0306-481 (SFD)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 - Ekp. Date
783503 131 CIO MIC . f, - � 1104
f
P ! �,`1 ��?Signature of Contractor d '
w V\ a
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
i
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 E.XPEMPT 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 f Nshould become
subject to the workers' compensation provisions of,Seetion':P00 of the Labor
Code, I shall forthwith comply with those provisions/
DateApplicant ! j y V /\ i
Warning: Failure to secure Workers' Compensation cow age 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, indemnity
& 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<r�epreseniatives=of this City to enter upon
the above-mentioned property for Inspection purposes.
Signature (Owner/Agent), -- -)/ ,nor`1711/ t._- Date 12 - z. tf - 0 j
BUILDING PERMIT PERMIT# '
DATE VALUATION LOT 03Vi-4 S1 TRACT
Ll . � $43.7,119.20
JOB SITE
ADDRESS
OWNER
CONTRACTOR / DESIGNER / EN INEER
126 N,11ID T1±- ST EZ'T
78.070 CADIZ
RYE BROOK )\TY 105-73
i'. ik QUI -K.- CA. 9225-4
(760)364-4832 MIX- 3237
USE OF PERMIT
C11 E17AMILY 1)4JF.i.UNG
lq.rt7 • PirRMIT] WEBS NOT INCLUDE E BLOCK lh".&s. LS. POOL OI: D7RI'irmWAY
1�P1�fKi�.A1.C..iIr ��vj C8C
IUR
CUSTOM C0113'D'A.UCT10ki 51W3.00 SF C Q rj 2003
PORC1nIPATIO 360.00 SF
C!.AI;.AMIC.ARPOP..T X31,00 31
� �^ �S%� �F
C►
--
i
t
.irEMENT.A,TED COYT OF CONKIMUCTICM 417,1 x.9.20
C'ON87RUCTION .FEE 10 1 -OW4 18-000 SIa752,sq
PLAW CH CK FEE IS
FRE DEPOSIT 101.000-1*51-i+ i g-$1,00uo
7e EC11ANiCA,L FEE .101-000-41-000 DS�2.90
ME0,Tr;,[FEE 301-000.420.000 $292.06
PL►J1+fiR3lHO FEE 101 -000-419-000 013.75.
STRONG MOTION Fr,;E - MID 101.000.241-,000 $41.71
GRADDI40 FEE 101-000-423-000 $1s oo
DEVELOPER 1MMP,AC:T FEE SZ405.00
ART IN PUBLIC PLAC&S , PIESPL 270-000-445-0.0.0
i
31:18-TMAL CONfS',CRCi'+�'.C'XO' ANW_ a?I..hN- 1HEr_'K $6,925A4
LEE PRE -MI) FE1?.S1 41=0.00
.'�O`:MI, F`E1Z1b.1;1°C'Ie;3.:V:S:t)1II� NOW
RECEIPT
DATA (
BY +fi.�
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
- _01(
Underground Ducts
Forms & Footings
F IfDucts
Slab Grade
Return Air
Steel
, Ut�(Combustion
Air
Roof Deck
Exhaust Fans
O.K to Wrap
C)
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
POOLS - SPAS
BLOCKWALL 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
- r'J
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:
12002 d/A/Cis Z)E4fia, Co -i0. a V .IT
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)
Date
12%4/03
No.
