9901-110 (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 B 2t 29!{)fl
Date i 9 V Signature of Contractor✓`y
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)."
()' Iam 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 GOLDEN
y+t Y 1l1p T Policy No. (7! +770
W
(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 Californian 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 those provisions.
Date: S Applicant '."'1'.4
Warning:. Failure to secure Workers' Compensation coverage is unlawful arid
sFiall 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 inspection purposes.
Signature (Owner/Agent)r/` Dated f
BUILDING PERMIT PERMIT#
•
9901-120
DATE VALUATION LOT TRACT
n 1< 1111 S239,179.04i 40 297-761
JOB`SITE —
APN
ADDRESS 5S-1.51 f.:ttIl11IF:I., VAL.LFy `
769-810-024
OWNER
CONTRACTOR/DESIGNER/ENGINEER
.,01_7I411=RN HILLS, LLC
R -C, HOBBS dila SOU rI[ER.N HILLS, LLC
t 430 E C:HAPMA,N AVE., Ste 100
55-960 ;EGA BLVD
OR. VINGE CA 92886
LA, QL1[NTA CA 922 S3
(714)633-7260 C.BL# 5487
USE OF PERMIT
S1NOLF FAMILY 171irFLUNG
LOT 40, PLAN WR. -8FD-PEEWIT Doth NOT INC'LbDE BLOCK WALLS
C3R POC7LS,
CUSTOM CONS'1'RilCTTON 21780.00
p['SyF
po-RCl'lll.".�'P LO 3311).00 7T
GARAMCARPORT 930.00 SF
9311MATED COST OF CONSTRUCTION
239,179.00
aput kkiff FEE'SOMMARY
CONSTRII.C'1'ii7NFEF 10.1.000-418-000
PLAN CRECK FE9 101-000.439-318 f:92 3.3'2
IYMCHANICAL FEE 101.000-421-000 �.tUS.t70
EWCI'R1'C.AL .tEE 1011 000-420-000 S 173AO
[ LUNBING F'EE 101.000-419-000 $186,50
V RONQ M0110!N FU - RI S:[11'7 101000-241-000 5-13,92
GRADING FEE 10.11-000-423-000 x20.00
(NFRASTRL'C'i'ME Ms 225-M-443-3-42 S5,282.78
ART IN muc: Pi.Acps _ REsir< 701-000 255-000 $347.95
FER DEPOSIT 101-000439.318 -8750,00
' SUB -TOTAL.. CONSrRMIGIN AND PLAN CHECK
$8,192.87
LESS ME -RAID FEES
4750,00
TOTAL PERMIT FE9'9 DUE NO'W
$7,442.87
REC IPT'
DATE ; r
BY Y
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
1A tl OfUnderground
Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
D II - Int. Lath
2
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer ConnectionZ
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wining
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
Sep =15-99 01:14P e
The. DanD e
cz"Kmy 1111c•.. tic 732542
ROOFING AND CONSTRUCT/ON
BIDS TO
THE R.C. HOBBS COMPANY
55-960 PGA BLVD,
LA QUINTA, CA. 92253
TELEPHONE #564-1559 FAX #564-2803
P. 02
Roofing Proposal
P.O. Box 277 Thousand Pa/ms, CA 92276
PHONE(760) 343-3786 FAX (760) 34.3-3096
JOB NAME:
MONTECITO COLLECTION (PHASE#1)
LA QU(NTA, CA
DATE 9-15-99
THE DAN DEE COMPANY INC. HAS SUPPLIED, AND INSTALLED THE
FOLLOWING AMOUNT OF O-HAGIN ROOF DORMER VENTS.
LOT# # OF VENT'S
40 15
41
16
42
16
43
17
44
17
45
16
NOTICE
'under the Mechbnics Lien Law (California Code nT Croil ProCedulo. Section 1181 er Sen ).any rgnlradur, subcontrartnr,'agaret, Suppler other person he. netp$ t0
improve your property but is nut paid for his work or supplies. has a right to enfurce a claim against your propoity. This means That. atter o Court hearing your propany int to
bu sold by a court officer and the proceeds of (tic sale used to satisfy the innebtedness. This can happen even rt you have paid your own conrrartor in lull. If Ute
Subcontractor, rahurei o, supuGur remains unpaid and if begat aclion is necessary to collect or enrnrre the teims of this contract, Tho prPvad,ng party shall be enutled to its
reasdrnblC attorney fees plus all Hosts or suit and interest Shall accrue an all sumn which ore duu 30 days after billing at the rato at 18 % per annum The OanDee Co. Inc.
is not responsible for (ways caused by weather, strike, malenal shnnalle or Qeldy in material supplied to (ne job or to any other delay neyond its vuritiol. The DanDee. Co
Inc, total nand ty under this contract or in negligence is limited Soiuly to the amount of tnis eontraCl .
We are fully covergd by workmen's compensation and public liability Insurance. Barriers names, and oolicv pumbers avallabla on reou�.SG
Any attention or deviation from the a gWvC sptscifications involving exu8 cost of material or labor will only be e)teouted upon written nrnerS for Same. dud will become an
extra charge over Inc sum mentioned in this propos2l All a9fouments must he matte in wr.lhrng and is based on free access to building for direct loading from our trucks
Prices are based on current costs of material and tabor. Increases or decreases, will be reflected at time of signing contract.
