05-1256 (SFD)T='
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' BUILDING & SAFETY DEPARTMENT
w� P.O. Box 1504 (7.60).777-7012
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F 78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
v !9 tion Number._ V5Y00A_01-2-5.6 Datee. 4/06/05
G� erty Address 79030 SHADOW TR
/ PN: 649-030-.069-20 -31310 -
\/ Application description DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . HIGH DENSITY RESIDENTIAL
Application valuation 171930
Owner Contractor
SANTA ROSA DEVELOPMENT INC MAFFEI, DAVID LETTERIELLO
46753 -ADAMS ST 1451 QUAIL STREET, #212
LA QUINTA CA 92253 NEWPORT BEACH' CA 92660
(760) 771-3345 (949) 863-9642
'WCC: STATE FUND
WC: .1620469-2005. 01/01/06
CSLB: 375176 11/30/06
CCC: B
------ Structure Information PLAN 1 W/CASITA (MARKET -RATE HOUSING) -----
Construction Type . . . . . TYPE V -'NON RATED
Occupancy'Type DWELLG/LODGING/LONG <=10
Other struct info . . . . . CODE EDITION 2001
# BEDROOMS 5.00
FIRE'SPRINKLERS NO
x GARAGE SQ FTG, 676.00
PATIO SQ FTG 293.00
NUMBER OF UNITS 1.00
x 1ST FLOOR SQUARE FOOTAGE 2706.00
-------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee 891.50 Plan Check Fee 144.87
Issue Date . . . Valuation . . . 171930
Qty Unit Charge Per Extension
BASE FEE 639.50
72.00 3.5000 THOU BLDG 100,001-500,000 252.00
------------------------------------------ ----------------------------------
Permit . . . . . . MECHANICAL
Additional desc
Permit Fee, . . 114-.50 Plan Check Fee 7.16
Issue.Date Valuation . . ... .0
Qty Unit Charge Per 'Extension
BASE FEE 15.00
3.00 9.0000 -EA MECH FURNACE <=100K 27.00
3.00 9.0000 EA MECH'B/C,<=3HP/100K BTU 27.00
6.00 6.5000 EA MECH VENT FAN 39x00
1.00 6.5000 EA MECH OTHER VENT SYSTEM 6.50
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: 05 - Jc25
Applicant:
Applicant's Mailing Address:
Date: *7, O S
ArchiteclI �W:
E
_
chitect or Engineer's Address.
ic. No.: 0
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under pena (of perjury that I am licensed under provisions of Chapter 9 (com encing with Section 7000) of Division 3 of the Business and Professionals
Code, and my License is b0full force and effect. �[
,,_11ticense Class "If�/� icense No.
/bate 1111' /��r�. / " /
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 oropeny 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 Owner.
WORKERS' C0:IPENS„TION' DECLARAT;GN
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
_'Vof 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
su d. M�rkers' ompensation i nce carrier agd�pq{icy r�u�r�p r
amer iPolicy Number 1 !ii 3'f (]�i �� — 2- 0 S
�I certify t at, iA the performance of the work for which this p rmi is is° s ed, I hall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
ate i pplicant
WARNING FAI RE 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.).
Lender's Name
Lender's Address - N
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 Ouinta, 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 correct. I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize re i5sentatives of this county to enter upon the above-mentioned property for inspection purposes.
DateSi! gnature (Applicant or Agent):
a
Page
2
Application Number . . . . . 05-00001256 Date
•4/06/05
------------------------------=---------------------------------------------
Permit . . . . . . ELEC-NEW RESIDENTIAL
Additional desc
Permit'Fee . . . 123.23 Plan Check Fee
7.70
Issue Date . . . . Valuation
0
Qty Unit Charge Per
Extension
BASE FEE
15.00
2706.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY
94.71
676.00 -.0200 ELEC GARAGE OR NON-RESIDENTIAL
13.52
------------------------------------------------------------=---------------
Permit . . . . PLUMBING
Additional desc'.
