05-1338 (SFD)4Z( BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
05-00001338 '
52845 JALISCO
767-200-011-48 -318741-
DWELLING - SINGLE FAMILY
LOW DENSITY RESIDENTIAL
175002
ci�a� 4 XryQ"
BUILDING & SAFETY DEPARTMENT .
BUILDING PERMIT
Owner:
TAYLOR WOODROW HOMES,
15 CUSHING
DETACHED IRVINE
IRVINE, CA 92618
,,..o<rchitect or Engineer:
`7 y
--------------------------------------------------
LICENSED CONTRACTOR'S 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 Class: Bicicen—se No.: 352047
Date: rl' , ontractor:/ (�
OWN -BUILDER DECLA ATION _
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
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).:
(_) 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
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
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.).
1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( 1 I am exempt under Sec. , B.&P.C. for this reason
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: R
LQPERA11 T
Contractor:
TAYLOR WOODROW HOMES INC
15 CUSHING
IRVINE, CA 92618
(760)275-0598
Lic. No.: 352047
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/07/05
"JUL0 8 2005
D
CITY OF LA QUINTA
------------------
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.
V-1 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 and policy number are:
Carrier LIBERTY MUTUAL Policy Number WA765D283614055
_ I certify that, in the performance of the work for which this permit is issued, 1 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 forthwi h. mpI with thus rovisions.
,<ate:;Jicant:
WARNING: FAILURE TO SECURE WOR RS' COMP SATION COVERAGE IS NLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO NE HUNDRED THOUSAND
DOLLARS 1$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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this 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 application,
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.
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 construction, and hereby authorize representatives
ofthiscounty to enter upon the above-mentioned property f� tion u po es.
,,Date: r nature (Applicant or Agent):
LQPERASIT
Application Number 05-00001338
Permit
. . .
BUILDING PERMIT
Additional
desc . .
Permit Fee
. . . .
905.50
Plan Check Fee
588.58
Issue Date
. . . .
Valuation . . . .
175002
Expiration
Date
1/03/06
Qty, Unit Charge
Per
Extension
BASE
FEE
639.50
76.00
----------------------------------------------------------------------------
3.5000
THOU BLDG
100,001-500,000.
266.00
Permit
. . .
MECHANICAL
Additional
desc . .
Permit Fee
. . . .
83.50
Plan Check Fee
20.88
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
1"/03./06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2.00
9.0000
EA MECH
FURNACE <=100K
18.00
2.00
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
. . . .
121.92
Plan Check Fee
30.48
Issue Date
. . . .
Valuation
- 0
Expiration
Date . .
1/03/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2685.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
93.98
647.00
--------------------------
.0200
ELEC
-------------------------------------------------
GARAGE -OR NON-RESIDENTIAL
12.94
Permit
PLUMBING
Additional
desc .
Permit Fee
. . .
161.25
Plan Check Fee
40_.31
Issue Date
. . . .
Valuation
0
Expiration
Date
1/03/06
Qty Unit Charge
-Per
Extension
BASE
FEE
15.00
15.00
6.0000
EA PLB FIXTURE
90.00
1.00
15:0000
EA PLB BUILDING SEWER
15.00
1.00
7.5000
EA _PLB WATER HEATER/VENT
7.50
ti
LQPERMff
INC"1-:l Application Number 05-00001338
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
9.00 .7500 EA PLB GAS PIPE >=5
6.75
1.00 15.0000 EA PLB GAS METER
---------------------------------------------------------
15.00
----------
Permit . . GRADING PERMIT
Additional desc' . '.
Permit Fee . . . . 15.00 Plan Check Fee
.00 -
Issue Date . . . . Valuation
0
Expiration Date.. . 1/03/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
------------7---------------------------------------------------------------
Special Notes and Comments
SFD - PLAN TYPE 1A'268S SQ.FT. LIVING.
R-3 OCCUPANCY, TYPE V -N CONSTRUCTION,
2001 CODES. PERMIT DOES NOT INCLUDE
BLOCK WALLS, POOL, SPA OR DRIVEWAY
APPROACH.
----------------------------------------------------------------------------
Other Fees . . . . . . . DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES.
