9901-113 (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
479699 13 2129/00
Date �t 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).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
O I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
Thereby 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.
CYOLDEN EA011.1 NWC 547701400
(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 I shall forthwith comply with those` provisions.
Date: '._, w '�?I 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 floginspection purposes.
Sig ature (Owner/Agents Date r' 7
BUILDING PERMIT PERM T#
99Ot•.113
DATEyJ� �j VALUATION $236,468.00 LOT ��� TRACT 28776
6 i P .-
JOB SITE
5' yyl"
ADDRESS _ Lt• URELVALLEY 1
APN
769-810-027
OWNER
CONTRACTOR / DESIGNER / ENGINEER
SOLFI`HERN HTLLS,'LLC
R.C. HOBBS diva SOU1'N1aRN HILLS, LLC
14301✓ CHAPMAN AVE., Ste 100
55-960 PGA BLVD
ORANGE CA 92886
LAQUTNTA CA. 92253
(714)633-7260 CSL# 5487
USE OF PERMIT
S ING1.1: 1,`AA1.11.,Y DWELLING
LOT 43, PLAN -213R-aF.i=i- PMW T ,WbS NOT ENCLUDE BLOCK WALLS
OR POOLS.
� US`;'OM CONSTRUCTION x.020.,00 SF
PORCff)PATIO Sr.
OAI'�AGEICARPORC 86'09 SE
EST_Ilt!J.L" 4 ED CMlXf OF MN 71"U�IJ=M.9.P1'Y
2.-W,468.011
PERM EEE SUNIMliWY
CONS M11C'1I N FEE 101-000-118-000 $i, r.tzv.0a
PL N. C1i1 !:K FEE 101-000-439.318 $969.76
iFXHAINFCAL FU 101-000-•4: 1-0110 $11.1.50
ELFfi:TfUCAL F 9 101 -OW -420-000 $1,80.30
PI1t.IlVI:F.{1NG FES 101-000-4.19-000 SIX-%
TMONG A 11'1014 FEE -13 - ID 101-000-241-iJUt) $25.65
tiRA1711ti`C FEE 101-000-423-000 $'-0.00
TIOIL s'1`I21.JeWRL M 225-000-443-342 $5,6174.77
ART 1N PUSIAC PLACES - RESIC 701-000-255.000 8301.17
FEE D1, 031T 101-000.1439-318 4750.00
SL43-179fAll. CONsURLIC710N ANDPLAN CHECK
$8,748.85
LESS PIZE-PAii3FEES
4750.011
TOTAL PE1EtltM FEES DUE NOW
$7,998,85
n A
RECEIPT
DATE / �'��"
BY f j
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab GradeReturn
Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing /irj
Compressor
Insulation 4012Aft,Vents
Fireplace P.L
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
D II - Int. Lath
Final
Final I ZMsPOOLS-SPAS'
BLOCKWALL APPROV LS
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
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
Colt gmiy bK,.- L is 732542
ROOf/NG AND CONSTRUCTION
P.O1
Roofing Proposal
P.O. Box 177 Thousand Pa/ms, CA 92276
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
41 16
42 16 111
[43 17
44 17
45 16
NOTICE
'Unow 11 Mechanics' Llint law (Catifornla Cope of ()ival procedure Section 1 lal er Req ), any contractor, suhcxntractor. Igrgorer. supplier other person ne rimptt tr,
improve your property bill 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 solei by a crnrn nf(LCef Ind the, rlmrretia of InP. Sale llsed to satisfy me. IndebledneSa This Can happen P.ven it Voll nave.. pall yowl own COnlfactpi in Dill If the
SCDconlfaclal, latxnur it suopliur icrtlainS unDard anp d legal action is necessary 19 collect of enforce Inc tefnls or Isis COnlrdct, the prevailing pally shad UC entitled tt, its
reasonable artnmey fees plica all rosrc of slriT and interest shall accrue an all sums. which are due 30 days after hilling at IhP rale; .ar 19 %, per annum The OanOee Co. Inc.
is not responsible for delays caused by weather, strike. material shodage or delay in material supplied to the job or to any other delay beyond its control. The Dan Dee Co
Inc. total liability under INS contiact Win negi genr,R is limited snlely to the amount or lnis mnlrant
We are fatly covered by wtackmeRs compensation and public IiabilltX insurance. Carriers narnes and policy numbers available pn regue;t,
Any allerabon or deviation from the a above specifications invnlving extra cost of material or labor will only by PxeCuted upon written orders for Same, anti will necome an
extra charge over Ine sum mentioned in this proposal. All agreements must be made in writhing and is based on free access to building for direct loading from our trucks.
Pricesare based on current costs of material and labor. Increases or decreases, will be reflected at Ume 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 caused from
acts of Ood. such as earthquakes, thunderstorms. nail or any other weather conditions beyond roofers control.
'11 --------------------------------------------
1�.Sjqq
----------------------------- DA*I'L----- --
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1'11`DAfVI)IT ('().
SEP -17-99 FRI 12:28 WESTERN INSULATION FAX NO. 9096868786 P.04
WESTERN INSULA'T'ION, INC.
4211 Latham Sheet, liversidO, 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:
PRO.lECT: MONTECITO COLLECTION
PHASE:
TRACT: 28776
LOT: 43
SITE ADDRESS: 54-997 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: '?Ie6r7
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
TITLE: PRODUCTION MANAGIYR
DATE SEPTEMBER 17, 1999
Certificate of Occupancy �I
City of La Quinta
Building and Safety Department OF,.�t°`'�
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
54-997 LAUREL VALLEY
Owner of Building: SOUTHERN HILLS, LLC
Building Official
VN
Bldg. Permit No.: 9901-113
Land Use Zone: RL
Address: 1430 E CHAPMAN AVE, STE 100
City: ORANGE, CA., 92886
By: DANIEL P. CRAWFORD JR.
Date: 11-4-99
POST IN A CONSPICUOUS PLACE