0008-005 (RR)r^ \� LICENSED CONTRACTOR DECLARATION
I het y a$,l'rn 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
460707 aj9 &A 31/2(
Date k ;(46 Signature of Contractor
OWNER -BUILDER DECLARA 4ON J
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.
(w,)- 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:
CarrierYILI.A.NMA INS CO Policy No. fi#G30672i$4
(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 shal ,fo hwith comply with -those provisions�-
Date: �� ( 066' Applicant `� 1 uun t + -4 G d
_r ,
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
BUILDING PERMIT PERMIT#
DATE VALUATION LOT
TRACT
tMMO£ S$A«OU
JOB SITE
ADDRESS 8,435 AVMWA VAIX&, yO
APN
OWNER
CONTRACTOR/DESIGNER/EN (NEER
MECCA WM.9UX
P. 'MO LA RJOI?i:edG
53-435 AV )A VALLEJO
68.314 XTELEY RD,
LA QIWrA CA 92253
CATWMDRAL CffY CA 922-14--,
(760)324-5482 C!Bu
X2,30
s
n
USE OF PERMIT
OMOMAL BU=190
RE ROMP(REMOVE E &t. UPLAC& 01:AV EL IZ06 ' AND RLI: LACE WITH
PIONEER LIT EYtf`910HT HACIENDA Ic; 0 9.35?43 - CLASS .R. FIRE
RATING MATERIAL MUST BE USED)
VALUATION
&500.00 LS
Es'rwiATED con of c4)AmY7C:"17:om
PERAW FW. SUM "RY
REROOF IME 103 --000-41 S -OW MOD
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 properiy for inspection pilrposes- RECEIPT
Signature (Uwner/Agent) F— "'`J `'�' @Date " ` 4)
SCIS -TOTAL CON#'�"� IJiff.11:0H AND FTS! CHWX
LESS PRE -PAID MU,
DATE
T(YS..AL+ rmwr ims DUE Now
DATE FINALED IINSPECTOR
V,
8150 $.00
$10-00
$0100
_Xiom
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 r57
Exhaust Fans
0. 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
_ _ _ _7
Final 4S/
Final
POOLS - SPAS
BLOCKVVALL APPROVALS
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
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
S.Temp. Use of Power
Final
Utility Notice (Perm)
Lowell A. DUKleth, Consulting Engineers CE -#9901
1790 Troy Lane Oceanside, CA 92054 (760) 721-0464 • (760) 721-3613 FAX
City of La Quinta Jul' 12, 2000
c/o Petronella Roofing 2K-,065
68-314 Kieiey Road
Cathedral.City, Ca. 92234 FAX 760 328-4612
Re: Use of liteweight concrete roof. tile to reroof existing
residence`at 53435 Avenida Vallejo, La Quinta, Ca. -92253, Rebbeca
Wilson owner.
Gentlemen:
This is to advise you that I have personally inspected the
subject roof structure and.find it satisfactory for.the support
of liteweight concrete roof tiles laid with .a normal 3" headlap.
I have formed this professional opinion after gathering data and
analyzing the following information. r
1. The structure was'built about'1980 under the Uniform Building
Code and -County of•Riverside permits & inspections. No drawings
are available. ,
2. •Existing roof support is with prefabricated trusses with one
California fill -frame area as follows:
Res: Truss A @ 241, spc'g, 231411 max. spans.
2x8 RJ @ 2411 spc'g, 1118" max. spans, Ca. fill.frame.
Gar: Truss G @ 2411 spc'g, 191711 spans.
3. The roof pitch is just under 4:12 pitch, use 16psf LL.
4. The following -represents the new loading conditions.
'All weights in PSF Truss 2x8@24"
Pioneer Liteweight Hacienda ICBO 3748. 5.9 5.9
Building paper -Insulation 1.0 0•.6
15/32" plywood sheathing -existing. 1.4 1".4
Truss wt or 2x8 @ 24" RR 2.1 1.4
1/211 drywall ceiling 2.2 -0-
DEAD LOAD 12.6 9.3
LIVE LOAD 16.0: 16.0
DL+LL TOTAL 28.6 25.3•,
DESIGN LOAD' *30 26•
* Trusses built in 1970 to 80 were designed for 33psf or more.
