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04-3749 (SFD)J T4hf 4 4 a" BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (.760).777-7012 OF- 78-495 CALLE TAMPICO FAX (760) 777-'7'0 11 '5,1, RA QUI A, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT MAY 03 2064 _ � M5 , -, N um e q;n, w, r"]1;'_A b Appl'- "' e W .4 - -r-e -J.. ? S a s . . 1. . - . . . . 57810 SANTA ROSA TR - Date 4/29/04 APN: 762-240-013-28 -30487 Application description DWELLING - SINGLE FAMILY DETACHED Propetty..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 (7 6 0) 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 710.00 PATIO SQ FTG .610.00 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 100,001-50,0,0.00.- 252.00 ------------------------------------------------------ Permit . . . . . . -------- MECHANICAL 7 ------- Additional desc Permit Fee 114.50 Plan Check Fee 7.16 Issue Date Valuation 0 Qty. Unit Charge Per Extension -BASE FEE 15.00 P.O. Box 1504 • n/ 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: Q % Date: -3 D Applicant: Lai:I.Citect or Enaineer: Applicant's Mailing Address: AFehitect 6r Engineer's Addres§: t_ c No.: 5b S 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 e, and my Licen s in full force and effect. License Class e No.22� / Date d Contractor 3_ee /WW 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 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 it ce carrier and policy number are: Cartier .-olicy 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 provision ate 11`'1 plicant Or WARNING: FAILURE TO SECURE W RKERS' 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 IIhhereby affirm under penalt of perjury (that there is as const coon len ing age cy for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). /vender's Name 9 t IT C,pr+�IKyV�.� Le er s Address 76 �b ` 0 C_.:4►�'� LSC. 2 fl43 f f� 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 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 informati rect. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to t above-mentioned property for inspection purposes. ate /" __Ag -nature (Applicant or Agent): 9 - Page 2 Application Number . . . . 04-00003749 Date 4/29/04 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 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ------------------------------------'-------7-------------------------------- 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 1.0.0 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 28, PLAN 2/CT.PERMIT DOES NOT 1j Page 3 Application Number . . . . 04-00003749. Date. 4/29/04 ---------------------------------------- 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 .0.0 .00 3956.72 05/11/2005 08:48 951-686-8786 WESTERN INSULATION PAGE 07/17 4211 Latham Street • Riverside, Califomia 92501 • Phone: (909) 686-8760 • Fax: (909) 686-8786 CF6R 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: TRACT/PHASE: SANTA ROSA TRAILS / PHASE 1 LOT 28 SITE ADDRESS: 57-810 SANTA ROSA TRAILS - LA QINTA, CA CEI— � BLOWN INSULATION MANUFACTURER: GREENFIBER THICKNESS: 10.3" R- VALUE: R-38 CEIL--- ING3' BATTS MANUFACTURER: KNAUF THICKNESS: 12" R- VALUE: R-38 FILINGS: BATTS MANUFACTURER: KNAUF THICKNESS: 6'/: R- VALUE: R-19 INTERIOR WALLS- BATTS MANUFACTURER: KNAUF THICKNESS: 3 Y:" R —VALUE: R-11 GENERAL CONTRACTOR: GREYHAWK HOMES BY: TITLE: DATE: INSULATION CONTRACTO LICENSE NUMBER: 794484 R: WESTERN INSULATION, L.P. BY: TITLE: PRODU=005 AN��ER�� DATE: MAY 11 �a��uwc�a,c Certificate of Occupancy I,4CM01AM .�oF9 Building & Safety Department z 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. ` of i BUILDING ADDRESS: 57-810 SANA ROSA TRAIL Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-3749 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL SANTA ROSA DEVELOPMENT Address: 40-847 SANDPIPER COURT City, ST, ZIP: PALM DESERT, CA 92260 . .�� By: GARY HARTMAN Date: MAY 17, 2005 Building Official POST IN A CONSPICUOUS PLACE