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04-6927 (MECH)T4hf 4 4 Q" D. Box 1504 . -495 CALLE TAMPICO QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT .(760)777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 I-----1'pp is o umber . . . . . C04-000'0692777 Date 3/17/05 Property Address 53000 JEFFERSON ST FIRE BOWLS APN: 772-410-035- - - M Application description MECHANICAL Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 32000 Owner Contractor ND LA QUINTA PARTNERS CANYON VIEW POOLS,'INC., 81100 AVENUE 53 3465 LA CAMPANA WAY, #4 LA QUINTA CA 92253 PALM SPRINGS CA 92262 ' WCC: AU INS WC: 00500024508 01/01/06 CSLB: 779165 05/31/06 CCC: A -B -----------.----------------------------------------------------------------- Permit ELEC-MISCELLANEOUS Additional desc.. Permit Fee 19.50 Plan Check Fee 4.88 Issue Date Valuation. . . . . 0 Qty Unit Charge Per Extension BASE FEE '15.00 6.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 4,.,50 ---=----------------------------------------------=--------------------- Permit MECHANICAL ----- Additional desc .Permit Fee 54.00 Plan Check Fee-.. 13.50 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 6.00 6.5000 EA MECH OTHER MECH EQUIPMENT 39.00 Permit PLUMBING Additional desc Permit Fee . . 34.50 Plan Check Fee 8.63 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 6.00 .7500 EA PLB GAS PIPE >=5 4.50 1.00 15.0000 EA PLB GAS METER 15.00 Special Notes and Comments COMMERCIAL.- UNLISTED FIRE BOOLS (6 EA. P.O. Box 1504 • �II�� 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: /9*- (9Z� Applicant: ' Applicant's Mailing Address: Architect or Engineer: r VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3' Architect or Engineer's Address: Lic. No.: t$UILUINU PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION �hi)aynaffirrn 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 y License is in f I force and effect./ -7 7e Class G H �it[i/cense No. ate 3 �O X06 -Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law forthe following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation -of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): U 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 and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). L) I am exempt under Sec. , BA P.C. for this reason Date WORKERS' 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. Z_ I have and will maint workers' compens on insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is U /� eo, �M/ytworke ' compen tion�urance carrier and policxrry¢�r arc+ Cam.r V o/P licy Number �0r�� VVVVdj g _ I certifWat, in the performance 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 wZEDTHOU3SAND S. 2 Q � Date ✓ —� D _ aP WARNING: FAILURE TO SECUOMPENSATION COVERAGE IS UN Fi lI AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDDOLLARS ($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. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is'a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this 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 application, the owner, and the applicant, each agrees to, and shall, defend, indemnify and hold harmless the City of La Ouinta, its . officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 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 in mation is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this co toe to pon the above-mentioned pro erty for inspection purposes. /3? �i Date Signature (Applicant o gent): r'��E�.�(.l� ilk Page 2 Application Number . . . . . 04-00006927 Date 3/17/05 ---------------------------------------------------------------------------- Special Notes and Comments QTY) GAS FIRED, EXTERIOR INSTALLATION. 