25237
Owner
Jeffrey & Audrey Nagelberg
Address
126 N. Ridge St.
City
Rye Brook Zip 10573
Tract #
Type
Single Family Residence
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515
Q BERMUDA DUNES r
rn RANCHO MIRAGE
�J INDIAN WELLS b
PALM DESERT y
LA QUINTA
�INDIO �^
O
APN #
631-771-007
Jurisdiction
La Quinta
Permit #
0306-481
Study Area
No. of Units
1
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 49045 Calle Flora 5084 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.14 X 5,084 S.F. or $10,879.76 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By O/C-PFF Bank & Trust, Jeff Read Check No. 526804163
Name on the check Telephone 771-3497
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exe pted by Patricia Barbuzza Payment Recd $0.00
$10,879.76 Over/Under
Signature 1
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or
other payment identified above will begin to run from the date, on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
Jan 21 05 12:11p John Read 760-777-8789 p.1
4
V1`Y OF LA QUINTA
f�;� • _��h . BUILDING & SAFETY DEPARTMENT
777-7012
INSPECTION REQUEST LINE
777-7153
JEFFttY & AUDREY NAGELBERG
Owner
Contractor KAHUILLA CONSTRUCTION
0306-481
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS
SFD - PERMIT DOES NOT INCLUDE BLOCK WALLS
POOL OR DRIVEWAY APPROACH. 2001 CBC
TYPE OF INSPECTION DATE 1NSP•
TEMPORARY POWER -
SETBACKS d
U/G PLUMBING / WASTE 5W LvU
U/G ELECTRICAL I GROUNDING _ 4
FOOTINGS / STEEL '
CONCRETE SLAB
e— a AA T
04Y NOT POUR CONCRETE UNTIL ABOVE SIGNE
ROOF NAIL / PRE -ROOF
OKAY TO WRAP ~,
FRAMING COMBINATION
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH MECHANICAL
INSULATION
COVER NO WORK UNTIL ABOVE SIGNED
INTERIOR GYP. BD. DRYWALL --Zd O
EXTERIOR LATH
GAS TEST
SEPTIC ABANDONMENT
SEWER CONNECTION _ p
SEPTIC / GREASE INTERCEPTOR
ti -c �c
mXsbpfRy INSPECTIONS
FOOTINGS / STEEL
BOND BEAM
POOL / SPA / WATER FEATURE INSPECTIONS
PRE-GUNITE / SETBACKS
U/G PLUMBING
U/G GAS
U/G ELECTRICAL
PRE -PLASTER ALARMS / BARRIERS
FINAL INSPECTIONS
MECHANICAL c ! l
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT.
FINAL / JOB COMPLETED
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
.�c k4
e �nnc•�kkt r k-�av�.0 la - �e� �� . c
Z -
u
lqy �nw 1x4ttre4k
STRUCTURAL AND CIVIL ENGINEERING
DENISE R. POELTLER, INC. -
73.661 Highway 1.11 • Suite G • Palm Desert; California 92,260
www.theflyingbuftress.com
18 August 2003
Mr. Tom Har"g,'Building Dire(_tor.
CITY OF LA QUINTA
Department of Building and Safety
78-495 Calle Tampico
La Quinta, CA 92253
RE: Nagelberg Residence
Job Site Address: 49-045 Calle Flora
The Enclave
Subject: Truss Acceptance Letter
.Dean Mr. Hartung:
I have -reviewed the total deflection, live, dead, and drag loads used for the design of the
gang -nail roof trusses prepared by FOXWORTH GALBRAITH TRUSS'COMPANY
(dated 8-8-2003), and found them in substantial conformance with the structural
documents prepared by my firm.
��i4®�
_ ® r
Respectfully. submitted, �����. `��6�
UJ
4 CC
ap.'��`ii
Denise R: Poeltler
R.C.E. 33446 -
W.O. 03-122
cc: Mr.. Stephen Jones, Stephen Jones Design and Construction, Inc.
(760).779-0405 0 FAX •(760) 779-1.317
CITY OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESS _PERMIT NUMBER OWNERt5Kofr FA91QcR5 i LLG BUILDER gAh1dl4LA adSi7,je / �de-
This form shall be posed on the iob with the Building Inspection Card at all times in ,Iconswcuous olace. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work andlor the voidance
of building permit. For each applicable trade. all information requested below must be completed by applicant. 'On File' is not an acceptable response.
