06-0231 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&ty/ 4 4
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00000231
Property Address: 81813 VIA LA SERENA
APN: 767-200-011-20 -318742-
Application description: DWELLING - SINGLE FAMILY DETACHED
Proverty Zoninq: LOW DENSITY RESIDENTIAL
Application valuation: 191320
Applicant:chitect or Engineer:
rooks C). Fiu,n.FZ__
-
_--
-------------------------------------------------
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.
Lice se-Classl: B ice a No -, 352047
Date: 1 4 ontractor:
O R -BUIL ER DECLARATIO
I hereby affirm under penalty of perjury that I am a mpt from the Contractor's State License Law for the
following reason ISec. 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).:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and .01
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 _ I 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.).
I—) 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:
LQPERMIT
Owner:
TAYLOR WOODROW,
15 CUSHING
IRVINE, CA 92618
(341)000-1200
Contractor:
TAYLOR WOODROW
15 CUSHING
IRVINE, CA 9261
(760)275-0598
Lic. No.: 35204
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/13/06
HOMES, INC.
------------------------------------—-------
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.
-A 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,
�� �//,aand agree that, if I should become subject to the workers' compensation provisions of Section
--� X700 of the La de. I shall forthwith m ittttit a provisions.
ate: 'la., ,�/f/,1,f��- plicant:
WARNING: FAILURE TO SECURE WORK RS' C PENS TION COVERAGE I &LAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP 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 611
city and county ordinances and state laws relating to building constructior`and hea thorize representatives
of this o��u��nty��t(/Qe��nter upon th ove-mentioned operty for inspection ppuuu_ ,a F:
at5 ature (Applicant or Agent): L •'/
f
LQPERMIT
Application Number . . . . . 06-00000231
Permit
. . .
BUILDING PERMIT
Additional
desc . .
Permit Fee
. . . .
961.50
Plan Check Fee
156.25
Issue Date
. . . .
Valuation . . . .
191320
Expiration
Date . .
7/12/06
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
6.75
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date . .
7/12/06
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
----------------------------------------------------------------------------
6.5000
EA MECH
VENT FAN
39.00
Permit
. . .
ELEC-NEW RESIDENTIAL
Additional
desc . .
Permit Fee
. . . .
134.85
Plan Check Fee
8.43
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date . .
7/12/06
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
10.92
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
1.00
7.5000
EA PLB WATER HEATER/VENT
7.50
Application Number . . . . . 06-00000231
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 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 . . 7/12/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 20, PLAN 4C, 3047 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
15.63
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 182.35 .00 .00
182.35
Other Fee Total 2439.76 .00 .00
2439.76
Grand Total 4016.21 .00 .00
4016.21
LQPERMIT
Southwest Inspection and Testing, Inc.
441 Commercial Way, La Habra, CA 90631
' /' O.n
� 9�29�90�(7� 4) 526-8441 •Fax (562) 946-0026
REGISTFRFn INSPFS'Sn01L I RFPII6)PT
TYPE OF Reinforced Concrete ❑ Str6ctural Steel Assembly ❑ Quality 06ntrol
INSPECTION ❑ Post Tensioned Concrete ❑ Fire Proofing ❑ Other
REQUIRED ❑ Reinforced Masonry ❑ Asphalt
Job Address
Job Name i
Issued By
Type of Structure Architect
Material Description (type, grade, source) Engineer
G Contractor
Inspector(s) No Subcontractor
TESTS PERFORMED
TYPE OF SAMPLE
SLUMP
QUANTITY IN SET
ADDITIONAL 9EMARKS ON SAMPLES
INSPECTION SUMMARY — LOCATIONS OF WORK INSPECTED, TEST SAMPLES TAKEN, WORK REJECTED, JOB PROBL=MS, PROGRESS, REMARKS, ETC.
INCLUDES INFORMATION ABOUT - AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED NUMBER, TYPE & IDENT. NO'S OF
TEST SAMPLES TATN: STRUCT. CONNECTIONS (WELD MADE H.T. BOLTS TORQUED) CH CKED, ETC.
T
X�?
CERTIFICATION OF COMPLIANCE CONTINUED ON NEXT PAGE M PACE nF
I HEREBY CERTIFY THAT I HAVE OBSERVED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED
WORK UNLESS OTHERWISE NOTED. I HAVE FOUND TH WORK TO COMPLY WITH THE APPROVED PLANS,
SPECIFICATIONS, A BLE SECTION OF GOVERNING BUILDING LAWS.
