9709-132 (SOTB)r
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
tf17"< -NIa t�ffFfsta
ate' Sigriature of
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:
O 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.
(1� 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 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
6ject to the workers' compensation provisions of Section 3700 of the Labor
ode ,l< t II fort wit comply wrthahose ji�ovision
Date: Applicants 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 R•
application. °p
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 resulf'of this applicaton agrees. to, A 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 ofsuch
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 >,
/he above-mentioned propertytfforirispection purposeS. i
gnature• (Owner/Agent) Datef�1�%
2 r
r
PERMIT# CONTROLS#•a `
SUILDING PERMIT 9709432 59 2
, L
DATE VALUATION. (,(�jj,{f�{t.. LOT TRACTbl
J013 SITJ
ADDRESS F001
APN
- - ` ^
OWNER CONTRACTOR / DESIGNER / ENGINEER > "
4��i'!.�.47 r4In, `) t ,
$,+.�\��a elm+ � .• ..i.,�J1 i~Il.:a �xe �d .i: � ��n,'V �� •
��ary3_"+ k4 f z.0 t city ( i'J'�•J:�S i�' t if" i� a�` $s
0115 0i46 t14
USE OFPERMIT,
r
'NIy 41Af041"AS O L T.lWIT fd9149-Utl.(i OR, h OCA iQ-0 .[4#4'11.,i'4T AULT
ONLY.
n t i , 1X"rALL. 26.00 UF
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'ii it•�,t.Pei' .'
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titlt:.t-"1Y{.T.C. �-L CONN_ T]RAX-3111* AND ► VT NN (°i�i»,E",'•j�
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c f .�!_, IM le Ova $ IF, lief?tib
JPJ
SEP 3.0.1997
4pp
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CEIPT
DATE FBY
DATE FINALE D
INSPECTOR
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
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
steer,
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
Fodures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
ton
ATMAS TER
. . . . . . . . . . . . .
_ , ..K �t 0
n, anon
... _ . _mice Proceduies
Heatpm
150A
--
jes
Pool &
2 "%. 0_ -3 & -0
5 0
BM2 Mo'l 'I
iDE51
T.
FOR YOUR SAHT-Y5��"�---��;
• Do not try, to 1i ht any, appliance
• D
o not touch any electrical switch; do
not L building.:.,
'iii any In your
11himedlately call your gas supplier, from
I n h
eig bor'sphone Follow the gas
supplier's instructions.-
If you. cannot reach your gas suppl er,
call the fire'dioartrfient.
Installation
anq'�sWvlce must be
Z-,for'm'e'd' by ""'alifl6d installer; service
.'_ W
enc
as su
ppil6r.
Do ftbt'store j ~other l.
.
gasoineor
mmable'Va"porc
fla and liquids in the vicinity
of this aY
'other'aor .
H;
WHATTO -SMELL'GAS � -DO IF YOU.
=
77,
• Do not try, to 1i ht any, appliance
• D
o not touch any electrical switch; do
not L building.:.,
'iii any In your
11himedlately call your gas supplier, from
I n h
eig bor'sphone Follow the gas
supplier's instructions.-
If you. cannot reach your gas suppl er,
call the fire'dioartrfient.
Installation
anq'�sWvlce must be
Z-,for'm'e'd' by ""'alifl6d installer; service
.'_ W
enc
as su
ppil6r.
,.C -ON 01,T101
BJE CT.T.O.
Llr-APRLIC
_
LLAT -10N -.',".AS -PER-..
ABL 00,
.
........
a,
H;
=
,.C -ON 01,T101
BJE CT.T.O.
Llr-APRLIC
_
LLAT -10N -.',".AS -PER-..
ABL 00,
.
........
,.C -ON 01,T101
BJE CT.T.O.
Llr-APRLIC
_
LLAT -10N -.',".AS -PER-..
ABL 00,
• -. � ,may .L' .:k,. •5:f.
