9907-138 (SFD)'LICENSED CONTRACTOR.DECLARATION
thereby 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
B..OWW20f
c,Date Signature of Contractor,—'
.OWNER -BUILDER DECLARATIONi .
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 isnot 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.
( y I have and will maintain workers' compensation insurance, as required by
Sidon 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..: -
GOLi3i"N SAC LF, -fieri i°7'w' 1,400
(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 forthwithicomply with those provisions
Date: 4 12- + Applicant ' �f,1
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 madeto 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, agenfs,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.
a
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) AA-ej'�`��� Date 10
V
PERMIT#
BUILDINGPERMIT
. 'I29fif)•a
DATE LOT ,���.TRACTJOB
SITE
ADDRESS �q��. IM,wz _Ac c u
APN
OWNER
CONTRACTOR DESIGNER ENGINEER
SO JTIbN HILLS LLQ ,.
RIC: Ht")US d/aiolr,.jI �141.1,1S,
, .r, LC
14391; CfhkPhiA%i.AVE STE 100
55-9660 PGA 13LVD '
C)RANG L CA. 92W6
LA QUf'h TA . CES. 921-53
CBA '5487
USE OF PERMIT
OFD -1.0 10 1'1:A14 f.A P ERNUT :CXsES .\�Cii' 1140LU11A ix &K 'WALL OR
*f:�UL. i �,"a. 3..r�:t� CHIkeCt1;1;Fz.FSAfG"1'1'U:t+1 � 't.= FOli.MULTIPLE, SUBMIlTi L,
R�'<��Ki.\✓J,"7fR'�:�'�v.� ,U•.I,�.Sii7 #l.Ld .
GaiPL:i:41WCARP0, Wr 7I3ii.tAtf 3
. .9 ST-ASQ�f�.ari•.9�R.p COSTO.r`.OLWiS'1 :f•A?fJX
tl'n
PERii U FEE ST.DMM,s1, VV..
COMINTIR1.>IC1 .1171 )t+I t 8p, IQ I -(KK)- 4184031.,2'73. 1
p7.,!4N C'3- EC3 FEE 10e -OW-439-1 119 !j 24sQ,tt+'P
h
mr.+.'Gavu,41C.A'1•.1 i3 1 )if-•3tI^! 1') 5.1.24,00
W?CTRT..Ct11:.I"3si .. .. I014roo-420.00i`r
:€'I,Ub41i41i�r� �'�• @0.1.-ftt)€'�•4•i5A 4Li1 '�ii�5,'%�
�;;� �;� ,...,.,
�''�`ftl'�.'t�i(a ,�.'f{ f'i �{1l�'�!i��< �'t,�����t I'����,�,.�fR'"'00!14 • �1.c7 �!(�
++*y. 'X�' +'�
_",RAD WCI .trifn
i, VT:1 to IAl. !C ! fs2s t Sit iiia
ART IN PUBIAC •KA.0SSS•.tU-316
if
S'TAVTfA'.`XL C004S?'ROMION AND P'r,.AN CHBIrK
$4,458,"
T¢:@`e AIJ f'ER1ii6`1' f>i*,�:',� .4DVE'Now.
��i fl.9f3
RECEIPT
DATE
BYf+`/� , •..
DATE FINALED
INSPECTOR
V
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
i OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Steel
_
Return Air
Combustion Air
Roof Deck
'0 pa
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation _ O&Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wali Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final D
BLOCKWALL APPROV S
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
I
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
Gas Piping
_
j
Encapsulation
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: �J
.Emerald Roofing, Inc.
78-670 HIGHWAY.1111 STE.174
LLA QMTA , CA 92253'
1c# 770940
(760)347-9869
I .
NAME /ADDRESS
MONTECITO AT PGA WEST
THE R.C. HOBBS COMPANY
SSS -487 SOU TERN HILLS
QUINTA CA 92253
PROPOSAL
I M� AnuvL Mlk;LS, SPEGIVICATIONS AND CONDITIONS ARE SATISFACTORY AND
ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.
PAYMENT WILL BE MADE AS OUTLINED ABOVE.
SIGNATURE
k ' .
I• '
DATE
PROPOSAL #
6/1/'00
1122,
I M� AnuvL Mlk;LS, SPEGIVICATIONS AND CONDITIONS ARE SATISFACTORY AND
ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.
PAYMENT WILL BE MADE AS OUTLINED ABOVE.
SIGNATURE
k ' .
I• '
DESCRIPTION
TOTAL
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'HAGIN VENTS
1 2 -AR
55-142 SOUTHERN HILLS
17
2 3 -BR
55.164 SOUTHERN HILLS
16,
I 3 -CR
55-186 SOUTHERN HILLS
16
4 2 -CR
55.208 BIG SPRINGS LOOP
17
S 2-A
55-230 BIG SPRINGS LOOP
17
3-C
55-252 BIG SPRINGS LOOP
X' y 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-. r ;. _ 3-A
55-340 SOUTHERN HILLS
16
1 3-C
55=362 SOUTHERN HILLS
16
1
I
J
'
f
I ,
I
John
Jones; President
TOTAL. so.00
I M� AnuvL Mlk;LS, SPEGIVICATIONS AND 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 909 666.8786 P.03i19
WESTERN INSULATIONt INC.
4211 Lotbam Street, Fiverelde, Califorr►ia 92501
Tel. (9091686-8760 Fax (909)686-8786
INSULATION CERTIFICATE
THIS IS TO CERTIFY THAT INSULATION ALIFORNIA ADMINISTRATIVE CODE, TITLE AS BEEN INSTALLE6 IN CONFORMANCE 24,H
THE CURRENT ENERGY REGULATION,
STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
TRACT / PHASE: MONTECITO TRACT # 29004
LOT# 10
SITE ADDRESS: 55-340 SOUTHERN HILLS .
EXTERIOR WAL
MANUFACTURER: Johns -Manville THICKNESS: 5 1/2" R -VALUE: R-21'
CEILINGS:' TTS BLOW
MANUFACTURER: Johns- anville THICKNESS: 13" R -VALUE: R-38
CML112GSz BATTS GLOW
MANUFACTURER: Gteenstone THICKNESS: 10.3" R -VALUE: R-38
----------------------------------
-----------------------------
_GENERAL CONTR CTOR:_ CENTURY AMERICAN DEVELOPMENT
LICENSE NUMBER:
BY:
TITLE: -
-DATE:
IN$ATION CONTRACT R: WESTERN INSULATION, INC.
UL.
LICENSE NUMBER: 481278
BY:
t
TITLE:.PROD ION MAN ER
DATE JUNE UOOO
AUG -07-2000 MON 12:25 PM SPATES FABRICATORS FAX N0. 7603974724
SPATS
FABRICA"CORS INC.
Re:siderttial, "Commercial & Floor 'rrusse.s "
P.
02
;
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 compromi%ed.by the
installation of roof-rnounted vents called "O'Hagan&'. In the process of their installation, .
the top cord of the trusses was cut as deeply as 1-%Z 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. Itis 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
Q... pricate,01'''f Occupancy01
�-
city -0,f ta Quinta F
Building and :Safety Department
OF
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=340 SOUTHERN HILLS
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9907-138
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.
7—,t, Date: 8/10/2000
Building Official
`POST IN A CONSPICUOUS PLACE
j t
Q... pricate,01'''f Occupancy01
�-
city -0,f ta Quinta F
Building and :Safety Department
OF
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=340 SOUTHERN HILLS
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9907-138
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.
7—,t, Date: 8/10/2000
Building Official
`POST IN A CONSPICUOUS PLACE