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04-3762 (SFD)-4 1504 ALLE TAMPICO 'A, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760)'777-7153 Qty Unit Charge Per BASE FEE Extension 15.00 UApplic-ation Number Date 4/29/04 Property Address 57888 SANTA ROSA TR APN: 762-240-013-31 -30487— 30487 -Application Applicationdescription DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 208860 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: 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 'Chec'k-Fee 165.91 Issue Date . . . . Valuation 208860 Qty Unit' Charge Per Extension BASE FEE 639.50 109.00 3.5000 -----.-. THOU BLDG 100,001-500;:,000`: 381.50 Permit MECHANICAL.----------------------I-`--?-�------------- Additional desc Permit Fee . . . . 118.00 Plan Check Fee 7._38 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per BASE FEE Extension 15.00 A r P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: �L�- �� Z&A Applicant: Applicant's Mailing Address: Date: Engineer: Architect or Enginee 's ddress: .1 7f lw Lese.�—�— Cb4 � Z 6 CS 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 License isAfull force and effect. �� �ise Lnse Class d.J i ft 2-13 mate Con�tor are 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 Policy Number I certify that, in the performance of the work for ' h this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califom' , a agre that hould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those ovisio ,,,�e A44 3A/ 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.). / Lenders Name `-�')�• 1 /J��.� A Lend sAddress ,��� �.%A✓��j��AI ��—.A5D W. 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 can on. I certify that I have read this application and state that the abov formati is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this c my to enter u n the above-mentioned property for inspection purposes. /rJ'ate Signature (Applicant or Age •' 1 Y Page • 1 , i, Page 2 Application Number 04-00003762 Date 4/29/04 Qty Unit Charge Per Extension 2.00 9.0000 EA MECH FURNACE <=100K 18.00. 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 1.00 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 Is'sue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00` ------------------------------------------------------------- Special Notes and Comments --------------- SFD - LOT 31, PLAN 3/CT. PERMIT DOES Page 3. Application Number 04-00003762 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 .00 .00 193.09 Other Fee Total 2369.62 .00 ..00 2369.62 Grand Total 4033.44 .00 .00 4033.44 05/11/2005 08:48 951-686-8786 WESTERN INSULATION PAGE 04/17 Wast RESIDENTIAL ONTRACTING 4211 Latham Street • Riverside. California 92501 • Phone' (909) 686-8760 • Fax: (909) 686-8786 License # 794464 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 31 SITE ADDRESS. 57-888 SANTA ROSA TRAILS — LA OINTA, CA -------------------------------------------------------- CEILINGS: BLOWN INSULATION MANUFACTURER: GREENFIBER THICKNESS: 10.3" R- VALUE: R-38 CEILINGS: BATTS MANUFACTURER: KNAUF THICKNESS: 12" R- VALUE: R-38 CEILINGS: BATTS MANUFACTURER: KNAUF THICKNESS: 6'/." R- VALUE: R-19 INTERIO WALLS: BATTS MANUFACTURER: KNAUF THICKNESS: 3 Y27 R —VALUE: R-11 GENERAL CONTRACTOR GREYHAWK HOMES BY: TITLE: DATE: INSULATION CONTRACTOR: WESTERN INSULATION, L.P. LICENSE NUMBER: 794484 BY: k TITLE: PRODUCTION AGER DATE: MAY 11, 2005 Sent By: AMPAM-LDI; 909.340 9688; May -12-05 8:48; Page 6 57-888 Santa Rosa Trail C:.- AAAA.... . # '-6R 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 optionl.) 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 Equipment Identical (SEER, etc)' Location Duct Load Capacity 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 t;CF-1 R value] (attic, etc.) R -value (Btu/hr) (BTU/Hr) FAU CARRIER 58STX110122 2 80.0% ATTIC R-4.2 L10,000 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 [aCF-IR valuel (attic, etc.) R -value (Btu/hr) (BTU/Hr) A/C COND. CARRIER 388RC060000 2 12 ATTIC R4.2 60,000 1 2 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 appropriate requirements for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable. AMPAM LDI Mechanical 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 External Heater Mfr Name & Type (Std, culation, # of Identical (kW or Volume (EF, RE) Loss (95) Insulation R - Type/# Model Number Point -of -Use) Control Type Systems Btu/hr) (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 11 L 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 Certificate of Occupancy C OF'TBuilding & Safet Department 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: 57-888 SANTA ROSA TRAILS t Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-3762 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 Date: APRIL 1, 2005 Building Official POST IN A CONSPICUOUS PLACE