� " ' .= sy;�1'4' `..y, - .., .. :w ., r `t: ��.i•� r Sn,re , ..y,i '_ .- .. .„ }'•._17• -. .'--. _
. r . Venting system should be located per ANSI HWS, are self -venting and require no additional vent
Z223.1, (latest edition), National Fuel Gas Code; ' piping. A windproof cabinet and solid steel roof pro-
which states that: y, ;.
tect them from the wea-her. This unit shall not be
.'A A venting system shall terminate at least +3 "; operated outdoors at temperatures below that indi- ,
feet above any forced air inlet located within 10 ' t cated here (400F).
feet. x .. '
.1:_-'-,._1 . When locating a DHO modeI'consider that high
""The venting system of other than a direct vent 4t �' winds can roll over or deflect off adjacent build
"K appliance shall terminate at least 4 feet below, is ings, walls, and shrubbery to create a negative
=�y 4 feet horizontally'from, or 1 foot above any meddraft causing flari lout and sooting, reduc- -
. door, window; or gravity air•inlet into any u t, � _ing combustion efficiency and damaging '
,` building. The bottom of the vent teiminal shall ' ..controls. Normally,.placingthe heater at least 2 _
r " " _feet from any wall vrill prevent this:condition ,
t'be located at least 12 Inches above grade. t� , ., ,i
2 r Periodically check the venting systemTh�`e'
{Clearances *r_ n ��" f r f°
heater's venting arEas must never be ob-
�* s s r nAT ; , E ; structed in ariy way and minimum clearances ' r
,..
The following installation and service clearances must be observed t prevent restriction of com-
`must be maintained from combustible'materials• =' ` bustion and ventilation air: Remember; shrubs
grow and in time mc
obstruct.a heater'swent-
.:rte
f"r_'Indoo�lnstallations
_
Outdoor Installations
NTop - 36"
Top - Open and
vFront Unobstructed
Unobstr a&ed .
'.Vent - 6"; Alcove - 24"
Front - Unobstructed
-'Back-6" _
Back 6"
-Combustible'
Non Combustible
...Non
Floor: ; .,' '
Right Side (Water
,.Floor
Right Side (Water'
• Side) -12"�' °
Side)
Left Side - 6" ,
Left Side -.6",,,
ing areas. Keep appliance area clear and free of . ,t
combustible and fla�-nmableliquids. .�, ,
3. 'Do not install this appliance under an ovWr6g
less than 3 feet from the top of the appliance.
The area under the Overhang must be open on
N threesides. Ysa r
-" 4. Do not. Install under a deck'' ,o
ti Outdoor heater -high wind conditions:
In areas where highiwinds area dailyoccur-
td
Figure 10 " rence, or where severe downdrafts are presen ue
The discharge opening of the vent must be at to surrounding structures; if may be necessary to
least three feet above the roof surface and at least install the HWS outdoor vent cap assembly. When in
doubt always use a high wind stack See Figure 2.
a
'..two feet higher than any portion of a building within Installation instructions are provided in the carton
ten feet horizontally. The vent stack shall be at ;+,, +,,,, sA,c ;,of,r _ ~'
M•yt 4.
least five feet in height above the drafthooi
outlet The vent cap location shall
�., _ .. _, - x Baa
have a minimum clearance of 4 feet
horizontally from electric meters, gas,
meters; regulators and relief open- =
ings. ;-
The weight of the vent or chimney
must not rest on the heater draft-
hood. Support must be provided in .
accordance with the applicable codes.
The HeatMaster®top and drafthood •^
must be easily removable for mainte-
nance and inspection. The vent pipe 11
must be supported to maintain proper
clearances from combustibles.
NOTE: For more detailed methods of
providing air for combustion and
ventilation, refer to latest edition of
the National Fuel Gas Code, ANSI Z-
223.1. -
Venting, extending above the roof
by more than five feet, should be
guyed or braced above or below the
roof to protect the vent from wind
and/or snow damage.
