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04-5618 (SFD)- BUILDING & SAFETY DEPARTMENT P.O. 11 ��x=1504 (760):777-7012 10F 1t�`9 7'8-495 `ALLE TAMPICO FAX (760) 777-7011 r�. i� ,:. Au� 4 iCA Qut•NTA,. CALIFORNIA 92253 INSPECTION REQUESTS'(760) 777-7153 cls of LAQU1%,TA BVILDING PERMIT FItdAAcE D�P7. Application :Number'04 00;00.5618 Date 7/23/04 .Property Address .,.,-5-75-5'0'-""S'ANTA .ROSA TR �APN;:: 7:62-240-0.13=1.9 _34,087.,. - Application 'descr.iption..: ,;'DWEL.LING�. -S'INGLE FAMILY DETACHED Property Zoning ,LOW�;DENSITY RESIDENTIAL Applicat ion�.valuaaion. `168844 ;p Owner Contractor SANTA ROSA DEV ^'GREYHAWK, ' INC. 40847.SANDPIPER CT 1.6.03.TRASK ROAD PALM. DESERT' CA 92260, ENCIN.ITAS CA 92024 r• WCC: EXEMPT :., a"' �.... WCc EXEMPT 10/21/04. .0 798228: "08/31/05 CCC ' B -=-=---- -------- Structure Informati,on,:--- --------------------- Construction Type TYPE`.V 'NON RATED Occupancy Type,, DWELLG'/LODGING/LONG <'=10 Flood Zone NQN',A' O -FLOOD ZONE Other struct info CODE EDITIO14 2.001 CBC . # ;BEDROOM;S. 4.0.0 F. FIRESPRINKLERS. NO GARAGE SQ FTG, .809.00 PATIO SQ --FTG 394.00 .NUMBER". OF UNdTS'° 1.00 `{ : ` FG .00FIR Permit . . BUILDING PERMIT Additional des` Permit -,Fee 8,8.:1.00: Plan Check- Fee 143.16 Issue Date `.. Valuation . . . . 168844 Qty Unit Charge. Per Extension BAS E'FEE 639.50 69.00 .3:-'5000 'THOU BLDG.. 100,,0-01.-50.0;_000 241.50 Permit , MECHANICAL, Additional des` Per'' Fee 10.8 .0,0, Y Plan iCheck,.Fee' . 6.75 Issue Date " Valuation 0 Qty Unit Charge Per Extension 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: Applicant: Applicant's Mailing Address: S Date: �S ' q--(� �{ chitect or Engineer: _ 4 cid chc Aoou- -r;4,o sL, Architect or €ngineer's Address: ic. No. _S -DS 00 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 Licen sin full force and effect. ,,.,License icense C�ljass 'ss cense No. Date O ontractor_ C J1 � � % .✓�/ �l�( OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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.). U 1, 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: 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 lGforth 'th comply with those provisions. Rate r/, fCpplicant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVE L, 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 1 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 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 certity 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 upon the above-mentioned property for inspection purposes. /Date o /' nature (Applicant or Agen Page 2 Application Number . . . . . 04-00005618 Date 7/23/04 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 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'NEW RES - 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 6.0000 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 EA PLB LAWN 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 19, PLAN 1/CASITA. PERMIT DOES Page 3 Application Number 04-0,000.5618 Date 7/23/04 Special Notes and Comments NOT INCLUDE BLOCK,:.WALLS,,. POOL, SPA OR DRIVEWAY AP'PRbACH ... " 7 5 %. REDUCT_I:ON 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 DI,F CIVIC CENTER - RES; 366.00 ENERGY REVIEW 14.32 DIF FIRE PROTECTION=RES 97.00 GRADING 'FLAN SCHECK FEE .00 DIF LIBRARIES - RES 225.00 DIF:PARK"K INT FAC - RES 5.00 DIF-"PARKS/REC - RES 502.00 STRONG MOTION (SMI '7 RES 16.88 DI'F STREET",MAINT FAC`' -,°RE$, 15.00 DIF' TRANS P,O.RTF;T,I ON':- RES 1098.00 Fees summary d ChargePaid ' Credited Due -,=-- ,.