05-3645 (BLCK) w
IIIIIII VIII III VIII(III 72
P.O. BOX 1504 �____ IE 4 VOICE(760)777-7012
78-495 CALLE TAMPICO FAX(760)777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS (760)777-7153
BUILDING PERMIT
Date: 10/04/05
Application Number: 05-00003645 Owner:
Property Address: 8T850-AVENUE 53 TAYLOR WOODROW HOMES, INC
APN: 767-200-011- - - 15 CUSHING
Application description: WALL/FENCE IRVINE, CA 92618
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 142020
Contractor:
Applicant: Architect or Engineer: TAYLOR WOODROW HOMES INC D /a► Q
15 CUSHING �l
. IRVINE, CA 92618
(760)275-0598 OCT
0 4 nn
I Lic. No. : 352047 1UQ
C��N QUIAP
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with 1 hereby affirm under penalty of perjury one of the following declarations:
Section 7000)of Division 3 of the Business and Professionals Code,and my License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
License Class: B ce se No._352047 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
issued.
�' ontractor: 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
OWNER- UILDER DECLA ION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exemp from the Contr or'a State License Law for the Carrier LIBERTY MUTUAL Policy Number WA765D283614055
following reason(Ser(y 7031.5,Business and Professions Code: Any city or county that requires a permit to _ I certify that,in the performance of the work for which this permit is issued,I shall not employ any
construct,alter,imprbtia,demolish,or repair any structure,prior to its issuance,also requires the applicant for the person in any manner so as to become subject to the workers'compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that,if I should become subject to the workers'compensation provisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the.Business and Professions Code)or 3700 of the Labor Code,I sh forthw'th comply with those provisions.
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).: te: plicant:
(_1 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 WARNING: FAILURE TO SECURE WOOERS,1GMPENSATION COVERAGE IS UWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONhES
UNDRED THOUSAND
and who does the work himself or herself through his or her own employees,provided that the DOLLARS($100,000). IN ADDITION TO THE COST OF COMPENSATION,DAM AS PROVIDED FOR IN
improvements are not intended or offered for sale. If,however,the building or improvement is sold within SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT
(_1 I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044,Business and Professions Code: The Contractors'State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon,and who contracts for the projects with a contractor(s)licensed 1. Each person upon whose behalf this application is made,each person at whose request and for
pursuant to the Contractors'State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_1 I am exempt under Sec. ,B.&P.C.for this reason the owner,and the applicant,each agrees to,and shall defend,indemnify and hold harmless the City
of La Quinta,its officers,agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
Date: Owner: 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
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued(Sec.3097,'Civ.C.). city and county ordinances and state laws relating to building construction,and hereby authorize representatives
of this county to enter upon th bove-mentioned property foA�onses.
Lender's Name: Da :�Si ature(Applicant orAgend
Lender's Address:
LQPERMIT
Application Number . . . . . 05-00003645
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 790.00 Plan Check Fee 00
Issue Date . . . . 8/17/05 Valuation 142020
Expiration Date 2/13/06
Qty Unit Charge Per Extension
BASE FEE 639.50
43.00 3 .5000 THOU BLDG 100, 001-500, 000 150.50
----------------------------------------------------------------------------
Special Notes and Comments
5447 LF COMBO UP TO 3' RETAINING WALL
WITH 6' GARDEN WALL/120 LF 4 ' GARDEN
WALL/110' 3' RET WALL/100 LF 5' RET
WALL/2 GATES. ALL DETAILS PER PROTO II
WALL SYSTEM & APPROVED ROUGH GRADING
PLAN STAMPED BY CDD.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . CHANGE OF CONTRACTOR 4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 790.00 790.00 .00 .00
Plan Check Total .00 .00 .00 . .00
Other Fee Total 4.50 .00 .00 4.50
Grand Total 794.50 790.00 .00 4.50
LQPERMIT -
IIIIIII VIII II�VIII IIII 73
IE
P.O. BOX 1504 VOICE(760)777-7012
78-495 CALLE TAMPICO FAX(760)777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS(760)777-7153
-� BUILDING PERMIT
Date: 8/17/05
Application Number: '05-00003645 Owner:
i Property Address: 81850 AVENUE 53 TAYLOR WOODROW HOMES, INC
APN: 767-200-011- - - 15 CUSHING.
Application description: WALL/FENCE IRVINE, CA 92618
Property Zoning: LOW DENSITY RESIDENTIAL DLrlu
Application valuation: 142020 rAUG 17 2005 Contractor:
Applicant: Architect or Eng nee TAYLOR WOODROW HOMES INC
CITY OF LA QUINTA 15 CUSHING
FINANCE DEPT. IRVINE, CA 92618
(760)275-0598
Lic. No. : 352047
-- - - ------- -------- ---------- -------- -- -- -- --- ---- ---------------- - -------------- ----------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000)of Division 3 of the Business and P ssionals ode,and my L' se is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
License Class: B ice a No.: 204 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
issued.
Date: rI •�- Contractor: _ I have and will maintain workers'compensation insurance,as required by Section 3700 of the Labor
y Code,for the performance of the work for which this permit is issued. My workers'compensation
OWNER-B ILDER DECLARATIO/ions
- insurance carrier and policy number are:
I hereby affirm under penalty of perjury that am exempt rom the Contractor'sLicense Law for the Carrier LIBERTY MUTUAL Policy Number WA765D283614055
following reason(Sec.7031.5,Business and Professions Code: Any city or coat requires a permit to _ I certify that,in the performance of the work for which this permit is issued,I shall not employ any
construct,alter,improve,demolish,or repair any structure,prior to its issuanceequires the applicant for the person in any manner so as to become subject to the workers'compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provif the Contractor's State and agree that,if I should become subject to the workers'compensation provisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 3700 of the Labor Code,I sh comply wit th a provisions.
