The URL can be used to link to this page

04-5610 (SFD);` ., O� z BUILDING & SAFETY DEPARTMENT Pr� G-B•o�� 504 (760).777-7012 7.8=4.95..�GIILLE TAMPICO FAX (760) 777-7011 LA QUINT CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 AUG 04 2004 1 i b BUILDING PERMIT CITY OF LA QUINTA FINANCE DEPT. Application Number c04y„.00 005;610y� Date 7/23/04 Property Address 57628 SANTA ROSA TR APN: 762-240-013-22 -30487 - Application description DWELLING - SINGLE FAMILY DETACHED Property Zoning LOW DENSITY RESIDENTIAL Application'valuation . . . . 20*6412 Owner Contractor SANTA ROSA DEV GREYHAWK, INC. 40847 SANDPIPER CT 1603 TRASK ROAD PALM DESERT CA 92260 ENCINITAS CA 92024 (760) 6.34-1031 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..5000 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 V P.O. Box 1504 78-495 CALLS TAMPICO ��Gicv LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: '•• • ••• i NEWS' �� Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: Sf - 4 - b Architect or Engineer's Address: BUILDING PERMIT DECLARATIONS k 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 cede, and my Licgpse�. is in full force and effect. • 7 /License Class K Lse No. r_n %N C. 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 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 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 n� 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.,4f„ urance carrier and policy number are: arrier �` 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. 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 A 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. I 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 construction, tland eerr/eby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. O / s D " �gnature (Applicant or Agen . Application Number 04-00005610 Page 2 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 18.00 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 o 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 ------------------------------ .020.0 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 15.00 ------------------------------------------- Special Notes ----------------------------------- and Comments SFD - LOT 22 PLAN 3/CASITA. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR t Page 3 Application Number . . . . . 04-00005610 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 • a��tiu f�, � 1 C_atoof Occupancy%. Ortific OF�wJ 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: 57628 SANTA ROSA TR Use classification: SFD , ". Building.Permit No.: 04-5610 . Occupancy Group: R3. Type of Construction: VN Land Use Zone: RL Owner of Building: SANTA ROSA DEV LLC Address: 40847 SANDPIPER CT City, ST, ZIP: PALM DESERT CA 92260 , By: GARY HARTMAN dt"L Date: 1-26-06 Building Official POST IN A CONSPICUOUS PLACE