04-5615 (SFD)r
BUILDING & SAFETY DEPARTMENT
P.O: Box -1504' (760) 777-7012
C� p It _D- '8t--4,9'5-7C_)LF
E' I AMP I,GO FAX (760) 777-7011
—L•AUQuIN ' �; IC'ALIFORN�IA 92253 'INSPECTION REQUESTS (760) 777-7153
N
AUG 0 4,2004BUILDINGP,.ERMIT
;I'
CITY. OF LA QUINTA
Appld.c.art-�i!e"i Eg%I�m'ber . ' . . . 0"4 OS(Z T15 . Date 7/23/04
Property Address' 57539 SANTA ROSA TR
APN "` 762-,24,0-013715 -3.0;487 -
Application description~DWELL`ING - STNGLE.FAMILY DETACHED
Property Zoning,. LOK.DENSITY,RESIDENTIAL
Application: -valuation 168844`
Owner Contractor,.
SANTA ROSA DEV GREYHAWK, INC.
40847 SANDPIPER CT1:603' TRASK`ROAD
PALM DESERT CA 92260 'ENCINITAS CA 92024
(760),. 634-1.031
WCC: EXEMPT
WC :. ; `.: EXEMPT 10/21/04
'-CSL B; 798228 08/31/05
;CCC B
-------------------------- Structure...Informat.on` -------------------------
Construction Type .. . . . . TYPE V - NON' -RATED
Occupancy Type DWELLG/LODGING/CONG <=10
Flood Zone- . . . . : . NON-AO'FLOOD ZONE
Other struct info . . . . . CODE EDITION 2001 CBC
# BEDROOMS 4'.00
FIRE SPRINKLERS NO
GARAGE SQ.FTG 809.00
PATIO. SQ FTG,394.00
NUMBER -,OF UNITS 1.00
..FIRST •FLOOR SQ. FTG 2583.00
Permit BUILDING PERMIT
Additional desc
Permit Fee 881.;0.0 Plan Check.Fee 143.16
Issue Date Valuation . . . . 1,68844
Qty Unit -Charge. Per Extension
BASE FEE 639.50
69.00 3.5000 THOU BLDG 100,001-5001000 241.50
Permit MECHANICAL
Additional desc
Permit Fee 108�:,00e Plan Check Fee 6.75
Issue: Date Valua.ti`on 0
Qty Ur -it' Charge Per Extension
P.O. BOX 1504 •
" VOICE (760) 777-7012
78.495 CALLS TaMPlco FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: &/ S Date: 14 -0
Applicant: Architect or r�Engineer:
/rlictis Engineer,
Applicant's Mailing Address: Architect or Engineer's Address:
ni
Lic. No.:j�
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 License is in full force and effect./l
cense Class n! ✓�%i/ceensez�No.
Date Contractor
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 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 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.).
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 I am exempt under Sec. BA P.C. for this reason
Date Owner
WORKERS' 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:
Cartier 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' comperisation provisions of Section 3700 of the Labor Code, I shall
fort with comply with those provisions.
Date Of
Applicant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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.
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 Buildin. and SafeAPPLICty ACKNOWLEDGEMENT
9 y 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, 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
constructio , and eerreby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
ate��� re natu
g (Applicant or Agent):
Page
2
.Application Number
.
. . .
. 04-00005615 Date
7/23/04
Qty Unit
Charge
Per.
S
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
5.00
6.5000
EA'
MECH VENT FAN,}
32.50
1.00
6 .:5 0 0
E.A.
MECH . EXHAUST.' HOOD
6.50
Permit . . .
-
.
-------------------------------------------------
ELEC-NEW. RESIDENTIAL
+.
Additional desc
..
Permit Fee
121.59..
Plan Check. Fee
7.60
Issue Date .
. .
