9907-139 (SFD)LICENSED CONTRACTOR DECLARATION
U) I hereby affirm under penalty of perjury that I am licensed under provisions of
I— Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04 W Professionals Code, and my License is in full force and effect.
O =) ch License # Lic. Class Exp. Date
e t
I W 478689 KI
e Contractoro Z r--
O�
Signature of
CD P- o OWNER -BUILDER DECLARATION
_J V
UJ W I hereby affirm under penalty of perjury that I am exempt from the Contractor's
~ U) License Law for the following reason:
Z_ ( ) 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).
C'')O I am exempt under Section B&P.C. for this reason
LO
N Date Signature of Owner
Orn
Z WORKER'S COMPENSATION DECLARATION
CL
C Q Z I hereby affirm, under penalty of perjury one of the following .declarations:
r P--; O () 1 have and will maintain a certificate of consent to self -insure for workers'
X w Y= compensation, as provided for by Section 3700 of the Labor Code, for the
mJ Q performance of the work for which this permit is issued.
Q C) I have and will maintain workers' compensation insurance, as required by
O 0 Q Section 3700 of the Labor Code, for the performance of the work for which this
d F- permit is issued. My workers' compensation insurance carrier & policy no. are:
Z Carrier Policy No.
0 O Cit�I.L1i�: T.� tlfa:f.&5 VT��^ fl`'-; 014$d0
Q (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
3 subject to the workers' compensation provisions of Section 3700 of the Labor
Code, all fq wi�j ornoy with thp' a t visloni
/ate:V i 7 pplicant <r 1A� f fi�;.� , L C
� 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 applicaton agrees to, & shall, indemnify
k 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 all City,,, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned grope / for inspection purposes.0.1
Signature (Owner/Agent) Date -
V . .
BUILDING PERMIT PERMIT#
> TRACT
DATE j01. �{R � p VALUATION Y&Y K,% LOTJOB
1 a ruVtf {
1
SITE
ADDRESS.C�9_'-A,r7.S42gM1
OWNER
CONTRACTOR / DESIGNER / ENGINEER
vraFf'tX kl. b f'f x Q if '{' P
s 1-^.'f.4A .. J,V L YM4iy,/;t/l.r4s
y� A
:2 i fJr l7i�Q •l1. w01?''�''fON1'.t
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7.9 PS 1 S' S 'r Y'1
1.4f q..-,o.1.t ,r.iA�L•,
1410 F Ci -I ii�z�lc`tiv".tlVE S 1.E '00554%0
i���. �3i.��
c:7R� N431? C.A. 92886
1..AQUINITA
CI
91253
C;1414
5487
USE OF PERMIT
��fvea'i, FE1MiL81 i elFdat i..Iiti1Ci
:�`F- f.,i ��' �i tN A: 4 2A PMAN3f.'k. D013^.. NOT I' 3C`ii}3 ,1�v,�: r4.K €�J t�Z'!: OR
4 YiS`. tisi!( C.'-C,`r.i�fS1"t<liE,"?'i�1i 3,0270.00 SF
c;�t►.4f.ACie�d.,11.#YtaL�ki"k' +4f.9.13(t �d�'
EST 11'�A►�'��:D CX 8T �J�' �Y NIS"�'�'�t�"';il:.r'-0,
25614 .01)
'O� ,"11tV" 1'1ON FENS f 01 4,fCDd3-4 1 SAM 5.1,189+ 01
MAN 47TIECK FRF J 0J _ 'V )-43%_31f.1 �i�4i!•i 'Ft>
'�)
ME'C H ATj7iCAL rUI ? 10 1, 40004211-CC13 i i 1. e0
"
&aLECT 41C Al, Fa,
PIL'Ut1W1:@ft3.F"HF, ).Ol -000-419-04 V
STROWO M,(Yrft )?rt' t,T-l'? ,. RFF A ? 01 -MIR -24140) $ w�,f^,•"+
i FJ `
c_11111 `VITV F FEE 101.-000-421-4f63C1
t5°V.C3lrf:.1£%'i►4�"S iF,s1„4D7.0
ART N WA,4i.il,' ;PI>Ai;ES -1 ESIV 7014}:1iA-25:%-0 � 11.1 F
F
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?k,AN 6, F QJK
TS
LESS PRE -PAID FE
$0,00
'A'A70`AL VER,i@IAT Ff;16S.Wfk,' NOW
,,/ J7
RECEIPT
DATE
BY !
ogEftINALqJD
/20
INSPECTOR
N
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
//
Ducts
Slab Grade
/
Return Air
Steel
A
Combustion Air
Roof Deck
0V
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
/ 7lO
Compressor
Insulation 3
Vents
Fireplace P.L. 7
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
3 2
/aZ
Final 4to
BLOCKWALL APPROVALS
Final
POOLS - SPAS
Steel
Set Hacks
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
I I
Gas Piping
PLUMBING APP OVALS
Gas Test
Electric Final
Waste Lines
/
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
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)
..5
Emerald Roofing, Inc.
78-670 HIGHWAY 111, STE.174
LA QMTA , CA 92253
L' Ic# 770940
(760)347-9869
INAM/ADDPXM
MONTECITO AT PGA WEST
THE R.C. HOBBS COMPANY
55-487 SOUTHERN HILLS
LA QUINTA CA 92253
PROPOSAL
DATE
PROPOSAL #
611'00
1122
JOB ADDRESS
LOTS 1-11 ==O'HAGIN VENTS
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 OUTLINED ABOVE.
i
SIGNATURE
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 HII.LS
17
?� 3 -BR
55-164 SOUTHERN HILLS
6.3
16.-
a' 3 -CR
55-186 SOUTHERN HILLS
16
4 2 -CR
55-208 BIG SPRINGS LOOP
1.=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
9 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
III
J
-
I
i
John Jones; President
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 OUTLINED ABOVE.
i
SIGNATURE
JUNr02-2000 10=55 WESTERN INSULATION
909 686.8786 P.04i19
i
WESTERN INSULATION, INC.
4211 Latham Suvct, Mvwsfde, Callf"M& 92301
Tel. (909) 68"160 Pax (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# 9
SITE ADDRESS: 55-318 BIG SPRINGS LOOP
€]C�R105 WAILS:
MANUFACTURER: Jahns Manville THICKNESS; 5 1/2" R -VALUE: R-21
CEILINGS: BAITS BLOW
MANUFACTURER: Johns -Manville THICKNESS: 13" R -VALUE: R-38
CEILINGS: BATTs CLOW)
MANUFACTURER: Greenstone THICKNESS: 10.3" R -VALUE: R-38
----------------------------------------------------------------
„CENER LL CONTRACTOR:' CENTURY AMERICAN DEVELOPMENT
LICENSE NUMBER:
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRO ON MA ER
DATE JU ,2000
I
Cerdricate, o',f 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
ollowing:BUILDING ADDRESS: .' , 55-318 BIG SPRING
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9907-139
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: SOUTHERN HILLS LLC Address: 1430 E CHAPMAN AVE STE 100
City: ORANGE, CA., 92886
By: DANIEL P. CRAWFORD JR.
Date: 7/20/2000
Building Official
POST IN A CONSPICUOUS PLACE
MW