9907-128 (SFD)L�; LICENSED CONTRACTOR DECLARATION
ereby 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
"1
eDate y t t� Signature of Contractor--JO—I.—
I.—
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:
Carrier Policy No.
C OLDKN "GILD IN= _`04*'711400
(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
sub}ect to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those.pfovisions.
Date: j 'L ?. y Applicant—
Warning:
pplicant 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 Vold 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
Zthg above-mentloned property for Inspection purposes.
hSignature (Owner/Agent) � r 'M, 0"'4 � Date 4 2 L)
PERMIT #
PERMIT
{BUILDING
DATE 1 VALUATION S.2.59,674.50 LOT TRACT . 'IT) 71%6
JOB SITE ADDRESS 1� J *SOUTHERN HILIS
APN
OWNER
CONTRACTOR/DESIGNER/ENGINEER
lJ/1f g"I UST 4T�T T 1 1 i1
i f\J\• A J.LJ I ,4 .1 1�. J.Ar_/ Y.Al./\>
p G i-iP�[1 4;
\. 11l. J U tha "S'." rTTYERN 1111L) % .Pt„Ttil;'
14301: C14JV"MAN AV9 .SM' 1Cr0
35—%0 PGA BLVD
QkANG11, (,,*A 9.2886
LA U191:A CA 9225-1
f 71 �i6 T2F5(i T3[.€f 5487
USE OF PERMIT
SltvLr1<Y� 1vA�111;x" i�iA/Ia;�..i.1Ff�C3
D . LO f 23 PLA1 2A f1fiN t"vl T D(i1;S 9011' INC: LLTIET BLOCS WALL OR
VkXJi,355 o PLAN C:1Jk:(K XPX)UK:V.ION APP1.1b.0 FOR MUi:1'11'LE SU MJITTAL
CWTO-111 COTNSMUC710N 3,07.i.00 SIS'
i'ORCirPPATIO 324,40 SF
C3t� 'k�t�.C;1li .ACt�'tti.{ i' blo1i) IS
E ST."N TIED COSIT at, CON3,12;
INSPECTION RECORD
OPERATION
DATE 3 INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms &Footings /
Ducts
Slab Grade
Return Air
Steel 4
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing 4
Compressor
Insulation
Vents
Fireplace .L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath 3 6 G
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 Q
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
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 12:14 WESTERN. INSULATION 909 686 8786 P.12i16
• ,! •. it _ .. .. - , - r .. .°.
WESTERN INSULATION, INC.
4211 IAUiam'Stmet, Riversidd, California 92501
' Tel. (909) 686-8760 Fax (909) 686-8786
. INSULA'TION CERTIFICATIE
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH
.THE CURRENT ENERGY REGULATION; CALIFORNIA ADMINISTRATIVE CODE, TITLE 2.4,'
STATE OF CALIFORNIA, IN THE, BUILDING LOCATED AT: ;
TRACT /PHASE; , MONTECITO COLLECTION- 28776 PHASE 3A
LOT # f23 4
SITE ADDRESS 54900 SOUTHERN HILLS, LA OUINTA, CA
'EXTERIOR WALLS:
. MANUFACTURER;,. GREENSTONE THICKNESS:• 10.3"• :R—VALUE* R-38 '
• COLIN S• BATTS
MANUFACTURER: s JOHNS MANVILLE THICKNESS: 13" R -VALUE: R-38
CEILIN51t: _ ATTS BLOW
MANUFACTURER:JOHNS NVILLE THICKNESS: " . 5.5" R—VALUE: R-21
GENERAL_ CONTRACTOR: R. C. HOBBS CO.
LICENSE NUMBER:: F
BY:
TITLE:
DATE:.
INSULATION CONTRACTOR' WE STERN' INSULATION,- INC.
LICENSE NUMBER: 481278
BY:
— . 11 1 rl�E
TITLE; OFFICE "MANAGER
DATE OCTOBER 19, 2000
' :;13s, i a'rr ,
-. •AUG -07-2000 MON 12:25 -PM SPATES FAis `?BRICATORS. FAX NO. 7603974724 P. 02
4.
PATES
FABRICATORS INC.'
Rrsidorniat, Commercial & 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 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-%Z inches.
Spates Fabricators has provided 3 separate repair drawings (see attached); which, r>vill
cover all different types of trusses on this job that might have been compromised. Any .
truss with a saw cut greater than F/, inch MUST be repaired using the appropriate repair
drawing. i
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 ovcrsee the
CORRECTrepairs ori these trusses. They are responsible for restoring the safety and
functioning of these, compromised frusses. =
Sincerely, 4.
David Spates
Vice President
• - _ .. k
45-435 MIDDLETON STREET. THERMAL, CALIFORNIA 92274 • (760)'3'
760) 397-4122 • FAX.(760) 397-4724 ' 'Y
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-A TRACT# 26776
LOT# PLAN# '
ADDRESS
# OF VENTS
1.7 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 2-13'
54-856 SOUTHERN HILLS-
17
22 2-0
54-878 SOUTHERN HILLS
17
23 2-A
24
54-900 SOUTHERN HILLS
17
3 -CR
54-922 SOUTHERN HILLS
16
PHASE 3-13 TRACT# 28776
LOT# PLAN#
25
ADDRESS
# OF VENTS
3 -AR
54-944 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 1-8
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
M
X(Certificat6.
o
r F
City.of La'Quinta
5
Building.and Safety.D,epartinent ��Mo.F-_
R
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; " 4
BUILDING ADDRESS: 54-900 SOUTHERN HILLS
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit•No.:. 9907-128
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
l
_. -Owner of, Building: SOUTHERN HILLS LLC- Address: 1430 E.CHAPMAN AVE STE 100 .
City: ORANGE; CA. `92886
-By: DANIEL P. CRAWFORD JR.
Date: 7/17/01
Building Official
POST IN A CONSPICUOUS PLACE