9907-145 (SFD)LICENSED CONTRACTOR DECLARATION
1`6ereby 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
i',Professionals Code; and my License is in full force and effect.
License # Lic. Class Ezp. Date
478a9 13
D/ate �' �'! Signature of Contractor
L/ .. r�
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that) am' exempt from the Contractor's
License Law for the following reason:
( ). 1, 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).
O I am. exempt under Section , B&P.C. for this reason
Date Signature. of Owner:
WORKER'S COMPENSATION DECLARATION
I her affirm: underpenalty of :perjury, one of .the following declarations:
( ) .1 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.
ii'f :l.Ois �d ti./t,.Lr°�,.L ►�v".''�IU ;f�3`iiil)�+'I'�li: .
(This section need not be completed if the, permit valuation is for $.100.00 or, less).
(
i'll 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 witwo_se proly4sions. +
Date: U.. f '� ' Applicant li).i>. d Lti
'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 a's provided for. in Section 3706
of the Labor Code, interest and atto'rney'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'pumuant 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 certifythat 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.-
CM4
Signature (Owner/Agent)-_"1_ _1r'< Date
PERMT/t
BUILDING PERMIT rt-
° 5
DATE VALUATION LOT' TRACT.
JOB SITE_ Y��7�
ADDRESS .2 Si<0�1f7!6— xA1y v+IEV _ _ 0
APN 2
769,424 tp�}�
OWNER*
CONTRACTOR / DESIGNER / ENGINEER
SV"l.l.I.Rt.RIt' •� C"ALL,I a,✓`{,.�1...•.,, _
�f.�.. .'�S 1.1 .t+'Y.i..A111'.O�.L�,%...��•/GA C. •.�I ..i.MV}9 LLC
GRANGH CA 9-J03b
L.A. L�[J�N'6. ; .i:A 42;2"3
. (714)633-77-60 irBL :# 5487
USE OF PERMIT
SINGLE FAMiLVI MVLLi`Nt
3,0 - L' OT 3 .ItA N 3CR �ER!WIT :'&X -M N6T iN`i:Li3'uB E3Lom., OR
POOL,.79%9 KAJ:4 OWN'. RcDUC7101-1 APP}.•LK) FOR TvI:IJI 'i lf"j:1¢� `�`4tl3ialt'�"} e�F.
CUST021 l L"MSTRUi t'iON 3,3'72.0 S
POPIL'):'T/i" no 314.00 Sf r
GA,ttAUV0e1.PPOR'}` Ti ;slia SY .
..FSU • ..Nycos 0.. �6..'1l:Vr.*➢'.k.bU%+�4..yfa t� .._
780,6=20
�.;+./.`► y�'«j� y, ���t. ,�•�y q g�,i%'.kl�
.
�:l"»a>1f S'AIC<t3C,°{.'C�;1�'ri gr}�}} "qrJt•C?ilt!-41,i;4.-Ut3#i �:27'.}.�ti
F'r;A?d 101-(rWL439,AkC4t�.►
m:r Inde:liL j ° . t t :�c�-cam $18'9. 52
}'r.0 b�F3if 3'r; f0941*419-ow 1205.75
�'-
X.-FF,-f� 11i •ci—z,���.-ii(d".°`3.i6ft .
::'�! ,
A3�,`r YN t.-USL tC MAA, h 5 RESS f4)�-flip)- SvW3
ISt.I:'�b-"T't DUI, �'C�I+7L��.�OC MON PI�,r u
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RECEIPT
DATE
BY {
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms &Footings
/ !
Ducts
Slab Grade
,
I Return Air
Steel
4
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
3 2,( _
Compressor
Insulation
pa
Vents
Fireplace P.L.
i Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
i
Exterior lath
Drywall - Int. Lath
_
�!I
QP
Final
Final
/fid
POOLS - SPAS
BLOCKWALL
APPROVALS
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
v
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:
I
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)
AUG -07-2000 MON 12:25 PM SPATES FABRICATORS
SPATES
FABRICA"TORS INC,
Residential, Comrnercial & Floor -trusses
August 7, 2000
FAX NO. 7603974724
Re: Monteeito Collection by R.C. Hobbs Co., Phase 3
To Whom It May Concern:
e -
The roof trusses on Phase 3 of the Monteeito Collection have been compromise bythe
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 Y4 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
P. 02
85-435 MIDDLETON STREET, THERMAL, CALIFORNIA 92274 • 1760) 397-4122 • FAX (760) 397-4724
Emerald Roofing, Inc.
78-670 HIGHWAY 111, STE.174 '
A QIJINTA , CA 92253
is 770940
(760)347-x%69
]NAB� / ADDRESS
MONTECITO AT PGA WEST
THE R.C. HOBBS COMPANY
55-487 SOUTHERN Fm l S
QUINTA CA 92253 .
PROPOSAL.
