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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