05-3366 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 05-00003366 \
Property Address: 81913 VIA LA SERENA
APN: 767-200-011-36 -318741-
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoninq: LOW DENSITY RESIDENTIAL
Application valuation: 175002
I
Applicant: ,,_�rchitect or Engineer:
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.
Licensee Class:: B License 352047
ate:tr/% ntractor:
OWN -BUILDER D LARATION
I hereby affirm under penalty of perjury that I am exempt from the Co ractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any ci 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 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: l
Lender's Address: 1�
LQPERN1IT
Owner:
TAYLOR WOODROW HOMES, INC.
15 CUSHING
IRVINE
IRVINE, CA 92618
SEP 1- 2 2005
CITYOF LAQlU1NTA ( 760
WOODROW HOMES INC
E, CA 92618
275-0598
No.: 352047
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/02/05
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.
,xl 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
/ ��3gq700 of the Labor Code, I f rt it l comp ith those provisions.
Date: ' 2-t/ pplicant:
WARNING: FAILURE TO SECURE WOR ERS' CO ENSATIONKINES
AGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVI P TO ONE 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
of this county
11''totenter upo a above-mentioned property for' p€cti n Gr ses.
ate: ' _ \ Signature (Applicant or Agent): ! �—
Application Number . . . . . 05-00003366
Permit . . . .
. .
BUILDING PERMIT
Additional desc
.
Permit Fee . .
. .
905.50
Plan Check Fee
147.15
Issue Date . .
. .
Valuation . . . .
175002
Expiration Date
1/29/06
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
5.22
Issue Date . .
. .
Valuation . . . .
0
Expiration Date
1/29/06
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
7.62
Issue Date . .
. .
Valuation . . . .
0
Expiration Date
. .
. 1/29/06
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
Issue Date
Expiration Date 1/29/06
Plan Check Fee . .
Valuation . . . .
Qty Unit Charge Per
BASE FEE
15.00 6.0000 EA PLB FIXTURE
1.00 15.0000 EA PLB BUILDING SEWER
1.00 7.5000 EA PLB WATER HEATER/VENT
LQPERAIIT
10.08
0
Extension
15.00
90.00
15.00
7.50
Application Number . . . . . 05-00003366
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 Da"te 1/29/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 36, PLAN 1C 2685 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
------------------------7---------------------------------------------------
Other Fees . . . . . . . . . DIF COMMUNITY CENTERS -RES'
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
14.72
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 170.07 .00 .00
170.07
Other Fee Total 2437.22 .00 .00
2437.22
Grand Total 3894.46 .00 .00
3894.46
LQPERAIIT
Southwest Inspection and Testing, Inc.
10826 South Norwalk Blvd., Santa Fe Springs, CA 90670
(562) 941-2990 - (714) 526-8441 - Fax (562) 946-0026
REGISTERED INSPECTORS'S DAILY REPORT
=z' -o
D
TYPE OF ❑ Reinforced Concrete ❑ Strcictural Steel Assembly ❑ Quality Control
INSPECTIONAM Post Tensioned Concrete ElFire Proofing ❑ Other
REQUIRED ❑ Reinforced Masonry ❑ Asphalt
Job Address /T„(may City /�
Jofq Name 40� 1 L,!)` 71,T/ OV7
P .v �J 1�
Is�qY Q'.1
Type of Structure
Architect
Material Description (type, grade. sourc
Enginee&r
/•9g::f����'
Contractor
Inspector(s/)�Name
Subcontractor!
r
TESTS PERFORMED
TYPE OF SAMPLE
SLUMP
QUANTITY IN SET
ADDITIONAL 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,IVUMBER, TYPE & IDENT. NO'S OF
TEST SAMPLES TAKEN: STRUCT. CONNECTIONS (WELD MADE H.T. BOLTS TORQUED) CHEC<ED, ETC.
09
2 s 1- Ver I- - Se
CERTIFICATION OF COMPLIANCE CONTINUED ON NEXT PAGE ❑ PAGE OF
I HEREBY CERTIFY THAT I HAVE OBSERVED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED I IN IM T REG. H �- O.T. HOURS
WORK UNLESS OTHERWI NOTED. I HAVE FOUND THIS WW RK TO COMPLY WITH THE APPROVED PLANS,
SPECIFICATIONS, AN PLICABLE SECTIONB�F THEB4VERNINB BUILDING LAWS. Iwo
All inspections based on a minimum of 4 hours and over 4 hours - 8 hour
minimum. In addition, any inspection ex ending past noon hour will be an'8
/ TURE CrF REGISTINSPECTOR hour minimum.
` 7E0 le—�` Approved
PP b Y
TY NO. AGENCY Project Superintendent
WHITE - OFFICE COPY, CANARY - ACCOUNTING COPY, PINK - INSPECTOR'S COPY, GOLDENROL - JOB SITE COPY
SOUTHWEST
Inspection & Testing, Inc.
To Whom It May Concern:
Continuous Inspection & Materials Testing
® ® ® ® ® ® ® ® ® ® ® ® ® ® ®
,I..rr �..: ti -�J _ , .. r•>+{, -G: •,fit:,. �r _
�"` `�-� . �y" vi �lf� ti'l'e ��'' x.37 �aC! � �� ti+`S� 1,•
441 Commercial Way, La Habra, CA 90631-6168
(562) 9L1-2990 • (714) 526-8441
FAX (562) 946-0026
Enclosed you will find copies of Daily Inspection Reports and or
Compressive Strength Testing Results for your jobsite
We have enclosed these copies for you records.
