04-3792 (SFD)BUILDING & SAFETY DEPARTMENT
c,°�"/<v`° P.O. Box 1504
(760)•777-7012
�`VOF ft�9 78-495 CALLE TAMPICO FAX (760) 777-7011
LA-QU A, CALIFORNIA
W 92253 INSPECTION REQUESTS (760) 7.77-7153
D
-BUILDING PERMIT
MAY 03 2004
Prp�p�l�i� .a d o .Number00=1:_A_03_7_9-2
Date "A 3 0/ 0 4
Pro ert�Ad°d'ress
57732 SANTA ROSA TR
APN:
762-240-0.13-26 -30487 -
Application description
DWELLING - SINGLE FAMILY
DETACHED
Property Zoning ... .
. . . . LOW DENSITY RESIDENTIAL
Application valuation
1.70892
Owner
---------------- - - -
Contractor.A
- -- ''1-------------
--
SANTA ROSA DEV
---.-- ..---
GREYHAWK, INC.
40847 SANDPIPER CT
.1603 .TRASK ROAD
PALM DESERT
CA 92260 ENCINITAS
CA 92024
(760) 634-1031
WCC: NONE
WC: EXEMPT
08/31/05
CSLB: 798228
08/31/05
CCC: B
--------------------------
Structure Information -------------------------
Construction Type . .
. . TYPE,V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/CONG <=10
.Flood Zone .. . . .
. . . NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION
2001CBC
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 . . . .
888.00 Plan Check -Fee
144.30
Issue Date . . . .
Valuation
170892
Qty Unit Charge
Per
Extension
BASE FEE
639.50
71.00 3.5000
THOU BLDG 100,001-500,000
248.50
----------
Permit
-------------------------------
MECHANICAL
-----
Additional desc
Permit Fee . . . .
130.50 Plan Check -Fee
,8.16
Issue Date,
Valuation . .
. . 0
Qty Unit Charge Per
BASE FEE
Extension
15.00
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:
Date:
Att, ect or En ineer�:
1 P-*- h- LA-+ q , L
Archit ct or En Ineer's Address:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty 11 perjury that I am licensed provisions Ch 9,(col�hencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my Licens in full force and effect. G! �LtiV(
License Class License No.
Date MAV3Tactor l .to 1 W)V__
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 fora 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 sate. 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. , B.& P.C. for this reason
Date
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 Calif ' Tee that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with th a pr s
V, -A,
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
1 hereby affirm under penalty of perju11ry that there is
a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
,,�<ends NameE
Len er's Address '319
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 certify that I have read this application and state that the abo ' format act. I agree to comply with all city and county ordinances and state laws relating to building
construction, and he authorize representatives of this unty to r u n above-mentioned property for inspection purposes.
Date Signature (Applicant or A
Page
2
Application
Number
04-00003792 Date
4/30/04
Qty
Unit Charge
Per
Extension
3.00
9..0000
EA MECH FURNACE <=100K
27.00
3.00
16.5000
EA MECH B/C >3-15HP/>100K-500KBTU
49.50
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
8.54
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
.00
15.0000
EA ELEC TEMPORARY POWER POLE
--------
.00
-----------------------------------------------
Permit .
. . . . .
---------------------
PLUMBING
Additional
desc
Permit Pee
. . . .
169.50 Plan Check Fee
9.66
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00-
5.0016.00
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
9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00
8.00
1.5000
EA PLB VACUUM BRKR >5
12.00
1.00
15.0000
EA PLB GAS METER
15.00
----------------------------------------------------------------------------
Permit
. . . . .
GRADING PERMIT
Additional
desc
Permit Fee
. . . .
15.00 Plan Check Fee
:0.0
Issue Date
. . . .
Valuation
0.
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
-------------------------------
Special Notes
-------------=-------------------------------
and Comments
SFD - LOT
26, PLAN 1/CT.
PERMIT DOES NOT
Oro,.,r
Page 3
Application Number . . . .
041-00003792
Date 4/30/04
----------------------------------------------------------------------------
Special Notes and Comments
.INCLUDE BLOCK WALLS, POOL, SPA
OR
DRIVEWAY APPROACH.75t 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
14.43
DIF
FIRE,PROTECTION-RES
97.00
GRADING PLAN CHECK FEE
.00
'
DIF
LIBRARIES - RES
225.00
DIF
PARK MAINT FAC - RES
.5.00
DIFPARKS,/REC
-*RES
502.00
STRONG MOTION (SMI) - RES
16.13
DIF
STREET MAINT FAC -RES
15.00
DIF
TRANSPORTATION - RES
1.098.00
Fee summary Charged
Paid Credited'
Due
Permit Fee Total 1324.59
.00 .00
1324.59
Plan Check Total 170.66
.00 .00
170.66'
Other Fee Total 2435.56
.00 .00
2435.56
Grand Total 3930.81
.00 .00
3930.81
Sent.8y: AMPAM-LDI;
57-732 Santa Rosa Trail
909 340 9668; May -12-05 8:50; Page 10/19
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The information provided on this form
is required; however, use of this form to provide the information is optionl.) After completion of final inspection, a copy must be provided to the building
department (upon request) and the building owner at occupancy, per section 10-103(b).