Outdoor models with a DHO or
n
Outdoor Installation r,
Figure 11
4' MIN. '
of 4' MIN. I
3 MIN. FORCED
AIR
INTAKE
10,
Mill.
c
4a
7i I
tC
m
'1k
N
M111 -mg -
communicating With'the,,5�,,"t',t- When ducts are used, they shall be of the
® Ni•� `1. '-.:When directlye
outdoors, each opening hll haV6 same cross-sectional area as the free area
a
minimum "o the openings to Which they connect. The
7 u free area 1 square inch. 06r f
'4 000 BTU per hour of totalinput rating of 'minimum urn dimension of rectangular air ducts
all equipment in the enclo��ure:;00g.. ,l shall b4'rofless than 3 inches.
2 When communicating Mth the'butdo6rgForalcove installations, the'drafthoo'd (DHI)
-through vertical ducts, each oNhihg shall'. shall be installed 'k7is to be in the same atmo-
have a minimum free area of 1squaird'inch spheric pressure zone as the,.e6mbustion air inlet to
per 4,000 BTU p6� hour-bf,,total'inout"r"�a't-i'ng the pool heater..',V54�t
Locate the r;�Wspa heater as close as
of all equipment in the'enctdsure:
e
3. ;Wh ncommu'nicatingWith'�ffiieoUtdobrs'�Fir.."
:�;� . practical to a chimney or gas vent. See Figures 6, 8,
f,
ic -..,and aterback
through h-6hz6htal _d'_u6fs--,,,each_"6 'enihM,, nd 9. Do *1 draft div'erte'r (DI -11) in any
ti p
-
-`�'shal I ha6e i ffiinii ree:area ,.df' 1 square waylriitall draft dirert6r (DHI) 66 top of heater.,
_iho
e i�l should be of blued steel or
per ZOOO BTU per hoor oflotal1hpOt'
-rating v,
-'!A, of all equipment iffthei�njclosute:g-vt� galvariiied steel with double wall construction when
4 4"i nz M passing thru walls &W TO
k',
Ell
Vent Top Installation .r.
_nx
Installation On Blocks
Figure 6 I
WN
FE , W
Figure 7
'INDOOR MODELS
TYPICAL INSTALLATION
-12"
MIN
BACKDRAFTDIVERrm
s,
MUST BE INSTALLED 07J
DIRECTLY ON HEATER
NO
OR
AORCUT NECK
12"
MIN.
iFLANGE CONNECTIONS
nQ
DO NOT RESTRICT
OR REDUCE PIPE SIZE
VVV
GAS COCK
PLASTIC PIPE
y. -P, (PVC, ETC.)
GAS SUPPLY
SEE CHART
FOR SIZE-'
_�
CHECK VALVE
Y
Below Ground -Installation
NONCOMBUSTIBLE
SED'MENT TRAP (OPTIONAL) OR
Figure
NATURAL GAS ONLY
BELOW GROUND INSTALLATION
Indoor Installation
Figure
GRILL SIZE FOURSQUARE INCHES
8
PER 1000 BTUH FOR EACH GRILLE
-4— VENT CAP
VENT CAP
DOUBLE WALL,.
VENT PIPE -
VENTILATO N
AIR
COMBUSTION
THRU APPROVED Z-
I
GROUND LEVEL
AIR
ROOFJACK
GRADUAL RISE
6T
• OF ONE INCH PER
RISE OF ONE
ICH PER FOOT N
VENTILATONM,ng
OUTLET
AIRrY
DRIPTEE
DRIP L �zt DIVERTER
co
'4TEE ADO NOT ALTER
BACKDRAFT
k! r 7y --.&OR CUT NECK
DIVERTER
< 0
%
GASCOCK COMBUSTION
AIR
DO NOT ALTER
OR CUT NECK
GAS COCK
IL
LEVEL NkOMB69f[Mj` j;.
