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04-3750 (SFD)0 Tdf .4.4 a" BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPE.CTION_REQ=UESTS7(760) 777-7153 BUILDING PERMIT Qty Unit.Charge Per BASE FEE Extension 15.00 Application Number . . . . 04-000_0-1- -:Date 4/30/04 Property Address .. 57747 SANTA ROSA APN: 762-240-013=8---•=3048`7 - Application description . . . DWELLING -'SINGLE FAMILY DETACHED Property Zoning . . . . . .. LOW DENSITY RESIDENTIAL Application valuation 179157 Owner Contractor 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 2001CB.0 FIRE SPRINKLERS ( NO GARAGE SQ FTG 710.00 PATIO SQ ;-FTG 610. OQ,_ NUMBER OF UNITS- -_ 1.00`� FIRST FLOOR SQ FTG � 2747.00 ' Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 891.50 Plan .Check Fee 144.87 Issue Date Valuation . . . . 171191 Qty Unit'Charge Per Extension BASE FEE .639.50 72.00 3.5000 ---------------------------------------_-----'-------------------------------- THOU BLDG 100,001-500,000 252.00 Permit . . . . . . MECHANICAL..•, ._ ,. Additional desc Permit Fee . . . . 114.50 Plan Check. Fee 7.16 Issue Date . . . . Valuation . . . . 0 Qty Unit.Charge Per BASE FEE Extension 15.00 1 � P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 07- a Date: Applicant ,AfchitV or Engineer: y f&L,,-a Applicant's Mailing Address: Architect or En gInee 's Address: q4 -+D0 1VLe� ey �iu� Svt 2�1L �NO. 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 my Lic a is in full force and effect. �� �^ n cense Class -,cense NLo. (, 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 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 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 insu%nnrcarrier and policy number are: Cartier • "15olicy Number A ertify that, in the performance of the work for w h th' ertnit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califo a, an r A f I uld become subject to the workers' compensation provisions of Section 3700 of the labor Code, I shall forthwith comply with thos provisions. ate -A-..Ii ��— 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 pena t of perjury that there is a construction nding agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). �Lendefs Name [v- // ers Address P�� _`31 i6 9 a k/��� f� r �20�3 - /67v 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 abo mfo ati e I agree to comply with all city and county ordinances and state laws relating to building construc ' n, and hereby authorize representatives of this co my to ent up nth a ve-mentioned property for inspection purposes. Date ignat/S ure (Applicant or Agent u Page 2 Application Number . . . . . 04-00003750 Date 4/30/04 Qty Unit Charge Per Extension 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 6.00 6.5000 EA MECH VENT FAN 39.00 11.00, -------------------------------------------;--------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 125.35 Plan Check Fee 8.77 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2747.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 96.15 710.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 14.20 Permit . . . . PLUMBING Additional desc Permit Fee . . . . 199.50 Plan Check Fee 12.47 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 20.00 6.0000 EA PLB FIXTURE 120.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 2.00 7.5000 EA PLB WATER HEATER/VENT 15.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 10.00 ..7500 EA PLB GAS PIPE >=5 7.50 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 8, PLAN 2/CT.PERMIT DOES NOT Page 3 Application Number 04-00003750 Date 4/30/04 ------------------------------------------------------------------------------ Special Notes'and Comments INCLUDE BLOCK WALLS, POOL,. SPA OR DRIVEWAY APPROACH. 75% 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 14.49 DIF FIRE. PROTECTION -RES 97.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 6.00 DIF PARKS/REC - RES 502.00. STRONG MOTION (SMI) - RES 17.11 DIF STREET MAINT FAC -RES 15.00 DIF.TRANSPORTATION - RES 1098.00 Fee' summary ----------------- Charged ---------- Paid Credited Due Permit-Fee Total 1345.-85 ------------------------------- .00 .00 1345.85 Plan Check Total 173.27 .00 .00 173.27 Other Fee Total 2437.60 �.00 .00 2437.60 Grand Total 3956.72 .00 .00 3956.72 Sent By: AMPAM-LDI; 909 340 9688; 57-747 Santa Rosa Trail Site Address May -12-05 8:53; Page 17%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 option!.) 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). J r HVAC SYSTEMS: Xeadag Equipment Equip. Type # of Efficiency Duct Duct or Heating Heating (pkg. heat CEC Certified MR, Make di: Identical (AFUE,etc.)' Location Piping Load Capacity Pump, etc.) Model Number Systems [ZCF-1R value] (attic, etc.) R value (Btu/ht) (BTU/FIr) FAU CARRIER 59STXI10122 1 80.090 ATTIC R-4.2 110,000 FAU CARRIER 58STX090116 1 80.090 ATTIC R-4.2 90,000 Cooling Equipment Equip. Type # of EI%ciency Duct Cooling Cooling (pkg. heat CEC Certified Compressor Unit Identical (SEER, etc)' Location Duct Load Capacity pump, etc.) Mfr. Name and Model Number Systems [aCF-IR value] (atttc, etc.) R -value (Bwlhr) (BTU/Hr)A/C COND. CARRIER 38BRC060000 1 12 ATTIC R-4.2 60,000 AX COND. CARRIER 3BERC048000 1 12 ATTIC 2-4.2 48,000 12 reads greater than or equal to, 1, 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 1 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 LDI Mechanical izu 5/112005 HVAC Subcontractor (Co. Name) OR General Contractor OR Owner WATER HEATING SYSTEMS: Water CEC Certified Distribution IfRecir- Rated laput Tank 'Efficiency , Standby External Heater Mfr Name & Type (Sid, culation, # of Identical (kW or Volume (EF, RE) Loss (%) Insulation R - Type/# Model Number Point -of -Use) Control Type Systems 13tu/hr) (gallons) value FAUCETS & SHOWER HEADS; All faucets and showerheads installed are listed in the Commisions Directory of Certified Faucets and Showerheads, , pursuant to Title -24, Part 6, Subchapter 2, Section 111. 1, the undersigned, verify that the equipment listed in the catcgmy 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. RCR COMPANIES U Signature, Date Plumbing Subcontractor (Co. Name) OR General Contractor OR Owner COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy =:Cerifcto of Occupancy a?dy 4 OFT_ Building & Safety Department 1 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: 57-7.47 SANTA ROSA:-TRAIL Use classification: SFD - l ' . Building Permit No.: 04-3750 Occupancy Group: R3 Type of Construction: VN " . Land Use Zone: RL- Owner of Building: GREYHAWK, INCAddress: -1603 TRASK RD City, ST, ZIP: ENCENITAS,CA92024 r' By: GARY HARTMAN r �l b' Date. -30-2005 Building Official 'In Ll " POST IN A CONSPICUOUS PLACE