06-0215 (SFD)moo'
P:O. BOX 1504 �^� VOICE(760) 12
( ) 777-7 o
78-495 CALLE TAMPICO FAX (760) 777-7011
- LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 1/13/06
Application Number: 0:60.0 00 0 12 �� Owner:
Property Address: 52618 PALAZO YLOR WOODROW HOMES, INC.
APN: 767-200-011-50 -318742- CUSHING
Application description: DWELLING - SINGLE FAMILY DETACHED INE, CA 92618
Property Zoning: LOW DENSITY RESIDENTIAL ® 4)000-1200
Application valuation: 182392 U
• U 1 �� � � �Q�� nt ctor:
Applicant: chitectI or Engineer: J � TAYL R WOODROW HOMES INC
SHING
- 1���p '✓. Q0° 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 1 hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Pro essionals gode, 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 CI ss: Li 352047 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�/ issued.
ate:•O W ontraaor: pL I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
T-' Code, for the performance of the work for which this permit is issued. My workers' compensation
W R-EVILDER DECLA ON insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am mpt from the Contract is State License Law for the Carrier LIBERTY MUTUAL Policy Number WA76SD283614055
following reason (Sec. 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, improve, 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 became 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 700 of the L r Code I n
hall fohlw 1 om y 6'iRb 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 WORKERS' MPENS ION COVERAGE UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES AND CIVIL FINES UP TO ONE 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, DAMAGES 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 ismade, 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 _ 1 I am exempt under Sec.. , BAP.C. for this reason the owner, and the applicant, each agrees to, and shall defend; indemnify and hold harmless the City
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: -
LQPERMIT
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.
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 county ordinances and state laws relating to building constrbqion, and hereby authorize representatives
of this co lyto nter upon the
D e: above-mentionbefor inspectiS
ture(Applicant or Ag
Application Number
. . . 06-00000215
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . ..
930.00
Plan'Check Fee
151.13
Issue Date
Valuation
182392
Expiration Date
7/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
639.50
83.00 3.5000
----------------------------------------------------------------------------
THOU BLDG
100,001-500,000
290.50
Permit . . .
MECHANICAL
Additional desc .
Permit Fee
83.50
Plan Check Fee
5.22
Issue Date . . . .
Valuation . . . .
0
Expiration Date
1/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2•.00 9.0000
EA MECH
FURNACE <=100K
18.00 -
2_0.0 9.0000
EA MECH
B/C <=3HP/100K BTU
18.00
5.00 6.5000
EA MECH
VENT FAN
32.50
Permit . .
ELEC-NEW RESIDENTIAL
Additional desc .
Permit Fee . . . .
129.52
Plan Check Fee
8.10
Issue Date . . .
Valuation . . . .
0
Expiration Date
7/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2928.00 .0350
ELEC
NEW RES - 1 OR 2 FAMILY
102.48
602.00 .0200
----------------------------------------------------------------------------
ELEC
GARAGE OR NON-RESIDENTIAL
12.04
Permit . . .
PLUMBING
Additional desc
Permit Fee . . . .
174.00
Plan Check Fee
10.88
Issue Date . .
Valuation . . .
0
Expiration Date`.
7/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
17.00 6..0000
EA PLB FIXTURE
102.00
1.00. 15.0000
EA PLB BUILDING SEWER
•15.00
LQPERMIT ..
Application Number . . . . 06-00000215
Permit . . . . PLUMBING
Qty Unit Charge Per
Extension
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM
9.00
10.00 .7500 EA PLB GAS PIPE >=5
7.50
1.00 15.0000 EA PLB GAS METER
15.00
Permit GRADING PERMIT
Additional aesC .