�a."ry' Perm.t Fee Total.1292.09 -= ------------------------ 1292.09 -p-If Tan Check Total .00 .00 1'67.92 .00 .0.0 167.92 Other Fee ' Total 2436:20 . 00 . 00 2436.20 =;. Grand Total 3896.;21 .00 .00 3896.21 4a..; Lr i ✓t,C� � � .A J Contractor GRFVRAWK_ INC Permit Number 04-5618 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 57-550 SANTA ROSA TRAIT. SFD — LOT 19, 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 /o- 57 U/G ELECTRICAL/ GROUNDING FOOTINGS / STEEL CONCRETE SLAB i .. DO NOT POUR CONCRETE UN IL ABOVE SIGNED .'ROOF NAIL /PRE -ROOF / OKAY -TO WRAP 5s { 1 ERA51NG COMBINATION. :�:�;,�ROUGH ELECTRIC. UGH PLUMBING ROUGH MECHANICAL COVER NO WORK UNTIL -ABOVE SIGNED TH SEPTIC ABANDONMENT SEWER CONNECTION �' o `i S T• SEPTIC / GREASE INTERCEPTOR MASONRY INSPECTIONS BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE / SETBACKS U/G PLUMBING U/G GAS U/G ELECTRICAL PRE -PLASTER ALARMS / BARRIERS FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER MtGFiANIUAL."l.' .PUBLICpORKS DEPARTMENT /Z -/j . — , jZ COMMUNITY DEVELOPMENT DEPT.17 ^- (> FINAL / JOB COMPLETED /�_ �. /-,-- ABOVE -,r ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING 0� O CITY OF LA QUINTA _ - w BUILDING&=SAFETY DEPARTMENT of w INSPECTI,ONIREQUEST LINE 777-7153 �Owner •LSAANTA ROSA TRAILS, i,I,C Contractor GRFVRAWK_ INC Permit Number 04-5618 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 57-550 SANTA ROSA TRAIT. SFD — LOT 19, 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 /o- 57 U/G ELECTRICAL/ GROUNDING FOOTINGS / STEEL CONCRETE SLAB i .. DO NOT POUR CONCRETE UN IL ABOVE SIGNED .'ROOF NAIL /PRE -ROOF / OKAY -TO WRAP 5s { 1 ERA51NG COMBINATION. :�:�;,�ROUGH ELECTRIC. UGH PLUMBING ROUGH MECHANICAL COVER NO WORK UNTIL -ABOVE SIGNED TH SEPTIC ABANDONMENT SEWER CONNECTION �' o `i S T• SEPTIC / GREASE INTERCEPTOR MASONRY INSPECTIONS BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE / SETBACKS U/G PLUMBING U/G GAS U/G ELECTRICAL PRE -PLASTER ALARMS / BARRIERS FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER MtGFiANIUAL."l.' .PUBLICpORKS DEPARTMENT /Z -/j . — , jZ COMMUNITY DEVELOPMENT DEPT.17 ^- (> FINAL / JOB COMPLETED /�_ �. /-,-- ABOVE -,r ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING Certificate of Occupancy T4&t 4 4 Q" 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- Coale and the various- ordinances..of the City regulating building construction and/or use. BUILDING ADDRESS: 57-550 SANTA ROSA TRAIL Use classification: SINGLE FAMILY DWELLING Occupancy Group: R3 Type of Construction: VN Owner of Building: SANTA ROSA TRAILS, LLC ZA� Building Official Building Permit No.: 04-5618 Land Use Zone: RL Address: 40847 SANDPIPER CT City, ST, ZIP: PALM DESERT, CA 92260 By: GARY HARTMAN Date: DECEMBER 20, 2005 IN A CONSPICUOUS PLACE