2001 CMC. **INSPECTION / TESTING PROGRAM BY APPROVED AGENCY REQUIRED ** ---------------------------------------------------------------------------- Other Fees . . . . . . . . ..`HOURLY PLAN'CHECK 105.00 Fee, summary Charged Paid Credited Due d Permit Fee Total 108.00 .00 .00 108.00 Plan Check Total 27.01 .00 .00 27:01 ;. Other Fee Total 105.00 .00 .00 105.00 Grand Total 240.01 .00 .00 240.01 r _ Z- 506 -0(0 f Bin ity of La Quinta Building 8 Safety Division Permit # CLP.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 �27 Building Permit Application and Tracking Sheet X Project Address:S3.00O�XI?ft,2 o.,v 4 Owner's Name: Qui � des A. P. Number: Addtrss: Ej_ �� fJ, /�� 3 X Contractor: Q Address: X City, ST, Zip: X Telephone: State Lic. # Arch., Engr., Designer: Address: City. ST. Zip: Cin', ST, Zip: /L t f Telephone: Q� Project Description` 0 N City Lic. #: pv,,�Vf N Telephone: �- Construction Type:Occu c Lic.panty: Stat Project type (circle one): New Add'n Alter Repair Demo X Name of Contact Person: Sq. Ft.:#Scoria: # Units: X Telephone # of Contact Person: _275st• A%1 c� /S Total Permit Fees s�j C O>a 4)ppr0 v e -W imatc alue of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calix. Reviewed, ready for corrections yo Plan Check Deposit Trutt Calcs. Called Contact Person ?i Plan Check Balance ' Energy Cales. Plans picked up (p/n ! d� Construction Flood plain plan Plans resubmitted litMechanical Grading plan2'' Review, ready for correctionstissue Electrical Subcontactor List Called Contact Person Plumbing Grint Deed Plans picked up S.Pt.I. H.O.A. Approval . Plans resubmitted Grading IN HOUSE:- '^' Review, ready for orrection issue jrZ Developer Impact Fee Planning Approval Called Contact Person li Pub. Wks. Appr Date of permit issue School Fees RC • 1 .. _V ,.4 c� /S Total Permit Fees s�j C O>a 4)ppr0 v e -W This letter is to serve as confirmation that RADCO has a contractual agreement with ND La Quinta Partners, LLC to conduct an on-site third -party field evaluation and testing program on the six unlisted custom built gas-fired open flame illuminating appliances to be installed within the perimeter towers of the new Hideaway Clubhouse in La Quinta, CA. RADCO's third party field evaluation will be conducted for determining if the overall construction, installation, and operation of the gas-fired illuminating appliances comply with applicable portions of the following nationally recognized codes and standards: • NFPA 1 Uniform Fire Code • ANSI/NFPA 54 National Fuel Gas Code • NFPA 160 Standard for Flame Effects Before an Audience The California Mechanical and Plumbing Codes • ANSI Z21.42 Gas -Fired Illuminating Appliances • ANSI Z21.50 & 60 Decorative Gas Appliance Standards RADCO's preliminary evaluation of the design submittal drawings has concluded that the proposed design meets with reasonable concepts of safety for gas utilization equipment and is in general compliance with applicable portions of the codes and standards referenced above. On behalf of ND La Quinta Partners, LLC, RADCO would like to request that the necessary permits be granted allowing the equipment to be installed in order for RADCO to evaluate the appliances final construction and installation. Once satisfactory, RADCO will prepare a letter of recomendation allowing the equipment to be operated in order to facilitate the performance testing portion of our program. Upon satisfactory completion of RADCO's field evaluation and testing programs RADCO shall submit a formal report to ND La Quinta Partners, LLC for their submittal to your department, and, the appropriate RADCO Field Evaluation Acceptance. Labels, bearing the RADCO registered trademark, will be applied to each appliance successfully evaluated. If you have any questions or comments please don't hesitate'to call. Sincerely RADCO R. Scott Schaffner, Manager Gas Testing Lab & Field Services • /ASS r�f.Cit E Orriial CITY C.