN
ADDRESS
M-4-10 �, 3fWTW,,ti.tDAEY,
OWNER
CONTRACTOR/ DESIGNER/ EN INEER
"}8,:-F I RUNA V{+t1'M. °'
5?i•-'923 'RUNAWAY 33AY
;a."aac t,WD•Zi sit �",A 92.261
.61WAi7DAD'r.TJN": Z CA 921-1
USE O!FFPERMIT
�
0.7.Lk'B W1r.R:3.3•���YlA.L.� .it'� Cs«�1,.:t31i �i•
..
Iiss,? SA Y5M.") PE.RkR T O :RS NOT FiJC UDE HLOCKV`ALI, PQ A)L,'r3TkiL
Ott DRIV;4.f,'T4Y APPPSMCH, 7,511% RFD ai:ED PLL AIA' < sSECKi. VPt j•011
ow S13id E TYPE.
' 1RAC T CONSTRUCTION ION 8F
t7{3 T:lv�l��irl� 74.00 Sr
4,11.00 3
EARXIM.NXIMI COMV, 0r,
16,70
�G����"alt�7w'�?iY���=;�� •. ��i��JCO=�'��'�RSr3 �f;91'.F=� •
PLAIN C:HIMCK �_f
tt1-�ye'�311�i+1�y•tSs)^.�
L•.CJi:�r 1AP4Q,'s;!' .�\)21141 0a,-39_315
t
�Tt�0)40 MOTIONITE-RURD 111,1. OO.24I.O 3 ��nWYI
UpVID THD 1WEE i A? ^0(.'IQ"4ii'd-NUD l5. o
EVIE � PER XV4Fl CT HI >r , r .cyn
��//.yy//�� ,tt 4.2 t
k.RY-aXui�i Pao.4A14 11:7b^a.JfIS� 441-34!,a VOtt, 10
, 4'
' fA-11-T`7,iA T, COYSTRIVi�1J.. O N 2WD F':uw?SN <.11.��.
1'a 1,93
14
NOV 2 5.2003
CITY O� LA QU{N`rA,
sRz�n�.t�rl� faIFPT •
RECI=IPT - _"DATE�
BY
DATE FINALED
INSPE
G .Z
r
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Underground Electric
Ducts
Slab Grade
Final
Return Air
Steel
Gas Test
Electric Final
Combustion Air
Roof Deck
U
Exhaust Fans
O.K to Wrap
Equipment Enclosure
F.A.U.
Framing
Sewer Lateral
Compressor
Insulation
.Encapsulation
Vents
Fireplace P.L.
Gas Test
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Final
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
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)
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 f
Plumbing;Flnal
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
�'COMMENTS:
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)
Certifica to of Occupancy
`.I� Lw8ou7rn44� .
OF Building Y p & Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 53-440 AVENIDA JUAREZ
Use classification: SFD Building Permit No.: 0307-070
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC
Owner of Building: DGH DEVELOPMENT CORP Address: 78-921 RUNAWAY BAY
City, ST, ZIP: BERMUDA DUNES CA
By: STEVE TRAXEL
Date: 5/26/2004
Building Official
POST IN A CONSPICUOUS PLACE
2 February 2004
The City of La Quinta
Department of Building and Safety
78.495 Calle Tampico
La Quinta, CA 92253
Project: Single Family Residence for:
D. G. H. Development Corporation at
53440yAvenida.. rau da.. w
La Q`uinta; CA
Regarding: Project Observation and Field Revisions
To Whom it May Concern,
LES D. GARLAND
Architecture, Interiors, Space and Land Planning
Structural Calculations
On 30 January 2004 1 visited the noted project site to perform code required structural
observations. At the time I noted only minor blocking, nailing and strapping issues that were
resolved at the time of my visit.
Therefore, I hereby state that the project's structure is in substantial conformance with the
structural design intent as represented in the construction documents.
If you have any further questions regarding this project please do not hesitate in contacting me.
Sincerely,
74.854 Velie Way, Suite 5 o Palm Desert, CA 92260 Phone: (760) 340.3528 o Facsimile: (760) 340.3728
„99,
2 February 2004
REVISED: 9 FEBRUARY 2004
The City of La Quinta
Department of Building and Safety
78.495 Calle Tampico
La Quinta, CA 92253
Project: Single Family Residence for:
D. G. H. Development Corporation at:
X53 4=40"Avenida,Jdacez::�
La Quinta, CA
Regarding: Project Observation and Field Revisions
To Whom it May Concern,
ES D. RAR LAN O
Architecture, Interiors, Space and Land Planning
Structural Calculations
On 30 January 2004 1 visited the noted project site to perform code required structural
observations. I noted only minor blocking, nailing and strapping issues that were resolved at the
time of my visit except for the following. Shear wall "F" was not provided with the required 3x
PTDF sill plate required in the construction documents. Attached please find my remedial detail
to correct the missed 3x plating and studs. Please note that no special inspection is called for at
the retrofit anchor bolting because no uplift forces are applied to anchor bolts, only base shear
forces. -
Therefore, once the remedial detailing has been provided, I hereby state that the project's
structure is in substantial conformance with the structural design intent as represented in
the construction documents.
If you have any further questions regarding this project please do not hesitate in contacting me.
Charles D. Garland
Architect
74.854 Velie Way, Suite 5 ❑ Palm Desert, CA 92260 ❑ Phone: (760) 340.3528 ❑ Facsimile: (760) 340.3728