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04-3785 (SFD)BUILDING &SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA,. CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153. BUILDING PERMIT to 0 3 C2 Application Number . . . . . r-04-0=0=0=0=3`785, Date 4/29/04 Property Address . . . . . 57851 SANTA ROSA TR, -',,c,' APN:762-240-013=-5---30487s--- Application description DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . LOW DENSITY RESIDENTIAL Application valuation,. 170892 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 2001CBC FIRE SPRINKLERS NO GARAGE SQ FTG 809.00 PATIO SQ.FTG 394.00 NUMBER OF UNITS.. 1.00 FIRST FLOOR SQ FTG 2583.00 ----------------------------------_ ----------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee 888.00 Plan Check -Fee'. 144.30 Issue Date . . . . Valuation 170892 Qty Unit'Charge Per Extension BASE FEE 639.50 71.00 3.5000 THOU BLDG 100,001-500,,0,00 248.50 Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 130.50 Plan Check Fee 8.16 Issue Date . . . . Valuation . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 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: Q 3 7B 5 Date: Applicant: ArctIect or Engine r:. -- Applicant's Mailing Address: _Arphitect or ngi er'Addkss: P4(V4 226D t—CN O.: 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 Codeand Licen in full force and effect. �� A Licensse Classss � e�nse ,No�.j G BateMAY C LirLxV utaJ `L—, 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 insurance carrier and policy number are: Carrier �workfor I certify that, in the performance of th this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia f I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those ovi 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 construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name (U13 7 �ders 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, indemnify 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 permit to cancellation. I certify that I have read this application and state that the above in a ' n is corr ree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize represe lives of this count o enter on ve entioned property for inspection purposes. ate ignature (Applicant or Agent): Page 2 Application Number . . . . . 04-00003785 Date 4/29/04 Qty Unit Charge Per Extension 3.00 9.0000 EA MECH FURNACE <=100K. 27.00 3.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 49.50 5.00 6.5000 EA MECH VENT FAN 32..50 1.00 6.5000 EA MECH EXHAUST HOOD. 6.50 ---------------------------------------------------------------------------- Permit . . ,. . . . ELEC-NEW RESIDENTIAL - Additional desc .L. Permit Fee . . . . 121.59 Plan Check Fee = 8.54 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00. 2583.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 90.41 809.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 16.18 .00 --------------------------------------------- 15.0000 EA ELEC'TEMPORARY POWER POLE .00 Permit . . . . . . PLUMBING ------------------------------- Additional desc Permit Fee . . . . 169.50 . Plan,Check.Fee 9.66 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 16.00 6.0000 EA PLB FIXTURE 96.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 8.00 .1.5000 EA PLB VACUUM BRKR >5 12.00 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 5, PLAN 1/CT. PERMIT DOES NOT. a Page 3 Application Number, ----------------------------------------------------------------------------- 04-00003785 Date 4/29/04 Special Notes and Comments INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH.75o 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 14.43 DIF'FIRE PROTECTION -RES 97.00 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 16•.13 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due --------------------------- Permit Fee Total 1324.59 ---------- -------------------- .00 .00 1324.59 Plan Check Total 170.66 .00 .00 170.66 Other Fee Total 2435.56 .00 .00 2435:56 Grand Total 3930.81 .00 .00 3930.81 Sent By: AMPAM-LDI; 1 Santa Rosa Trail 909 340 9688; May -12-05 8:52; Page 15/19 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). HVAC SYSTEMS: * of Effeciency Duct Cooling Cooling Heating Equiparent CEC Certified Compressor Unit Identical (SEER, etc)' Location Duct Equip. Type pump, etc.) N of Efficiency Duct Duct or Heating Heating (pkg. heat CEC Certified Mfr, Make 8c Identical (AFUE,etc.)' Location Piping Load Capacity pump, etc.) Model Number Systems [?:CF -IR value] (attic, etc.) R -value (Btu/hr) (BTUIW) FAU CARRIER 58STXI10122 1 80.0% ATTIC R-4.2 110,000 FAU CARRIER SSSTX090116 1 g0.o% ATTIC R4.2 90,000 Cooling Equiptnent 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-IRvalue) (attic, etc.) R -value (Btdhr) (BTU/Hr) A/C GOND. CARRIER 39BRC060000 1 12 ATTIC R-4.2 6Q000 A/C COND. CARRIER 38BRC049000 1 12 ATTIC R-4.2 48,000 12: reads greater than or equal to. I, 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 -1R) submitted for compliance with the Energy Efficiency Standards for residential buildings, and (3) equipment that meets or exceeds the appropriatereq ' for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable. AMPAM LDI Mechanical Jennife rvizu 5/11/2005 HVAC Subcontractor (Co. Name) OR General Contractor OR Owner WATER HEATING SYSTEMS: Water CEC Certified Distribution If Recir- Rated Input Tank Efficiency Standby Extemal Heater Mfr Name & Type (Std, culation, N of Identical (kW or Volume (EF, RE) Loss (%) Insulation R. Type/N Model Number Point -of -Use) Control Type Systems Btu/hrI (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 l 11. 1, 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. Signature, Date RCR COMPANIES Plumbing Subcontractor (Co. Name) OR General Contractor OR Owner COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy ` s 05/11/2005 88:48 ' 951-686-8786 WESTERN INSULATION :",PAGE 13/17 mmmmmma w R1 4211 Latham Street Riverm, ide. California 92501 - Phone: (909) 686-8760 - Fax: (909) 686-8786 CF6R IN3 a TION CERTIFICATE THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLI; 24, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: TRACT/PHASE: SANTA ROSA TRAILS / PHASE 1 ' LOT 5,851 SITE ADDRESS: ------------------------------------------------------------------- 57-817 SANTA ROSA TRAILS — LA OINTA, CA CEILINGS: MANUFACTURER: BLOWN INSULATION GREENFIBER THICKNESS: 10.3" R. VALUE: R-38 CEILINGS: BATTS MANUFACTURER: KNAUF THICKNESS: 12" R- VALUE: R-38 CEILINGS: MANUFACTURER: BATYS KNAUF THICKNESS: 6'/4" R- VALUE: R-19 INTERIOR—WALLS: BATTS MANUFACTURER: KNAUF THICKNESS: 3 Yi° R —VALUE: R-11 GENERAL CONTRAC OR: GREYHAWK HOMES BY: TITLE: DATE: INSULATION CONTRACTOR: WESTERN INSULATION, L.P. LICENSE NUMBER: 794484 BY: TITLE: PRODUCTION AOER DATE: MAY 11, 2005 Certificate of Occupancy W 5. T4'yl p � Iruosouirn ��� OP'I ��� Building Y p & Safety Department 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: 57-851 SANA ROSA TRAIL Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-3785 y 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