9901-114 (SFD)LICENSED CONTRACTOR DECLARATION
I hey, by 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
19
,j -
Signature of Contractor (�
22000
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.
0 IFAGLIs 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,
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 forthhwO comply with thosetvisions".
Date: 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.
x 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/Agee f�%""'""'Date%^ f
PERMIT #
BUILDING PERMIT
9"1_114
DATE VALUATION ,1,25iSf�� LOT 44/ TRACT 24f'7yo
JOB SITE _
ADDRESS .54.979 LAKUL VALLUM
APN
769-1110-0:28
OWNER
CONTRACTOR / DESIGNER / ENGINEER
SOME, KN DILLS, LLC
R.C. HOBBS dba SOUTHERN HILLS, LLC
1430 E CI-TAPMA.N AVE., Ste 100
55-960 PGA BLVD
ORANGE CA 92886
LA C)UfNTA CA 92253
(714)633--r200 CBLt1 5487
USE OF PERMIT
LING
SINGLE FAMILY DWELLING
.L(Yi" 44, PLAN 2 -SFU- PM41T DOES N()1 1XCi i DC BLOCK WALLS OR
POOLS. ISI A74 C" I CK FEEREDUCED 75V. FOP, ft-AXTIPLE ISSCANCE Cr
SAI IE PLAN TYPE,
USTONI CONSTRUCTION 11020.00 SF
PORC 0ATIO 112-0,00 SF
G1AR.A.GEICA:RPORT $65.40 SF
EST MLATED CONT OF Ct1NS TItUCTION
256,4468.01)
PERM T FEE, SUMMARY
CiJN."rTRi7C7.'IOld,2 EE 10.1-OW418-000 $.t,IFi�.ti0
PLAN G1IEC K FEE 10.1.000-439-318 $242.44
I4[E'24ANICAL FEE 1.0.1-000-421.-0()0 $111.150
FLEC`fPJC;A: FEE 101-000420-000 $.IM50
1F>i',C INt3I+iMC 101-OW4119-000 St86.50
STRONG MOTION FEE- -RE-SID .101.000-741.,000
GRADrNG E.EE 190-000-423-000
.1XF 2AST.R JCTL?i 6'M�R 22.5-000443-342 $5;i74'107
ART IN FLIBL 1C: PLACES - R631 AC 700-000-255.000 $391.17
SUB -TOT -AL •CON,57RUC ION ND PLAN CHECK
:$8,0`? 1.53
LESS 1 -'RE -PAW FE133S
°.0.(9)
TOTAL PERMIT FEES DUE NOW
$8,021.53
RECEIPT
v, ��1 5
DATE'"fl,
� I f f`
BYit M\4 �(J ' �/A
S'
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 30
Exhaust Fans
OX to Wrap S
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
xtedor Lath
Drywall - Int. Lath
or
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 Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Vottage 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
CoW*M y 1hK&. L is 732542
ROOFING AND CONSTRUCTION
BIDS TO:
THE R.C. HOBBS COMPANY
55-960 PGA BLVD.
LA QUINTA. CA. 92253
TELEPHONE #564-1551 FAX 0564-2803
P. 01
Roofing Proposal
P.O. Box 177 Thousand Palms, CA 92276
PHONE(760) 343-338S FAX (760) 343-3096
JOB NAME;
MONTECITO COLLECTION (PHASE#1)
LA QUINTA, 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
'Undcf Nle MCChanics' Lie,' Low ICantomla Code of Civil procedure Section t i m er SM 1. any rxmrraetor. suhnoniractor. lmborer. n(tnerps ro
improve your pmperty but is not paid for his work or supplies. has a right to enforce a claim against your property. This means that. after a conn hearing your property could
ne sold oy a coun nniQr}f anti tha, prnr"rlA or mP. sale 1rSB010 salrsry me. inaerilednP.ss T'nls Can happen even it yo11 nave,. paid your own contractor til lurl if the
Subcontractui. Wb(iiui or suopliur remain$ unDOid 0-10 illegal aCUon is necessary to collect or enforce Inc tc-ans orinis 0untract. trle prevailing party Shall be Entitled to its
rPaconabla armmey tees plus all cost, of cui? and interest shall accrue an all sums. which are due 30 days aher hilling ar IhP rale ar IN I/, per annlrm 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 liability under Ilbs cont"RI Orin negl,rlence is limited Solely In me amnum nr this contract
WO areAft covered by vygrkMgn s compensation and public liabillty insurance Carriers names and ROIiCX numbers available pn regkikg,
Any alteration or dewalipn from the a above specifications involving extra coat hf material or labor will only he executed upon written orders for game. and will nPtrnme an
extra charge over lne sum menlioned in this 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 time of signing contracL
Before and or during roofing operations and the completion of roofing, The DanDee Co Inc. will not be responsible or liable for damage catrsod from
Bets of 006. aucn as earthquakes, thunderstorms. nail or any other weather conditions beyond roofers control.
'fill: DANI)1•F (Y).
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SEP -17-99 FRI 12:28 WESTERN INSULATION FAX NO, 9096868786 P.05
WESTERN INSULATION, INC.
4211 Latham Su'e 4 Riv=-sidc, CaUomla 92501
Tel. (909) 686.8760 Pax (909) 686-8786
INSULATION CERTIFICATE
THIS 1S 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: 44
SITE ADDRESS: 54-979 LAUREL VALLEY, LA QUINTA, CA
EXTERIOR WALLS:
-------------
MANUFACTURER: Manville
,THICKNESS: 5 112" 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 CONTRACTQR: SOUTHERN HILLS, LLC /THE R.C. HOBBS COMPANY
LICENSE NUMBER:
BY.
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRODU ION MA AGER
DATE SEPTEMBER 17, 1999
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: 54-979 LAUREL VALLEY
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction
Owner of Building: RC HOBBS
Building Official
Bldg. Permit No.: 9901-114
Land Use Zone: RL
Address: 55-960 PGA BLVD
City: LA QUINTA, CA., 92253
By: DANIEL P. CRAWFORD JR.
Date: 10/6/99
POST IN A CONSPICUOUS PLACE