9907-132 (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
478689. 02/29121}(
C r,
ate Signature of Contractor.,,-_
OWNER -BUILDER DECLARATION.
I hereby affirm under penalty ofperjury that I 'am exempt from th6.Contractor's
License Law for the following reason: -
( ) '.I, as owne7of 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 urider'Section B&P.C. for this reason
Date Signature of Owner u
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:
Carver Policy No.
GOLDENIE MXIC 51.7701400
I •
(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 ariy 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 tho ej( rovi/ sions.
Daae: h—, '2 -' 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 fog 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
6orrect'.1 agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
theabove-mentioned property f�jrj'nnspec�tion purposes.
YSignature (Owner/Agent)-3�� " Date
BUILDING PERMIT PERMIT#_____
:DATE �„ p VALUATION SM9:9 474.. . LOT TRACT 1*28776
t,.•. 12 2� / �y
JOB SITE 54-98 " 8
ADDRESSS
APN •1.f2�-�U'1 0-6119
OWNER
CONTRACTOR / DESIGNER / ENGINEER
ST0il:I'°4 RJii HILLS LC
R,C C•:CBBS &a. S OLT H M. N :HILLS; LLC
JANE %:H.r%P&,It1N AVF STE. 100
55460 Pisa .i3.LVI)
G31a %<jZrl� d'.A 92886
'IA C)UINI'A. CA 92253
(714) 133-12MI 0131..0 W
USE OF PERMIT
SIN61.1 FAtVIIL1 OW1 L.L1NU
. M - LOT 27 PLAN 2AIP.&Uff 00tS NOT INCL UDE BLOCK WAi L OR
1{(J0.i .75°!u PLAN 4 HW1ti' RED ICfJON At%P), FA-) r' )R MCILTI'PI.H ISUBM14111fiL
CUSTtr'+.NT CONI Si'WUMUi4 3.07 5.00 Sr
PCif2CIff"x1.',00 31410.N SF'
GAAAGUT CAft1'C)RX 810.00 °u"F
€EISMI :c'.E9 SUMMARY
CONS'6`1ZMIT1;Ci1iFEE 1014M-418-000 $1.199.50
�
Pr,AN('111FCK M, 3 101-000-439-318 $244.37
Air,a tKX(CM,, FE C 10:1-000-421-000 $111. Jo
ELEC'I'I1.ICA UM 1.0.1-0t7t 420-000 $18.1.133
Ia1:1JWfJ 1NZ+'t'F E: 1.01-000-4.19-000 $1.ff5.5U
ti l'i;(>Nf i ,Mii�'f'.iC1N F:Zi.f - RES$ D 0 i) t dilifl-241 4KY) $75.97'
CRA. 1114C? F023 10,1-000.423,000 $:10,00
'Des'i+E10PER. iNIPACT FIR1? $1,901.1x:1
.
AR!r f PUT -61. KX,S - RESU3 7014A)0-25.54XX) 5399.19
1.03-1POTAI, CC)NMIJCI`€ON AND PLAN CH CK
K'235.3,5
LESS FIXE••1'r'LILI FEES
$0.00
'3O AL 61C&tE09I'I."'1+'E;E04 ff3UE'NO W'
S4;I7:i.:16
S
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 01
Return Air
Steel
Combustion Air
Roof Deck (p
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing Gi�LrL
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
Final
Final
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 I 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
Encapsulation
Gas Piping
Gas Test
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)
',9CT-19-2000 12:15 , , WESTERN INSULATdON 909 686.8786` R. 16/16.
" fl �iipE�ST�RIv -INSULATION INC.
r 4211 Latham Street, Riversidc, C%UorWa 92501
If ` TeL (909);686.8760 Fax (909)686-8786
-, Ii1 gULATION CERTIFICATE �
THIS'IS TO CERTIFY, THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH,
THE.CURRENT ENERGY REGULATION, CAI.IFORNIA,ADPAINI5TRATIVE'CODE, TITLE 24,`
STATE OF CALIFORNIA, IN ;THE BUILDING LOCATED AT: a
TRACT 1 PHASE: , MONTECITO COLLECTION- 28776°PHASE 3A ,
LOT #j..