Trade / Classification
Contractor
State Contractor's License
Workers Compensation Insurance
City Business License
Company Name
Classification
(e.g. A, B. C-8)
License Number
(xxxxxx)
Exp. Date
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWOfAK(C-12)
19.r4d(Z-sotr"r�(a4.di4C,��JIr%
G -!Z
61f�f
C(xx/xx/xx)
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044-0141V71-572-72
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STRUCT. STEEL (C -51).`A
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1117<041561 -� f
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044- /2.5 f 493
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,77 LATH, PLASTER (C•35) MAA IJA17R/v/4lLf r� .fr
C-3 72G49�
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1
DRYWALL (C-91 ..
PJAIZiJAVX'1,C/AI.L ?ZAs£_Rr
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7?d�e'S
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0.31,-03
HVAC (C-20}
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ROOFING (C•391 ....:"..:.:..
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S% � F''*)C'
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SHEET METAL (C-43).,,
.4, R A LAQj$1
c%240
382%3
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SEWAGE DISP. IC -42)
t./r.fnlo1!l4!'c-dr1 J' i
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CABINETS IC -81 SJ!�.Ini �.e..t Ditlrl r '
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�- 24
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LANDSCAPING (C-27) L_11S aeOp
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'� _ Ir -IQ (P130/0q
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Sladden Engineering
760 772 3895;# t
I vv r I -- --- r. 1
6782 Stanton Ave., Suite A, Buena Park, CA 90621 (714) 523-0952 Fax (714) 523-1369
39-725 Garand Ln., Suite G, Palm Desert, CA 92211 (760) 772-3893 Fax (760) 772-3895
July 21, 2003
Stephen Jones Design & Construction, Inc.
Post Office Drawer 4656
Palm Desert, California 92261
Project: 49-045 Calle Flora
The Enclave
La Quinta, California
Subject: Geotechnical Update
RECEIVED
J 2 2 2003
f
Project No. 544-3322
03.07-457
Ref Soil Engineering Report prepared by Buena Engineers, Inc., dated February 24,
1986, Job No. B -16022-P1, Report No. 86-02-272.
As requested, we have reviewed the referenced Soil Engineering report as it relates to the
design and construction of the proposed single family residence. The project site is located at
49-045 Calle Flora within the Enclave development in the Santa Rosa Cove area of the City
of La Quinta, California. It is our understanding that the proposed residence will be a
relatively lightweight wood frame structure.
The lot was previously graded during the rough grading of the project site. The rough
grading included overexcavation of the native surface soils along with the placement of
engineered fill material to construct the subject lot and adjacent lots.
The referenced report includes recommendations pertaining to the construction of residential
structure foundations. Based upon our review of the referenced report, it is our opinion that
the recommendations provided in the referenced report remain applicable for the design and
construction of the proposed single family residence.
Although the lot has been previously rough graded, remedial grading including
overexcavation of the weathered surface soils is recommended. The building pad area should
be cleared of weeds, and moisture conditioned. The weathered surface soils should be
overexcavated to a depth of at least 2 feet below existing grade. The exposed surface should
be recompacted so that a minimum of 90 percent relative compaction is attained. Any fill
material should be placed in thin lifts at near optimum moisture content and compacted to at
least 90 percent relative compaction.
Tj_ ^-03;12:36PM760 772 3895;# 2
�, J. 4 I ♦ L L V J 1 L•— � t e r/ � l O U V C 1 1 r/ O 1 111 U C J C I 4 f V V f! L J V J J �+ • L
July 21, 2003 '2- Project No. 544.3322
03-07-457
It is our understanding that a subdrain system will be installed throughout the building
area. The proposed subdrain system is recommended and should be effective in mitigating
drainage problems encountered in other areas of the Enclave development. The use of non -
expansive import soils within the upper 2 to 3 feet is also being considered. The use of non -
expansive import soils should be effective in mitigating potential problems associated with
the expansion potential of some of the surface soils on the site.
Allowable Bearing Pressures: The allowable bearing pressures recommended in the original
Geotechnical Engineering Report prepared by Buena Engineers, Inc. remain applicable.
Conventional shallow spread footings should be bottomed into properly compacted fill
material a minimum of 12 inches below lowest adjacent grade. Continuous footings should
be at least 12 inches wide and isolated pad footings should be at least 2 feet wide.
