0109-198 (ELEC)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
�X 9f B'm °DLJ
Date a ! lf�, Signature of Cotractor - -"
71 n
• r rr
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 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- Policy N0.
STATE INIAD WeP.06131
(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 .Califomia/,apd,agree.,that if I should become
subject °to the workers' compensation provisions -of §ection 3700 of the Labor
Code I shajl for with comply with those` provisions_ /_!
�
pate: ' 9 1 A, A� ! Applicant �' �. (. s (.: � ' 1
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 Cdde, 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./
gnature (Owner/Agent)T��! r� Date
sa
DATE 1
JOB SITE
ADDRESS
OWNER
BUILDING PERMIT
VALUATION
RAV11010.1 rxt0 �4a�EWUM TMC
LA. f iTIPn-A
USE OF PERMIT
PERMIT #
LOT Qx ,198 ` TRACT
APN
CONTRACTOR/DESIGNER/
ART GAT7111 REE AU WC
CA 922,55 �i".@'l�s�+i°CC'014 �' 9i� £tC
(714)9348066 CIJUX 5177
NW9 P ARS ; INO WT LICHT ST.ANOLARDS PER Ai'PROVRO [?li..AN.
VALUATION
9.%00D,00 L3
'SkS .A,HUT.IM) co -sr OF *a.OA\Sa.J.7lRJCB..l,0.sA'l 1261,7GC4 oo
RUM."? RJ CA., VMS, 101-U00-420,000 $20
f
Aw.) Pulam CS, °$911.`T5
LAW PIMA Pfim Fc, U $01.00
w 1
TO . Is DUB;, NOW
Q �
RECEI ATE _ i[ BY� DATE FINALED INSPECTOR,
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings _ Q/
Slab Grade �; `
Underground Ducts
Ducts
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 Wail Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
Steel
POOLS -SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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:
451k�- fetes
-
CIL FZ'r, we- !3.7
A pr.
Eu lF T:;E APPROVED
PLANS AND JOB CARD ARE NOT ON
THE SITE FOR A SCHEDULED
INSPECTION. -
NO EXCEPTIONS!
=am
P.WiE 04
48 M GTIUIC49 STEEL
POM FINMED To
MATCH LUTMRE
2 -PIECE 15ME COVSR
24, VIA.
C04CFEM BASE
(4) A404 BOLTS
14" DIA x.42, x 4@ k1
a Nm iZS
q4 VW CAL MBAR
'43 WORMOWAL RMAR
MM4 'TWA AT MR -b O.C.
SNOW CAUM OR PAVIWj
4
C4K;OjTT
AA
LA QUIN
V&
SAFET-Y,DEpT
000
ONSTRU
C.rI04
. -T--.VT� �.DGHSTANDA-BASEDE, AIL-'
'6CA4E- AKME
DSD>I
(175 W. MAX.]
11502
(100 W. MAX.)
E.P.A. OS01= 0.97
OS02= 0.59
SPECIFICATIONS
HOUSING: HEAVY WALL ALUMINUM CONSTRUCTION WITH REMOVABLE BALLAST TRAY FOR EASY
BALLAST ACCESS.
REFLECTOR: HEAVY WALL ALUMINUM CONSTRUCTION. INSIDE OF REFLECTOR FINISHED WITH HIGH
GLOSS WHITE ENAMEL.
OPTICS: CLEAR TEMPERED GLASS DIFFUSER.
OPTION: CLEAR PRISMATIC OR OPAL GLASS DIFFUSER.
LAMP HOLDER: MEDIUM BASE PORCELAIN.
LAMP: (BY OTHERS)
BALLAST: H.P.F./C.W.A. AUTOTRANSFORMER. -20' STARTING TEMPERATURE. ELECTRICAL
COMPONENTS ARE MOUNTED TO A REMOVABLE BALLAST TRAY. BALLAST IS EQUIPPED
WITH FACTORY INSTALLED QUICK DISCONNECT PLUG.
FINISH: POLYESTER POWDER COAT -STATE OF THE ART 20 PSI PRESSURE POWER WASH AT
140' TEMPERATURE INCORPORATES FOUR STEP IRON PHOSPHATE PROCESS TO
CLEANSE AND PRETREAT THE METAL SURFACE FOR MAXIMUM PAINT ADHESION.
ELECTROSTATICALLY APPLIED TEXTURED POLYESTER POWDER TOPCOAT IS BAKED AT
400° TEMPERATURE FOR MAXIMUM HARDNESS AND EXTERIOR DURABILITY.
UU.L Listed for
L wetloeation
MOUNTING STYLES
XPK XPJ
WALL MOUNT
3. 1.0.
XPH
42'
3' 1.0.-1 F --
AVAILABLE FOR
MOUNTING I ONLY
ARMS ARE HEAVY WALL
EXTRUDED A L U M I N U M
CONSTRUCTION. FOR AOOITIONAL
ARM OPTIONS SEE ARM SECTION.