SEDIMENT TRAP' ki
SEDIMENT TRAP LEVEL NON-COMBUSTIBLE
FLOORING OR SLAB
.:.3 , •
Seqioft ILII �Iristalla�q
from the inside wall of a spa unless separatedfrom
hllmrtant notice. •�y P;ahe spa by a solid fence, wall or other permanent
,The instructions herein are intended for the usek solid *barrier. �'•
of a qualified technician, specifically trained ands Do not store chlorine or other corrosives in the
experienced in the installation of this type of j vicinity of your pool /spaheater
.
heating equipment. Some states require that s
installation and servicemen performing the installa �� ar
Air Supply: r , , • "
4 .M
tion be licensed. If this is"the case in your state, be Your heater is wind ar�d weatherproofed aril
sure that your contractor is proper) licensed Onl
f �- . ualified persons shall attempt to fix or repair..this A';tmay be installed outdoors with a DHO or HWS vent
�..rq �Y ak To install indoors•or, inside a shelter, use a DHI
r s
equipment according to these instructions „ gr ? Pent pak°Shelters must �e provided with adequate
�.
.c� .,trs+. s ,f'•y3 +r„ f(
-� ,, r t,� K♦`r combustion and ventilat on air vents to assure
Location of heater: '�� " a, Pk+' ro
.proper heater operation: These vents must be sized :� Y
:.Locate the pool /spa heater in an area where k,",according to the following chart,'located n accor
leakage of heat exchanger or connections will; note dance with the illustrations and must never be r
result in damage to the area adjacent to the heater ..obstructed when heater is in operation. -
When air blowers are used in spa/hot tub
or to the structure. When such locations cannot be �; -
avoided, it is recommended that a suitable drairiA';x installations, caution must be observed to insure r
'pan, with drain outlet, be installed under the heater,:' ,•: sufficient combustion air is available to the gas ,
The pan must not restrict air flow. -lez'' heater for proper combustion. A separate blower air
,i, ,�
duct is recommended-,
.�
�tx r 4.
• ryY X M6 � .c
Venting�Fglupnient locate1 in confined spaces:
Your heater must be installed in accordance i,
with all local and state codes. Authorities having e � 4° Do not install in a closEt. �. l
A All Air Supply From Inside The Building: The
jurisdiction should be consulted before installation r,... confined space shall be provided with two per -
Vent sizing, installation and terminationahall be in ;y ';' ��
manent openings ca�nmunicating directly with
accordance with the latest edition of the National � -I
_: �; . a s � , : - an additional room(s) of sufficient volume so
Fuel Gas Code, ANSI Z-223.1. that the combined volume of all spaces meets
NOTE: Do not use the unit below 40°F temperature : ;:' the criteria for an urconflned space (a space
without adequate temperature protection.ti': whose volume is no =less than 50 cubic feet per
The heater rated BTUH inputs are suitable forz; , .a 1000 MO. The total input of all gas utilization
up to 2000 feet of elevation above sea level.,ln they equipment installed, in the combined space. shall "-
U.S.A. only, for elevations above 2000 feet, consult{'
"A►�; _ be considered in making this determination.
factory. w r '"' ; ���' Each opening shall rave a minimum free area of
The installation shall conform with the National w �s 1 square inch per 1,400 BTU per hour of the to- n
Fuel Gas Code ANSI Z-223.1 (latest edition) •and with tal input rating of al gas utilization equipment
the requirements of the authority having jurisdiP:-.:' - in the confined space, but not less than 100
tion. Design certified in the United States is in <-e..' . square inches. See Figure 5. One opening shall
compliance with American National Standard 221- be within 12 inches Df the top and one within 12
56 (latest edition). "x f° :` c' inches of the bottom of the enclosure.
Warning:",
Your HeatMaster® pool/spa heater must be
installed on a non-combustible floor or slab. Installa- '
tion on other floors may be accomplished provided
the floor under the appliance is protected with K1,
hollow masonry not less than 4 inches thick covered
with sheet metal of not less than 24'gauge: Such
masonry must be laid with ends unsealed and joints
matched in such a way as to provide. a free circula-
tion of air from side to side through masonry: The
masonry must extend a minimum of 12 inches`; _
beyond the heater to all sides. See Figure 7.16 all
cases, floor protection is the responsibility of the
installer and the installer must check to be certain
,that the floor is not exposed to excessive heat' w;"
during extended periods of operation." <�
This heater must be installed at least five feet
6
Input
Combustion Air
Ventilation Air
150,000
150 square in.