SITE ADDRESS 54-988.'SOUTHERN HILLS, LA'QUINTA, CA
�EXTERIORW-LLS:t
-
- —- ——- -———- ———— -———---———-----
MANUFACTURER:' GREENSTONE.... THICKNESS: ' 10.3" R—VALUE: R-38
CEILING > . BATTS , . • ` LOW
a. MANUFACTURER`:' JOHNS, MANVILLE` THICKNESS: � 13" ` . R -VALUE: R;36 `
CEILINGS!' t r TT BLOW
'
':,MANUFACTURER -t- JOH ANVILLE THICKNESS:. ; 5.5" • R=VALUE: R-21
`. GENERAL CONTR/AC 'OR:_ R . C. HOBBS CO. ,
LICENSE NUMPER -
TITLE: , ..
DATE: ` ' , , ,' •, � .. a
" INSULAT16N`IlCONTRACTOR: WESTERN INSULATION,'
' LICENSE NUMBER: 481278'
BY:
• , TITLE: '-OFFICE MANAGER ti
DATE OCTOBER .19, 2000: - -
S . •• { ' +'
TOTAL. P. 16
AUG-07-2000 MON 12:25.PM SPATES FABRICATORS FAX N0, "7603974724 -A2 ,
FATES
FASRICA"CORS INC.
Rr,5idemtial; c:ommercial & 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 compromi%ed 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 '/4 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 ar•e responsible for restoring the safety and .
functioning of these compromised trusses.
Sincerely,
David Spates
Vice President
85-435 MIDDLETON STREET, THERMAL, CALIFORNIA 92274 • (760) 3974122 • FAX (760) 397-4724
aA `
+ EMERALD RQOFING,
INC. ,
.
.
78-670 HIGHWAY 111, STE, 174
LA QUINTA, CA 92253
License No. 770940
_
(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 PGA
AT
WEST. BELOW ARE THE ADDRESS AND NUMBER OF VENTS INSTALLED.
PHASE 3-A TRACT# 28776
LOT# PLAN# :,
ADDRESS
# OF VENTS
17 3-C
54-768 SOUTHERN HILLS
16
18 3-A
54-790 SOUTHERN HILLS
16
' 19 ' 3-C
54-812 SOUTHERN HILLS
16:
20 2-A
54-834 SOUTHERN HILLS.
17 '
21 2-6
54-856 SOUTHERN HILLS
17
22 2-C
54-878 SOUTHERN HILLS
17
23- -2-A
54-900 SOUTHERN HILLS
17 '
24 ' 3-CR
54-922 SOUTHERN HILLS
16
PHASE 3-13 TRACT# 28776
LOT# PLAN#
ADDRESS
# OF VENTS '
25 3=AR
54944 SOUTHERN HILLS.
16 `+
26 2-C
54-966 SOUTHERN HILLS
17
27 2-A
54-988 SOUTHERN HILLS
.17.
28 1-A
55 010 SOUTHERN HILLS
17'
` .29 178
55-032-SOUTHERN HILLS
'17
30 1-CR
. -
55-054 SOUTHERN HILLS
17 '
31 1-AR
55-076 SOUTHERN HILLS
17
THANK YOU,
•
JOHN JONES
PRESIDENT
Certifica_
te of --O
C"cu,pancy„ 1 a
Cityof-La.Qin,
U M
�.Y
Building and. SafetyDepartment . �oFTti
,This Certificate issued pursuant to the requirements of Section 109 of the Uniform Bui/ding 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: 54-988 SOUTHERN HILLS - f
.Use Classification: SINGLE FAMILY DWELLING' Bldg. Permit=No.: 9901-132
Occupancy Group: R-3 '' Type of: Construction:. VN Land. Use Zone: 'RL
Owner of Building: SOUTHERN HILLS LLCAddress: ;,1430 E CHAPMAN AVE STE 100
City: ORANGE, CA., 92886
By: DANIEL. P. CRAWFORD JR.
Date: 12/18/2000,
..Building Official } "
POST IN A CONSPICUOUS PLACE
f