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05-1339 (SFD)N*� P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: ; 05-00001339 Property Address: 52840 JALISCO APN: 767-200-011-45 -318741- Application description: DWELLING - SINGLE FAMILY Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 176769 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: TAYLOR WOODROW HOMES, INC. 15 CUSHING DETACHED IRVINE, CA 92618 (341)000-1200 Contractor: Applicant: /Architect or Engineer: TAYLOR WOODROW HOMES INC 15 CUSHING IRVINE, CA 92618 (760)275-0598 Lic. No.: 352047 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: B / icense No.: 352047 Date: / 7- ontractor. �`— / OWN -BUILDER DECLARATIO I hereby affirm under'penalty of perjury that I am exempt from the Contractor' State License Law for the + following reason (Sec. 7031.5, Business and Professions Code: Any city o county that requires a permit to r 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).: (_ 1 1, 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 of 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, 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: a I A LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/07/05 D Q JUL 0 8 2005 CITY OF LA QUINTA FINANCE DEPT. 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 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, 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 or Code, I shall hwith c ply with those provisions. flats: 7oS pplicant: — WARNING: FAILURE TO SECURE WORT •RS' COMPRIsATION COVERA S UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES U TO ONE HUNDRED THOUSAND DOLLARS ($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 hereb authorize representatives. ofthis county to enter upon the above-mentioned property for ins ctierrpmp0 s. Date: U gnature (Applicant or Agen� Application Number . . . . . 05-00001339 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 909.00 Plan Check Fee 590.85 Issue Date . . . . Valuation . . . . 176769 Expiration Dater. 1/03/06 Qty Unit Charge Per Extension ' BASE FEE 639.50 77.00 ---------------------------------------------------------------------------- 3.5000 THOU BLDG 100,001-500,000 269.50 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 65.50 Plan Check Fee 16.38 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 5.00 ---------------------------------------------------------------------------- 6.5000 EA MECH VENT FAN ' 32.50 r Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 125.35 Plan Check Fee '. 31.34 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/03/06 , Qty Unit Charge Per Extension BASE FEE 15.00 t 2754.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 96.39 698.00 ----------------------------------------------------------------------------- .0200, ELEC GARAGE OR NON-RESIDENTIAL 13.96 Permit . . . PLUMBING Additional desc . Permit Fee 166.50 Plan Check Fee 41.63 Issue Date . . . . Valuation . . 0 Expiration Date 1/03/06 Qty Unit Charge Per Extension BASE FEE .15.00' , 16.00 6.0000 EA PLB FIXTURE 96.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA, PLB-WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 LQPERMTT v LQPERAfrT Application Number . . . . . 05-00001339 Permit . . . . . . PLUMBING Qty Unit Charge Per Extension 1.00 , 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 8.00 .7500 EA PLB GAS PIPE >=5 6.00 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 ---------------------------------------------------------------------------- Special Notes and Comments SFD - PLAN TYPE 2C, 2754 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 59.09 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 17.67 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited ---------- Due ` ----------------------------------------------- Permit Fee Total 1281.35 .00 .00 1281.35 Plan Check Total 680.20 500.00 .00 180.20 Other Fee Total 2481.76 .00 .00 2481.76 Grand Total 4443.31 500.00 .00 3943.31 v LQPERAfrT 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, C138, C143, C172, C173, C231, C1064 --- CONCRETE: X GROUT: MORTAR: SHOTCRETE: CORES: GUNlTE: ADDRESS: 52-840 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 # 46 ________________________________________________________________________________ CONCRETE SUPPLIER: SUPERIOR RDY MX PLANT: MIX #: D83625P TYPE OF CEMENT : II/V ADMIXTURE: TICKET #: 3433418 SLUMP : 4.5" WATER ADDED: 0 GAL AIR TEMP: 110 F CONCRETE TEMP: 85F MIXING TIME: 70 MIN TIME CAST: 8 AM ________________________________________________________________________________ DATE CAST: 7/28/2005 RECEIVED AT LAB: 7/29/2005 _______________________________________________________________________________ SPECIMENS MADE BY: TERRY SLAVIN SPECIFIED PSI: 4000 _______________________________________________________________________________ FIELD IDENTIFICATION| A | B | C | D | E _______________________________________________________________________________ LAB IDENTIFICATION : 513841 : 513841 : 513841 _______________________________________________________________________________ AGE DAYS : 7 : 28 : 28 DATE TEST : 8/4/2005 : 8/25/2005 : 8/25/2005 SIZE -IN. : 6.003X12 : 6.003X12 : 6.004X12 AREA-SQ.IN. : 20.30 : 28.30 : 28.31 CRUSH LOAD -LBS : 87160 : 120275 : 121730 COMP-STR.-PSI. : 3080 : 4250 : 4300 | H/D CORR FACTOR CORR.STR.-PSI TIME TESTED BREAK TYPE C.T.M. USED ASTM C39, C174, C192, C4701 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: loop A? J/ R E N A N R. LAB. MANA -w% ' , ASTM C89 BREAKS A= cone B= cone��nd split C= cone D=shear E=columnar - . Certificate of Occupancy -mQum& � of�J 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: 52-840 JALISCO Type of Construction: VN Owner of Building: TAYLOR WOODROW HOMES INC. Building Official Building. Permit No.: 05-1339 Land Use Zone: RL Address: 52-840 JALISCO City, ST, ZIP: LA QUINTA CA 92253 By: GARY SHOWALTER Date: NOVEMBER 23, 2005 POST IN A CONSPICUOUS PLACE