9905-339 (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
759465 �� g 4 Yi&201
DaterSignature 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.
Q, 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.
(This section need not be completed if the permit valuation tisfor3$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 3�6 Olof the Labor
Code, I shall forthwith comply with those?provisions.!, 1 / f `
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 for inspection purposes.
Si nature (Owner/Ageinti - f ` _� Dat n" '44
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 9905.339 TRACT
(W. 27/199 $119,253.5/5 216 28459-2
JOB SITE
APN
ADDRESS
78-.1513 SAN MARINO COURT
6094)74"38
OWNER
CONTRACTOR/DESIGNER/ENGINEER
ADVANCED DEVELOPMENT CORP.
'TRADITIt7141Al. BIBLDNI G CO INC
78-613 NAPLES DR
78-615 NAPLES OR
LA QU1N 7A CA 92253
LA QUINTA CA. 92253
(761J 772, I)222 CBIL# 5750
USE OF PERMIT
SFD -'LOT 26, PLAN 3B -• PLi'RNUT DOES NOT INCLUDE BLOCK WALL
LAR POOL
'l! ACT CONSTRUGMWN 2a025.00 Sr'
PORCIVPATIO 52.00 SF
OARAGElCARPORT 439.00 SF
LSTLNlNCEi D CO„W OF COlVSTRUCI10N
1.19,2:3.50
PERMIT ME SUABUkRY
CONSTRUC110N FEE 101-000.418-000 $709.50
PLAN CHECK FEE 101-000-=339-318 5387,90
rifffiHANICAL FEE 101 -WO -421-000 $53.50
IZLI t -DUCAL FEE 101.-000-420-000 $128.16
PI:UMBING FEE 101-000419-000 S140.75
STIZONO MOTION f f - RESID 101-000-241-000 $11.93
GRA1?ING FEE 101-000-423-000 $20.00
INFRA,ITRUCTME RE 223-000-443-332 12,667,64
AVRT IN PUBLIC PLACES - RES1JC 701-000-25+-000 $413.13
SU134DTAL CONSTRUCTION AND PLAN CHECK
$4„367.51
LESS P12E-PAID FEES
UAW
TOTAL, PERA9IT Pf,ES DUE NONY
54,367.51
RECEIPT _ J\
Dt4TE
BY !� }
DATE FINALED
INSPECTOR
'1 i; 1 ✓ ” f, 71— I k I 11
V
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
It BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Slab Grade
Ducts
Return Air
Steel
Combustion Air
Roof Deck
_ g_ 1c�p a„`
Exhaust Fans
O.K to Wrap
G /
F.A.U.
Framing
Compressor
Insulation
/—%Z —
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
047
Exterior Lath
Drywall - Int. Lath
Final
Final S ��
BLOCKWAL 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
— p —
Appliances
Final
Final17
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 Z zz
Utility Notice (Perm)
COMMENTS:
.. i
Bel Vista
Certainlreed M Lot 2E>, Plan 3
78-51.4 San Marino Ct.
La Quinta, CA 1"
Builders Statement
InsulSaW4
Fiber Gla6;s Blowing Insulation
InsulSafe"14 has been installed with the
manufacturer's recommendations to
provide a value of RaB_ using
2 bags:of:irisulation to cover 340£4
square feet of area at a minimum
thickn ss of l riches.
Installer ntractor(sign)
Paragon Insulation
Com )any fume
12%21/99
Date
Builder (sign)
Company Name
Date
Batts and Blankets
R -Value
Insulation
Thickrn�ss (in)
38
10, 12
�
30
874, 10
25
b
2 ?
6'/z
2
6'i,
l S . -
3'r: .
13
3 "z
11
3'h
Fiber glass batts or rolls have been
installed in accordance with the
manufacturer's recommendation to
provide an R -value of 38 in the
ceiling,13 in the exterior walls, ,
inlV%etloor or cr wl.space perimgnter.
fnstalle ontractor (sign)
Insula
2���on Insula
tion
tion
Company Name
12/21/99
Date
Builder (sign)
Company Narne
Date
Cade No. 30.24-233
THERMAL PERFORMANCE—ATTIC BLOWING APPLICATION
• In accordance with the chart below, you must install the minimum number of bags
per 1,000 sq. It. of ret area for each R=Value listed.
• The maximum net coverage must not exceed that specified for each R -Value.
• The installed insulation must be at or above the specified minimum thickness for
each R -Value.
• failure to install the required minimum weight per sq,. ft. of insulation at or above
the minimum 1:hickress will result in reduced R -Value.
• This product should not be mixed with other blown insulations or the thermal
claims will become invalid.
BAGS PER MAXIMUM MINIMUM WEIGHT. MINIMUM
R -VALUE 1000 SQ. FT. SQ. FT. PER BAG PUUNDS PER 5Q. FT, THICKNESS
To obtain a bags per Contents of bag Weight per sq. it. of Should not be
Thermal Resistance 1000 tq. ft. should not cover installed insulation should less than:
(R) of: of net area: more than: (sq. ft.) not be less than: (IVs.) (in.)
60 36.5 27 0.986 22
_ 49 29.6 34 0.800 18,12
44 26.4 38 0.712 10,
38 22.8 44 0.615 141h
30 18.0 56 0.485 12
26 15.5 65 0.418 101G
22 13.1 77 0.353 9
19 _ 11.1 90 0.3C1 774
13 7.7 129 0.209 i'h
11 6.1, 151 0.179 41
R -values are determined in accordance with ASTM C 687 and 513.
Complies with ASTM C 764 as Type 1 insulation.
"R" means resistance to heat flow. The higher the R -Value, the greater the
insulating power. To get the marked R -Value, it is essential that the
insulation is installer! properly.
DANGER; RECESSED LIGHT FIX-TURES—TO PREVENT OVERHEATING,
DO NOT INSULATE ON TOP OR WITHIN 3" OF SUCH
DEVICES, DOES NOT APPLY TO TYPE IC LIGHT FIXTURES
OR TO FLUORESCENT FIXTURES WITH THERMALLY
1
5,r
19
6'i,
l S . -
3'r: .
13
3 "z
11
3'h
Cade No. 30.24-233
THERMAL PERFORMANCE—ATTIC BLOWING APPLICATION
• In accordance with the chart below, you must install the minimum number of bags
per 1,000 sq. It. of ret area for each R=Value listed.
• The maximum net coverage must not exceed that specified for each R -Value.
• The installed insulation must be at or above the specified minimum thickness for
each R -Value.
• failure to install the required minimum weight per sq,. ft. of insulation at or above
the minimum 1:hickress will result in reduced R -Value.
• This product should not be mixed with other blown insulations or the thermal
claims will become invalid.
BAGS PER MAXIMUM MINIMUM WEIGHT. MINIMUM
R -VALUE 1000 SQ. FT. SQ. FT. PER BAG PUUNDS PER 5Q. FT, THICKNESS
To obtain a bags per Contents of bag Weight per sq. it. of Should not be
Thermal Resistance 1000 tq. ft. should not cover installed insulation should less than:
(R) of: of net area: more than: (sq. ft.) not be less than: (IVs.) (in.)
60 36.5 27 0.986 22
_ 49 29.6 34 0.800 18,12
44 26.4 38 0.712 10,
38 22.8 44 0.615 141h
30 18.0 56 0.485 12
26 15.5 65 0.418 101G
22 13.1 77 0.353 9
19 _ 11.1 90 0.3C1 774
13 7.7 129 0.209 i'h
11 6.1, 151 0.179 41
R -values are determined in accordance with ASTM C 687 and 513.
Complies with ASTM C 764 as Type 1 insulation.
"R" means resistance to heat flow. The higher the R -Value, the greater the
insulating power. To get the marked R -Value, it is essential that the
insulation is installer! properly.
DANGER; RECESSED LIGHT FIX-TURES—TO PREVENT OVERHEATING,
DO NOT INSULATE ON TOP OR WITHIN 3" OF SUCH
DEVICES, DOES NOT APPLY TO TYPE IC LIGHT FIXTURES
OR TO FLUORESCENT FIXTURES WITH THERMALLY
,7
1.3
U•g
/,
PROTECT -ED BALLASTS.
FRAMING ADJUSTMENT
To compensate for framing members the number of bags per 1000 sq. ft.
of net area shot.11d be
reduced as follows.
Joist Size Bags to deduct/1000 sq. ft. Bags to deduct/1000 sq. it.
(in.) Joists 16" O.C. joists 24" O.C.
2 x a 0.5 0.3
2 x 6 � 0.8 0.5
2 x 8 _ I:U 0
1998 Certaineed Corporation 12/98
,7
1.3
U•g
1998 Certaineed Corporation 12/98