= LjA_,'+. I A EUILDINV & SAFE=TY DEPT. ON q19/ciff DATE E3Y:o 04-612-7 �/ A o o copy RESOURCES • APPLICATIONS DESIGNS & CONTROLS, INC. January 19, 2005 3220 E. 59T" STREET LONG BEACH, CA 90805 Mr. Burt Hanada Tel. (562) 272-7231 Fax (562) 529-7513 City of La Quinta, CA www.RADCOinc.com PO Box 1504' email: info@RADCOinc.com 78-495 Calle Tampico La Quinta, CA 92253-1504 RE: Contract for Third Party Evaluation of Unlisted VIA: E -Mail to bhanada@la-quinta.org Dear Mr. Hanada: This letter is to serve as confirmation that RADCO has a contractual agreement with ND La Quinta Partners, LLC to conduct an on-site third -party field evaluation and testing program on the six unlisted custom built gas-fired open flame illuminating appliances to be installed within the perimeter towers of the new Hideaway Clubhouse in La Quinta, CA. RADCO's third party field evaluation will be conducted for determining if the overall construction, installation, and operation of the gas-fired illuminating appliances comply with applicable portions of the following nationally recognized codes and standards: • NFPA 1 Uniform Fire Code • ANSI/NFPA 54 National Fuel Gas Code • NFPA 160 Standard for Flame Effects Before an Audience The California Mechanical and Plumbing Codes • ANSI Z21.42 Gas -Fired Illuminating Appliances • ANSI Z21.50 & 60 Decorative Gas Appliance Standards RADCO's preliminary evaluation of the design submittal drawings has concluded that the proposed design meets with reasonable concepts of safety for gas utilization equipment and is in general compliance with applicable portions of the codes and standards referenced above. On behalf of ND La Quinta Partners, LLC, RADCO would like to request that the necessary permits be granted allowing the equipment to be installed in order for RADCO to evaluate the appliances final construction and installation. Once satisfactory, RADCO will prepare a letter of recomendation allowing the equipment to be operated in order to facilitate the performance testing portion of our program. Upon satisfactory completion of RADCO's field evaluation and testing programs RADCO shall submit a formal report to ND La Quinta Partners, LLC for their submittal to your department, and, the appropriate RADCO Field Evaluation Acceptance. Labels, bearing the RADCO registered trademark, will be applied to each appliance successfully evaluated. If you have any questions or comments please don't hesitate'to call. Sincerely RADCO R. Scott Schaffner, Manager Gas Testing Lab & Field Services • /ASS r�f.Cit E Orriial CITY C.= LjA_,'+. I A EUILDINV & SAFE=TY DEPT. ON q19/ciff DATE E3Y:o 04-612-7 �/ International Accreditation Service, Inc. CERTIFICATEOF ACCREDITATION This is to signify that RADCO (RESOURCES APPLICATIONS DESIGNS AND CONTROLS, INC.) 3220 EAST 591" STREET LONG BEACH, CALIFORNIA 90805 Testing Laboratory TL -209 has demonstrated compliance with ISO/IEC Standard 17025, General criteria for the competence of testing and calibration laboratories (encompassing the relevant requirements of the ISO 9000 series of standards), and has been accredited, commencing September 27, 1999, for the test methods listed in the approved scope of accreditation. (see attached scope of accreditation for fields of testing and accredited test methods) Patrick V. McCullen C. P. Ramani, P.E. Vice President President . This accreditation certificate supersedes any IAS accreditation certificate bearing an earlier date. The certificate becomes invalid upon suspension, cancellation, revocation, or expiration of