366.00
ENERGY REVIEW FEE
58.86
DIF FIRE PROTECTION -RES-
97.00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
.5.00
DIF PARKS•/REC - RES
502.00
STRONG MOTION (SMI) - RES
17.50
DIF STREET MAINT FAC -RES•
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged Paid Credited
----------------- ---------- ----------- ---------- ----------
Due
Permit Fee Total 1287.17 .00 .00
1287.17
Plan Check Total 680.25 500.00 .00
180.25
Other Fee Total 2481.36 -.00 .00
2481.36
Grand Total 4448.78 '500.00 .00
3948.78
ti
LQPERMff
` SOUTHWEST INSPECTION AND TESTING INC.
` 10826 S. Norwalk #A
Santa Fe Springs, CA 90670
562-941-2990 714-526-8441 Fax -562-946-0026
================================================================================
FIELD DATA ON TEST SPECIMENS
--- ASTM C31, C1389 C143, C172,
C173,
C231, C1064 ---
CONCRETE: X GROUT: MORTAR:
SHOTCRETE:
CORES: GUNITE:
ADDRESS: 52-845 JALISCO. LA QUINTA
JOB
#: 50211
DATE: 09/06/2005
JOB NAME: CARMELA
PERMIT
#:'
ISSUED BY: LA QUINTA
ARCHITECT:
ENGINEER:
CONTRACTOR: TAYLOR WOODROW
________________________________________________________________________________
SUB CONTRACTOR:
CAMPBELL CONCRETE OF CALIF.
LOCATION IN STRUCTURE: TR 31874-1
________________________________________________________________________________
( MODEL )
LOT # 48
CONCRETE SUPPLIER: SUPERIOR RDY MX
PLANT:
MIX #: D83625P
TYPE OF CEMENT : II/V ADMIXTURE:
TICKET #: 3433401
SLUMP : 4.5" WATER
ADDED: 0
GAL
AIR TEMP: 100 F
CONCRETE TEMP: 86 F MIXING
TIME:
TIME CAST: 7:30 AM
------------------------------ __________________________________________________
DATE CAST: 7/29/2005
_______________________________________________________________________________
.
RECEIVED
AT LAB: 8/1/2005
SPECIMENS MADE BY: TERRY SLAVIN
_______________________________________________________________________________
SPECIFIED
PSI: 4000
FIELD IDENTIFICATION| A |
_______________________________________________________________________________
B
| C
| D | E
LAB IDENTIFICATION : 513555 :
_______________________________________________________________________________
513555
: 513555
: :
AGE DAYS : 7 :
28
: 28
DATE TEST : 8/5/2005
8/26/2005
: 8/26/2005
SIZE -IN. : 6.000X12 :
6.001X12
: 6.001X12
AREA-SQ.IN. : 28.27 :
28.28
: 28.28
CRUSH LOAD -LBS : 104420 :
124010
: 128950
COMP-STR.-PSI. : 3690 :
4385
: 4560
| H/D
CORR FACTOR
CORR.STR.-PSI
TIME TESTED
BREAK TYPE
C.T.M. USED
REMARKS:
ASTM C39, C174, C192, C470, C617, C42
COMPLIES: X DOES NOT COMPLY:
______________________________________________________________________________
THIS REPORT SHALL NOT BE REPRODUCED, EXCEPT IN FULL WITHOUT THE APROVAL OF SITI
_______________________________________________________________________________
RESPECTFULLY SUBMITTED
SOUTHWEST INSPECTION AND TESTING
SAMPLES CAST BY OTHERS: -.Ole ;x.
~ RENAN
LAB. M
ASTM C39 BREAKS A= cone B= c��e and split C= cone D=shear E=columnar
Certificate of Occupancy
Tjhf 4 4 Qum&
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.
BUILDING ADDRESS: 52-845 JALISCO
Use classification: SFD
Occupancy Group: R-3 Type of Construction: VN
r
Owner of Building: TAYLOR WOODROW HOMES INC.
Building Official
Building Permit No.: 05-1338
Land Use Zone: RL
Address.- '52-845 JALISCO
City, ST, ZIP: LA QUINTA CA 92253
By: GARY SHOWALTER
Date: NOVEMBER 23, 2005 .
POST IN A CONSPICUOUS PLACE