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04-5609 (SFD)t in BUILDING& SAFETY DEPARTMENT P.O. Box 1504 (760),777-7012 78-495 CALLE TAMPICo FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS.(760) 777-7153 BUILDING PERMIT AppiII� a AUG V 4 X004 ---� tiaation Number . . �0-4�'''0�000�" 5609 Date 7/23/.04 Propertty_-IAddresslNTA• SANTA APN:� FINAIdCEDEPT. 57617 R08A TR 762-240-013-13 .-30487 - Appl•cationdescription . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . ... . . LOW DENSITY RESIDENTIAL Application valuation 206412 . t Owner Contractor SANTA ROSA DEV GREYHAWK, INC. 40847 SANDPIPER CT 1603 TRASK ROAD PALM DESERT CA 92260 ENCINITAS CA 92024 (760) 634-1031 WCC: EXEMPT WC: EXEMPT 10/21/04 CSLB: 798228 08/31/05 CCC: B -------------------------- Structure Information ------------------------- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info CODE EDITION 2.001 CBC . FIRE SPRINKLERS NO GARAGE SQ FTG 761.00 PATIO SQ FTG 481.00 NUMBER OF UNITS 1.00 FIRST.FLOOR SQ FTG 3236.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 1014.00 Plan Check Fee 164.78 Issue Date Valuation . . . . 206412 Qty Unit Charge Per Extension BASE -FEE .639.50 107.00 3.500'0 THOU BLDG 100,001-500,000 374.50 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 103.00 Plan Check Fee 6.44 Issue Date Valuation 0 Qty : Unit Charge Per BASE FEE Extension 15.00 i P.O. BOX 1504 78-495 CALLE TAMPICO VOICE (760) 777-7012FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number:— Sip 1� �J Lrrhitpt-f Date: - Li —O q Applicant: nr Fnninnor' w Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.:\V � �3 0 t$UILUINC7 PERMIT DECLARATIONS z L. 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 Lic a is in full force and effect. � 7� License Class ss icense No. Date - 4 Contractor CJ�� ��L✓ 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 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 contractors) 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 1 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 Y -p 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.). Lenders 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, 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. 1 certify that I have read this application and state that the above information is correct '1 agree to comply with all city and county ordinances and state laws relating to building ccoonstruccti�oUandhby authorize representatives of this county to enter upo above-mentioned property for inspection purposes. ate drSig (Applicant or Agen . Page 2 Application Number 04-00005609 Date 7/23/04 Qty. Unit Charge Per Extension 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU 1'8.00 7.00 6.5000 EA MECH VENT FAN 45.50 1.00. 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee 143.48 Plan Check Fee 8.97 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15_.00 3236.00 0350 ELEC NEW RES -'1 OR 2 FAMILY 113.26. 761.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 15.22 ---------------------------------------------------------------------------- Permit .. . . . . . PLUMBING Additional desc Permit Fee . . . . 164.25 Plan Check Fee 10.27 Issue Date . . . . Valuation 0 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 1.00 3.0000 EA PLB WATER INST/ALT/REP• 3.00 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 Qty Unit Charge Per Extension BASE FEE 15.0'0 Special Notes and Comments SFD - LOT 13 PLAN 3/CASITA. PERMIT DOES-,, NOT INCLUDE BLOCK WALLS,'POOL, SPA OR I Page 3 Application Number . . . . . 04-00005609 Date 7/23/04 -----------------------------------------------------------------=---------- Special Notes and Comments DRIVEWAY APPROACH.75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE. ---------------------------------------------------------------------------- Other Fees . . . . ... . . . ART IN PUBLIC PLACES -RES 20.00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE . 16.48 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 20.64 DIF. STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total -----=---- 1439.73 ---------- -------------------- .00 .00 1439.73 Plan Check Total 190.46 .00 .00 190.46 Other Fee -Total 2462.12 .00 .00 2462.12 Grand Total 4092.31 .00 - .00 4092.31 3 Gertiftcate"oOccu ancp Y. Aht 44Q OF 1'1 :. : 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 Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 57617 SANTA ROSA TR Use classification- SFD Building Permit No : 04-5609 Occupancy Group: R3 Type of Construction: VN Land Use Zone- RL Owner of Building- SANTA ROSA DEV Address- "40847 SANDPIPER CT } City, ST, ZIP: PALM DESERT CA 92260 By: GARY HARTMAN -�-� Date: 12-1-2005 uilding Of Ici POST IN A CONSPICUOUS PLACE 1101 C�� .. • ° of .- � � - � � .. R . � - ,� s ...�--�•( F FLA QUARTMENT•• _61Ui L -D1' Y F moo. 77-7012 - INSPE N REOUEST'LINE, "'- r�-- 7 7-7153 ..� Own r - ;ct Contractor__:_ - INC. Permit Number 04-5609 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES } 57617.SANTA ROSA TR > 'f JOB ADDRESS x ' SFD -LOT 13 PLAN 3/CASITA. PERMIT DOES, NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH/REPLACEMENT JOB CARD I TYPE OF INSPECTION DATE INSP. ` i TEMPORARY POWER j. SETBACKS ' U/G PLUMBING/ WASTE U/G ELECTRICAL /.GROUNDING FOOTINGS / STEEL ! CONCRETE SLAB DO NOT POUR CONCRETE UNTIL ABOVE SIGNED + ' j ROOF NAIL/ PRE -ROOF •� s OKAY TO WRAP I FRAMING COMBINATION I ROUGH ELECTRIC ROUGH PLUMBING_ ROUGH MECHANICAL INSULATION 6' COVER NO WORK UNTIL ABOVE SIGNED INTERIOR GYP. BD. DRYWALL },'• '' EXTERIOR LATH 5` of A GAS TEST SEPTIC ABANDONMENT " i SEWER CONNECTION, SEPTIC / GREASE INTERCEPTOR MASONRY INSPECTIONS • f FOOTINGS /STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS I PRE-GUNITE / SETBACKS U/G PLUMBING ` U/G GAS I U/G ELECTRICAL PRE -PLASTER ALARMS /BARRIERS) FINAL INSPECTIONS ` TEMP. USE OF PERMANENT POWER ELECTRICAL PLUMBING MECHANICAL j PUBLIC WORKS DEPARTMENT COMMUNITY DEVELOPMENT DEPT. - O•—OS FINAL / JOB COMPLETED ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TI IRN ON UTILITIES OR OCCUPY BUILDING.