9907-142 (SFD)LICENSED CONTRACTOR 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 is in full force and effect.
License # Lic. Class Exp. Date
Date F', (' "Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S 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.
4( 1 have and will maintain workers' compensation insurance, as required by
S ction 3700 of the Labor Code, for the performance of the work for which this
permit is' issued. My workers'' compensation insurance carrier & policy no. are:
Carrier Policy No.
GLIDE
W" l:�axl.is W" ti r„�riAviv��%
(This section need not be completed if the permit valuation is for $100.00 or less).
() 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 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 � os, .pfovis_in
Date: + a' ` Applicant
warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to'$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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions. and restrictions set forth on. his
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 applicator agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 aH.City, and State laws relating to the building
construction, and hereby authorize representatives,of'this City to enter upon•
the above-mentioned propeIr
for inspection purposes. �
nature (Owner/Ager~ Dated`"-' 12
BUILDING PERMIT PER
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TRACT
DATE}��t3VALUATION �•1�0➢.�cf�f LOTstow
JOB SITE
ADDRESS
'169424-007
OWNER
CONTRACTOR / DESIGNER / ENGINEER
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CJOAR 5487
USE OF PERMIT
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RECEIPT
DATE
BY j /I%
�lr
D INA
INSPECTOR
I "
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
j
Underground Ducts
Forms 8 Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
_
Compressor
Insulation
Vents
Fireplace Ff.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath_
ZV
Final
_
Final
BLOCKWALPkOVAL6
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Waste Lines
Gas Test
Electric Final
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances Appliances
11f
Final
COMMENTS:
/
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
i A.
IV Emerald Roofing, Inc.
78-670 HIGHWAY 111, STE. 174
LA QUINTA , CA 92253
Lic# 770940
(7601347-9869
:NAME / ADDRESS I
MONTECITO AT PGA WEST
THE R.C. HOBBS COMPANY
55-487 SOUTHERN HII.LS
LA QUINTA CA 92253
PROPOSAL.,
DATE
PROPOSAL #
611/'00
1122
JOB ADDRESS
LOTS 1-11 ==O'HAGIN VENTS
DESCRIPTION
TOTAL
TO WHOM IT MAY CONCERN;
0.00
EMERALD ROOFING HAS INSTALLED AT MONTECITO HOMES AT PGA
WEST ,THE O'HAGIN VENTS AT THE FOLLOWING
ADDRESSES BELOW:
LOT # PLAN .# ADDRESS
# OF O'HAGIN VENTS
1 2 -AR 55.142 SOUTHERN HILLS
17
2 3 -BR 55-164 SOUTHERN HILLS
16
3 3 -CR 55-186 SOUTHERN HILLS
16
4 2 -CR 55-208 BIG SPRINGS LOOP
17
5 2-A 55-230 BIG SPRINGS LOOP
17
6 3-C 55-252 BIG SPRINGS LOOP
16
7 2-A 55-274 BIG SPRINGS LOOP'
17
8 2-C 55-296 BIG SPRINGS .LOOP
17
2-A 55-318 BIG SPRINGS LOOP
17
10 3-A 55-340 SOUTHERN HILLS
16
11 3-C 55-362 SOUTHERN HILLS
16
r.
J J
1 "
Jahn Jones; President
li
TOTAL $0.00
THE ABOVE PRICES, SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND
ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.
PAYMENT WILL BE MADE AS OUTLRff D ABOVE.
SIGNIATURE
I
JUN -02-2000 10:56 WESTERN INSULATION 909 686 8786 P.07i19
VMSTERN INSULATION 9 INC.
4211 Latham Street, Riverside, CWcwz is 92501
Tel. (909) 686-8760 Fax (909) 686-8786
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: MONTECITO - TRACT # 29004
LOT# 6
SITE ADDRESS: 55-252 BIG SPRINGS LOOP
E TERIOR V &M -
MANUFACTURER: Johns-ManvAle THICKNESS: 5 112" R -VALUE: R-21
C ILINGS: AT7+ SLOW
MANUFACTURER: Johns -Manville THICKNESS: 13" R -VALUE: R-38
CEILINGS: BATTS8LO W
MANUFACTURER: Gieenstone THICKNESS: 10.3" R -VALUE: R-38
----------------------------------------------------------------
QENERAL CQNTR CTOR: CENTURY AMERICAN DEVELOPMENT
LICENSE NUMBER;
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE:
DATE
AUG-07-2000�MON-12 25 PM SPATES FABRICATORS
j PATES
FABRICATORS • INC.
Residemtial. commercial & Floor l'russes
August 7, 2000
FAX NO. 7603974724
Re: Montecito Collection by R.C. Hobbs Co., Phase 3
To Whom It May Concern:
P.
02
,
3:
2v4--
6 V -
The roof trusses on Phase 3 of the Montecito Collection have been compromised by the
installation of roof -mounted vents called "O'Hagan". In the process of their installation,
the top cord of the trusses was cut as deeply as 1-%Z inches.
Spates Fabricators has provided 3 separate repair drawings (see attached), which will
cover all different types of trusses on this job that might have been compromised. Any
truss with a saw cut greater than '/4 inch MUST be repaired using the appropriate repair
drawing.
It is the sole responsibility of R. C. Hobbs Co. to assess the trusses, select the correct
repair drawing and procedure. It is their responsibility, as well, to oversee the
CORRECT repairs on these trusses. They are responsible for restoring the safety and
functioning of these compromised trusses.
Sincerely,
David Spates ,
Vice President
85-435 MIDDLETON STREET. THERMAL, CALIFORNIA 92274 - (760) 397-4122 - FAX (760) 397-4724
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS: 55-252 BIG SPRING
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9907-142
Occupancy Group: R-3 Type of .Construction: VN Land Use Zone: RL
Owner of Building: SOUTHERN HILLS LLC
Building Official
Address: 1430 E CHAPMAN AVE STE 100
City: ORANGE, CA., 92886
By: DANIEL P. CRAWFORD JR.
Date: 8/14/2000
POST IN A CONSPICUOUS PLACE