It i's my professional opinion that the roof structure has
-been designed for the DESIGN LOADS shown and is therefore
considered.satisfactory for the support of the.imposed loads.
;`Thank you for this opportunity to be of service. Please
cohta°ct me if additional information' or detail .is required.
_• j 111 /- '; /��1
1/\ 6KNI`! 0I; 911
'G •-•ii�. .IJV
' S ' EVIL '�, �' Lowell . A . Du leth
RCE #9901
�.`•%rte^ � ;,��:• / ����1 _
Lowell A. Dukieth, Consulting Engineers. CE -#9961,,
1.790 Troy ,Lane Oceanside, CA 92054 (760) 721-0464 • (760) 721-3613 FAX
City of La Quinta Jul 12,' 2000
c/o Petronella Roofing 2K-065
68-314 Kie.ley Road '
Cathedral City, Ca. 92234 FAX 760 328-4612
Re: Use of liteweight,concrete roof tile to reroof existing
residence at 53435 Avenida Vallejo, La Quinta, Ca. 92253, Rebbeca
Wilson owner.
Gentlemen:
This is to advise you that I.have personally inspected the
subject roof structure and find it satisfactory for the support
of liteweight concrete roof tiles laid with a normal 31, headlap.
I have formed this professional opinion after gathering data and
analyzing the following information.
1. The structure was built about 1980 under the Uniform -Building
Code and:County of Riverside permits & inspections. No drawings'
are available.
2. Existing roof support is with prefabricated trusses with one
California fill -frame area as follows:-
Res:
ollows:-
Res: Truss A @ 2411 spc'g, 23'411 max. spans.
2x8 RJ @ 2411.spc1g, 111811•max. spans,.Ca. fill frame.
Gar: Truss G @ 24" spc'g, 1917" -spans.
3. The roof pitch is just under 4:12 pitch, use*16psf LL.
4. The following represents the new loading conditions.
All weights in PSF Truss 2x8@2411
Pioneer Liteweight Hacienda ICBO 3148 5.9 5.9
Building paper -Insulation 1.0 0.6
15/32" plywood sheathing -existing. 1.4 1.4
Truss wt or 2x8 @ 24" RR 2.1. 1•.4
1/2" drywall ceiling 2.2 -0-
DEAD LOAD, 12.6 9:3
LIVE LOAD -16.0 16.0
DL+LL TOTAL 28.6' 25.3
DESIGN LOAD *30 '26
* Trusses built in 1970 to 80 were designed for 33psf or more.
It is my professional opinion that•.the roof structure has
been designed for - the DESIGN LOADS.shown and is therefore
considered satisfactory for the support of the imposed loads.
Thank you for this opportunity. to be of service. Please
.< contact me if additional information or detail is required.
Lowell A.Dukleth
RCE -#9901
From Lowell Dukleth, Engineer PHONE No. 619 727 2321 Jul.14 2000 12:05PM P01
Lowell A: Dukleth, Consulting Engineers cE •�
54 fid°)'a'-aw' c'�o1'z�'3a�3 FAX Troy Lane Oceanside, CA 920
Petronella Roofing Co. July 14, 2000
66-314 Kieley Road •2k-065 r ,
Cathedral' City Ca. 92234 Pioneer Li to
FAX 76n 328•-4612
STATEMENT
Attn: Bill Fitzgerald
Re: Field inspections, analysis•and certified letter report, for
exieting roof structure at 53435 Avenida Valleju, La Quinta Ca.
91253, Rebbeca Wilison uwner. Report calls`for Pionccr Lite at
5:9ysf weight.
Professional'Bugineer 4.0:hre @ $00 $320.00
Total to"•date, now due and payable $320.00
• t