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9805-044 (SFD).,LICENSED CONTRACTOR DECLARATION I hereby affirrh 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 cAlic 121aiM Date 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 c6mpensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professionals Code) i ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( �'IJam exempt under Sectiori, , B&P.C: forr this reason at r. i .0 Signature of Owner / �•M-- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of'perjury one of the following declarations: O 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. (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 suJlect to the workers' compensation provisions of Section 3700 of the Labor C6de, I shall fort with comply with those rov Bions. ate: *� u Applicant G' a Warnin : Fai re 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, indemnity & 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 io caricellation. 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 i spection purposes. VSignature (Owner/Agent) - Dat PERMIT# BUILDING PERMIT 4��611;§_t14d CONTROL# DATE VALUATION $ 77,640.70 LOT 10 TRACT 17`714 O JOB SITE / X 811-945 AVENIDA RAMI] E2. 773773465-01ADDRESS JAPN OWNER CONTRACTOR / DESIGNER / ENGINEER . 1I9 (1TOR GARCIA O�3MITER l BUILDER o�'M-I C`.L'1{C�' 34355 COR.REGIDOR 4570i MON ROE ST ST E G (.A'f'H F 9�km. C n y' C; A. ., 92234 fN D10 C;A. 92201 (7(Q)347-3157 t_".jt3f., USE OF PERMIT SM t SF'17 - (3 REMOOM) PERKUT' GOES NOT WCDE.3LOCK WALLS Olt . POOL.PLAN Cl-1E;CX PORT10N OF F'U?5 REDUi:X-0 7_-V/o 0R-%1Vll 13 i.F_ t8S�UANC E. OF SAME PLAN 'r'�'P . PA lm�-�s' , MAY 14 1998 TRACT COrv,S:MiCTR.)4€ 1,215.(AD SF IkOftc-�r��:l°�v :uv _ _ GAItAa.FJC Axt 0Wr 526.00 SF I �� 9 ��' S d t Cf EST s1ti�1ATED COST O;"•' !.'L. NIS k d: XfT Ill ai%4 O ,. . C , rsl�rMNlIle>1t.V �:x;a'NST'RUMIONFR-', 101-000101-000-4184M $.�-5v F�3,AN 04FC'F F"_ 101.000.439-:315 $114,03 . it iI C'Q lAP (1C;AL .1 1 101 •-.000-421-000 $ 9p. r.(► F.I.1.4: RICAf. FEB 101-000-420-000 $f 6.35 E+LU'MttfNO FEF 901-000-4.19-000 .`�`1'1tnNr �9tYT1()?V 1'F:E - t�.►3`YT1'7 I f) I dH.N!--"41-.fN?0 $�,7ci • ' . GRAI)INO Fa., 101.000 -AD -000 V20.9)0 INFRA.;CR'I�CTL11RE k� . 22;-000-443-3 €2 $1,716._9 I"REC38E PLAN 101-()110-441-341 $'WS.Sit7 SI1--: 7TAt, c'QR74"T`la(1CTiC)U A..AIl) F't.:ah} C3it?Cfti. $2,7W.13 LE'S"'. PPE -PAID FEES $0.00 Tf)'�-:' LP 1;';�YAI11' FKx!:4 O0E, NCDLV D RECEIPT DATE BY DATE FINALED INSPECTOR �r r INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR _ BUILDING APP OVALS MECHANICAL APPROVALS Set Backs 4,114Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel _ Combustion Air Roof Deck Exhaust Fans O.IC 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 — Drywall - Int. Lath Final Final BLOCKWALL A PROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I 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 Y 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: ..Desert�Saids;Unified Scl'ool District Notice: 82-879 Highway 1:11 Document Cannot Be Duplicated. Indio, CA 92201 6.19475-350.0 CERTIFICATE OF COMPLIANCE Date ' 5/13/98 APN # 773-165-022 No. 17020 Jurisdiction La Quinta Owner NameHeCtor Garcia Permit # No, 51-945 Street Avenida Ramirez. Log # City La Quinta zip 92253, Study Area Tract # Lot''# Square Footage 1,215 Type of Development Single Family Residence No. of Units 1 Comments At the present time, -the 'Desert Sands Unified- School District does;,. nota collect fees on garages/carports, covered patios/walkways, residential additions •under 500square feet, detached accessorystructures or replacement mobilehomes. It has been determined'the above-named owner is exempt from paying school•fees at this time due to the following reason: EXEMPTIONNOT APPLICABLE. 5. This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.93 X 1,215 or. $ 2,344.95 the property listed above arid that building permits'and/or Certificates of Occupancy for this square footage in this.proposed project rriay now bre issued Fees Paid B Cashier Check/Bank of America/Bill Siandefer �'' ' Y `Telephone 347-31.� 1 .Name on the cheek By Dr. Doris Wilson Superintendent Fee collected /exempted by Juanita Greer Payment Received N$2g_ Check No.:, 2009914079 Signature [NOTICE: Pursuant of Ass bly Bill 3081 (CHAP 549 STATS. 