accreditation. See the IAS Accreditation Listings on the web at www.iasonline.org for current accreditation information, or contact IAS directly at (562) 699-0541. Print Date: 10/13/2003 Page 1 of 3 International Accreditation Service, Inc. SCOPE OF ACCREDITATION Testing Laboratory TL -209 RADCO (Resources Applications Designs and Controls, Inc.) 3220 East 59`h Street Long Beach, CA 90805 Page 2 of 3 R. Tucker Senior Vice President (562) 272-7231 FIELDS OF TESTING ACCREDITED TEST METHODS Fire UBC Standards 2-1, 15-2 and 26-3; ASTM Standards D 635 and E 136; API Standard 607 Physical/structural UBC Standards 14-1, 14-2, 15-5, 15-6, 21-6 and 21-7; ASTM Standards A 74, A 126, A 438, A 792, B 117, B 306, C 67, C 203, C 272, C273, C 282, C 296, C 297, C 303, C 473, C 518, C 564, C 578, D 256, D 380, D 412, D 471, D 570, D 572, D 618, D 624, D 638, D 648, D 696, D 751, D 756, D 779, D 781, D 790, D 792, D 816, D 828, D 882; D 896, D 905, D 1002, D 1037, D 1042, D 1204, D 1248, D 1333, D 1435, D 1499, D 1527, D 1621., D 1622, D 1623, D 1682, D 1761,, D 1784, D 1785, D 1788, D 1970, D 2126, D 2137, D 2239, D 2241, D 2247, D 2282, D2294, D 2299, D 2464, D 2466, D 2467, D 2468, D 2523, D 2581, D 2609, D 2661, D 2662, D 2666, D 2737, D 2751, D 2846, D 3034, D 3309, D 3311, D 3350, D 3679, D 3930, D 3965, D 4226, D 4317, D 4396, D 4477, D 5764, E 8, E 72, E 96, E 330, E 331, E 488, E 529, E 695, E 1333, F 409, F 438, F 439, F 441, F 628, F 789, F 810, F 845, F 876, F 877, F 891, F 949, F 1281, F 1282, F 1575, F 1667, G 21, G 23, G 26 and'G 53; ANSI/AAMA Standard 1402; UL Standard 1296; ASME Standard Al 12.6.1 M September 27, 1999 Commencement Date C. P. Ramani, P.E. President This accreditation certificate supersedes any IAS accreditation certificate bearing an earlier date. The certificate becomes invalid upon suspension, cancellation, revocation, or expiration of accreditation. See the IAS Accreditation Listings on the web at www.iasonline.org for current accreditation information, or contact IAS directly at (562) 699-0541. Print Date: 10/13/2003 International Accreditation Service, Inc. SCOPE OF ACCREDITATION Testing Laboratory TL -209 Page 3 of 3 FIELDS OF TESTING ACCREDITED TEST METHODS Equipment UL Standards 103, 127, 181, 234, 307B, 311,441, 737, 883, 1046, 1075, 1083 and 1091; ASME Standards A112.1.2, A112.19.5, A112.19.7M, Al 12.1'9.9M, Al 12.21.1M and Al 12.21.2M; ANSI Standards Al 12.14.1, Al 12.18.1M, Al 12.19.2M, Al 12.19.3, A112.19.6, A112.36.2M, 816.3, 816.4, B16.12, 816.15, B16.18, 816.22, B16.23, B16.24, 816.26, 816.29, Z124.1, Z124.2, Z124.3, Z124.4, Z124.6, Z21.1, Z21.5.1, Z21.5.2, Z21.9, Z21.9a, Z21.10.1, Z21.10.1 a, Z21.10.3, Z21.11.1, Z21.11.2, Z21.12, Z21.13, Z21.42, Z21.44, Z21.47, Z21.48, Z21.49, Z21.50, Z21.56, Z21.57, Z21.58, Z21.60, Z21.61, Z21.62, Z21.63, Z21.64, Z21.72, Z21.73, Z21.74, Z83.3, Z83.4, Z83.4a, Z83.7, Z83.8, Z83.9, Z83.10, Z83.1 Oa, Z83.11, Z83.12, Z83.13, Z83.14, Z83.15, Z83.16 and Z83.18; ANSI/ASME Standards A112.19.1M, A112.19.4M, A112.26.11V! and 61.20.1; ASSE Standards 1001, 1003, 1005, 1010, 1011, 1012, 1013, 1014, 1015, 1020, 1024, 1025, 1032, 1035, 1047, 1048, 1050, 1051 and 1052; NSF Standards 2-87, 4-86 and 8- 85; ANSI/ASSE Standards 1002, 1019 and 1037 September 27, 1999 Commencement Date ( pr C. P. Ramani, P.E. President This accreditation certificate supersedes any IAS accreditation certificate bearing an earlier date. The certificate becomes invalid upon suspension, cancellation, revocation, or expiration of accreditation. See the IAS Accreditation Listings on the web at www.iasonline.org for current accreditation information, or contact IAS directly at (562) 699-0541. Print Date: 10/13/2003 International Accreditation Service, Inc. CERTIFICATE