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04-3763 (SFD)a Q•� U BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO '' FAX (760) 777-7011 e L� QUIN riAA, C,ALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7.153 ,:BUILDING PERMIT. 14AT 0 3 200 l ^I- bio NU nber +3 Date 4/29/04 pp v,iE wti.4 - 0.0=0-0 3 7-6- rP opert`Addre . . . . 57836 SANTA ROSA TR APN: 762-240-013-29 -30487 Application description DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation 2,08860 Owner Contractor ---------------- - - - - -- ------------------ - - - - -- SANTA ROSA DEV oREYHAWK',�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/LONG <=10 Flood Zone . . . . . . NON-AO FLOOD ZONE Other struct info CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 761.00 PATIO SQ FTG 665.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 3236.00 ------------------------------------------------- --------------------------- Permit . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 1021.00 Plan Check;Fee 165.91 Issue Date . . . Valuation . . . . 208860 Qty Unit Charge Per Extension BASE FEE. 639.50 109.00 3.5000 THOU BLDG 100,0017500,000.,.. 381.50 ----------------------------------------_----------------------------=------- F Permit . . . . . . MECHANICAL Additional desc Permit Fee 118.00 Plan Check Fee 7.38 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE, 15.00 P.O. BOX 1504 •14 �� 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 ^ 3 %(c 3Date: � 3-�f Applicant: 1114rcp,teyct or Engineer: A c 1ICV Applicant's Mailing Addres :Architect o En sneer's Addres ic. 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 LicBe is in full force and effect. �]� /�► /License Class -,cense No. 'Date I .� n rector lit 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 insurance carrier and policy number are: Carrier Policy Number I certify that, in the performance of the work for which this it is issued, I shall not employ any person in any manner so as to become subject to the workers' compensationlaws of Califomi agree tth I become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with thos w rosions. WARNING: FAILURE TO SECURE WORKERS' COMPENSATIC{ 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 penaayy of perjurythat, theme is a construction ending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). /Lenders Namec-SCJ ' "C�✓' `'" wv � �GIh.�C� Lamers 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 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=ete I certify that I have read this application and state that I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of ove-mentioned property for inspection purposes. ate - ignat� ure (Applicant or A Page 2 Application Number 04-00003763 Date 4/29/04 Qty Unit Charge Per Extension 2.00 9.0000 EA MECH FURNACE <=100K 181.00 2.00- 16.5000 EA MECH B/C >3-15HP/.>100K-500KBTU 33.00 7.00 6.5000 EA MECH VENT FAN 45.50 1.00 6.5000'EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 143.48 Plan Check Fee 8.97 Issue Date Valuation . . . . 0 Qty Unit Charge *Per Extension BASE FEE 15.00 3236.00. .0350 ELEC NEW RES - 1 OR 2 FAMILY 113.26 761.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 15.22 ----------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 173.25 Plan Check Fee 10.83 Issue Date . . . . Valuation 0 Qty Unit'Charge Per Extension BASE FEE 15.00 17.00 6.0000 EA PLB FIXTURE 102.00 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 1100 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 9.00 .7500 EA PLB GAS PIPE >=5 6.75 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 29, PLAN 3/CT. PERMIT DOES i Page 3 Application Number 04=00003763 Date 4/29/04 ----------------------------------------------------------------------------- Special Notes and Comments NOT 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 22.15 DIF CIVIC CENTER - RES 367.00 ENERGY REVIEW FEE 16.59 DIF FIRE PROTECTION -RES 98.00 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 20.88 DIF.STREET MAINT FAC -RES 15:00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged ---------- Paid Credited Due Permit Fee Total 1470.73 ------------------------------ .00 .00 1470.73 Plan Check Total 193.09 1..00 .00 193.09 Other Fee Total 2369.62 .00 .00 2369.62 Grand Total 4033:44 .00 .00 4033.44 i Sent By: AMPAM-LDI; INSTALLATION CERTIFI, 57-836 Santa Rosa Trail 909 340 9688; May -12-05 8:49; Page'8/19 - 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 optioul.) 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- # of Effeciency Duct Cooling Cooling (pkg. heat CEC Certified Compressor Unit Heating Equipment (SEER, etc)' Location Duct Load Capacity pump, etc.) Mfr. Name and Model Number Systems Equip. Type # of Efficiency Duct Duct or Heating Heating (pkg. heat CEC Certified Mfr, Make & Identical (AFUE,etc.)' Location Piping Load Capacity pump, etc.) Model Number Systems [?CF -IR value) (attic, etc.) R -value (Btu/hr) (BTU/Hr) FAU CARRIER 58STX110122 2 80.00/0 ATTIC R-4.2 110,000 Cooling Equipment 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 [_>CF -IR value) (attic, etc.) R -value (Btu/hr) (BTU/Hr) AIC COND. CARRIER 38BRC060000 2 12 ATTIC R4.2 60,000 1 >_ reads greater than or equal to. 1, the undersigned, verify that the equipment listed above is: l) is the actual equipment installed, (2) equivalent to or more efficient than that specified in the certificate of compliance (Form CF -IR) submitted for compliance with the Energy Efficiency Standards for residential buildings, and (3) equipment that meets orex ropriate require nts for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable. AMPAM LD1 Mechanical 1e i".5/11/2005 HVAC Subcontractor (Co. Name) OR General Contractor OR Owner WATER BEATING 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 (%) Insulation R - Type!# Model Number Point -of -Use) Control Type Systems Btu/hr) (gallons) value FAUCETS & SHOWER BEADS: All faucets and showerheads installed are listed in the Commisions Directory of Certified Faucets and Showenceads, 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. RCR COMPANIES Signature, Date Plumbing Subcontractor (Co. Name) OR General Contractor OR Owner COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy 05/11/2005 08:48 951-686-8786 •` WESTERN INSULATION PAGE 06/17 4211 Latham Street • Riverside. California 92501 - Phone: (909) 686-8760 - Fax: (909) 686.8786 License 0 794484 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 29 SITE ADDRESS: 57-836 SANTA ROSA TRAILS — LA QINTA, CA ------------------------------------------------------------------- ILINGS: BLOWN INSULATION MANUFACTURER: GREENFIBER THICKNESS: 10.3" R- VALUE. R-38 CEILINGS: BATTS MANUFACTURER: KNAUF THICKNESS: 12" R- VALUE: R-38 FILINGS: BATTS MANUFACTURER: KNAUF THICKNESS. 6'/4 R- VALUE: R-19 INTERIOR WALL$: BATTS' MANUFACTURER: KNAUF THICKNESS: 3 %z . R—VALUE: R-11 GENERAL CONTRACTOR: GREYHAWK HOMES BY. TITLE: DATE: INSULATION CONTRACTOR: WESTERN INSULATION, L.P. LICENSE NUMBER: 794484 BY: TITLE: P1ODUCTION GER DATE: MAY 11. 2nnF �.a'�iuwt�Q.c ,- Certificate of Occupancy0 4 G� OFT9� Buildin & Safet Department 9► Y p 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: 57836 SANTA ROSA TRAILS Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-3763 F Occupancy Group: R3 Type of Construction: V -N Land Use Zone: RL Owner of Building: SANTA ROSA DEVELOPMENT Address: 40847 SANDPIPER CT. City, ST, ZIP: PALM DESERT, CA 92260 ` By: STEVE TRAXEL dt"t Date: APRIL 1, 2005 Building Official POST IN A CONSPICUOUS PLACE