DATE
PROPOSAL#
611x00
. 1122
aa� wnv�a rxa� c a, JrLl;ll'i1:A11VNJ ANL UVNVLHUM ARL WFIWAVFUKY AND
ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.
PAYMENT WILL BE MADE AS OUTLII4XD ABOVE
SIGNATURE r
DESCRIPTION
TOTAL {
TO WHOM IT MAY CONCERN;
I 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
iu ' 3 -BR
55-164 SOUTHERN HILLS
16 .,
'
-3-CR - = -'
55-186 SOUTHERN HILLS
16
i
2-6R
55-208 BIG SPRINGS LOOP
., 47
4 2-A,
55-230 BIG SPRINGS LOOP17
6 3-C
55-252 BIG SPRINGS LOOP
, r. 16
7 2-A
55-274 BIG.SPRINGS LOOP'
17
8 2-C
55-296 BIG SPRINGS.I.00P
17
9 2-A
55-318 BIG SPRINGS LOOP
17
10 3-A,
55-340 SOUTHERN HILLS
16
11, 3-C`
55-362 SOUTHERN HII.LS
16
r
John Jones; President
TOTAL $0.00
aa� wnv�a rxa� c a, JrLl;ll'i1:A11VNJ ANL UVNVLHUM ARL WFIWAVFUKY AND
ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.
PAYMENT WILL BE MADE AS OUTLII4XD ABOVE
SIGNATURE r
JUN -62-2000 10:57 WESTERN INSULATION 909 686 8786 P.10/19
INSULATIONS
��TE�t INce.
4211 Latham sheet, Riverside, California 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# 3
SITE ADDRESS: 55-186 SOUTHERN HILLS
EXTERIOR WA S:
MANUFACTURER: Johns -Manville THICKNESS: 5 112" R -VALUE: R-21
CEILINGS: BATTS ' BLOW +
MANUFACTURER: Johns -Manville THICKNESS: 13" R -VALUE: R-38
CEIL N S: BATTS BLOW
MANUFACTURER: Greenstone THICKNES . r R -VALUE: R-38
GE- ERAL CONTRACT -OR: CENTURY AMERICAN DEVELOPMENT
LICENSE NUMBER:
:BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PR I N MANAGER
DATE JUN ,2000
I
'APR Rg,0N TANDY 'r
�UILrj� 37630 Medjool Ave.
�G Al,,,Palmr-Desert, CA 92211
Office' (760) 772-7192
® Fax (760)• 772-7193
Pager (760) 776-3338
REGISTERED INSPECTOR'S WEEKLY,REP,ORT
TYPE OF
INSPECTION
PERFORMED
p
�/�
❑REINFORCED CONCRETE TRUCT. STEEL ASSEMBLY ❑
❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ OTHER
❑ REINFORCED MASONRY ❑ FIRE PROOFING
JOB LOCA*NDP�T:z
4,
Sov`lSEkN rG6-�. L Quc to CR
REPORT SEQUENCE NO.
TV 0 S UCTURE -
PERMIT NO.
DATE
DAY OF WEEK -
MATERIAL DESCRIPTION
ARCHITECT
IN SP CTOR
HRS. CHARGED
I
ENGINEER
n
ASSISTANTS
HRS. CHARGED
INSPECT ION
DATE
GENERAL CONTRACTOR I� J �s SUB
CONT `
RACTOR � J
3 -
DSS 6 c,��� �' o (8A_Ce_. (p(dqES 7p
8x -4-X 51Cot s
Effi ujeco(W& coVA_
LL) eoN (2
• 4
X t
I
'-COPY SENT TO CLIEN -ONTINUED
ON NEXT PAGE O
PAGE
OF _
CERTIFICATION OF COMPLIANCE
t
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS, SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
_SIGNATURE ( GIS R INSPECTOR' ,
DATE OF REPORT REGISTER NUMBER
-A
A01%
4uCypati. Y
Looe 6 f ,,, 'A our A I'
-(�-� .
C=
Iry.p-wuinta . x-�;a:_ - : y 4
a d`�:S fei .a :fie vart q- or �9``
I
This Certificate issued pqrsuant't6-'thb iequirements of Section',109,,o f the Uniform Building Code,
certifying- that, at the time of issudn'c'e; this structure was in comoliance'with the various ordinances
of the City regulating buildingconifruction or use. :For the following:,. -
BUILDING ADDRESS: 55-186 SOUTHERN HILLS
Use Classification: SING I LE FAMILY -DWELLING Bldg, Permit No.: 9907-145
Occupancy Group: li-,3 -Type, of, Construction: VN 'Lana Use Zone: RL
Owner of,Building: SOUTHERN HILLS LLd- 'Address: 1430E CHAPMAN AVE STE 100.
City: ORANGE, CA., 92886
By: DANIEL' P. CRAWFORD JR.
Date: 9/1/2000
Building Official
POST, IN A CONSPICUOUS PLACE