Val.uation
0
Qty Unit
Charge
'Per
Extension
BASE FEE
15.00
2583.00...0
, 350
ELEC NEW,RES -'1 OR 2 FAMILY
90.41
809.00
.000
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
6.0000
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
1.00
9.0000
EP;
PLB DAWN 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
Qty Unit
Charge,
Per
Extension
.BASE FEE
15.00
----------------------------=-----------------------------------------------
Special Notes
and Comments,
SFD - LOT' .16.,
PLAN 1/CAS,ITA.,PERMIT
DOES
J
Page 3
Application -Number:
. . . .
e
04-00.005615 Date
7/23/04
----------------------------------
Special, Notes and
i
J
Page 3
Application -Number:
. . . .
e
04-00.005615 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
- DI F,.COMMUNI'Y CENTERS=,RES
97.00
DIF. CIVIC CENTER- -.RES
366.00'
ENERGY REVIEW FEE,
14.32
DIF.`,FIRE PROTECTION -RES
t.
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
D`IF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION -.RES
1098.00
Fee summary
Charged
Paid Credited
Due
Permit Fee .To.tal
1.292.0.9
At .00
1292.09
Plan Check Total
167.92
.00 .00
167.92
Other Fee Total
243'6.20
.00 .0.0
2436.20
Grand Total
3896-.2i,**:`00
.00
3896.21
J
1, .
5 Tat
�. Certificate of Occupancy
.4j
I�3T•w,ro 4
s"a��MC�/
7
k
& Safety Department
OF Building Y p
,,
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
t'
provisions of the Building Code and . the various ordinances of the City regulating building;
construction and/or use..
.y
BUILDING ADDRESS: 57539 SANTA ROSA:TRAIL
T
Use classification: SFD Building Permit No.: 04-5615
k .
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RIL
k
Owner of Building: SANTA ROSA DEVELOPMENT Address- 40847 SANDPIPER COURT
City, ST, ZIP: PALM DESERT CA 92260
By: GARY HARTMAN
l6' Date: 12-8-2005
Building Official
POST IN A CONSPICUOUS PLACE
.._..
I
a •�o¢
s O QUINTA•.
UILDING &S DEPARTMENT
7 12
�P
IN SPE N R VEST LINE
• Off, G p�pT. 1:53
Owner S N A V
Contractor YHAWK; INC.
Permit Number 04=56,15._..
POST ON JOB IN, PLACE
INSPECTOR MUST -SIGN ALL APPLICABLE SPACES
JOB ADDRESS ' 57539 SANTA.ROSA TR
SFD - LOT.16, PLAN 1/CASITA. PERMIT DOES
NOT INCLUDE BLOCK .WALLS, POOL, SPA OR
DRIVEWAY APPROACH./REPLACEMENT JOB CARD
i
TYPE'OF INSPECTION DATE INSP.
TEMPORARY- POWER
SETBACKS
U/G PLUMBING / WASTE rZ/:Gv o c
iU/G ELECTRICAL/ GROUNDING
FOOTINGS/ STEEL
CONCRETE SLAB
DO'NOT POUR CONCRETE Vt4TIL ABOVE SIGNED.
j ROOF NAIL/ PRE -ROOF "'/ , r X7.5" 7
OKAY TO. -WRAP
I' FRAMING COMBINATION
j ROUGKELECTRIC -
ROUGH PLUMBING j
ROUGR MECHANICAL i
INSULATION
�.. COVER NO WORK -UNTIL ABOVE.SIGNED
GASJEST
I SEPTIC ABANDONMENT
SEWER'CONNECTION
SEPTIC / GREASE - INTERCEPTOR -
MASONRY INSOECTI
NTERCEPTOR-MASONRYINSPECTI
FOOTINGS / STEEL
BOND BEAM
POOL /.SPA / WATERFEATURE
PRE-GUNITE / SETBACKS
U/G PLUMBING
I. U/G.GAS
.INSPECTIONS
PRE -PLASTER (ALARMS J.BARRIERS) j j
`FINAL'INSPECTIONS
i TEMP. USE OF PERMANENT POWER
j ELECTRICAL
PLUMBING
MECHANICAL
i PUBLIC WORKS.DEPARTMENT // •Z 2 LLS
j COMMUNITY'DEVEL ,,; MENT DEPT I
FINAL;/ JOB•C.OM �f D _
IMEK-
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING