9901-112 (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
:178689 rs 2129/00
Date Z Signature of Contractor
OWNER -BUILDER DECLARATION
I he 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:
Cartier Policy No.
GOLDEN EAGLt
N'
VC 547701.400
(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
Code, I shall forthwith comply with those' -provisions..
Date: ,c� e',1yApplicant -
Warning: Failure tosecureWorkers' 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.
Or
Signature (Owner/Agent) �IDatC
BUILDING PERMIT
DATE VALUATION $28(jti2R 7f) LOT
JOB SITE
ADDRESS «°eG ...a.�LA C K1, VALLEY
OWNER
SOUTHERN RILLS,LLC
1430 E CRAF1'vIAN AVE., Ste tib
ORANGE, CA 9M6
USE OF PERMIT
SINGLE FAMILY i3 kfR,LXfNG
PERMIT #
!l�t19-11..2, t
42
APN
TRACT 2877o
769-81,0.026
CONTRACTOR / DESIGNER / ENGINEER
RC, HOBBS dba SOUINERN LOLLS, LLC
55-9 0 PGA BLVD
LA QC.1INTA CA 92'1153
M 4)63:3•-7260 (r BL# .5497
LOT 42, ALAN 3L -SbFD- kPFL&I[I ' '002S C��`t INC,`Lf.ii�E BL -C C".K W ALL OR
POMS. PIAN C;i;il;G.`K 17- ?6.Ft'EI IXXD 75% FOR X11IL.TIPLE ISSUANCE OF
S. 04E PLAN TYPE.
CUSTOM CONS'l°RU Y 10N :1.372.00 SF
PORC`I-PPATI.O 318.00 SP
GARACsF)CARPORT 700.40 SF
ESTINIA CED COST t:9F CONNSTRITL"'fJON
288,628.20
P. + ART PEE SUMMARY
CAN STRUCTJONlYa
101.000-418-{I00
$1,273.00
PLAN CI3,ECK FEE
10.1-000-4,39-319
$2610.00
MEC 1.1A14C:M,FES
101.000-421-000
$124.00
ELECTRICAL FEE
J01-000420-000
M9.52
PLUMBING FEE
101-000-419-000
$205.75
STRONG 110'rION EEE - REM
101-000-244-000
G12ADING 1%'E
101-000423-000
$20.00
TNFRAST'RC:!( TUKE FFE.
?25-000-443-3-42
S610MI00
ART INPUR IC PLACES - R;f`tiIC 701-U00-2.55-000
$451,57
SUB -TOTAL CO STRUC"1 ON AND PLAN CHECKI $8,55t.90
LE !Z PRIE PX0 FEE$ $0.100
"TOTAL PERA TT F, CES DUE NOW I u,SS1.90
DATE /`: BY 1Y I 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
OX 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
44
Drywall - Int. Lath 77
S
�21ft
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 Pibg. 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 Q
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
C MWaiky hKa., L is 732542
ROOF/NG AND CONSTRUCTION
P.01 _
Roofing Proposal
P.O. Box 177 Thousand Palms, CA 92276
PHONE(760)343-3385 FAX (760) 343.3096
BIDS TO.:
JOB NAME,-
AME;THE
THER.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
41
16
E42)
16
43
17
44
17
45
16
NOTICE
'Unci Ilte MCChOniCS' Lint Low (Caltroenla Cooe of Civil procedure Section 1181 of Req 1. Any contractor. suhconlrartor, lal)orer, supplier ornl:r pevsnn ne nerp.'% ra
improve your property but is not paid for his work or supplies, has a right to enforce a claim against your property. This means that. after a coup hearing your property could
ne sold ny a CA)un nn,cwr inn the, pfnrPee(IS Of the sale. used To sallsfy me Inaenlednes% T*nm Can nappPn even ,f you nave pato your own Contractor n) rt,li It the
subCon(factuf. 6 w1ul or suupliur winains unpaid 0n0 d legat action is necessary to Collect or enrorce trio terns or [his ounbaCt. the prevailing party shall oe enliuld lu Its
rP.ASnnahle Annmey feP.S plus All Costs of suit and Interest shall accrue an all sums, which are dile 30 days after hllling At the. rale Ar 18 rf per Annllm The Dan Dee Co. Inc.
is not responsible for delays caused by weather, strike, material shoftage or delay in material supplied to the job or to any other delay beyond its control. The OanOee Co
Int. total liability under llns contiact Orin nPgl genie. is limited.snleiy In the amnllnt nt Inls Cnnlrant
We .are fully covered by wiarkmeriscompensation and public liabillty insurance Carriers names and Rolicy numbers available pn request,
Any altefabon or dCnation from the a above specifications involving extra coir of material or latxw will only he, executed upon written orders for Satre. and will necome an
exlra charge over Ine sum menlioned in [his proposal. All agreements must be made in writhing and is based on free access to building for direct loading from our trucks.
Prices are based on current costs of materiel and labor. Increases or decreases, will be reflected at drive of signing eontracL
Before and or during roofing operations and the completion of roofing, The DanDee Co Inc. will not be responsible or liable for damage causott from
acts of Ood. such as earthquakes, thunderstorms. hell or any otherweMer coadmons beyond rooters control.
I'l IF DAfVDIA: CO.
11 L•:---------------------------------------------
C'
&s___ --t-L
SEP -17-99 FRI 12:28 WESTERN INSULATION
r
FAX NO. 9096868786
P. 03
w
WES'T'ERN INSULA'T'ION, INC.
4211 Latham Strett, Riversidc, California 92501
TOL (909) 686-8760 Fax (9091686-8786
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: 42
SITE ADDRESS: 55-115 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
CEILINGS: 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:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY: +
TITLE: PRObuctioN MANA ER
DATE SEPTEMBER 17, 1999
cl; y
r)#,W., J O
REGISTERED INSPECTOR'S WEEKLY REPORT
N TANDY
Medjool Ave.
RECQPal m Desert, CA 92211
Office (760) 772-7192
S-4Frax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE O STRUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
O
O OTHER
JOB L!�4 _
d`
T^ o
A v rz � iN l le �- Qu
REPORT SEQUENCE N0.
((11JJ\\
T:�VFT6CTURE L...o?�
PERMIT N0.
0 E I 1 u- L
-4
DAY OF WEEK
MATERIAL D SC
-
TI/QN
!Q o�
ARCHITECT
INSP CTOR
HRS. CHARGED
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPECTION
DATE
L
GENERASUB
CONTRACTOR o �-S C<D, CONTRACTOR
`� .LJ✓v�►- Ld C-1 � f ATE -S
ccx-4 0
E�i1C�N ( 601,
S ►+o � tv� � � � Gb eve
l.,e�
COPY SENT TO CLIENT ❑
CONTINUED ON NEXT PAGE O
PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT 1 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.
IGNATURE OF REGISTERED SPECTOR
�-C-9� v 6gq7J
DATE OF RE ORT REGISTER NUMBER
b
Certificate of Occupancy
City of La Quinta
Building and Safety Department OFTM
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:
Use Classification: . SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction:
55-115 LAUREL VALLEY
Owner of Building: RC HOBBS
y
Building Official
Bldg. Permit No.: 9901-112
Land Use Zone: RL
Address: 55-960 PGA BLVD
City: LA QUINTA, CA., 92253
By: DANIEL P. CRAWFORD JR.
Date: 10/7/99
POST IN A CONSPICUOUS PLACE