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