Continuous footings and isolated pad footings should be designed utilizing an allowable
bearing pressures of (1500 psO. The recommended allowable bearing pressures may be
increased by one-third for wind and seismic loading.
The bearing soils are non -expansive and fall within the "very low" expansion category in
accordance with Uniform Building Code (UBC) classification criteria. The pertinent 1997
Uniform Building Code Seismic Design Criteria are summarized on the following page.
If you have questions regarding this letter, please contact the undersigned.
Respectfully submitted,
SLADDEN ENGINEERING
Brett L. Anders
Principal Engineer 1
Letter/pc
Copies: 4/Stephen Jones
760 772 3895;# 3
7�c22-03; 12:36PM
a f,^,J ; •fl CALL VJ 1L•T/�r �lODUC11 rallll fJC�CI l. .
July 21, 2003
•3 -
Project No. 544.3322
03-07-457
1997 UNIFORM BUILDING CODE INFORMATION
The International Conference of Building Officials 1997 Uniform Building Code contains
substantial revisions and additions to the earthquake engineering section in Chapter 16.
Concepts contained in the code that will be relevant to construction of the proposed structure
are summarized below.
Ground shaking is expected to be the primary hazard most likely to affect the site, based
upon proximity to significant faults capable of generating large earthquakes. Major fault
zones considered to be most likely to create strong ground shaking at the site are listed
below.
Fault Zone
Approximate Distance
From Site
Fault Type
(1997 UBC)
San Andreas
12 km
A
San Jacinto
31 km
A
Based on our field observations and understanding of local geologic conditions, the soil profile
type judged applicable to this site is SD, generally described as stiff or dense soil. The site is
located within UBC Seismic Zone 4. The following table presents additional coefficients and
factors relevant to seismic mitigation for new construction upon adoption of the 1997 code.
ri
Near -Source
Near -Source
Seismic
Seismic
Seismic
Acceleration
Velocity
Coefficient
Coefficient
Source
Factor, Na
Factor N,
Ca
C11
San Andreas
1.0
1.1
0.44 Na
0.64 N,
San Jacinto
1.0
1.0
0.44 Na
0.64 Nv
ri
- •. �' V Y ���I Wim/'
th4e�
STRUCTURAL AND CIVIL ENGINEERING
DENISE R. POELTLER, INC.'
73.661 Highway 111_ * Suite G • Palm Desert, California 92260
www.theflyingbuttress.com
15 December 2004
Mr. Tom Hartung, Building Director
CITY OF LA QUINTA
Department of Building and Safety
78495 Calle Tampico
La Quinta, CA 92253
RE: Nagelberg Residence _
Job Site Address: 49045 Calle Flora, The Enclave
Subject: StructuralObservaiion
Dear Mr. Hartung:
I have "observed the structural elements and lateral load path (with exceptions rioted
below) for the structure referenced above and found them in substantial conformance
with the structural documents prepared by my firm-
Not observed by me, but inspected by the City Building Inspector or a Special Inspector:
1. Retrofit epoxy anchors. .
2. Plywood roof sheathing.
3: Steel frame fabrication and connection welding.
Respectfully submitted,!
gpF ESS/pN
�a 9m
No. 33446 to
Denise R. Poeltler * Exp. 6-30.06
R.C.E. 33446
P
C1V1�- Qac
W.O. 04-225 O���
cc: Mr. Jeff Read, Southern Hills Development Inc.
(760) 779-0405. 0 FAX (760) 779-1317
narmmmorn
WEEKLY'REPORT
Ty" OF
INSPECTION
PERFORMED
aldinfirook Ct
0
a OTHER
Palm Desert, CA 92211
otpm AMANCE No.
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Fax (760). 772-7193
Pager (760) 776-3338
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;-04Palm Desert, CA 92211
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�SPECIAL INSPE,CTION'.SERVICE,Fax (760) 772-7193
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TYPE OF
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