9901-115 (SFD)LICENSED CONTRACTOR DECLARATION
I tereby 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
3%situ 13 .I 21,9100
Date• _-21 i Signature of Contractor__ '
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:
Cartier Policy No:
00X,00.F td FAGL8 NWC 5457014110
(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, 1-,hall.forthwith comply with those provisions.
Date: *' =�'' `>� Applicant �"''�`�
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000,. in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest. and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to. the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
Ahold harmless the City of La Quinta, its officers, agents and employees.
• 2. Any permit issued as a result of this application becomes null and void if
work is not commenced- within 180 days from date of issuance of such
permit, or cessation of work for 180 days Will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I.agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter"upon
the above mentionedproperty fo�inspections./Sigature (Owner/Agent)Date
BUILDING PERMIT PERMIT#
99ox-i.1
DATE VALUATION LOT t TRACT
_8776
JOB SITE �i ri
ADDRESS 54-963 LAU�tRTr �• .A L)EY
APN
7 ! 11{}_02g
OWNER
CONTRACTOR / DESIGNER / ENGINEER
SOL'i'HERN HILLS., LLC
R.C. HOBBS dba SOUTHERN HILLS, LLC;
1430.E CHAP:&W-4 AVE,Ste 100
55-960 PCYA BL*% -D
ORANGE CA 92836
LA Qt1MA CA 92253
(714)633-7260 CBL# 5,187
USE OF PERMIT t
SML'rl:,> FAMILY i WE'LUNG
LOT 45, PLAN 3AR -SFDS PMffTt DOES NUF INCA. ME BT.C+c"b;;.WALLS
OR POOLS. PLAN +CIIECY. EFE RFD-VCFD 730o:F'OR MULTIPLE I:iSUIV4C '
Or SANTE PLAN TYPE.
1
CUSTOM CONSTRUCTION RUCTION 1.37 .00 SF
PORC iPATIO 319.00 SE
t •.AaAt3WCrla,RPORT 700.00,5F
"TtMATf,V COST OF Ct3tNNA AAUC'!°ION
280,628.20
PERMIT %RE .4U11$.MM&
CO?4ST'RUCTION:F EE 101-000-418-000 3;1,273.00
PLAN CHEC K4. FEE 101.000-4311-3.1.8 $260.00
NIFCRANICAL TTY, 101-000.421-000 $124.00
F113 `'ktCAL F'.r.� 01-000-420-0W $1.5+9.5 4
PLM1B1NG .FkiE 101-000-41.9-000 $20.75
STRONG MOTI.ONPEE -:Rl=SID 101-000-241-000 $28.06
GRADOTO FEF 01.000.423-000 $20,00
1NMA TRL1'G'1't1.RE FEE 215.1100-443.342 ,86,000.00
ART 114 PU MCIPLAC E'S-13.ESIC701-000-255.000 $4151.57
SUB-TC>"!'rli. CONSM.WrION AND PLN CHECK
$8,551.90
L1:SS PRE -PAID FE,, r,.S
$0.0e,
TOTAT, PERMIT FEES DIVE NOW
S8,551.'"
REC�EJ, T 11� 1�
/ DATE f q
BY J
DATE FINALED
INSPECTOR
.,p - y
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
O.K. to Wrap
F.A.U.
FramingCompressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
3
Final
Final D
BLOCKWALL APPROV S
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
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
c '
Thi DanDee
e
Co *Mly hw. L is 732.542
ROOFING AND CONSTRUCTION
P. 01
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 0564-1551 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
43
17
44
17
45
16
NOTICE
Vnotr Int MCChaniCs' Lie,' Law (Cardornia Looe of (>vu procedure Section 1181 er Sect 1. any contractor. subcontractor. laborer. supplier ntner person np "'tris rn
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
nP. sold fly a court nfl-ckr and the prnr*efJq of Itie Rale. Irsad to satisfy me IndebteanesIt This Can happen even if you have pard your own Conlracloi 0 It,ll If the
SubContfactor. laWicr or suopliur remain$ unpaid and ,t legal action -3 necessary to collect or enforce Inc tonns or Inis contract, the prevailing party shall be entitled to its
rPAsonahle Annmey fees phis all costs of suit and interest shall accrue an all sums. which are due 30 days after hitting At the rale ar 18 %, per annum The DanOee Co. Inc..