LUM. A B C
0501 14'21'/z• 17'/a•
OS02 13• 1 14• 1 1S'/e'
EXTRUDED ALUMINUM ARM AND
CAST ALUMINUM WALL BRACKET
ASSEMBLY PROVIDED WITH BUILT
IN EiASKETEO WIRE ACCESS FOR
FIXTURE/SUPPLY WIRE CONNECTION.
WALL PLATE
T
T
S'h'
1
41 HOILES
E.P.A
LAMP SIZE:
50 - 175 WATT
osul
(175 W. MAX.]
E.P.A.= 0.59
0502
(100 W. MAX.]
ALL ALUMINUM CONSTRUCTION.
INTEGRAL. SELF CONTAINEO
BALLAST COMPARTMENT.
THREE MOUNTING STYLES.
MODEL
NO.:
OPTICS
WATTAGE TYPE VOLTAGE
MOUNTING
FINISH
DSD
NMODO.:
NO.
OPTICS
LAMP
MOUNTING
FINISH
STANDARD:WATTAGE
TYPE VOLTAGE
❑DARK
D
9JCLEARPRISMATIC
❑XPKr ❑XPJPt
BRONZE
TEMPERED GLASS
0175 ❑ HPS 120
DBM
g
CPG
IM
❑MEDIUM
0150 0MIH 0208
❑XPH�
D
BRONZE
MEIN!
P100 ❑ MV 0240
❑WM •••...• 04,
BLACK
OPTIONS:
❑75 0277
❑1 ............ 0.
BKM
❑OPAL GLASS
❑WHITE
DIFFUSER
070 0480
WTM
WGD
OAKEa Ea& HEATRE9SIAATI
❑50 ❑ MT
❑SILVER
SLM
❑CLEAR TEMPERED
GLASS LENS
OPTION:
CG
❑ANODIZED
jOS01 L\LTI
AZ
ANODIZED
MEDIUM BASE
HOUSING MUST
LAMP ONLY
HAVE PUNT
FINISH COAT
EXAMPLE:
AZBBY
DSD2- 100 W. MAX.
SEE
SEE PAGE
ARM SECTION
3
FOR
FOR
ADDITIONAL
ADDITIONAL
ARMs
COLORS
OPTIONS
OPTIONS
❑ 3/8' IPS STEM MOUNT
AND SWIVEL CANOPY
(4•-0• MAX)................SM
❑ CHAIN MOUNTED
(4--O-MAX.) ............... CM
❑ HOUSE SIDE SHIELD
90' .......... HS 90'
135' ..........HS 135'
180'.......... HS 180'
❑ PHOTO CELL + VOLTAGE
(EXAMPLE: PC120V) ..... PC+V
❑ SINGLE FUSE
(120V., 277V) ...........SF
❑ DOUBLE FUSE
(208V., 240V) ...........OF
I�
II
m
LL
J
Q
u
Ln
11
15 /e 0.0. ALUMINUM
WITH W.P. CAST
ALUMINUM COVER
i— 24"-1
I
36°
XBC-1 -0� �— 3' 1.0.
E.P.A.= 1.94
J Lu.
XBC-2-180
E.P.A.= 3.21
2'X40
(4]'/z° OIA.
HOLES
�— 23"—_I
350 32'
0
tL..
3° ;•-
XBC-WM 4 yZp
DURABLE CORROSION RESISTANT, CAST AND EXTRUDED ALUMINUM
CONSTRUCTION.
u
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Plan View
Scale V = 16,
LUMINAIRE SCHEDULE LUMINAIRE LOCATIONS
Symbol Label Qt/ Catalog Number Description Lamp Filen
Lumens
LLF
.. 100W MH RATED @
D1 = 7 DSD1-CPG-10OMH 20 1/2" k 17 1/2" 8500 LUMENS OV07h5yg.ies 8500 0.81
�.
{ 100W MH RATED @
D2 2 DSD1-CPG 100MH 20 1/2° k 17 1/2" 8500 LUMENS OV07h5yg.ies 8500 0.81
J
STATISTICS
Description Avg Max Min Max/Min Avg/Min y.
SITE 1.7 fc 3.6 fc 1.0 fc 3.6:1 1.7:1.
No.
Label
X
Location
Y
Z
!
'
I,
�
I
MH
16.0
16.0
16.0
16.0
16,0
16.0
16.0
16.0
16.0
Orientation
L 0-0
0-0
0-0
180.0
90.a
270-0
270-0
90 -0
I 180-0
Tilt
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1 DI -73.5 -57.5 16.0
2 D1 -22.5 -57.5 16.0
3 D2 -18.0 -14.0 16.0
4 D1 -69.5 35.5 16.0
5 D1 - 83.5 -10.0 .16.0
6 D 1 35,5 -6.5 16.0
7 D1 33.5 -53.5 16.0
g b27.3 26.7 16.0
9 D1 -26-5 35.5 16.0
Client
COVE ELEC.
Date
JULY 25, 2001
Drawn By
DMD
Drawing No.
LS0195A6
1 Of 1