9907-130 (SFD)'LICENSED CONTRACTOR DECLARATION
#1 hereby. aff irm, 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
02/2-9/201
•Date Signature of Contractor ^�
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).
( ) 1 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.
(K 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.
GOL..£)ES;L4L EAGLE . - • N%10... 54-77701400
(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
Co6e,il,shall forthwith comply,w,ith•th Velprovisions.
,Date: roo '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 ins
p
ection purposes,
Signature (Owner/Agent) I y ' _ Date T 2 . f�
^��7
BUILDING PERMIT PERMIT109043,5
DATE VALUATION 52.30.1628..20 LOT i Zz7 TRACT 28776.
/jF
JOB SITE
ADDRESS � U�. +A i_II aY.iLai,. 0^
APN 7459L810-017
OWNER
CONTRACTOR/ DESIGNER/ ENGINEER_ _
501111,1 E.Rax fry; ),.1 i..1; '
RX" H.013'S; dba sat.Tl't1m;"N firs„.�s, LL IC '
i,450 E CRAPz1'1iV lVvT' 9rE 100
33.960 PG BLVD)
i73tA".NC3E (A 9186
LA. t;?Ujl+f TA CA 92753
(714)03-7260 M0 W
USE OF PERMIT
SMI-P.SMI-P. VANIHL F D4NE11VNG
SM - LOT :5 PLAN 3AR rMUWT DOES TNOT IivwURM BLOCK WALL OR ;
11CKA1 75°✓O.t LAN f;l3k Ciisiii OUC° ION APFL&T) f'ORA11ULTLILH SiJ'tl".1-TAL
•"r
CUSTOM CCZN^a:i'LIUCTIO 3,3172.00 Sr
PO CIPPAiIG 318.00.Sr-
4--r11ZAUkVCAttl+0 1' 700.W SF
1: STAUMIM i OS"T OF 1CONSTRUCf,10N
2S0,4623.20
PF,RMff FES SUMIAR"
F'Iffi 101-000-418,W0 $1.271(0)
Pf:rLIIIII r F -Pr, 10) - 439-`i t $ S260.00
APEC:ANICAIL .1170' 101mo-42,1--fl00 S124.00
P.ZECI ,U0AL I-IX10t-000-420-000 $189.52
PLUMIJI.NO .F0 101-t2iM}-4194= 52-05.75
STt2.OM MOTION SRF,,. R S'0O 101-flt)t1-241-W $28,06
OR,NUITNO II Lf~ 101.000- 4423-010A) 520.00
i EVIMOFS11 B ARACT 13LM 51,907.00
RT IN PUBLIC; PLACES— RE3.11, 701-000-255-000
SUP-111MAI CONS"`('j#TIC fON AND PLAN CHEX;'F,'
LESS PLUM -PAC( FEES'
SO.fli3
TOTAL PERj4 I'I VCES .01% NOW
$4,0&94)
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
Return Air
Steel
Ix
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing ,le
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
Va
Final
Final
BLOCKWALL APPROVALS
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
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
yZ —4�J
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:
OGT -19-2000 .121:15.` WESTERN INSULATION 909 686 8786 - P:14i16
WESTERN INSULATIONINC o
4211 Latham Street, Rivcraide, California 92501
TeL (909) 686-8760Fox (909)686-8786
a f.
- « ' INSULATION CERTIFICATE `
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN :CONFORMANCE WITH.
' THE CURRENT ENERGY REGULATION, CALIFORNIA ADM INISTRATIVE•:CODE, TITLE 24,
,STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: ;
TRACT /. PHASE: MONTECITO COLLECTION- 28776 PHASE 3A
LOT #' 25 ✓' -
SITE ADDRESS ,64-944 SOUTHERN HILLS, LA QUINTA, CA'
;EXTERIOR WALLS•' ` •• ' •
` MANUFACTURER -I GREENSTONE THICKNESS: 10;3" R -VALUE: R-38'' «
CEILINGS: BATTS. BLOW
• f
MANUFACTURER: JOHNS MANVILLE THICKNESS: 131" R•VALUE: R-38
CEILINGS: 4 S BLOW - +
MANUFACTURER: JOHNS ANVILLE THICKNESS: R 5.5 R -VALUE: R-21,
GENERAL CONTRACTOR: R -.'C. HOBBS CO.
" LICENSE NUMBER: '
BY: `
TITLE: -
DATE: w ,
INS
ULATIO CONTRACTOR: WESTERN INSULATION, `INC.' '
" LICENSE NUMBER:, 48127 '.
TITLE: OFFICE MANAGER
DATE OCTOBER: 19,.2000 "
AUG -077200,0 MON 12:25 PM SPATES -FABRICATORS FAX N0. 7603974724 P. 02
PATES
FABRICA"T4R'S INC.
FiFsideriti�l, commercial & Floor Trusses
August 7,20W
Re: Montecito Collection by R.C. Hobbs Co., Phase 3
To. Whotn,It May Concern:
The roof trusses on Phase 3 of the Montecito Collection have been compromised by the
installation of roof -mounted vents called'VHagane'- In the process of their installation, i
the top cord of the trusses was cut as deeply as 1-%a inches. f
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 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) 3974724
EMERALD ROOFING,
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
AT PGA
WEST. BELOW ARE THE ADDRESS AND NUMBER OF VENTS INSTALLED.
PHASE 3—ATRACT# 28776
,
LOT# PLAN#
17 �
ADDRESS
# OF VENTS
3_C
54-768 SOUTHERN HILLS
,
18 3—A
54-790 SOUTHERN HILLS
.16
16
19 3—C
20
54-812 SOUTHERN HILLS
16
2—A
54-834 SOUTHERN HILLS
17
21 2—B
-'54-856 SOUTHERN HILLS
17
22 2-0
54-878 SOUTHERN HILLS
17
23 2-A
54-900 SOUTHERN HILLS
17
24 3—CR
54-922 SOUTHERN HILLS
,
16
PHASE 3-B TRACT# 28776
LOT# PLAN# .'�
25
ADDRESS
.# OF VENTS
. .3 -AR'
54944 SOUTHERN HILLS.
16
26 2—C
54-966 SOUTHERN HILLS,
'54-988
17
27 2-A
SOUTHERN HILLS
17
28 1—A -.
55-016 SOUTHERN HILLS
17
29 1—B ;
`55-032 SOUTHERN HILLS
17"'30
1—CR
55-054 SOUTHERN HILLS
17
31 1 -AR'
;.
55-076 SOUTHERN HILLS
,17
o
-
THANK YOU, ,
JOHN JONES
PRESIDENT
r
Certificate of Occup
an_cy,__.
e �
Cit &L Quanta
1 ►n :and Safet Department' cMOBui•d g y
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 fol%wing- -
BUILDING ADDRESS: 54-944 SOUTHERN HILLS
Use Classification: SINGLE FAMILY DWELLING Y Bldg. Permit No.: 9907-130
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., 92286
By: DANIEL P. CRAWFORD JR.'
Date- 11/28/2000 '
Building Official r -
POST IN A CONSPICUOUS PLACE `