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9909-169 (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 # (� w Lic. Class Exp. Date �.`.�r 1"7.1.. Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor'si License Law for the following reason: (K) I, as owner of the property, or my employees with wages as theirs 'le compensation, will do the work, and the structure is not intended or offeredor 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 amam exempt under Section B&P.C..for this reason a�D to .7� > 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 .MIIr1-t�tff INS C Policy No. 92W43 70 (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 su�je t to the workers' compensation provisions of Section 3700 of the Labor 06de, Lshall ford with comply with those provisions,' /Date: .�/Jl Gl Applicant f -2 c.o 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,3bove-mentioned property for inspection purposes. re C� R7✓ Signature (Owner/Agent) �-r''�'� �-� �' � - • • � Date BUILDING PERMIT PERMIT#IO DATE a VALUATION .38.1,424JO LOT 4 TRACT 87" L f t "T' fi SITe 51- AVENI1DA, VEL ASCO APN 773-96"19 AOB DDRESS OWNER CONTRACTOR/DESIGNER/ENGINEER &;!fiTAVO ESPINOZA OWNER I BUl"IDER. W1`I I CVHC 1240 7M STREET 4_5701 MONROE ST S iE G COACHELL A CA 42236 INDIO CA 92201 (760)347-3157 CaL# USE OF PERMIT SINGLE FAMILY fi1Wi. LLINCI SFD (1320AGR) - PETMT DOES NO'T rocuAx BI. xx Wmx, oR PooL. . PIAN C.IE-CX FEE I2 X%D 7;4R,u'FOR MULTIPLE ISSUANCE OF SANE PLI"' 'IOW. TRAt"r CONST UC ION 1,320.00 3F PtAt:II'/PATTO 114.00 Sr QAPLAOD- CSU' PORT 420.00 SF E,9TIMATED ILNMT OF C( NST1tUMON $1,42449 PERMIT FEE SUMMARY CONSTRUCTION 1,01-M-4.18.000 $53.50 PLAN C"IMCK FEE 1014*01439-318 $118.61 ,NEZRAMICAL FEF 10141100-421-000 S53.50 ELEC'TM.IC'AL FEE I M -000.420-I?t1q S118.10 P1.Ii1NBIN4 FIW- !O1 -WO -419.000 $122.75 STRONG MOTION Fid - RESU) 1811408+0.241 -OW 33.14 GRADING FES 10.1-000-dW3.OQO 520.00 DE!'KI IPER WPA.tT FEF; 31.907.00 PRECISE PIAN IOi-011{1-I-I1-345 $100.00 :sd M-TiYFAL LONSIVK ION t ND PLAN CHECK $3,012.60 LESS PRE-PAJD FEES $0.00 TOTAL. PERtiiT FEFS DDE NOW Uv§12." fi RECEIPT DATE BY i DATE FINALED INSPECTOR a INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings , Slab Grade p' Ducts Return Air Steel Combustion Air Roof Deck 3 —/s $ ; Exhaust Fans O.K. to Wrap F.A.U. Framing r!s r — pa S7 s Compressor Insulation �(� — cgo �—J - Vents Fireplace P.L. ; Grills Fireplace T.O. I Fans & Controls Party Wall Insulation i Condensate Lines Party Wall Firewall Exterior Lath Ad _0W Drywall -Int. Lath 6 —! 7-7J� s7 Final Final BLOCKWAL AP ROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings s 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 Water Piping Heater Final Plumbing Final Plumbing Top Out JO 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: THIS ATTIC HAS `r Ar tE •1 e b �k BEEN INSULATED T0: 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. R -value is a measure of resistance to heat flow'-- the higher the R -value, the greater the insulating er. If you would like to add more insulation to your home, contact your Cocoon authorized dealer. a f n r, INSTALLED BY: ^^ AD iVZED INS TALl—Al 1V 81- 771 can er, VNI Indt9 0A 92201 BUILDER: Z�b CERTIFICATION: This is to certify that attic insulation has been installed in conformance with the coverage chart recommenda- /bags 1 tions on the opposite side of this card using g to cover L5!�?sq. ft/o ob ain an R -value of r NSTA,LLER'S AUTHORIZED SIGNATURE DATE TM THIS ATTIC HAS `r Ar tE •1 e b �k BEEN INSULATED T0: 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. R -value is a measure of resistance to heat flow'-- the higher the R -value, the greater the insulating er. If you would like to add more insulation to your home, contact your Cocoon authorized dealer. a f n r, INSTALLED BY: ^^ AD iVZED INS TALl—Al 1V 81- 771 can er, VNI Indt9 0A 92201 BUILDER: Z�b CERTIFICATION: This is to certify that attic insulation has been installed in conformance with the coverage chart recommenda- /bags 1 tions on the opposite side of this card using g to cover L5!�?sq. ft/o ob ain an R -value of r NSTA,LLER'S AUTHORIZED SIGNATURE DATE � a 4 Jif TM Cocoon Stabilized Insulation 30 lb. bag " A/anujacrured By.. ATOMIZED PNEUMATIC APPLICATION GREENSTONEC•:" R -Value at A LOUISIANA-PACIFIC COMPANY Net Coverage No Adjustment for Trusses 56.7 75°F Mean NOTE: This coverage chart compensates for settling - l` -`LL, and is for estimating purposes only. Stated R -value is 1 i provided by installing the required number of bags '.. t ci per 1000 sq. ft. at a minimum installed thickness. "- Installation of the required number of bags may yield r more than the specified minimum thickness and nainununa .� • weight per sq. ft. Actual coverage will be influenced iby job conditions and application techniques, and Installed 1 Ili!. y }4.!. { may vary as much as 10% without significantly '+ + affecting the stated R -value. Failure of the installer to _ provide at least the required number of bags per } ( - 1000 sq. ft. and at least the minimum thickness may Square Foot of Bags Required result in a lower installed R -value. Compaction may s 10 r" occur during installations above R-30, requiring more 4.7 3. .f. than the stated number of bags to obtain the Square Feet minimum installed thickness. i Less Than: Per Bag 1,000 Square Feet �:- •'p �, GreenStone and Cocoon are trademarks of iE� ! r - 1 ,, , GreenStone, a Louisiana-Pacific company. © 1997 ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART R -Value at •� S tr Ta Net Coverage No Adjustment for Trusses 56.7 75°F Mean Minimum Gross Coverage Based Maximum Net 6 `��'` ,3„• a +. Minimum Weight Temperature Thickness 2' x 6' Trusses an 16' Centers Coverage Per Square Foot Installed 1 Ili!. y }4.!. { The Weight Per To Obtain an Insulation Minimum Bags Square Foot of Bags Required Insulation Should Not Be Square Feet Required Per Installed Square Feet Per 1,000 Resistance (R) of: Less Than: Per Bag 1,000 Square Feet Insulation Per Bag Square Feet (inches) Should Nat Be Less Than: (lbs.) 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 ,a. }ja f , 1 ' GreenStone Industries, Inc. All rights reserved. Sidewalls (pressure filled -density 2.0 PPCF) •� S tr Ta Printed in USA. RV 30M 8/97. 56.7 17.6 20 (2 x 6) 5.5 32.7 6 `��'` ,3„• a +. B -97-7/13-A 36.1 rF a 1 Ili!. y }4.!. { 13(2x4)3.551.4 19.4 .583 56.7 17.6 20 (2 x 6) 5.5 32.7 30.6 .917 36.1 27.7 ■" f