9901-111 (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
478699 13 2/29100
-
ate � -� Signature of Contractor --=,J
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).
( ) 1, -,as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Cone). ,
( ). 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
Sedon 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:
Cartier Policy No.
CrOl;'®3'+N EY AC,iLE .NWC :'1 74 '14011
(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,
1 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
Code, Ls%t forthwith comply with.thos'e provisions.
Date:'d, f ,) 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 inspection purposes. `
i'�7'
Signa
yture (Ownb0Agent) Date
BUILDING- PERMIT PERMITk
99iiD-� 11
DATEVALUATION $280,62310 LOT TRACT 87 7 6
JOB SITE
ADDRESS 55-133 LAiJIiRT VALLiEY t
APN 769-81"2
OWNER
CONTRACTOR/DESIGNER/ENGINEER
SOUTHERN HILLS, LLC
R.C. R[OBBS &V SOII'IWERN HILLS, LLC
1430 E CRIXPL AN AVE., Ste 100
55-960 PG- BLVD
ORANGE CA 92886
LA QUTNTA CA 92253
171--f)61-31-7260 CBL# 5487
USE OF PERMIT
SINGLE 1:Att'CCLY DWE14ING
LOT 41, PLA 3C -SFD- P1i flT DOES NOT Ii3CLM- E BLOCK WALLS OR
POOLS.
CLT °TQAI' CONSTRUCTION 3,37:2.00 SP
PORMPATIO 318.00 Sp
GARAG111'C ARPO.IRT ,'00.00 SF
:CI S' (MATED COST OF COl1'�iT 1;i.Q1 A 10N
2841,628.20
�yg+_�y ��y�-y�g pp ppqq ��
A'J�RIMAT FIEE n)lJ.iN�Il\lARY
C'`ON37WICTION FEE 101.000-41R-000
PLAN CHECK FEE 101-000-439-318
M-WHr1NTCAI FEE 10.1-0401421-000 $124.010
ELECTR1CAl. FF- . 101-000-420-000 $189.52
PLUMBING MHE, 1,0.1.-00" 19-000 IS -105.75
STRONG .n OTIOlr n'E-MID 10,1-000-241-000 $28.06
GRA INGFE,; 101-004-423-000 $20.00
INFRAS1'RUC rURE FEE 225-000-443-2�42 6,009.00
ART :19 XMIAC PL,R.M - RES - 00-2.25:5-000 S45 1,57
-M.701
I EE DEPOSIT 101-000439-3118 4750.00
SUB-TC7r'AL CONS' RUC"1`IO:N AND I'?�:tiN CI�.ECk
ss),331-Im
LESS PRE -PAID FISE'S
417511.00
TOTAL PERMIT FEES DUE NOW
38,581.9.1.
RECEIPT - -
DATE✓ ` f,�
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
Combustion Air
Roof Deck
Exhaust Fans
0. K. to Wrap . /
F.A.U.
Framing S
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath S'
Drywall - Int. Lath
9
9
Final
Final
BLOCKWALL APPROV LS
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 9
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:
Sep -28-99 11:10A
'The DanDee
Cyan iy hKo. L is 732542
ROOHNG AND CONSTRUCTION
P.Ol
RoofingProposal
P.O. Box 177 Thousand Pa/ms, CA 91276
PHONE(760) 343-3385 FAX (760) 343-3096
BIDS TO.: JOB NAME;
THE R.C. HOBBS COMPANY MONTECITO COLLECTION (PHASE#1)
55-960 PGA BLVD. LA QUINTA, CA
LA QUINTA. CA. 92253
TELEPHONE #564-1551 FAX #564-2803 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-
14f7
16
`
42
16
43
17
44
17
45
16
NOTICE
'UnOcr Ula McCh0l*.'S' U00 Law (California Code of Civil procedure Section 1181 et Seq i. any nxlnrractnr. suhmniraCtor. IAgorer. Supplier orner pe..rson ne nrlpe fo
improve your property bill is not paid for his work or supplies, has a right [o enforce a claim against your property. This means that. after a conn hearing your property could
ne. Rnld by a cnun nrf,(,.f f :inn the, pfnrW.eds or the, Rate limed to sallsfy, me. Indentednesm Inlm can happen even it yoll nave.. old your nwn Contractor M lull If the
SubCOnlractuf, lutxa0l or suOpliur icinains unpaid 0,10 rf legal action r3 neCCSSary Wr011ect or enforce trio teflns Of [his ContlaCt. the prevailing party 5tlall be entitled w its
reasonable airnmey fees phlm all costs of mit and interest shall accrue an all sums, which are due 30 days after hilling at IhP rale ar ii; % per annum The DanDee Co. Inc.