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).: ;Date:Oy Applicant:
(_1 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 WARNING: FAILURE TO SECURE WOR RS'CO ENSATION COVERAGE IS U LAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO 0 E HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees,provided that the DOLLARS($100,000). IN ADDITION TO THE COST OF COMPENSATION,DA AGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If,however,the building or improvement is sold within SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT
(_1 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044,Business and Professions Code: The Contractors'State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon,and who contracts for the projects with a contractor(s)licensed 1. Each person upon whose behalf this application is made,each person at whose request and for
pursuant to the Contractors'State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. ,B.&P.C.for this reason the owner,and the applicant,each agrees to,and shall defend,indemnify and hold harmless the City
of La Quinta,its officers,agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
Date: Owner: 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
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relating to building construction,an�eBBBreby authorize representatives
of this county to enter upon the above-mentioned property pection pur s_!r
Lender's Name: - �j ._
Date: 2 - Signature(Applicant or A nt):
Lender's Address: -
LQPERMIT
Application Number . . . . . 05-00003645
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . 790.00 Plan Check Fee 00
Issue Date . . . . Valuation 142020
I Expiration Date 2/13/06
iE
Qty Unit Charge Per Extension
BASE FEE 639.50
43.00 3 .5000 THOU BLDG 100, 001-500, 000 150.50
----------------------------------------------------------------------------
Special Notes and Comments
5447 LF COMBO UP TO 3 ' RETAINING WALL
WITH 6' GARDEN WALL/120 LF 41 . GARDEN
WALL/110' 3 ' RET WALL/100 LF 5' RET
WALL/2 GATES. ALL DETAILS PER CITY
STANDARD & APPROVED ROUGH GRADING PLAN
STAMPED BY CDD.
Fee summary Charged Paid Credited Due
----------------- ---------- - ---------- ---------- ----------
Permit Fee Total 790.00 .00 .00 790.00
Plan Check Total .00 .00 .00 .00
Grand Total 790.00 .00 .00 790.00
a
LQPERMIT .
Southwest Inspection and Testing,Inc.
IIIIIIIIIIIIIIIIIIIIIIIII 74 10826
59414990 rwalk Blvd., Santa Fe Springs, CA 90670
156
IE 1 (714) 526-8441 - Fax (562) 946-0026
SWIT Job No. Date
REGISTERED INSPECTORS'S DAILY REPORT F5 O -30- 57'
TYPE OF ❑ Reinforced Concrete ❑ Streictural Steel Assembly ❑ Quality Control
INSPECTION ❑ Post Tensioned Concrete ❑ Fire Proofing ❑Other
REQUIRED Dif Reinforced Masonry ❑ Asphalt
Job Address SI-85Z V�' City
La +
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Job Name CcArmelo,
Permit Noy` 3 Issued By
Type of Structure I; Architect VV
120
Material Description(type,g ode.source) Engineer
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Contractor
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Inspector(s)Name/" Subcontractor �_ el
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TESTS PERFORMED
TYPE OF SAMPLE SLUMP QUANTITY IN SET ADDITIONAL REMARKS ON SAMPLES
INSPECTION SUMMARY— LOCATIONS OF WORK INSPECTED, TEST SAMPLES TAKEN, WORK REJECTED, JOB PROBLEMS, PROGRESS, REMARKS, ETC.
INCLUDES INFORMATION ABOUT-AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED,NUMBER,TYPE&IDENT.NO'S OF
TEST SAMPLES TAKEN: STRUCT.CONNECTIONS(WELD MADE H.T.BOLTS TORQUED)CHECKED,ETC.
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CERTIFICATION OF COMPLIANCE CONTINUED ON NEXT PAGE PAGE OF
1 HEREBY CERTIFY THAT I HAVE OBSERVED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED TIME IN TIME OUT REG.HOURS O.T.HOURS CYLINDERS
WORK UNLESS OTHERWISE NOTED.I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, n p
SPECIFICATIONS,AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. PN 13 r
�� (� ! All inspections based on a minimum of 4 hours and over 4 hours 8 hour
15. 6 minimum. In addition,any inspection extending past noon hour will be an 8
IGNATUR REGISTERED INSPECT R hour minimum.
Approved by
SPECIAL NO. AGENCY Project Superintendent
WHITE - OFFICE COPY,CANARY - ACCOUNTING COPY,PINK - INSPECTOR'S COPY,GOLDENROD - JOB SITE COPY
"w
�TT m Continuous Inspection &Materials Testing
Inspection & Testing, Inc. 10826 South Norwalk Blvd., Santa Fe Springs, CA 90670
(562) 941-2990 • (71.4) 526-8441
FAX (562) 946-0026
To Whom It May Concern:
Enclosed you will find copies of Daily Inspection. Reports-and-or
Compressive Strength Testing Results for your jobsite
We have
enclosed these copies for your records.
If you feel you have received any reports in error please return them
to Southwest Inspection and Testing.
If you have any questions or comments, please do not hesitate to call.
Thank you,
Southwest Inspection & Testing