04-3761 (SFD)BASE FEE 15.00
BUILDING &.-SAFETY DEPARTMENT
P.O. Box
1504
(760).777-7012
��41 OJF 78-495
CALLE TAMPICO FAX (760) 777'-7011
A,,,,CALIFORNIA 92253 INSPECTION REQUESTS
(760) 777-7153
0 3 2004
BUILDING PERMIT
1Lq-&tz-gj--qq'. 11 U
e . . . . .
Date 4/29:/04
Prop
5794.0 SANTA ROSA TR
EYP
762-240-013-33 -30487
Application description
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
(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/LODOING/CONG,<=10
Flood Zone . .
. . . . . . NON -AO FLOOD ZONE
Other struct info
CODE EDITION
2001 CBC
FIRE SPRINKLERS.
NO
GARAGEISQ FTG
761.00
PATIO SQ FTG
865.00
NUMBER OFUNITS
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 100,0.,01-500.,000-
381.50
Permit . . . .
. . MECHANICAL-..
Additional desc
Permit F ' ee . .
. . �118.00 Plan Check Fee
7.38
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: 44 r3 76 Date:
Applicant: c ' ct or En i eer:
GtY �u&se. e
Applicant's Mailing Address- :4
t or Engine 's dd ess:
:AILi�r -1�-' �'�'eY
22 G-6
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 full force and effect. /7er b ZZ�
Lyse Class / License No. ! O
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 which 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 greethat, if I hould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those pr isions\
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHAEL-StIBJECT 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 'f that thnnere is a construction lendin agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name /t.7T'-�'F� `J9! r
Lender's Address �4 l��C (7C; �� ��/�yS O'J C&i 120(3 44 0
/ 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 information is I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize
representatives of this county en th a ove-mentioned property for inspection purposes.
ate plicant or Agent):
Application Number . . . . . 04-00003761
Page 2
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
Issue Date
Valuation
0
Qty
Unit Charge
Per
Extension
--------------------------------'--------------------------------------------
BASE
FEE
15.00
Special Notes and Comments
SFD - LOT
33, PLAN 3/CT.
PERMIT
DOES
Page 3
Application Number
----------------------------------=-----------------------------------------
. . . . .
04-00003761'
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
z 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 82/17
RESIDENTIAL
4211 Latham Street • Riverside. California 92501 - Phone: (909) 686-8760 - Fax: (909) 686-8786
License 0 794484
CFf R 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 33
SITE ADDRESS: 57-940 SANTA ROSA TRAILS — LA QINTA, 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 Y.- R- VALUE: R-19
INTERIOR WALLS: BATTS
MANUFACTURER: KNAUF THICKNESS: 3W R—VALUE: R-11
GENERAL CONTRACTOR: GREYHAWK HOMES
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, L.P.
LICENSE NUMBER: 794484
BY: 16
TITLE: . PRODUCTIO MANAGER
DATE MAY Y 11, 20 5
Sent By: AMPAM-LDI;
57-940 Santa Rosa Trail
909 340 9688; May -12-05 8:47; ' Page.4
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The infonnation 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). • y
HVAC SYSTEMS:
it of
Effeciency
Duct
Cooling Cooling
(pkg. heat CEC Certified Compressor Unit
Heating Equipment
(SEER, etc)'
Location Duct
Load Capacity
pum 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
[ZCF-1R value]
(attic, etc.)
R -value
(Btu/hr) (BTU/Hr)
FAU CARRIER 59STX110122
2
80.03%
ATTIC
R-4.2
110,000
Cooling Equipment
Equip. Type
it of
Effeciency
Duct
Cooling Cooling
(pkg. heat CEC Certified Compressor Unit
Identical
(SEER, etc)'
Location Duct
Load Capacity
pum etc.) Mfr, Name and Model Number
Systems
[2CF-1R valuel
(attic, etc.) R -value
(Btu/hr) (BTUIM)
A/C COND. CARRIER 39BRC5 0000
2
12
ATTIC R4.2
60,000
1 2 reads greater than or equal to.
1, 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 -IR) 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
J rzu 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 MG 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 HEADS:
All faucets and sbowerheads installed arc listed in the Commisions Directory of Ceded Faucets and Showerheads,
pursuant to Titic-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, l 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
COPY TO: Building Department
HERS Provider (if applicable)
Building Owner at Occupancy
RCR COMPANIES
Plumbing Subcontractor (Co. Name) ,
OR Genal Contractor OR Owner
- ,- Certificate of Occupancy
0FT9�� 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: 57-940 SANTA ROSA TRAIL
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-3761
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
Owner of Building: SANTA ROSA TRAILS, LLC 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