OF -ACCREDITATION This is to signify that RADCO RESOURCES, APPLICATIONS, DESIGNS AND CONTROLS, INC. 3220 E. 59T". STREET, LONG BEACH, CA 90805 Inspection Agency AA -650 Type A (Third -Party) Body has demonstrated compliance with the ISO/IEC Standard 17020, General criteria for the operation of various types of bodies performing inspection (encompassing the relevant requirements of the ISO 9000 series of standards), and has been accredited commencing July 1, 2003, to provide inspection services in the approved scope of accreditation. (see attached scope of accreditation for field type, range, methods and procedures of inspection) Patrick V. McCullen Vice President C. P. Ramani, P.E. President This accreditation certificate supersedes any IAS accreditation certificate bearing an earlier date. The certificate becomes invalid upon suspension, cancellation, revocation, or expiration of accreditation. See the IAS Accreditation Listings on the web at www.iasonline.org for current accreditation information, or contact IAS "directly at (562) 699-0541. Print Date: 10/01/2003 Page 1 of 2 International Accreditation Service, Inc. SCOPE OF ACCREDITATION Inspection Agency AA -650 Type A (Third -Party) Body RADCO Resources, Applications, Designs and Controls, Inc. 3220 East 59th Street Lona Beach. CA 90805 Page 2 of 2 Michael L. Zieman President lr%F71 077_7')11 FIELDS OF INSPECTIONS TYPE AND RANGE OF INSPECTIONS INSPECTION METHODS AND PROCEDURES Foam Plastic Insulation Board In -plant ICC -ES Interim Criteria AC 12 and Section 4.2.1 of RADCO Quality Assurance Manual procedures Fiber Board In -plant ICC -ES Interim Criteria -AC 158 and Section 4.2.1 of RADCO Quality Assurance Manual procedures Wood Trusses In -plant ANSI/TPI 1-2000 and Section 4.2.1 of RADCO Quality - Assurance Manual Roof Underlayment In -plant ICC ES Interim Criteria AC 165 and AC 188, and Section 4.2.1 of RADCO Quality Assurance Manual Plumbing Fixtures and Components In -plant Section 4.2.1 of RADCO Quality Assurance Manual Gas Appliances In -plant ICC -ES Interim Criteria AC 103 and Section 4.2.1 of RADCO Quality Assurance Manual Structural, Mechanical, Electrical and Plumbing In -plant Section 4.2.1 of RADCO Quality Assurance Manual Systems of Prefabricated Construction July 1, 2003 elzallv az Commencement Date C. P. Ramani, P.E. President This accreditation certificate supersedes any IAS accreditation certificate bearing an earlier date. The certificate becomes invalid upon suspension, - cancellation, revocation, or expiration of accreditation. See the IAS Accreditation Listings on the web at www.iasonline.org for current accreditation information, or contact IAS directly at (562) 699-0541. Print Date: 10/01/2003 .� ..v -�.-�c. cv, .oa• r•�� .,r we .a..�coaoVGG rnG Automated Fire and Water Effects, Inc. 7500 Woo Lake Mead Boulevard #9-480 Las Vegas. Nevada 89128 Tel: (702) 301-8419 Fax: (702) 838-8066 November 10, 2004 City of La Quinta . Building & Safety Department PO Box 1504 78-495 Calle Tampico La Quinta, CA 92253 Re: The Hideaway Fire rings on existing columns 53-000 Jefferson St. Dear Mr. Hanada, We are responding to your plan check corrections of October 25, 2004 as follows: • Testing program* We will be using RADCO for 3rd party field evaluation and testing. This will include the mounting, operation, clearances according to numerous local and national standards including the California Mechanical Code. They will provide a copy of the testing protocol directly to you. • The testing protocol will include the relevant sectlons of NFPA 54, etc. Please call me if you have any questions. Sincer , Courtney R. Millburn, P.E. r.. ' �,' __` ." '' `' ' DirectorJig U; -J' r �;;r` f 1' DEPT. I j� DATE 3 �� BY