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