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04-5617 (SFD)BUILDING & SAFETY DEPARTMENT ---P :0;: B4O -1 X04 t. (760) 777-7012 G+�pF9` " 78-4}95 CA•L� TAMPtCo FAX (760) 777-7011 LA .QUINT' C� ALIFORN[A 92253 INSPECTION REQUESTS (760) 777-7153 AUG Q� 4 =y200� I.U' . • � � - � .: . " BUILDING: PERMIT d < CITY OF LA QUINT% FINANCE DEPT App kation Number" ` ;.0'4""0,0005617> Date 7/23/04 Property ,Address iJ 5 7 5'2 4`'SANTA 'R'OSA ' T:R ' APN: 76.2,-24-0::-.0,13-18. -34087 - Application description . DWELLING<:-- SINGLE FAMILY DETACHED Property Zoning .LOW::-DENSTTY RESIDENTIAL - Application valuation "°fi688441"1. Owner Contractor,,- SANTA ROSA DEV GREYHAWK, INC:. 40847 SANDPIPER CT 1-603.;;TRASK ROAD PALM DESERT CA 9.226.0 ENCIrN_ITAS CA 92024` . , � 0 °. (,-. )� .,r634-,1;03=1 WCC ..EXEMPT ^a WC:., EXEMPT 10/21/04 CS'LB: 79'8228 08/31/05 CCC- -------------------------- ----------- ------------- Structure Information - -------------------------- Construction Type . . . . . TYPE V - NON'.RATED Occupancy Type.--. -DWELLG/LOD`GING/CQNG <=10 Flood Zone NQN=F,O FLOOD. ZONE Other struct info ". " CODE''EDITION -`' 2001 CBC # :'BEDROOMS'. 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG. 809.00 PPTIOx:SQ ,,FTG .: 394.00 NUMBER. OF UNITS 1.00 FIRST FtO, R, SQ FTG 2.583.00 Permit . . . . . .. BUILDING PERMIT Additional desc Permit Fee..... 881,90 Plan. -.:Check Fee; 143.16 Issue Date Valzation . . . 168844 Qty Unit Charge Pe'.r Extension " c BASE' FEE 639.50 69.00 3 .5000 THOU BLDG --10,0,.001-500,000 241.50 Permit . . . . . . MECHANICAL`° Additional desc Permit Fee, 108:-00 Plan Check wFee 6.75 Issue Date Val`u'ation 0 Qty Unit Charge .Per Extension ' a P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 164 - Applicant: 4 -Applicant: Applicant's Mailing Address: Date: Li _V �( or ngineer: OLS Aa dv Architect or Engineer's Address: No. J-V,-e`bj BUILDING PERMIT DECLARATIONS 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 Lice;k in full force and effect. // License Cle ass nse No.zg6z,ZS DateZIA.-Iractor�� /✓(� OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U 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.). U 1 am exempt under Sec. , B.& P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 1 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 Policy Number 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 Labor Code, I shall forthwith comply with those provisions. Date 9A- k:I'�Applicant CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNM UL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN 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 IMPORTANT Application is hereby made to the Director of BuildingAPPLICANT ACKNOWLEDGEMENT Safety a s set forth on this applicauon. 1. Each person upon whose behalf this application is made, each person at Permit ehose request st and efor conditions sn whose benefit work 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, indemnity and hold harmless the City of La Ouinta, 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 to enter the above-mentioned property for inspection purposes. /Date O Sure (Applicant or Agent): Page 2 Application Number . . . . 04"-00005617" Date 7/23/04 Qty Unit Charge Per Extension BASE FEE, 15.00 3.00 9_0000 :EA. MECH FURNACE :<=1Os0K - 27.00 3.00 9.000.0 EA MECH B/C:.<=3HP/100K BTU 27.00 5".00 6.5000 EA MECH VENT FAN 32.50 1.00 6.5000 EA MECH EXHAUST HOOD. 6.50 Permit . . . . . . ELEC-NEW"RESIDENTIAL Additional desc Permit Fee 121.:59 ". Plan Check Fee 7.60 Issue Date. . . . Valuation 0 Qty Unit Charge Per ;; Extension BASE FEE 15.00 2583.00 .0350 ELEC'NEWxRES - 1 OR 2 FAMILY 90.41 809.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 16.18 Permit . . . . . . PLUMBING _. Additional desc Permit Fee . . . 166.50 Plan Check Fee .10.41 Issue Date Valuation 0 Qty Unit Charge Per` Extension BASE FEE 15.00 16.00 6.000'0 EA 'PLB"'FIXTURE' 96.00 1.00 15":`0'000'. 