Before and or during roofing operations and the completion of roofing, Tho Danoes Cc Inc, will not be rosponsible or liable for damage caused from
acts of God. such as eaMNuakes, thunderstorme, hall or Oily other weather conditions beyond rooters cuntrai.
----------------------------------•-
• f)A ll--------------------
i -L- - L-7.. ----- ---------------------------------
1;-- --1-� y
1 j---
--------------
TM-., DANDLE CO.
29-99 02:15P P.02
. The
Dan'Dee
' Cgnpoy Jim% LiC 732542
ROOFING AND CONSTRUCTION
1D LL:
THE R.0 HOBBS COMPANY
55-960 PGA BLVD.
LA QUINTA, CA 92253 Z-103
PHONE# 564-1551 FAX# 564-599x1
Roofing Proposal
P.O. Box 277 Thousand Palms, CA 92276
Phone (760) 343-3385 Fax (760) 343-3096
JOB NAND:
MONTECITO COLLECTION
PHASE# 1.
LA QUINTA, CA 92253
DATE 7-29-99
1 XTRA) .0 -HAG N ROOF VENTS
ROOFER TO SUPPLY, AND INSTALL O-HAGIN ROOF VENTS.
LOTX
# OF VENTS
1
16
2
17
3
16
4
17
5
16
6
17
7
16
g
15
9
16
40
15
41
•16
42
16
43
17
44
17
45
1�
_
TOTAL # OF VENTS
243 X $40.100 EA. TOTAL PRICE $9,720.00
--------------------------------------------------------------------------------------------- -
Under alae Mechanics' Liert Law (Califomia Code of Civil Procedure. Section 1181 ell SuQ. ). airy Contractor. subcontractor, laborer. supplier olner person he helps l0
improve your property but .s nn1 paid for III$ work or supplicS. has a right to enforce a Claim against your property This means 1110t. after a court hearing your property
could be 5010 by A court OfGCnr an(I the proceeds of 01h. Sale used 10 satiyfy Ink% indebtedness. Thij C.9n happen even it yotr nove paid your own wnU:irror in full. If the
Subcontractor. laborer or supplier tumarns unpaid and it tragal action is ncccssary In collect or enfo,cc Ota Terms of this contract. 11,0 prevamng pang shin by enrrled to its
reagnnable ahurnGy tees pills all costs Of Sun and interest Shatl ar:rnle an all sunt S. wbicn are due 30 dbys atter billing at the relu 8t 18 % Fpr annum. The DanDee Co.
Inc. is riot responsible for delays caused by wcalnP.r. strike, maternal Shortage or delay in rnalerral supplied to the job Or jr, any ocher delay beyond d3 control. Tic
DanDee Co Inc. tolJI i ;rbiliry under this contract or in nogligence rs limited solely to the amount of this conlrarl
We are fully coveredby workMgjjs compen n and public liability Insurance. C i ► names and policynumbers avails. .on
request.
Any alleralion or deviation from the a 000ve specifications involving extra COSI of mteriat or labur W-11 Only he executed upon warten orders for same, and will become
an uxtra cnarge over the sum memioned in this proposal. All agreements must be made in Sinning and is based on Ire& access to buildintl Inr direct loading horn ;aur
trucks.
Prices are based ort current costs or material and labor. increases or decreases, will be reflected at time of signing eontraet.
Before and or during roofing operations and the completion of roofing. The DanDee Co Inc. will not be responsible or liable for damage caused from
acts or God. such as contlquakes. thunderstorms, hall or any other weather conditions beyond roofers cordrol.
�• DATE.
DATE-
` _...
SEP -17-99 FRI 12:27 WESTERN INSULATION
Ll
FAX NO. 9096868786 P.01
WESTERN INSULATION, INC.
4211 iat" Street, Rivtxsido, California 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:
PROJECT: MONTECITO COLLECTION
PHASE:
TRACT: 28776
LOT: 40
SITE ADDRESS: 55-151 LAUREL VALLEY, LA QUINTA, CA
---------------------
EXTERIOR WALLS:
MANUFACTURER: Manville THICKNESS: 5 1/2" R -VALUE: R-21.
CEILINGS: BATTS
MANUFACTURER: Manville THICKNESS: 13" R -VALUE: R-38
CE(LINGS: BLOW
MANUFACTURER: Greenstone Ind THICKNESS: 10.3" R -VALUE: R-38
------------------------------------------------------------------
GENERAL CONTRACTOR: SOUTHERN HILLS, LLC / THE R.C. HOBBS COMPANY
LICENSE NUMBER:
BY: ,
TITLE: ' )sip
DATE: '
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
.TITLE- FIRODUCTIOKMANAGMER
DATE SEPTEMBER 17, 1999
All
Certificate of Occupancy0 o
Lrco�ouirv�4�
G� OFTBuilding & SafetDepartment
y
This Certificate is issued pursuant to the requirements of Section 109 of the California Building ;
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 55-151 LAUREL VALLEY
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 9901-110
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, ST, ZIP: ORANGE, CA 92886
By: DANIEL P. CRAWFORD, JR.
Date: SEPTEMBER 15, 1999
Building, Official
POST IN A CONSPICUOUS PLACE