,
Permit Fee, 207.00 Plan -Check Fee
12.94
Issue Date Valuation . . . .
0
Qty Unit Charge Per
Extension
BASE FEE
15.00
20.00 6.0000 EA PLB FIXTURE
120.00
1..00 15.0000 EA PLB BUILDING SEWER
15.00
2..0.0 6.0000.EA PLB ROOF DRAIN12.00
2.00 7.5000 EA PLB WATER HEATER/VENT
15.00
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
1.00 9..0000 EA PLB LAWN SPRINKLER SYSTEM
-9.00/
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
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
--------------------------------=-------------------------7-----------------
Special Notes and Comments
SFD -LOT 20, PLAN 1B/CASITA, 2706 SF.
PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK
WALLS OR DRIVEWAY APPROACH. 751.
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
•
14.49-
E
Page 3
Application Number
. . . . .
05-00001256 Date
4/06/05
----------------------------------
Other Fees . . . .
. . . . .
-----------------------------------------
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
17.19
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
Paid Credited
Due
Permit Fee Total
----------
1351.23
------------------------------
.';00 .00
1351.23
Plan Check Total
172.67
.00' .00
172.67
Other Fee Total
2436.68
.00 .00
2436.68
Grand Total
3960.58
.00 .00
3960.58
E
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,- Certificate of Occupancy0 o
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G� OF'I'1'�9� Building & Safety Department
a
4
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: 79-030 SHADOW TRAIL, LOT 20
y:
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 05-1256
yY
Occupancy Group: R-3 Type of Construction: V -N Land Use Zone: RH
Owner of Building: SANTA ROSA DEVELOPMENT INC Address: 46-753 ADAMS ST
x
City, ST, ZIP: LA QUINTA, CA 92253
;
By: KIRK KIRKLAND
s
^b Date: MARCH 26, 2007
Building Official
POST IN A CONSPICUOUS PLACE
1e191l2pG Olt.:
GI�LB IIVT
o� BUIL & S TM
777-7012 • c,
IN TIONF(EQ.
777.7 3�
Owner 48TH &ADA , OR �QIIMTA '
CIE D
Contractor GROOVE C CTION
Permit Number 05-1256
POST ON J013 -IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES .
JOB ADDRESS 797030S. OW TRAIL
SFD — LOOT 20, PLAN 1B, PERMIT DOES NOT ,
rNCLUDF POOL, SPA,, BLOCK WALLS, OR
DRIVEWAY APPROACH •
TYPE OF INSPECTION DATE
TEMPORARY POWER INSP.
SETBACKS
• U/G PLUMBING / WASTE _
U/G ELECTRICAL/ GROUNDING
FOOTINGS /STEEL
' . CONCRETE SLAB --� •
DO NOT POUR CONCRETE UNTIL ABOVE SIGNED
ROOF NAIL I PRE -ROOF
OKAY TO WRAP
FRAMING COMBINATION G.
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH MECHANICAL
I
INSULATION
COVER NO WORK UNTIL ABOVE SIGNED
INTERIOR GYP BD.DRYWALL
EXTERIOR LATH -
GAS TEST ` -
SEPTIC ABANDONMENT
SEWER CONNECTION
SEPTIC / GREASE INTERCEPTOR
MASONRY INSPECTIONS
FOOTINGS / STEEL
BOND BEAM �=
POOL / SPA / WATER FEATURE INSPECTIONS
PRE-GUNITE / SETBACKS
U/G PLUMBINr.
PRE -PLASTER (ALARMS / BARRIERS
FINAL INSPECTIONS
TEMP. USE OF PERMANENT POWER -
ELECTRICAL
PLUMBING
MECHANICAL
PUBLIC WORKS DEPARTMENT
COMMUNITYDEVELOPMENTDEPT,
FINAL / JOB COMPLETED
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN -ON UTILITIES OR OCCUPY BUILDING