Permit Fee . . . . 15.00 Plan Check Fee
.00
Issue Date . . . . Valuation
0
Expiration Date 7/12/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
-----------------------------=----------------------------------------------
Special Notes and Comments
SFD - LOT 5,0, PLAN 3C, 2928
SF.2001 CODES. PERMIT DOES
NOT INCLUDE BLOCK WALLS, POOL, SPA OR
DRIVEWAY APPROACH. 75% REDUCTION TO
PLAN CHECK FEES DUE TO MULTIPLE
ISSUANCE OF SAME PLAN TYPE
-----------------------------------------------------------------------------
Other Fees . . . . . . . . . DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE -
15.11
DIF FIRE PROTECTION -RES
97.00
DIF LIBRARIES - RES
225.00
J DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
STRONG MOTION (SMI) - RES
.502.00
19.20
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged Paid Credited.
Due
--- ---------- ---------- ----------
Permit Fee Total 1332.02 .00 .00
1332.02
Plan Check Total 175.33 .00 .00
175.33
Other Fee Total 2439.31 .00 .00
2439.31
Grand Total 3946.66 .00 .00
3946.66
LQPERMIT ..
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THISY RL=1O SHALLAOT T1Ff=ihCED; EXCEPTJN FU_.. WIT{OUTQIE.1PF)VAq.0.IT
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SAMPLES Li ST BY 1:)•T•h•l15:RS ;;'
I OB. -MANAGER
4STQ C39 BREAKS Si's ('= Ane ),:::: cone and split 1;::_:: cone •��::�:<s!-sea r fic:: Ah"l.tllit•tar
Southwest Inspection and Testing, Inc:
441 Commercial Way, La Habra, CA 90631
�� (5642) 94,1-2990 • (714) 526-8441 • Fax (562) 946-0026 0
It
REGISTERED INSPE ORS'S DAILY REPORT Sw b o at�
TYPE OF fTReinforced Concrete ❑ Strrictural Steel Assembly ❑ Quality C44trol
INSPECTIONPost Tensioned Concrete
REQUIRED ❑ ❑Fire Proofing ❑Other
Reinforced Masonry ❑ Asphalt
Job Address
city
Job Name
v
Type of Structure/Architect
Material Description (type, grade, source) Engineer
+
for
Inspectors) Ill
Subcontractor
TESTS PERFORMED
TYPE OF SAMPLE
SLUMP
QUANTITY IN SET
ADDITli 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 SA PLES EN: STRUCT. CONNE TIONS (WELD MADE H.T. BOLTS TORQUED) CHECKED, ETC.
X 144
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE OBSERVED TO THE BEST OF MY LEDGE ALL OF THE ABOVE REPORTED
WORK UNLESS OTHERWISE NOTED, I HAVE FOUND THIS TO COMPLY WITH THE APPROVED PLANS,
SPECIFICATIONS, ANBD EaAQ4BIf-$ECTIONS RNING BUILDING li
W3I4TURE OFREGI EREDINSPECTOR
�� ��'
SPECIALTY N0. AGENCY '
CONTINUED ON NEXT PAGE L f PAGE OF '
TIME IN I TIME OUT I REG. HOURS I O.T. HOURS I CYLINDERS
All inspections baseo a inimum of 4 hours and over 4 hours - 8 hour
minimum. In ad ' is)), ny i spection wending past noon hour will be
hour minimum
Approved by%�2tc—(J(P
WHITE - OFFICE COPY, CANARY - ACCOUNTING COPY, PINK - INSPECTOR'S COPY, GOLDENROD - JOB SITE COPY
QJ1 Certificate of occupancy
•�� I Sw4�
OF�ti Building. & Safety Department
This Certificate is -issued pursuant to the requirements of Section 109 of the California .Building
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
Use classification: SFD
Occupancy Group: R-3
BUILDING ADDRESS: 52-618 PALAZO
Type of Construction: VN
Owner of Building: TAYLOR WOODROW HOMES INC.
-I-, Z, A le -
Building Official
POST IN A C
Building Permit No.: 06-215
Land Use Zone: RL
Address: 52-618 PALAZO
City, ST, ZIP: LA QUINTA CA 92253
By: STEVE TRAXEL
Date: January 31, 2008
UOUS PLACE