is not responsible for delays caused by weather, strike, material shoitage or delay in material supplied to the job or to any other delay beyond its control. The DanDee Co
Inc. total (lability under lll-s contrac.l or m rill-qenre is Ilmlted Solely to the., amount of irim nonlrint
We .are fu)ly covered by WQrkmerl's compensation and public liability insurance Carriers names ando�licy numbers available pn requ(kst,
Any alteration or deviation from the a above specifications invnlvins extra Goat of material or lahor will only be executed upon written ortterg for same. and will necnme an
extra charge over ane mum mentioned in this proposal. All agreements must be made in wrilhing and is based on free access to building for direct loading from our trucks.
Price& are based on current costs of material and labor. Increases or decreases, will be reflected at time of signing contract.
Before and or during roofing operations and the Completion Of roofing, The DanDee Co Inc. will not be responsible or liable for damage eausod from
acts of Ood. sucn as earthquakes, thunderstorms. hell or any other Weather condlUone beyond roofers control.
'I'lll: I)AN01:l.: (:().
----------- DATL-
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SEP -17799 FRI 12;27 WESTERN INSULATION FAX NO. 9096868786 P•02 .,
f
WESTERN -INSULATION, INC.
4211 L lmm stnot, Rivcrsmo, CaUorniEL 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: 287,76.
LOT: 41
SITE ADDRESS: 55-133 LAUREL VALLEY, LA QUWTA, CA
----------------------------------------------------------------
EXTERIOR WALLS:
MANUFACTURER: Manville THICKNESS: 5 1/2" R -VALUE: R-21
CEILINGS: BATTS
MANUFACTURER: Manville THICKNESS: 13' R -VALUE: R-38
CEILINGS: BLOW
MANUFACTURER: Greenstone Ind. THICKNESS: 10.3" R-VALLIF• R --IA
GENERAL CONTRACTOR: SOUTHERN HILLS, LLC / THE R.C. HOBBS COMPANY
LICENSE NUMBER:
BY:
TITLE:
DATE:"'�`�
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRODUCT ON MANA ER
DATE SEPTEMBER 17, 1999
op./
ApR
"''"V?4ON TANDY
RFcp 37630 Medjool Ave.
C7 Palm Desert, CA 92211
NO 6;Aj . `Office (760) 772-7192
ISRECIAL INSPECTION'Fax (760) 772-7193
Pager (760) 776-3338
REGISTERED INSPECTOR'S WEEKLY REPORT
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE �TRUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
❑
❑ OTHER
JOB LOC
; '-13 A 0 mel._ WIS.
4-A-
REPORT SEOUENCE NO.
TVPSCJy1RE� d �/
ERMIT N0.
lm
254
DAV OF WEEK
MATERIAL DESCRIPTIO �� `��O
ARCHITECT
I Sf,% R
HRS. CHARGED
L ^�( (
ENGINEER rh• L) -
ASSISTANTS
HRS. CHARGED
GENERAL
INSPECTION CONTRACTOR
DATE
SUB C)
O 10 J o CONTRACTOR r-
`
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COPY SENT TO CLIE ❑
CONTINUED ON NEXT PAGE ❑
PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
SIGNATURE OF REG S ERED INSPECTOR
DATE OF REPORT REGISTER NUMBER
Certificate of Occupancy
City of La Quinta
Building and Safety Department
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 following:
BUILDING ADDRESS: 55-133 LAUREL VALLEY
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction
Owner of Building: SOUTHERN HILLS, LLC
Building Official
VN
Bldg. Permit No.: 9901-111
Land Use Zone: RL
Address: 1430E CHAPMAN AVE., STE 100
City: ORANGE, CA., 92886
By: DANIEL P. CRAWFORD JR.
Date: -11/22/99
POST IN A CONSPICUOUS PLACE