9907-137 (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
7 3 D'V 911,31
L-10/ate �; " Signature of Contractor
OWNER -BUILDER DECLARATION f
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 theirsold
compensation, will do the work,.and:the structure.is.not.intended or:offered for
sale (Sec. 7044, Business & Professionals Code).
( ) 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
C6de).
( )' 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 .Coale, for the
performance of the work for which this permit is•issued. ' `.;
I have and will maintain workers' compensation insurance, as required by
Sn 3700 of the Labor'Code, for the performance,of the work.for which this
epermit'is Issued. ,My workers compensation `insurance carrier & policy no. are:
Carrier Policy No. "
a tl.�3 i�C n 9d7'i0 40
(This section need not be'compieted 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 personin 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 forthwit , comply with§V
,thoseipio�isi6ns.
bate- 10, '• 1(Applicant` .�. h a .
AWarning:•Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to.$1'00,000;•in
addition to the cost of compensation, damages as provided for 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 bf 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. l
$Ignature' (Owner/Agent) _ Date
PERMIT# .
BUILDING' -PERMIT '
zr
DATE �0f1311"VALUATION, �f� ver _0 LOT h'i, TRACT
.290D4
JOB SITE
ADDRESS i�� Slu+;��r2r
APN
.OWNER
CONTRACTOR / DESIGNER / ENGINEER s
1430 E i:Ult MAIN k4,•VE M 100:
-55.960 PtIA HIND
E I2 +T4"x.�t CA 47 f`+
D: AQ;1Wr,,i*'�. -
i 92.253
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USE OF PERMIT
SW LAIPAMILYMILING
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RECEIPT
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
// Q
Ducts
Slab Grade
Steel
Return Air
Combustion Air
Roof Deck
/ _
E�fiaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
All
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVAL
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
,s
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
/ sp
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:
0
AUG -07-2000 MON 12:25 PM SPATES FABRICATORS
PATES
FABRICA"CORS INC.
Residential, Commercial .& floor 'rrusSes
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-% 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 Y4 inch MUST be repaired using the appropriate repair
drawing.
Ir 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 compromissod trusses.
Sincerely,
1A --A
David Spates
Vice President
85-435 MIDDLETON STREET. THERMAL, CALIFORNIA 92274 -(760) 397-4122 • FAX (760) 397-4724
F�merald Roofing, Inc.
7 -670 HIGHWAY 111, ST, E.174
LLAQy, VWTA 9 CA 92253
Lic# 770940
(71I60)347-9869
lNA11� /ADDRESS .
MONTECITO AT PGA WEST
THE R.C. HOBBS COMPANY
55-4.7 SOUTHERN HILLS
LA QUINTA CA 92253
PROPOSAL
DATE.
PROPOSAL #
6/1/:00
1122
JOB ADDRESS
LOTS 1-11 ==O'HAGIN VENTS
rn wnvv� rxtc ra, �r�c it 1c A1'tO1vS A1VD CONDITIONS ARE SATISFACTORY AND
ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.
PAYMENT WILL BE MADE AS OUTLINED ABOVE
SIGNATURE
DESCRIPTION
TOTAL
TO WHOM TT MAY
CONCERN;
0,00
EMERALD ROOFING HAS INSTALLED AT MONTECITO HOMES AT PGA
WEST ,THE O'HAGIN
VENTS AT THE FOLLOWING ADDRESSES BELOW:
�,; -��: Vis;'
� - :
!
..
•
LOT # PLAN #
ADDRESS
# OF O'HAGIN VENTS
1 • 2—AR
55.142 SOUTHERN HILLS
17
3 -BR
55-164 SOUTHERN HII.LS
16,
3 ; 3 -CR
55-186 SOUTHERN HII J S
10
E 2 -CR
55-208 BIG SPRINGS LOOP
17
5 ' 2—A_
55-230 BIG SPRINGS LOOP
17
61 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
1 . _- - _ , 3—C
55-362 SOUTHERN HILLS
16
f:
John Jones, President
TOTAL $0.00
rn wnvv� rxtc ra, �r�c it 1c A1'tO1vS A1VD CONDITIONS ARE SATISFACTORY AND
ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.
PAYMENT WILL BE MADE AS OUTLINED ABOVE
SIGNATURE
JUN -02-2000 10:55 WESTERN INSULATION 909 686 8786 P.0✓19
IUATERN INSULATIQNt INC.
4211 Latham Street, Riverside, California 92501
Tel. (909)686.8760 Fax (909) 686-8766.
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#
SITE ADDRESS:
11 1
55-362 SOUTHERN HILLS
-------------------------------------------------
EXTERIOR WADS:
MANUFACTURER:
Johns -Manville THICKNESS: 5 112N R -VALUE: R-21
CEILINGS:
TS BLOW
MANUFACTURER:
Johns -Manville THICKNESS: 13" R -VALUE: R-38
CEIUN6
BATTS OW
MANUFACTURER:
Greenstone THICKNESS: 10.3" R -VALUE: R-38
------------------------------------------------------------------
ENR L CONTRACT—OR: CENTURY AMERICAN DEVELOPMENT
LICENSE NUMBER:
'
BY:
TITLE:
DATE:
INSULATION ONT C OR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY: PAY, &to
TITLE: PROD ION MAN
DATE JUNE ,2000
a
icto ccu arc
City of.LaQuinta
Building and "Safety Department M OF TN
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 fol%wing:
BUILDING ADDRESS: 55-362 SOUTHERWHILLS
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9907-137
Occupancy Group: R-3 Type of Construction: VN Lan.d.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: 8/18/2000
Building Official
POST IN A CONSPICUOUS PLACE