HVAC SYSTEMS:
Keating Equipment
Equip. Type
(pkg. heat CEC Certified Mfr, Make &
pump, etc.) Model Number
FAU CARRIER 58STX110122
FAU CARRIER SBSTX090116
Cooling Equipment
# of
Efficiency
Duct
Duct or
Heating Heating
Identical
(AFUE,ete.)'
Location
Piping
Load Capacity
Systems
[zCF-1R value)
(attic, etc.)
R -value
(Btu/hr) (BTU/Hr)
l
80.00/o
ATTIC
R4.2
110,000
1
80.0%
ATTIC
R4.2
90,000
ATTIC
R-4.2
60,000
A/C COND.
CARRIER 38BRC049000
1
Equip. Type
# of
Effeciency
Duct
Cooling Cooling
(pkg. heat
CEC Certified Compressor Unit
Identical
(SEER, etc)'
Location
Duct
Load Capacity.
pump, etc.)
Mfr. Name and Model Number
Systems
[2C&Ilk value]
(attic, etc.)
R -value
(Btulttr) (BTU/Hr)
A/C COND.
CARRIER 38BRC060000
1
12
ATTIC
R-4.2
60,000
A/C COND.
CARRIER 38BRC049000
1
l2
ATTIC
R4.2
48,000
I a reads greater than or equal to.
I, the undersigned, verify that the equipment listed above is: 1) is the actual equipment installed, (2) equivalent to or more efficient than that specified in the
certificate of compliance (Form CF -I R) submitted for compliance with the Energy Efficiency Standards for residential buildings, and (3) equipment that meets
or exceeds the appropriate requirements for manufactured devices (from the Appliance Efficiency Regulations or Pari 6), where applicable.
AMPAM LD1 Mechanical
Jennifer zu 5/11/2005 HVAC Subcontractor (Co. Name)
OR General Contractor OR Owner
NATER HEATING SYSTEMS:
Water CEC Certified Distribution If Recir- Rated Input Tank Efficiency Standby External
Heater Mfr Name & Type (Std, culation, # of Identical (kW or Volume (EF, RE) Loss (°k} Insulation R -
Type!# Model Number Point -of -Use) Control Type Systems Btu/hr) (8allons) value
FAUCETS & SHOWER HEADS:
All faucets and showerheads installed are listed in the Commisions Directory of Certified Faucets and Showenccads,
pursuant to Title -24, Part 6, Subchapter 2, Section 111.
I, the undersigned, verify that the equipment listed in the category above my signature is the actual equipment Installed and that the equipment meets or exceeds
the requirements of the Appliance Efficiency Standards. In addition, I have verified that the equipment is equivalent to or more efficient than the equipment .
specified on the Certificate of Compliance submitted to demonstrate compliance with the Energy Efficiency Standards for residential buildings.
Signature, Date
COPY TO: Building Department
HERS Provider (if applicable)
Building Owner at Occupancy
RCR COMPANIES
Plumbing Subcontractor (Co. Name)
OR General Contractor OR Owner
05/11/2005 08:48 951-686-8786
Wester
RESIDENTIAL
WESTERN INSULATION, PAGE 08/17
[ion L.P.
ONTRACTINC
4211 Latham Street - Riverside. California 92501 - Phone: (909) 686-8760 - Fax: (909) 686-8786
CFbR INSULATION CERTIFICATE
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24,
STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
TRACTIPHASE: SANTA ROSA TRAILS / PHASE 1
LOT 26
SITE ADDRESS: 57-732 SANTA ROSA TRAILS — LA QINTA, CA
------------------------------------------------------------------
CEILINGS:
BLOWN INSULATION
`
MANUFACTURER:
GREENFIBER
THICKNESS:
10.3"
R- VALUE: R-38
CEILINGS:
BATTS
MANUFACTURER:
KNAUF
THICKNESS:
12"
R- VALUE: R-38
CEILINGS:
BATTS
MANUFACTURER:
KNAUF
THICKNESS:
6'/," .
R- VALUE: R-19
INTERIOR WALLS:
BATTS
MANUFACTURER:
KNAUF
THICKNESS:
3 %a"
R—VALUE: R-11
GENERAL CONTRACTOR: GREYHAWK HOMES
BY.
TITLE:
DATE.
f
INSULATION CONTRACTOR: WESTERN INSULATION, L.P.
LICENSE NUMBER: 794484
BY:
TITLE: PRODUCTIq MAW—ER
DATE: . MAY 11, 2005
r (�
Certi cate of Occupancy
6(4p
f � _� L.c•_�R+7tn Cc
-
G� OF T'9w' Building & Safety Department
artment
a
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.
t
r
BUILDING ADDRESS: 57-732 SANTA ROSA TRAIL
d
Use classification- SINGLE FAMILY DWELLING Building Permit No.: 04-3792
t
'
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
ti
Owner of Building.- SANTA ROSA TRAIL, LLC Address: 40-847 SANDPIPER CT.
City, ST, ZIP: PALM DESERT, CA 92260
By: GARY HARTMAN
a'a~t Date: July 7, 2005
Building Official
POST IN A CONSPICUOUS PLACE