150 square in.
200,000
X200 square in.:
x';200 square in �
250,000
250 square in.
250 square in.
300,000 -
300 square in.
-300 square in.
350,000
350 square in.
350. square in.
400,000
400 square in.
400 square in.
Figure 5
B. All Air Supply From Outdoors: The confined
space shall be provided with two permanent
openings, one commencing within 12 inches of
the top and one commencing within 12 inches of
the bottom of the enclosure. The openings shall
communicate direc :ly, or by ducts, with the
outdoors or spaces (crawl or attic) that freely
communicate with the outdoors. '
9-7 .
CARLOS ELIAS
,
Civil Engineer
38825 Charlesworth Dr.
.`
Cathedral City, CA 92234
+ ,
(619).328-7271
ST/Z�Gr(iRL Ga��� uL—t oN 5
WiN6'eo, Poor -
8XS.�X 6'.' 015151,2 U60 -LT SSCGc,gr�ory
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TRat,�S �e� l�o2TL✓���1�-G6�'�l�tJt �1 hlJ�3L�C�i?tON, OR6CVtN6U1.►�2
dwcAF'm fi�qwKS �r2 �?v`�lt MSS S! 6►2S
u&PU44L STEEL
NJ= CoPF•;x w a3 = .c�2o(35����''- lf% f 0.= IJt;PTH=60
• • .'
U = CoEFF.xw q 2 = ,•342- �'3,�(,�z= X31
.
'k
. #� UST. S7L :Ca./G `�o'c, 600 x'02 �'I = 91�' `� V=
D2�ZoErt�t�. STS .
42(,3 5;() �- 4 31
j 0(vL- STS . � (� "o , C . 6000 Fog M d 914,14 ✓= 5 5 '
U s 6- `04- Hoa tz,
'
#4C � G"o.c,
. 8" T1!!cK �on�C. �s cr< . �•Au. CE��S.�RourEa - • � ..
VERT, s•rr..
•
I2"
3 CCNr(N.
2, o„
y
Z500 PSI
-
CONC.
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71NG
POOL AREA SCALE 1/8" 1'
PLOT PLAN -NO -SCALE ® ,9si? / kyr
t/�7� r 7� 5 0 ..
POOL SIZE % 'DEPTH . TO PER SO. FT. ❑INCLUDED
TEMPL. NO. FILTER NO. NOTE: SHALLOW END .... ❑ LADDER ..... ❑
SHAPE NO. RETURN LINES DEEP EVD DIG .... ❑ SLIDE ....... ❑
P -TRAP .....: ❑ LIGHT IN SPA .:. ❑
ACCESS. FT. FENCE BACKWASHLINE ....,❑ SPA ........ ❑
MOTOR . Puivp HP ❑ r ' ��i
LIGHT . ANTISYPHON YES
ELECTRICAL FT. BONDING YES
GAS FT. TILE COPING NO.
FILL LIM .........
_.._ORINATOR
GRADING .........
❑
ROPE RINGS
... ❑
HEATER........
❑
MAINT. KR .....
❑
GUNITE INSP.. . I . .
.-.. ❑
TREES .......
Cl
BOARC ..........
❑
OTHER .......
❑
LOT I l OWNER
t PALM" ENTERPRISES : JOB 4DDRE,nSS �' ..7 ��/✓`rG -� �� O
POOL/SPA CONSTRUCTION COMPANY _ TRACT �''`� �� `� CITY i(.y(X ,
MAP NO:
619-325-2187. JOB ?HONE BUS. PHONE
SALESMAN PLAN NO.
CITY LIC. NO. CONTRACTOR NO. C53-591925 ,JOB N0. '' -
7
7
J