1996) this will serve to not fy you that the 90ay.approvalpenod:in which you may protesPlhe tees or other payment identfied bove will begin to runfrom the date on which the building"or installation permit for this project is issued or ori which they are`paid'.tothe Dislrict(s)or to,another publicentity authorized to ollect them on the District('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check:application form to district copy for-alLwaivers. Embossed Original- Building'Dept./Applicant Copy.:- Applicant/Receipt Copy - Accounting n Coachella Valleyrflousi'" Cbaffdon, 9 Plaza 1, 45-701 Monro6 Street, Suite G.,-lndio,tA 92201 TEL: ( 0) 347-3157 FAX::(760) 342-6466 ATTORNEY-IN-FACT AGREEMENT, IMe, hereby appoint COACHELLA VALLEY'. HOUSING COALITION and/or any of-,.Its,-;�'utho"rized'�-."a'g'e'ntq as:-, our attorney -in fact for the " - -authorized ­ -I j:', 'my! purpose of executing -ady::fidtic , es of'p­rh'pI6b C. ion, waiver,. of liens and/or executing contracts with subcontractors; prid/brlreldasO of I . iens and/or handling building permit's relating: to that,certain real property described below. All thatcertain land locatedand being -in -the County, f Riverside, State of California, described as.fbllow's-: LOT 10 OF BLOCK 58 OF UNIT'5 OF SANTA CARMELITA AT VALE LA QUINTA, A&SHOWN. BY MAP - RECORDED IN, BOOK 18, PAGE 63 OF MAPS, RIVERSIDE COUNTY RECORDS.* Date ector Garcia Date f\sfami1y\anna\miscfor\aftnyfa Re 17 k2�c6ou THIS ATTIC HAS BEEN INSULATED T0: R- 3s This attic has been insulated to the R -value indicated above, with Cocoon" the high -efficiency insulation. Made from a minimum of 80% recycled materials, Cocoon is scientifically formulated to deliver greater efficiency per inch than other insulation materials. RESIDENCE ADDRESS: W � l D � l 9_4 Vii m I ��z INSTALLED BY:M01011nri9d Z�44"J*2 -feal n A cr- Lel n i BUILDER: G�/ 14C Ll G I YVl On Iry e- Sf L CERTIFICATION: This is to certify that attic insulation has been installed in conformance with the coverage chart recommenda- tions on the opposite side of this card using Lto bags to cover IWisq. ft. to obtain an R -value of . R -value is a measure of resistance to heat Flow - the higher the R -value, the greater the insulating power. _ p If you would like to add more insulation to your TALLE 'S AUTHORIZED SIGNATURE DATE home, contact your Cocoon authorized dealer. .11enujacnlrcrl 13r. GREENSTONE:•:" A LOUIS I ANA- PACIFIC COMPANY XO-I'C: This coycmge chart compensates for sealing and is for estimating purposes only. Stated R,alue is provided by installingthe required number of bags per IoGO sq. h. at a 111inimmn installed thickness. Installation of the ayuind nunalxr of Ings I'my yield more than the specified minimum thickness and minintun weight per sq. h. Actual coverage will be influenced by job conditions and application techniques. and may vary as much as loll, without significantly affecting the stated R -value. Failure of the installer to provide at (cast the required number of hags per 1000 sq. ft. and at least the mininmm thickness may result in a lower installed R -value. Compaction may occur during installations alwwe N-10, retluiring more than the stated number of bags to obtain the mininmm installed thickness. GreenStone and Cocoon are trademarks of GreenStone, a Louisiana-Pacific company. © 1997 GreenStone Industries, Inc. All rights reserved. Printed in USA. RV 30M 8/97. 8.97-TT/G-A Cocoon Stabilized Insulation 30 lb. bag ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART 51.4 19.4 Net Coverage Yo Adjustment for Trusses 56.7 R -Value al Minimum 5.5 Gross Coverage Based on Maximum Net .917 Minimum'Weight 75°F Mean Temperature Thickness2' x 6' Trusses on 16' Centers Coverage Per Square Foot The Weight Per Installed Square Foot of Bags Required To Obtain an Insulation Square Feel I..��mam Ba Bags Installed Square Feet Per 1,000 Insulation Should Not Be Per Bag Required Per Insulation Per Bag Square Feel Resistance (R) ol: Less Than: 1.000 Square Feet Should Not Be (inches) Less Than: (Ibs.) R-50 13.5 20.5 48.8 1.464 21.3 46.9 R-42 11.4 24.4. 41.0 1.230 25.6 39.1 R-40 10.8 25.6 39.0 1.171 26.9 37.2 R-38 10.3 27.0 37.1 1.113 28.4 35.2 R-32 8.6 32.0 31.2 .937 34.0 29.4 R-30 8.1 34.2 29.3 .878 36.5 27.4 R-24 6.5 42.7 23.4 .703 46.4 21.6 R-22 5.9 46.6 21.5 .644 51.0 19.6 R-19 5.1 53.9 18.5 .556 59.5 16.8 R-13 3.5 78.8 12.7 .381 87.0 11.5 R-11 3.0 93.1 10.7 .322 102.8 9.7 R-13 (2 x 4) 3.5 51.4 19.4 .583 56.7 17.6 R-20 (2 x 6) 5.5 32.7 30.6 .917 36.1 27.7