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