0305-083 (RER)CO
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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
Date 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 Signature of Owner , j4•— ....
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 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
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date: Applican
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
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) Date `
PERMIT#
BUILDING PERMIT
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DATE VALUATION LOT TRACT
JOB SITE
ADDRESS
APN
OWNER
CONTRACTOR/DESIGNER/EN INEER
y'q i t
USE OF PERMIT
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t;ITY OF LAUINTA _ 41
F,! r a fJ.r:?- r r+T.
RECEIPT
DATE
BY:
DATE FINALED
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
i
Insulation
—
Vents
/
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drptall - Int. Lath
Final
Final
- ��
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
j
Equipment Location
Underground Electric
Final j
PLUMBING APPROVALS
Waste Lines
Water Ptping z
Underground Plbg. Test
Gas Piping
Gas Test
Electric Final
Heater Final
Plumbing Final
Plumbing 'Fop Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
J
f
Final
-7
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)
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Spare Bedroom Remodel for the SLEZAK RESIDENCE
48-721 San Vicente La Ouinta CA 92253
Owner/Builder: Rex and Jacqline Slezak
(760)771-3992
Basic Description:
The remodel will involve the removal of the existing walk in closet to allow for
more usable living space. A new closet/storage area will be created, by reclaiming a
finished attic space to be accessed by a half turn staircase. To allow for code height
requirements for the stairway as well as additional light a 4' x 8' skylight will be installed
directly over the landing/closet entrance.
Detailed Description:
The existing 66"x 78" walk in closet will be eliminated by removing the two non
bearing walls which define it to soffit level. The light switch and the one receptacle
existing in these walls will be relocated to the nearest adjoining walls.
On the opposite wall a 32"x 48"x 94" storage area will be constructed to
accommodate a landing for the new half turn staircase. 2x 6's with 16"centers topped by
'14" plywood will be used on in the ceiling for adequate support. The interior will be
accessed by a 2'x 80" louvered bi-fold door. The landing will be enciused by a 36" high
railing consisting of 1.5" steel railing with 1" steel balusters a maximum of 4" apart.
This railing will be anchored not only to the landing floor but also to the 6"x 6" support
beam at the closet entrance.
The new "Salter" half turn 12 gauge steel staircase uses a footprint 36"x 67" with
11 treads with 8.5" rise. Each tread will have a flake board cover to accommodate
carpeting. The 1.5" aluminum handrail with end caps is positioned to allow for 1.5"
clearance from all adjoining walls. All balusters are 1" rounded steel, 36" high and a
maximum of 4" apart.
The existing wall separating the closet from the bedroom will be opened up to
allow for an adequate entrance as well as some design interest. Two 6"x 6" beams one
on either side of the closet opening plus 2 sets of 2, 2x6 trimmers at either wall will
support the 6"x 6" headers, one accommodating a 36" span to the right of the entrance,
the other a 54" span to the left. These spans will be enclosed with 36" high railings
consisting of 1.5" steel railings and 1" steel balusters a maximum of 4" apart anchored
the 6"x 6" beams.
Above the landing and back into the closet area a 4'x 8' double insulated skylight
will be installed in the roof. As well as allowing for extra light and some architectural
interest, it will provide for the 6'6" headroom required for the winding stairway landing
and closet entrance.
The new closet area ceiling light switch will be moved to the wall beside the
opening and hooked up to another 3 way switch by the bedroom entrance.
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NEW PLAN
Dcsigned for applicatlo.n5 regulated by'rhe National Building
Code or the Uniform Building Code. Also recommended for
stairs .that will be used by small children.
Please check with our local building ins;.ector for the. dimen-
sional requirements in your area before placing your order.
The smallest stair available to still maintain the building code is
5' diameter. Salter Industries manufactures Code Stair Packages
in 5', 5'6" and 6" diameter. Code Stair Packages also include
extra balustrades far a maximum spacing of 4
30° Treads for stair bizes
6iC-5L6"C-6'C
Floor to Floor Height
Required Number
Degree
Tread Ad-ustm.ent
of
of
Min.
Max
Treads & Risers
Rotation
85"
95"
9 10 1
rod
93'/,"
- 10412"
10 1
3000
102'
114"
11 1
3300
110'f"
123'1
12 1
3Bi3°
119"
133"
13 1
390°
A
oow to s
A special 600 platform is e
supplied with this package. '
The platform is not as versatile 6
as a square one. For ordering s
purposes use these diagrams to a "
choose the appropriate layout. to s
Available sizes are 5', 66", and " 8
I
6' diameters.
BOCA and UBC Cade; Packages Include:
(A) 300 stair treads
(B) 3 to 4 balusters per tread (maximum spacing of 4").
(C) A 60° platform. This will provide a minimum of 66" head-
room
(D) 1 U/ - alumiriufn handrail with end caps.
(E) 1 platform rail
(F) Center column; .bape :plate and top .cap..
(G) 4;0" tall column extension (not shown).
Finished
Platform
Clear
ameter
Weil Dpeni
Size
Walking Path
5'
62 x 62
31 x 31
261
68 x 68
34 x 34
29"
61
74 x, 74
37 x 37
32"
,minimum opening is 2'smaller than the recommended
opening size. Talk to your salesperson for further information.
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'he perfect stair for balcony and deck applaatio.ris. `Note: the half: turn
oes riot require a platform.
1 treads adjust from 90" to 102" i_-67-
2 treads adjust from 971/2" to 110'/=" a 6 ,
(A) Center Column, base p
p): 1" O;D, steet baluster's
(C) AdjUstabl'e steel treads
0 1 %!, O D: vinyl handrail;
(E) Platform railing, '4" O.0
(F) 38"' tall column extensi
(G) 1800 wood balcony br�
s
eir". F > A QU
BUILDING & SA - DEPT.
and 1"'>gt�s� PROVED -
BY.
NOTE The half -turn does not. require a platform
'Note: Pill .models. include:
(A) Hardware for the installation.
(8) installation instructions.
s 5 5 7 9
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121
SPECIAL 6'6" `
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry oui these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more speck information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration), For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7
FAX: (76 777-
OWNER'S IGNA IDATE
Vt--e,
PROPERTY ADDRESS
03o5-d03
PERMIT NUMBER(s)