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05-1341 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tit!t 4 XP Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 LQPEn1IT Date: 7/07/05 Application Number: 05-00001341 Owner: Property Address: 52810 JALISCO TAYLOR WOODROW, HOMES, IN APN: 767-200-011-46 -318741- 15 CUSHING Application description: DWELLING - SINGLE FAMILY DETACHED IRVINE, CA 92618 Property Zoning: LOW DENSITY RESIDENTIAL (341) 000-1200 Application valuation: 191320 JUL 0 8 2 05 Contractor: Applicant: /Architect or Engineer: CITY OF LA QUINTA TAYLOR WOODROW HOMES INC FINANCE DEPT. 15 CUSHING IRVINE, CA 92618 pp�[JCs— /v�l/1J f��j (760)275-0598 Lic. NO.: 352047 Cie --------------------------------------------------------------7---------------------------------- 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 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 License No.: 352047 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is � Date: �'� ractor: �- 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 OWNE •BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's ate License Law for the Carrier LIBERTY MUTUAL Policy Number WA765D283614055 following reason (Sec. 7031 .5, Business and Professions Code: Any city or c unty 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 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 shall forthwith comply with tho ns. 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): _Zr,7 'Upplicant:' (_) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 11 the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE W KERS'. CO PENSATION COVERAGE IS UN FUL, 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 O 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, D 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 FE . 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, 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—) 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. 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 ounty to enter upon above-mentioned property for ins tion pu p ees. Lender's Name: Date: / /' ignature (Applicant or Agent): Lender's Address: M .� LQPEn1IT is t Application Number . . . . 05-00001341 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 961.50 Plan Check Fee 624.98 Issue Date . . . . Valuation. . . . . 191320 Expiration Date . . 1/03/06 Qty Unit Charge Per Extension BASE FEE 639.50 92.00 ---------------------------------------------------------------------------- 3.5000 THOU BLDG 100,001-500,000 322.00 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 108.00 Plan Check Fee 27.00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/03/06 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 6.00' ---------------------------------------7------------------------------------ 6.5000 EA MECH VENT FAN 39.00 Permit ' . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 134.85 Plan Check Fee 33.71 Issue Date . . . . Valuation 0 Expiration Date 1/03/06 Qty Unit Charge Per Extension BASE FEE 15.00 3047.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 106.65 660.00 -------------------------------------------------------------------=----=--- .0200 ELEC GARAGE OR NON-RESIDENTIAL 13.20 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 174.75 Plan Check Fee 43.69 Issue Date . . . . Valuation 0 Expiration Date 1/03/06 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 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 LQPERAIfT O LQPERMIT Application Number . . . . . 05-00001341 BASE FEE 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 11.00 .7500 EA PLB GAS PIPE >=5 8.25 1.00 15.0000 ----------------------------7----------------------------------------------- EA PLB GAS METER 15.00 Permit . . . GRADING PERMIT 62.50 Additional desc . . DIF FIRE PROTECTION -RES 97.00 Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . 0 Expiration Date . . 1/03/06 19.13 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - PLAN TYPE 4B W/SKYDECK OPTION, 3047 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 62.50 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 19.13 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged ----------------- ---------- Paid Credited ---------- ------ - ---- ---------- Due Permit Fee Total 1394.10, .00 .00 1394.10 Plan Check Total 729.38 500.00 .00 229.38 Other Fee Total 2486.63 .00 .00 2486.63 Grand Total 4610:11 500.00 .00 4110.11 J , 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: GUNITE: ADDRESS: 52-810 JALISCO. LA QUINTA JOB #: 50211 DATE: 09/06/2005 JOB NAME: CARMELA PERMIT #: 05-1339 ISSUED BY: LA QUINTA ARCHITECT: ENGINEER: CONTRACTOR: TAYLOR WOODROW SUB CONTRACTOR: CAMPBELL CONCRETE OF CALIF. ________________________________________________________________________________ LOCATION IN STRUCTURE: TR 31874-1 ( MODEL ) LOT # 45 ________________________________________________________________________________ CONCRETE SUPPLIER: SUPERIOR RDY MX PLANT: MIX #: D83625P TYPE OF CEMENT : V ADMIXTURE: TICKET #: 3433418 SLUMP : 4.5" WATER ADDED: 0 GAL AIR TEMP: 110 F CONCRETE TEMP: 85 F MIXING TIME: TIME CAST: 7 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 : 513842 : 513842 : 513842 : : _______________________________________________________________________________ AGE DAYS : 7 : 28 : 28 DATE TEST : 8/4/2005 : 8/25/2005 : 8/25/2005 SIZE -IN. : 6.001X12 : 6.002X12 : 6.003X12 AREA-SQ.IN. : 28.28 : 28.29 : 28.30 CRUSH LOAD -LBS : 83850 : 118820 : 120275 COMP-STR.-PSI. : 2965 : 4200 : 4250 | H/D CORR FACTOR CORR.STR.-PSI TIME TESTED BREAK TYPE C.T.M. USED ______________________________________________________________________________ REMARKS: ______________________________________________________________________________ ASTM C39, C174, C192, C470, C6171 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: ^ LAB. M - »' _- ASTM C39 BREAKS A= cone B= con' and split C= cone D=shear E=columnar ' Certificate of Occupancy T4`�t 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: 52-810 JALISCO Use classification: SFD Building Permit No.. 05-1341 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL Owner of Building: TAYLOR WOODROW HOMES INC. Building Official Address: 52-810 JALISCO City, ST, ZIP: LA QUINTA CA 92253 By: GARY SHOWALTER Date: NOVEMBER 23, 2005 POST IN A CONSPICUOUS PLACE