0403-029 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chanter 9 (commencing with Section 7000) of Division 3 of the Business and
`P,rofhsionals Code, and my License is in full force and effect.
License# �pLic..Class Exp. Date
12�
•0 f« J'1 {7'f wl I 5 ai n ijy7
Date ;'� f 7 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).
() I am exempt under Section B&P.C. for.this reason
Date Y `/ Signature of Owner !
WORKER'S COMPENSATION CLARATION
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 foi 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. S'T1 I,Z, pUtID Policy No. 1€88263-02
(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 with those provisions.
t Date:y ,_ ..•✓ 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, interest and attorney's fees.
.... r
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.
Signature (Owner/Agent) f; 114- - Date
BUILDING PERMIT PERMITk
. ,. .
DATE r VALUATION 291 415ei .60 LOT 48.
TRACT 2899 IJOB
SITE
ADD RESS •. .o-;�.v:-tTT.iutl ai •11: ��1' ~� .
APN r�7!5 a^�rY.2T
OWNER
CONTRACTOR/DESIGNER/EN (NEER
C.RV. j..A+4li.yzE"1'A7o is
2 l0 , ir+J t l3 61 1! Risk:, .1 Cao
100 1' . WAZMp'1°ON AVE. 4) 00
ESCONDIDO CA 92025
IMCNOWUIDO (,:A 92025
(m)839-8238 C.KA 5415
USE OF PERMIT
0.401Z FAMILY D'tiV" , G- .
SW e - li )`f 44 #LAN DOES 140T MCL.'UDE ttl..t.1C:K `NN -l's,
POOL O.P A O`t1. DRAiF_I'y Y A OPM;AC::K 71'36 RED1a<THON t`C7 MAN
CHECK lirEI: WE TO MULTIPLE ISSUANCE OF 5:�3 , 9 PLAN TYPE
CUSTOM C-611d'I'i&.1JCTIO_N :MtH.00 S.F
PORCHIPA.9'IU4 748.08. SP
I1A A-C#VCARPt?RT 660.00 SF
1 S17MAI 73 C0.Vr OF COMMUCnow
294.5109M
C0. TRU0.TION F.M 101 X000.418.000 $1,32no
PLAN CHECK FRE 101-000.439-.318 $260.62
WCH ANICAL M 101-000-421-000 $143,60
TLa,1'R.ICAL. FEEP, 101-000-420-000 $210.2's
-
Pt'UMOTHO MOR 101.000-419.000
.STFLONO MOTION PEZ • R'PSIO 103 -040-no4 1-000 �L9.44
0HAI9ING A;d _01 -000 3J$.,Do
AR'C INPUBLIC UBLIC PLACU - RE, SIC 270-000-445-000 $236130
E.IU t••'1MAL tw[ NSTR7 0,17 1014 MD PxtlC4RC ;
X1,810.
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p&A KRIM;FES DUE now
MAR 18 2004 11
CITY OF LA QUINTE2
RECEIPTB,✓
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FINAL
DAT/E2
INSPEC O
T
6
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7
INSPECTION RECORD
OPERATION
DATE-.
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
erground Ducts
_
Forms & FootingsDucts
Slab Grade
Return Air
Steel _Combustion
Roof Deck '
O.K. to Wrap
Air
Exhaust Fans
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 3
Final
Final
BLOCKWALL A PROVALS
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
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 76
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) Q
COMMENTS:
07/01/2004 12:03 760-743-3109 SCHMIT ENGINEERING PAGE 02/03
Schmit Engineering
Structural Design
To: The City of La Quinta
Building Inspection Department
Date: July 1, 2004
Re: Eagle Bend @ PGA West, Plans #1, & #2
Innovative )Resort Communiti s
Plan Check No.: 0305-053
This letter is in regards to the above referenced project. As requested, on J aly 1, 2304, as the engineer
of record, :..made a site structural inspection for Phase VI. My inspection included one each of the
floor plan types: Plan #1A lot 444, and Plan 42C lot Al. The following is a list cfmy findings.
Plan ;#1:
1. Provide 2x blk'g and A35 shear -transfer clips above beams at front o.'� garage, in line with steel
columns. Blocking is offset above beams.
2. Check to verify drag straps are installed in the following locations per pan, at the end3 ofthe 5.25
x 16 t earn above covered patio"at back of house, and at back patio to ho<ase strap ties (LSTA-24).
MSTI48 from 6x10 cantilevered beam to "K" shear wall between the Casita B -.droom and Casita
Lounge. LSTA-24 from girder truss to wall above ,zecondary master bedroom to exterior wall of
walk -.n closet.
3. At'.edger to wah connection at left side of entry wall verify 5-16d nail,i min. each stud.
5. Verify t1tat at all interior shear wall locations that tie A35 shear transfe- clips have been installed,
between the block and top plates as shown in details 16/A11.3, 3/A11.3, 12/Al 1.3; etc.
6. No opening was framed in wall facing courtyard at walk-in closet off of Casita Bedroom.
7. Tightened down all anchor bolt nuts and verify that at all sill plate breaks that an anchor bolt is
install -,d per standard sill plate anchorage detail
Plan 42: "
1. ShE ar transfer claps appear to be missing above the 5.25 x 14 P.L. bear, i at front of garage in line
with z teel columns.
2. Check to verify drag straps are installed in the following location per ply n, from the header to "R"
type s'aear panel's at the rear of the house offgather:ng room.
3. Extend the "I" type shear panel to front of garage at the left side of garage near entry gate.
CO
1965 Rohn Road, Escondido, CA 92025 ('1060) 743-0592
07/01/2004 12:03 760-743-3109 S--HMIT ENGINEERING PAGE, 03/03
4. See item 45 above for plan #1.
5. See :item 47 above for plan 41:
5 x 11.78 to 6x12 beam. Existing hanger appears to be wrong
6. Check hammer at rear patio from 5.2
type ar d also installed incorrectly.
7. Three holdowns appear to be missiung at the shear wall between the Casita Bath and Casita
Bedroom.
If you should have any questions regarding this letter, or need any further clarification, please do not
hesitat-, to call me.
Sincerely,
X pFESS/
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John Schmit
R.CT1. #35417 No.ssatT ae
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