If you have received any reports in error please return them to Southwest
Inspection and Testing.
If you have any questions or comments, please do not hesitate to call.
Thank you,
Southwest Inspection & Testing
Southwest Inspection and Testing, Inc.
10826 South Norwalk Blvd., Santa Fe Springs, CA 90670
(562) 941-2990 • (714) 526-8441 • Fax (562) 946-0026
REGISTERED INSPECTORS'S DAILY REPORT
F 850 SWIT lob No.
211
Date
1 2-7--106
TYPE OF ❑ Reinforced Concrete ❑ Stritictural Steel Assembly ❑ Quality Control
INSPECTION ❑ Post Tensioned Concrete ❑ Fire Proofing ❑ Other
REQUIRED ❑ Reinforced Masonry ❑ Asphalt
Job Address City
iil) Lu "IT
Job Name
Permit No. Issued By
Architect
Type of Structure
Material Din (type. grade. source)
g n Qso Z2.0-�PtS �Xp 11 0
Engineer
� �
Ia Q
A 6.Lo�
Contracto- 1
l`�
Inspector(s)Name `� HE,
1N tom!
Subcontractor
%,,� ��--��-
i LL—C �J :.� ►c�C. 1 t
TESTS PERFORMED
TYPE OF SAMPLE
SLUMP
QUANTITY IN SET
ADDITIONAL REMARKS ON SAMPLES
T�7
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 SAMPLES TAKEN: STRUCT. CONNECTIONS (WELD MADE H.T. BOLTS TORQUED) CHECKED, ETC.
1 n1 0 DV-* 5 is t.t
L�v�D �. EPOS
IDE—LL1iIiiiNJ �I2-� 3PLLLL
ftL W -rW ISMCItJ '1"p Ale..
3318 -- 1 8 --61 c6ti PC to 5ee&i 0 6 -
3 P 1 G 1 Ab I -0115 Pr L4
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE OBSERVED TO THE B
WORK UNLqS OTHERWISE NOTED. I HAVE FOUND
SPECIFICAT10TlS. AND APPLICABLE SECTIONS AF TI
OF
NO.
'KNOWLEDGE ALL OF THE ABOVE REPORTED
TO COMPLY WITH THE APPROVED PLANS,
ING BUILDING LAWS.
INSPECT
1 - ccs
AGENCY
CONTINUED ON NEXT PAGE ❑ PA -3E OF
TIME IN TIME OUT REG. HOURS O.T. HOURS CYLINDERS
7�_ -1�1- -�
All intpections bas d a i um of 4 hours and over 4 hours - 8 hour
minimum. In addi ' n, a y s tion eaten ing pas hour will be an'8
hour minimum. —
Approved by
Project Supeintendent
WHITE - OFFICE COPY, CANARY - ACCOUNTING COPY, PINK -INSPECTOR'S COPY, GOLDENROD - JOB SITE COPY
Southwest Inspection and Testing, Inc.
10826 South Norwalk Blvd., Santa Fe Springs, CA 90670
(562) 941-2990 • (714) 526-8441 - Fax (562) 946-0026
REGISTERED INSPECTORS'S DAILY REPORT
TYPE OF einforced Concrete ❑ Str6c,tural Steel Assembly
INSPECTION ❑ Post Tensioned Concrete ❑ Fire Proofing
REQUIRED ❑ Reinforced Masonry ❑ Asphalt
sw 2 ( ; Date
(( a5
11 Quality Control
D Other
Job Address
=Z9
3 C�n ^ i � City
191r �J C / l
Job Name 0-2?2:
/
r
Permit No.
Issued By ���4
Type of Structure
l Vt
'''
�e,
ff
Architect
Material Description (type, gra e, source)
Engineer
Contractor %
Inspector(s) Nome
,, n /T tc„
Subcontractor
TESTS PERFORMED
TYPE OF SAMPLE
SLUMP
QUANTITY IN SET
ADDITIONAL 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 SAMPLES TAKEN: STRUCT. CONNEECTIONS (WELD MADE H.T. BOLTS TORQUED) CHECKED, ETC.
G zc
? ZSR
1913
q
os- - 3cc-
Z
G �� �7 ��/
off• 3-3.6 Z-
1,24,
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE OBSERVED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED
WORK UNLESS OTHERWISE NOTED. I HIE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS,
SPECIFICATIONS, AND PPLICABLE E IONS OF THE GOVERNING BUILDING LAWS.
_ 7//,
"SIGNATURE OF REGISTERED INSPECTOR
�Oe,7-7 65 Gc�—
SPECIALTY NO. AGENCY
CONTINUED ON NEXT PAGE ❑ PAGE OF
TIME IN TIME OUT REG. HOURS O.T. HOURS CYLINDERS
All inspections based on a minimum of hours and over 4 hours - 8 hour
minimum. In addition, any i ection extending past noon hour will be an'8
hour minimum. r
Approved by
Project Superntendent
WHITE - OFFICE COPY, CANARY - ACCOUNTING COPY, PINK - INSPECTOR'S COPY, GOLDENROD - JOB SITE COPY