9907-120 (SFD)2, 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
Z 47 8689 B -
,D a - j'1 ; ► " -Signature of Contractoro
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;7 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.
( v)- 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.
GOLD. E. -MOLE i°MX9770.1400
(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
Subjeci to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with -those provisions. '
Date: �_^ r Applicant-- ��
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706'
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety '
for a permit subject to ,the conditions and restrictions set forth on his
application.
1. Each person upon•whose behalf this application is made & each person'at
whose request and for whose benefit work is performed under or pursuant.to
any permit issued as a result of *this_ applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its - officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180.days'will subject permit. to cancellation.
I certify that I have read this application and state that the above information is
correct. I. agree to comply with all City, and State laws relating to the building
construction, and hereby, authorize representatives of this City to enter upon
the above-mentioned property for iin�spection purposes.
-
Signature (Owner/Agent) ��"' �-'� -"-- 'Date 7n
PERMIT #
BUILDING PiERMITDT
DATE �4y1i7'g� TRACT
1 � ��
ADDRESS I&�1J..lHER1i;>�iRiLS� �"
APN
OWNER • r- ' —_ - -- — — —
CONTRACTOR / DESIGNER / ENGINEER --: — -- -
sJ$. rflI "1141 "lit's LLC
R.C. t fO.BBS d a S01117HIERN .WLLS, .LLC:
1430 E C:HAPMAN AVE SaE, 100
35.960 PGA BLVD
ORANGE CA 92886
LA QUMTA. CA 92255
(714)631,7260 CRL# '54$7
USE OF PERMIT
S1' D - LOT 24 PLAN 3CR PERNIZT DOES NOT INCLUDEBLOCK 'tF1,1i , Oil
POOL. 75%PLAN E:1.1&;CK itl~.Ll-0010 IN APP):,1W FOR .MUL' .0-11,8 8WI\{1'.i.7AL
CUSTOA4 C,'?'.1031WC` 101% 3,37.x..00 SW
PCij CI-0ATIO 33.A.uU STS
QAjt.A. JEA, °ARj'OR. 7t)t1;ti0 SIF
t;S'.'IMr fLPID CaST OI+' C:ON�'t'I LKCTIONN
280,6-nx)
PERFtrI;F:T .FEE SUMMARY
C0N31'R0'C'1'I0N'•EH 1014X)0-418-000 3.00
KIAKCWICK ME 101 -000139 -SJR g�sr.n0
297C`t1:AN-RCAL V1133 101-000-421-0120 $.121.ii0
EI.BC 1 R1.CAL FEW 104-000-420-000
9:1.U1M BI NG H-6 101-000-419-000 $;ZG3.7a
`�"T0?c7Nf TviCYYt.tlyd'I�FP�. �:t~:Si€} ?04,OM-24'.1-000
C�<.r�1�27dC.mi? T31-at2ti.4t2-ooaMii.1
:l�1rsYELt:+a�.1�t it�•�ti:C;"I'i�F� �1;911T.a4
.
Att'1' j'N Kffttc PLACES - 70:1-000-255-000 345!.57
fiC1;3-TC)TAL C 0W59TRUC'TT0`Nf A,NY1) j)i:AN C j`fF:C.K
$���t.?f✓ ° !
..P'SS :PRE-PAIDFEUS
TOTAIe PERMIT FEk P.`�I DUB, lotO
�►43�Sf5.�
RECEIPT
DATE
BY '
DATE FINALED
INSPECTOR
L �•
:I
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
/p
Final
Final
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
Gas Piping
PLUMBING APPROVALS
If 1
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
A,
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
�eZ-tp
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:
OCT -.19-2000 12:15 WESTERN INSULATION' 909 686 8786 P.13i16
.n- . • 1 . ; - . j
WESTERN INSULATION INC.
