9903-080 (SFD)N I)
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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 U- 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.
;) 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 & policy no. are:
Carrier Policy No.
(This sect onneed not be'dompleted if the permit valuation is f6r $1100 00 o 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 Se ti n 3700 of the Labor
Code, I hall forthwith comply with those provisio S.
Date: 70-!q4 Applicant •4 1 l d
l
Warning: Failure to secure Workers' Compensation coverage is unla ul 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
& hold harmless the City of La Quinta, its officers, agents and employees.:r
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 property for inspection purposes.
Signature (Owner/Agent)rU14-�Dates +'%1
BUILDING PERMIT PERMIT#
9 03-0A0
DATE. VALUATION LOT TRACT
' e_0 ' % $262,641.90 Eta 29003
JOB SITE
APN
ADDRESS
f 6�►�kif 71✓�i3+i[i ijjl��'
'
769-530-007
OWNER
CONTRACTOR/DESIGNER/ENGINEER
13ROOKF'IELD HOMES SAN DIEGO INC.
BROOKFIELD HOMES SAN DIEGIO INC.
12565 PUNTE DET., MAK SUITE 200
12865 POINTE DEL MAR, SUi C , 200
DFL NIAR CA 92014•-3559
DEL riLAR CA 92014-38:
019IM-8500 C.13L f# 5350
USE OF PERMIT
LOT 15, PLAN 3, -SF i- P:EPOATT DOES NOT n4CLUDE BLOCK WALL OR
POOL. PLAN CI-MCK M REDUCED 75�� FOR NAILIPLC 1:5SUAN I.. OF
01 air
cusrcu cON rRucrrm 3,10x'(10 SF
PORCH fWl10 519.00 SP
GARACEICARPORT '-7.00 SF
F,SiIMA,T .1) CONT OF CUNS71'RUC"'.1'O:O
262,c 41. 0
Y
PCR1%11T FI;F SUMMARY
CONSTRUCTION FEE 101-000-418-000 $1.,210.40
11t AN CHECW� FEE 101•-00", 39.318
NJECHANICAL FRE to 1 _000-42 t -000 $941.00
ELliCITRIC'AL FW 10.1-000-420-000
P1.IJNIBII' GFrW 101.-000411.000 $tri2.75
sTRUNC31!vti rioN.FEE - REsiD 101-000=241.-000 S26.26
flRAt7titilc 101-000-4231-000 $.?0,00
1I`)f RA3TRUf TLfRIi FF9 225-000443-342 $5,754.13
SART 17.4 PUBLIC PLACFiS - RESIL 701.0130-255-000 1i406,60
SU4--TOTAL CONS0N'tglD .PIS W CHECK
APR 2.1 1999 IfOTAYL PC- RMI: r FUES DUF, NOW
S8.1.27.65
RECEIPT
DATE
I 'I
BY'
I DrSAL
INSPECTOR
V
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
"Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
InsulationApo,
kz
Vents
Fireplace P.L.
Grills
Fireplace T.O. ,
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
/0 6
Drywall - Int. Lath
Final
Final /
BLOCKWALL APPROVALS
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
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
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)
COMMENTS:
OCT -19-2000 12:15 WESTERN INSULATION 909 686 8786 P.15i16
r
WES'T'ERN INSULATION, INC.
4211 Latham Street, Rivereidc, CWilbmia 92501
Tei. (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 COLLECTION- 28776 PHASE
3A
LOT #
�2V' - I
SITE ADDRESS
54966 SOUTHERN HILLS, LA QUINTA, CA
EXTERIOR WALLS:
MANUFACTURER:
GREENSTONE THICKNESS: 10.3"
R -VALUE: R-38
CEM :
BATTS LO
MANUFACTURER:
JOHNS MANVILLE THICKNESS: 13"
R -VALUE: R-38
CEfLINGS:
S BLOW
MANUFACTURER:
JOHNS MANVILLE THICKNESS: 5.5"
R -VALUE: R-21
--------------------------------------
GENERAL CONTRACTOR:
R. C. HOBBS CO.
LICENSE NUMBER:
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY: (&�
TITLE: OFFICE MANAGER
DATE OCTOBER 19, 2000
AUG -07-2000 MON 12:25 PM SPATES FABRICATORS FAX NO. 7603974724 P. 02
PATES
FASRICA"TORS • INC.
Resideritial. Cornmercial & Floor "Trusses
August 7, 2000
Re: Monteeito Collection by R.C. Hobbs Co., Phase 3
To Whom It May Concern:
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-%a 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'/, 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
EMERALD ROOFING, INC.
78-670 HIGHWAY 111, STE. 174
25
LA QUINTA, CA 92253
26
License No. 770940
27
(760)347-9869
October 26, 2000
1-A
MONTECITO AT PGA WEST
1-B
THE R.C. HOBBS COMPANY
1 -CR
55-487 SOUTHERN HILLS
1 -AR
LA QUINTA, CA 92253
THANK YOU,
TO WHOM IT MAY CONCERN:
JOHN JONES
EMERALD ROOFING HAS INSTALLED O'HAGIN VENTS AT MONTECITO HOMES AT PGA
WEST. BELOW ARE THE ADDRESS AND NUMBER OF VENTS INSTALLED.
PHASE 3-A TRACT# 28776
LOT# PLAN#
ADDRESS # OF VENTS
17 3-C
54-768 SOUTHERN HILLS 16
18 .3-A
54-790 SOUTHERN HILLS 16
19 3-C
54-812 SOUTHERN HILLS 16
20 2-A
54-834 SOUTHERN HILLS 17
21 2-B
54-856 SOUTHERN HILLS 17
22 2-C
54-878 SOUTHERN HILLS 17
23 2-A
54-900 SOUTHERN HILLS 17
24 3 -CR
54-922 SOUTHERN HILLS 16
PHASE 3-B TRACT# 28776
LOT#
PLAN#
25
3 -AR
26
2-C
27
2-A
28
1-A
29
1-B
30
1 -CR
31
1 -AR
ADDRESS
# OF VENTS
54-944 SOUTHERN HILLS
16
54-966 SOUTHERN HILLS
17
54-988 SOUTHERN HILLS
17
55-010 SOUTHERN HILLS
17
55-032 SOUTHERN HILLS
17
55-054 SOUTHERN HILLS
17
55.076 SOUTHERN HILLS
17
THANK YOU,
JOHN JONES
PRESIDENT
S
Certificate of Occupancy.
City of La Quints
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: 55-866 BRAE BURN
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9903-080
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: BROOKFIELD HOMES SAN DIEGO
INC
Building Official
Address: 12865 POINTE DEL MAR, STE 200
City: DEL MAR, CA., 92014
By: DANIEL P. CRAWFORD JR.
Date: 12/14/2000
PICUOUS PLACE