9907-135 (SFD)LICENSED CONTRACTOR DECLARATION'
I hereby affirm under penalty of perjury that I am licensed under provisions of -4 -
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
/ate f o Signature of Contractor---
OWNER-BUILDER.
ontractor 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) I.have and will maintain workers' compensation insurance, as required by
Section 3700 sof. 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 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
�jode, I shall forthwith comply with thos- ovisions.
Aate: t "Z''• : c 7 ' Applicant -�-j
Warning: rFailure to,secure Workers' Compensation coverage is unlawful and
shall subject'ari eri ployer 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.
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:l 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.
bS g ature (Owner/Agent)'" Date
PERMIT #
�- BUILDING PERMIT
DATE f VALUATION LOT �j TRACT 118776 .
JOB SITE, i -
ADDRESS f55-054r�.@.J1
APN
76941#42-2-
6941#42-OWNER
OWNER
-
CONTRACTOR / DESIGNER / ENGINEER
r -
C'PYrMAOr) k1 VVY 1 �.11 r
Ir..�t�a+ci,+.u• tt a.ia...,l. t.�t.,
f � i'inL�Ja)ie:iiiCvvria��c1A� iJ��liib,f j iN
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1 24 >4 �A 7ivV'% i .kA�l k. a 1 E 100
��^�Qi� .t. Uity 31L V 1.!
irI#ANt�x1q CA. 92886
LA QUIN•I'A. CA. 92253
USE OF PERMIT
5-114 i.t.3: FAMiLY L%WELl..NG
%ea -L: i W i lii i�it POW].T.��iuES NOT it+%,L'uO i.+^r4 K ,�.L i:,.ic
1'OUL.7 YP6PLAId 4.11kX:.Alii•:UVC 1'LfJN APPLIED F0Rt biJI:111 Lli SLI- INUl")'AL
1�)s IUL�Y til�..'�1i11k\E3l.i.��JIV `,!(f�i1�,17'>i3t'
.
citllc�ltar <ftlltC'C3it,'1' y3u.00 SY
PERMIT FRE SUMMARY
CON11'IMUCTIONFEE 101-000-418-000 so
PLAN ((-TFCL fTF 101-Qfln-439-i19
4lrs� lYA'v"ICAC 1701,33 1C:t.-0011421100O
ELi a :) f1 CAL, 'tT%E- io1-Oi}'ii420-M
!?U.fWINCYFhX 101 -000 -419 -#?U
51')Z.f)? �7 ?viCi'i T(1ptTXF, -1$I <SJO 10 1.11W_-?dt-fi()$23 9`7.
rIZiNDI,fC!1F . 10'1-000..:;23,1300 $20.00
FiL•'V1s"l.G:PHIR iAVA.C;`i 7'riE $ f;9t)1.Ot3
tt.R.'1' IN PUBLIC P.1 A.CEu - I E311; 701-000-255-W0 �_a4fi.l5
SI .ANT)T`'-NNf3')�W;K
1?A?i
A�l..ibl,i iY .1�^1'�"J�b •iaESS
�fl
11J,1
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
OPERATION
I DATE
I INSPECTOR
OPERATION
I DATE
I INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set BacksP I A
Underground Ducts
Forms &-2,//00 AJh
Ducts
Slab Grade
I Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap r7lffV
F.A.U.
Framing & :;ra 11 /�
Compressor
Insulation
Vents
Fireplace P.I.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall
7 —aftu Aeklx4P
Final
Final
BLOCKWALL APPROVA�§
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 0
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 F
Alkng
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:
f,NSIVU v1 Luvv uvn IL'w lit J1nLL'.J 1'npaLvniV(W
a•
PATES
FABRICA,rORS INC.
Residential, C:ommorcial & Floor Trusses
August 7, 2000
MA 11U. (OU0ZI N (e4 r. UL
Re: Monteeito Collection by R.C. Hobbs Co., Phase 3
To Whom It May Concern:
The roof trusses on Phase 3 of the Monteeito. 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-% inches.
Spates Fabricators has provided 3 separate repair drawings (see attached), which gill
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 ovcrsee the .
CORRECT repairs on these trusses. Whey ge responsible for restoring the, safety and
functioning of these compromised homes.
Sincerely,
David Spates
Vice President
I
0
85-435 MIDDLETON STREET. THERMAL, bALIFORUJA gig7,4 • (760) 397-4122'- FAX (760) 397-4724
u
OCT -19-2000 12:12 WESTERN INSULATION 909 686 8786 P.04/16
WESTERN INSULATION, INC.
4211 Latham Strict, Riverside, California 92WI
TCL (909) 686.8760 Fax (909) 686-8786
INSULATION CICATE
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 I 3A
LOT # 3;0,:
SITE ADDRESS 55-064 SOUTHERN HILLS, LA QUINTA, CA
-----------------------------------------------------------
EXTERIOR WALLS:
MANUFACTURER: GREENSTONE THICKNESS: 10.3" R -VALUE: R-38
CEILINGS: BATTS BLO
MANUFACTURER: JOHNS MANVILLE THICKNESS: 13" R -VALUE: R-38
CEILINGS: !�p
BLOW
MANUFACTURER: JOH S MANVILLE THICKNESS: 5.5" R -VALUE: R=21
--------------------------------------
GENERAL CONTRACTOR: R. C. HOBBS CO.
LICENSE NUMBER:
BY:
TITLE:
DATE:
INSULATION CONTRACT
NTR CT :WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: OFFICE MANAGER
DATE OCTOBER 19, 2000
C ertificate of Occupancy
City of La - Quinta
Budding and SafetDe artm_ent
y p . FoFti.
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: 55-054 SOUTHERN HILLS '
Use Classification: - SINGLE FAMILY DWELLING Bldg. Permit No.: 990.7-135
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: SOUTHERN HILLS LLC ` Address: SOUTHERN HILLS, LLC
City. 1430E CHAPMAN AVE STE 100
�a By: DANIEL P. CRAWFORD JR.
' x
Date: 1/22/01
Building Official
POST IN A CONSPICUOUS PLACE