' 4211 Latham Strcct, Riverside,,& fornia 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 COLLECTION= Z4. 28776 PHASE 3A
LOT'it - -
•SITE ADDRESS Cyd 922 SOUTHERN'HILLS;.LA QUINTA, CA '
-"=----------------- ------------------------------------------ .
EXTERIOR WALLS
MANUFACTURER::' GREENSTONE THICKNESS: 10.3"'.. R' -VALUE: R-38'
CEILINGg:` BATTS BLOW "
MANUFACTURER ; JOHNS MANVILLE THI NESSE 13" R -VALUE: R-38 ,
CEILINGS: ATTS, BLOW
MANUFACTURER: • I' JOHN NVILLE • -THICKNESS- ` 515" R -VALUE:. R-21,,;
----.-- ------- - ----- -- ;-.
GENERAL CONTRACTOR: R . C. HOBBS -CO. '
LICENSE NUMBER: '
9Y:
TITLE:
DATE:
'
INSULATION: CONTRACTOR:' WESTERN INSULATION, INC.
` LICENSE NUMBER: 481.278
,BY: k'
TITLE: OFFICE MANAGER t -
DATE OCTOBER 19, 2000
AUG -07-2000 MON 12.25.PM'SP'ATES FABRICATORS FAX N0. 76039,74724 P; 02+,
PATES
FASRICA"CORS ING.
Re:side.ruial. c:ornmercial & Floor "rrusse'.s
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 " 4'Hagans". 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.
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
'EMERALD ROOFING,
INC.
. '?
78-670 HIGHWAY 111, STE,
174
-
LA QUINTA, CA 92253
-
Llcense No. 770940
,r
(760)347-9869
October 26, 2000
MONTECITO AT PGA WEST
THE R.C. HOBBS COMPANY
'
55-487 SOUTHERN HILLS
LA QUINTA, CA 92253
TO WHOM IT MAY CONCERN; .
EMERALD ROOFING HAS INSTALLED O'HAGIN VENTS AT.MONTECITO HOMES
AT PGA
WEST. BELOW ARE THE ADDRESS AND NUMBER OF VENTS INSTALLED.
PHASE 3-A-TRACT#28776
LOT# PLAN# ' .
17
ADDRESS
# OF VENTS
3-C
54-768 SOUTHERN HILLS
16 "
18 3-A
54-790 SOUTHERN HILLS
16 '
19 3-C "
20
54-812 SOUTHERN HILLS
16
2-A
54=834 SOUTHERN HILLS
17
21 2-9
54-856 SOUTHERN HILLS
17
22 2-0 ,
54-878 SOUTHERN HILLS
17
23 2-A
54-900 STHERN HILLS
.
17
24 3 -CR
54-92280 UTHERN HILLS ,
16
PHASE 3-B TRACT# 28776
LOT# PLAN#
25
ADDRESS
# OF VENTS
3 -AR'
54944 SOUTHERN'HILLS
26 2-C
54-966 SOUTHERN HILLS
17
27 2-A
54-988 SOUTHERN HILLS
17
28 1-A
55-01.6 SOUTHERN HILLS
17
29 1-8
55-02 SOUTHERN HILLS
17
30 1 -CR
55-054 SOUTHERN HILLS
17
'31 " • 1 -AR
55.076 SOUTHERN HILLS
.17
.
t1
THANK.YOU,
'
-'JOHN
JONES
PRESIDENT
Certificate of Occdpanc
Cit of La Quanta s
ty
Building and ' Safety Depa'rtment OF _
This'Certificate issued pursuant to the requirements of ,Section 109".6f the;, Uniform=Bui/ding Code, -
certifying that, at the time of issuance, -this structure -was in comp/lance with the ,various ordinances
of the ;City regulating building construction. or use. For, the following.
BUILDING'ADDRESS: _ 54=922 SOUTHERN HILLS' .
Use Classification: SINGLE; FAMILY DWELLING Bldg. Permit No.: 9907-129
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_11
Date: 11/27/2000
•
Building Official _
POST IN A CONSPICUOUS PLACE' * ;