GNATURE OF REGISTERED INS
.ffCIOR
SPECIALTY AGENCY
CYLINDERS
r 4 hours - 8 hour
n hour will be an'8
WHITE - OFFICE COPY, CANARY - ACCOUNTING COPY, PINK - INSPECTOR'S COPY, GOLDENROD - JOB SITE COPY
. 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, C1439 C172,
C173, C231, CK064 ---
CONCRETE: X GROUTx
MORTAR: SHOTCRETE: CORES: GUNITE:
ADDRESS:.81-8I3 LA
SIRENA, LA QUINTA MOB
On 50211 DATE: 7/30/2006
JOB/NAME: CARMEN
@ LA QUINTA PERMIT
#: 06-231 ISS']ED BY: LA QUINTA
ARCHITECT: SOUTH COAST ARCH. ~ ENGINEER:
INFINITY GROUP
CONTRACTUR: TAYLOR
........................ ..................... ........ ...............
WOODROW HOMES SUB CONTRACTOR: CAMPBELL CONST. .
^LOCATION IN STRUCTURE:
........ ........ .............................. ............... -.... -.... .... .... .... .... .... --........................................................ ....... ---.... .... ... .............. ......................... .... ....
LOT#20/ SLAB 8 FOOTINGS
---.................. -----r-
CONCRETE SUPPLIER:
.... ... ... ............ --.... .... .... .... -.... .... .... ......... ...... .... ............
SUPERIOR PLANT: 71
... ................ ........ ........... ................. .......... -............... .... ... .... -........ ........ ... .... .... .... --
MI)( #: D836251 -D
TYPE OF CEMENT : V
#DMIXTU :
TICKET #: 297299
SLUMP :
WATER ADDED: 0
GAL. AIR TEMP:
CONCRETE TEMP:
MIXING TIME:
TIME TAST:
---..... .... ............ ........ ................... ............
DATE CAST: 6/22/2006
-_------_-------_------------_----------------_-------------__-----------------
.... ............................. ................ .... .... .............. .......................
........ .......... .... .... -.... ............ ........ ........... _................ .... ....... ....... -.................. --
RECEIVED AT LAB: 6y23/2006
SPECIMENS MADE BY:
TERRY S.
SPECIFIED PSI: 4000
FIELD iDENTIFICMTIOMI iDENTIFICATION|
-.................................... .......
A \ B
| - C | D | E
....... ... .... ....
LAB IDENTIFICATION
... .... ....................... ........ ....... ........ -...
.......... .............................. .............. ... ............ .... .............. --
: 609784 : 609784
.... .... .... -........................................... ... _........ ...... ........ ................ ....... -----
n,609784 : :
.......
................
AGE DAYS �
........ .................... ............................ .......... ............ ...................
: 7 : 28
........ ...... ................ .... ........ .... .... ... .................... ......... ....... .......... ....................
: 28 : : '
DATE TEST
: 6/29/2006 : 7/20/2006
: 7/20/2006 : :
SIZE -IN.
: 6.000X12 : 6.000X12
: 6.000X12 : :
AREA-SQ.IN.
: 28127 : 28.27
: 28.27
CRUSH LOAD -LBS
: 90450' : 125760
: 123610
COMP-STR.-PSI.
: 3200 : 4450
: 4370 : :
\ H/D
: :
: : :
CORR FACTOR
: :
: : :
CORR.STR.-PSI
: :
: : :
TIME TESTED '
: :
:
BREAK TYPE
: :
:
C.T.M. USED
: FORNEY : FORNEY
: FORNEY : ' :
............ ............... .............. ........ .... ..... ... ........ ............ ............................... ................................... -_.... ............... ..................... ... ................... ........... ... ......... : ...................... .... .................... ... -
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:
,
ASTM C39 BREAKS A= cone B= convr and split C= cone D=stear E=columnar
^
. , .
Certificate ®f Occupancy
`,�: Lcoesoenhn `'�
5
G� OF IBuilding & 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. 81-813 VIA LA SERENA
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 06-231
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
Owner of Building: TAYLOR WOODROW HOMES, INC. Address: 15 CUSHING
City, ST, ZIP: IRVINE, CA 92618
By: EDDIE MUIR
'--' Date: OCTOBER 22, 2007
Building Officia
POST IN A CONSPICUOUS PLACE