is not responsible for delays caused by weather. strike. material shoilage or delay in material supplied to the job or to any other delay beyond its control. The Dan Dee Co
Inc. total liability under th.s contract or m nP,gl gencP 13 IImltPd solely In the Amount of this contract
We. are fully covered by WQ*mcn's compensation and public fiabillty insurance Carriers names and RolicX numbers available on request,
Any allerabon or deviation from the a above specifications involving extra coat of material or labor will only he executed upon written orders for Same. and will necnmP an
extra charge over lne 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.
Prtees are based on current costs of materiel and labor. Increases or decreases, will be reflected at Ume of alpning contract_
Before and or during roofing operations and the Completion of roofing, The DanDee Co Inc, will not be responsible or liable for damage causoA from
acts of 0od. such as aanhqualtos, thunderstorms. hell or any other weather coadmons beyond roofers control.
--------------------------------------------------------------------- --------------------------------- DA'1'L-------'--------------------------------------
A
----- - - ------------ ------------------------------------------- ----------------------------------- UA ---CI_�. �_!_�-------------
L F
I'I II: DANI)lil•: CO.
SEP -17-99 FRI 12:29 WESTERN INSULATION FAX NO. 9096868786 P,06
WESTERN INSULATION, INC.
4211 Latham Strcct, Riverside, Calitomia 92501
Tcl. (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: 45
SITE ADDRESS: 54-961 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:
Y.TITLE:
DATE:
INSULATION CONTRACTOR; WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY: 1
TITLE: PAODUCTIM MANAGER
DATE SEPTEMBER 17, 1999
C17Y OF LA n(( JON TANDY
37630 Medjool Ave.
Pallrn Desert, CA 92211
A� 1 REC-D Office (760) 772-7192
SRECIAL INSPEFax (760) 772-7193
REGISTERED INSPECTOR'S WEEKLY REPORT SppP"er (760) 776-3338
TYPE OF ❑ REINFORCED CONCRETE"r[S`TRUCT. STEEL ASSEMBLY ❑
INSPECTION ❑ POST TENSIONED CONCRETE d`ASPHALT ❑ OTHER
PERFORMED ❑ REINFORCED MASONRY ❑ FIRE PROOFING
JOB LO�IJ{�( / ( ^ � kjA I j & Qu`.,j\rA- C'A- REPORT SEOUENCE NO.
TYPE F TRUCTURE / a PERMIT N0. Dg E_( 9 _9
DAY OF WEEK
rgS
MATERIAL WCIXt.L d\ ARCHITECT INSPERTOR HRS. CHARGED
E- --? (T -J ENGINEER I ASSISTANTS HRS. CHARGED
INSPECTION GENERAL
DATE CONTRACTOR
Co .
SUB ,^
CONTRACTOR S• �Pl �y
l
&s�.
-3 c0 6—
-X .9A-sC-- -
to o (q eL l 0 N
W
76S-
1
S Io Co-
- S-
g X S« co( s
1+o P
W e -c-6 t t-1 c-.- rbUlj
0a
-=ae-
COPY SENT TO CLI E
CONTINUED ON NEXT PAGE ❑
PAGE OF
CERTIFICATION OF COMPLIANCE ra-)
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY SI NATURE OF REGISTERED 10S ECTO
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. 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:
Use Classification: SINGLE FAMILY DWELLING
54-961 LAUREL VALLEY
Bldg. Permit No.: 9901-115
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: SOUTHERN HILLS, LLC
Building Official
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