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04-7377 (SFD)d Box 1504 15 CALLE TAMPICO UINTA, CALIFORNIA 92253 Application Number Property Address . . . APN: Application description Property -Zoning . . . . Application valuation . BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-00�_SAN �AR _ Date' 11/22/04 �5 7 7 5 8 SA TR 762-24-0-013-=27_ -30487 - . . . DWELLING - SINGLE FAMILY DETACHED . . . LOW DENSITY RESIDENTIAL 17,1778 Owner Contractor SANTA ROSA DEV GREYHAWK, INC. 40847 SANDPIPER CT 1603 TRASK ROAD PALM DESERT CA 92260 ENCINITAS CA 92024 (76.0) 634-1031 WCC: EXEMPT WC: EXEMPT 04/30/0E 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 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 766.00 PATIO SQ FTG 136.00 NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- FIRST FLOOR SQ.FTG 2709:-00 Permit .. . . BUILDING PERMIT Additional desc Permit Fe,e . . . . 891.50 Plan Check Fee 144.87 Issue Date Valuation 171778 Qty. Unit Charge Per Extension BASE FEE 639.•50 72.00 3.5000 THOU BLDG 100,001-500,000 252.00 Permit . . . . . . MECHANICAL s Additional desc Permit Fee 90.00 Plan Check Fee 5.63 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 9.0000 EA MECH'B/C <=3HP/100K BTU 18.00 5.00 6.5000 EA MECH VENT'FAN 32.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 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: d 4 ' 7 7 Date: ZZ •04 Applicant: tect or Engineer: Applicant's Mailing Address: E:r;chitAect or Engineer's Address: 4 --tic. 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 Co e, and my se is in full force and effect. -,cense Class -,cense No. TT AA ate 11 Z? U`� �torr�_�%L.IC /k/r 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. , B.8 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: Carrier 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 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. I agree to comply with all city and county ordinances and state laws relating to building construction, andhereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. ate ignature (Applicant or Agent): Page 2 Application Number . . . . . 04-00007377 Date 11/22/04 --------------------------------------------------------------------------- Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 125.14 Plan Check Fee 7.82 Issue'Date . . . . Valuation 0 Qty Unit Charge Per % Extension BASE F ' EE 15.00 2709.00 .0350 ELEC NEW. RES 1 OR 2 FAMILY 94.82 766.00- .0200 ---------------------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 15.32 Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 179.25 Plan Check Fee 11,*.20 Issue Date . . . . Valuation... 0 Qty Unit Charge Per Extension BASE FEE 15.00 18.00 6.0000 EA PLB FIXTURE .108.00 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 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM '9.00 9.00 .7500 EA PLB GAS -PIPE >=5 6.75 1.00 15.000'0 --------------------------------------------------- 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 - - - - - --- - - I - - - - - - - - - - - - - - - - - - - --- - - - - - ---- 7 - - - - - - SFD - LOT 27, 2709 SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCKWALLS, 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 Page 3 Application Number . . . . . `04-00007377 Date. 11/22/04. Other Fees . . . . . . . . . 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 17.17.. DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION'- RES 1098.00 Fee summary Charged Paid. Credited Due Permit Fee Total 1300.89 .00 00 1300.89 Plan Check Total 169.52 .00 .00 169.52 Other Fee Total 2436.66 _ .00 .00 2436.66 Grand Total 390.7.07 .00 .00 3907.07 lc--' CITY.OQUINTA BUILDING & S F TY DEPARTMENT 'r V ____--777-7012 V.s ..I- NSPE TION..REQUEST LINE k.Cf- _b0l 777-7153 Owner SANTA ROSA DEV Contractor GREYHAWK, INC. Permit Number 04-7377 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADdRESS 57758 SANTA ROSA TR SFD - LOT 27,2709 SF.'PERMIT DOES NOT INCLUDE POOL, SPA, BLOCKWALLS, OR DRIVEWAY APPROACH/REPLACEMENT JOB CARD TYPE OF INSPECTION I DATE I INSPP, TEMPORARY POWER SETBACKS U/G PLUMBING / WASTE U/G ELECTRICAL/ GROUNDING FOOTINGS / STEEL �- CONCRETE SLAB/ i_'F_.A. i— _ c� DO NOT POUR CONCRETE UNT i BOVE SIGNED ROOF NAIL / PRE -ROOF p �' OKAY TO WRAP FRAMING COMBINATION ROUGH ELECTRIC ROUGH PLUMBING ROUGH MECHANICAL COVER NO WORK UNTIL A OVE SIGNED INTERIOR GYP. BD. DRYWALL f EXTERIOR LATH ia- a 6- ��-- GAS TEST SEPTIC ABANDONMENT SEWER CONNECTION SEPTIC / GREASE INTERCEPTOR MASONRY INSPECTIONS FOOTINGS / STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE / SETBACKS U/G PLUMBING U/G GAS U/G ELECTRICAL PRE -PLASTER (ALARMS/ BARRIERS FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER ELECTRICAL PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT ee— COMMUNITY DEVELOPMENT DEPT. Z Zo O S M - FINAL / JOB COMPLETED /;, �z/. -- I ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING .r EXCertificate ,- of Occupancy 5 G� OFT1'�9� Building & Safety Department .i 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 kprovisions of the Building Code and the various ordinances of the City regulating building construction and/or use. V ' +• $' BUILDING ADDRESS: 57-758 SANTA ROSA TRAIL V f Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-7377 7 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL i I Owner of Building: SANTA ROSA TRAILS, LLC Address: 40847 SANDPIPER CT i ` City, ST, ZIP: PALM DESERT, CA 92260 r By: GARY HARTMAN r' Date: DECEMBER 22, 2005 t . Building Official d POST IN A CONSPICUOUS PLACE