9907-147 (SFD)LICENSED CONTRACTOR DECLARATION
•1 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
AM
Date Signature of Contractor �1.00
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:
Camer Policy No. q
FAVI +' 14, W' 1 [- 4T't:tZ/ t"119
(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
Code, I shall forthwith comply with those proL
ns.
Date: , t • `%Applicant r >
r
/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
& 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 property,,,for inspection purposes.
Sig ature (Owner/Agent)—,• se �I Datt"���r ~% J
BUILDING PERMIT PERMIT#
DATE � ,,WALUATION LOT k TRACT
JOB SITE
ADDRESS: .titi) •.v_:
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,RECEIPT
DATE
BY i r r
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings Q
f /� _
Ducts
Slab Grade j
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
V
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wali Firewall
Exterior Lath
D II - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL
APPROV S
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
L(�
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
G
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)
AUG-07-2000 MON 12:25 PM SPATES FABRICATORS FAX NO. 76039747241 P. 02 :
. SPATES
FABRI.CA,r.ORS INC.
Residential, C:c�mmPrcial &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-% 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
71
Emerald Roofing,'Inc,
78-670 HIGHWAY 111, STE..174
11A QUINTA , CA 92253:
Lic# 770940
(760)347-9869
NAM/ ADDRESS
MONTECITO AT PGA WEST
THE R.C.. HOBBS COMPANY
55-487 SOUTHERN HELLS
LA QUINTA CA 92253
i
PROPOSAL
DATE
PROPOSAL #
6/1/'00
1122
JOB ADDRESS
LOTS 1-11 I�'HAGIN VENTS
I
I
i
DESCRIPTION
TOTAL
I 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'HAG1N VENTS
L1�-- 2 -AR, 55-142 SOUTHERN HILLS
17
2 3 -BR 55-164 SOUTHERN HELLS
16
3 3 -CR 55-186 SOUTHERN HILLS
16
4 2 -CR 55-208 BIG SPRINGS LOOP
5 2-A 55-230 BIG SPRINGS LOOP
17
6 3-C 55-252 BIG SPRINGS LOOP
f, " -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 HELLS
16
11. 3-C 55-362 SOUTHERN HELLS
16
r
1 ..
J
�hn Jones; President
TOTAL' $0.00
rnl� "UVE rMCKS, SYLUMICATIONS AND CONDITIONS ARE SATISFACTORY AND
ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED:
PAYMENT WILL BE MADE AS OUTLINED ABOVE.
G ,
SIGNATURE
JUN -02-2000 10:57 WESTERN INSULATION
909 686 8786. P.12/19
Jam• :A ° -
WESTERN INSULATION i INC e
4211 Lath= Street, Riverside, California 02501
Tel. (909) 686-8760 Fox (909)686-8786
I11iSULATIOrT CEYtTIFICA'E
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# 1
SITE ADDRESS: 55-142 SOUTHERN HILLS
-------'---------------------- -------------. --------------------
EXTERIOR WALLS;
MANUFACTURER: Johns -Manville THICKNESS: 5 112" R -VALUE: ,R-21
CEIL_ INGS BATTS BLOW ,
MANUFACTURER: Johns -Manville THICKNESS: 13" ' R -VALUE: R-38
CEILINGS: BATTS tO W
MANUFACTURER: Greenstone THICKNESS: 10.3" R -VALUE: R-38
GENERAL CONTRACTOR: CENTURY AMERICAN DEVELOPMENT
LICENSE NUMBER:
BY:
TITLE:
DATE:
INSULATION CONTMCTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
r
BY:
TITLE: PROOU N MAW&R
DATE JUNE 2tftO
..�Qccupancy
�,ertificate-'Odr
City
of La Quinta'Building and Safety Department
t
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: 55-142 SOUTHERN HILLS
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9907-1437
4
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.
�_.4 Date: 8/31/2000
Building Official
POST.IN A CONSPVCUOUS PLACE