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 1.00 9.00.00 EA`PLB LAWN SPRINKLER.SYSTEM 9.00 8.00 .7500 EA PLB-GAS PIPE.>=5' 6.00 1.00 15:.0000 EA PLB. GA'S' `METER 15.00 -------------------------------------=-------------------------------------- Permit . . . . GRADING.PERMIT Additional desc Permit Fee . . . . 15..00 Plan Check Fee .00 Issue Date . . Valuation . . . . 0 Qty Unit.Charge Per Extension BASE FEE 15.00 -----------------------------------=-------------- Special Notes -------------------------- and Comments SFD - LOT 18, PLAN 1/CASITA. PERMIT DOES 16 Fee summary Charged Permit Fee Total 1292.09 Plan Check Total 167.92 Other Fee Total 2436.20 Grand Total 3896.21 Paid Credited .00 Page 3 Application Number . . . . . 04=00005617 Date 7/23/04 -------------------------------------------------------_--------------------- Special Notes and Comments NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. 75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES •366.00 ENERGY REVIEW FEE 14.32 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE 00 DIF LIBRARIES - RES `225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 16.88 DIF STREET'MAINT FAC -RES 15.00 DIF TRANSPORTATION -.RES 1098.00 Fee summary Charged Permit Fee Total 1292.09 Plan Check Total 167.92 Other Fee Total 2436.20 Grand Total 3896.21 Paid Credited .00 .00 .00 .00 .00 .00 .00 .00 Due 1292.09 167.92 2436.20 3896.21 CITY OF LA Q�UINTA BU.ILDyING: & SAFE IN DEPARTMENT OF INSPECTION REQUEST LINE 777-7153 Owner SANTA ROSA TRAILS, LLC Contractor GRFXHAWK, INC, Permit Number 04-5617 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 57-524 ,SANTA ROSA TRAIT. SFD — LOT 18, PLAN 1C. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH TYPE OF INSPECTION DATE INSP. TEMPORARY POWER SETBACKS U/G PLUMBING / WASTE m U/G ELECTRICAL/ GROUNDING FOOTINGS / STEEL CONCRETE SLAB DO NOT POUR CONCRETE UN IL ABOVE SIGNED ROOF NAIL/ PRE -ROOF I f /9 /a r- 1 Z6 - OKAY TO WRAP os- FRAMING COMBINATION ROUGH ELECTRIC ;ROUGH PLUMBING f it ROUGH MECHANICAL INSULATION COVER NO WORK UNTIL AP OV SIGNED INTERIOR GYP. BD. DRYWALL 6/ EXTERIOR LATH GAS. TEST �- L SEPTIC ABANDONMENT SEWER CONNECTION 7 SEPTIC./ GREASE INTERCEPTOR MASONRY INSPECTIONS FOOTINGS / STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE / SETBACKS U/G PLUMBING U/G ELECTRICAL 'PRE -PLASTER (ALARMS/ BARRIERS) I . .: FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT 2. COMMUNITY DEVELOPMENT DEPT. .Z -16 - U FINAL / JOB COMPLETED i;V7 ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING •E �5�:. 's _w .-. htt'�i�Ti 'i4--_" iY4. -:. �ft^..T+l��A'&�'Y't.'Sii\ ".e i�. ?.�✓.M'.x i' �...1 ii `C:F3+'C '. -:.?�V t: ,GF.Kir �i.i._ 4"^^&:.�Y"i4�C�k�a-5.. -. :. h1.1 ah. .2-SP.'sn'1i 1s4W':'. -�:;. . k:..e6SL 4+J2^.f'6t3. -. P' - fdn° •f W% a.•C' Certificate of Occupancy 3 s��',r U = y • If,j ` 3 � ! � r"Co��� Ir Safety Department 0 9 BuildingY F 3 1 /" i This Certificate is issued pursuant to the requirements of Section 109 of the California Building 9Ji ' Code, certifying that, at the time of issuance, this structure was in compliance with the r provisions of the Building Code and the various ordinances of the City regulating building ! i•,I �I J construction and/or use. BUILDING ADDRESS: 57-524 SANTA ROSA TRAIL I7 i oyt ? Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-5617 rte! f7 ' # Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL r � Owner of Building: SANTA ROSA TRAILS, LLC Address: 40847 SANDPIPER CT = � J f i City, ST, ZIP: PALM DESERT, CA 92260 3 ; By: GARY HARTMAN 8 �; � Date: DECEMBER 22, 2005 Y V � Building Official { POST IN A CONSPICUOUS PLACE ,rd_�#a..9o._a: �:i'.�in:�.i-�-'�N6.�?��4-�'Y� rm7�.�+"tial,tt_erca5�0..c�"�+C'Kr.ti.��iBk:.vuF•&�b,�e'tt"SeTi.��r�.�w'9h�+t'�v�3v'.�3'�`e4c'��lUr»cc�GrA.'r�itd�n'Or3�'k-.. �-iPe;:��Y.�4�"h sN 3SSS� -rsty["'rPM�'ht�a".��..:�'3.�-'�.3�"�f-'-��":'.�sn i"'z 'r�hx�.�U"� i•