9703-086 (SFD)LICENSED CONTRACTOR DECLARATION
I h6reby 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 l� Exp. Date
/_,/
ate Signature of Co racto
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.
CAI. C: C)N01 W'%B Urm
(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 . etCtion 3700 of the Labor
Code, I rh II fo `hwith comply wl h those provisions. 4
atee;' ' y M t Appli77 cant,..
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 propeht for inspection pu . oses. f 13h
/Signature (Owner)Ag n. 'tom�������' ate_. .
BUILDINGPERMIT PERMIT# CONTROL#
4919
GATEQ 97 VALUATION �f��� y LOT TRACT
2366)1% 1JOB
SITE
ADDRESSwomm:4.1iJ 9914 1PI
APN 6"2911-007
OWNER
CONTR�ACTORi/ D/ESIG(N(ER / ENGINEER
Sii: .�i hilt ?l�Fl .moi
Rli(���i.�1�1i7:���llkxf�-
i►
l2&'Z iii ARi6,)14' HWY
1292 Lit: AIM01W HW
UPLAND f'tl 01 ?X'
ITNI.,i N'U CSA 91785
tt��4'�i31.33!� t`')31.ld '�31A
USE OF PERMIT
Nil)
4I�i.) •-#�kf<11"it t Ltl,>i,„moi Nt � 1` itVt't.ifilk: tbl.t,n.'1�. 1vr1i�..A.S Ui2I't!{.li. . .
AZ-
'1RAxA 'l t.'0W t'lzLk,'_TR.oN' 1A 11,00 S.:
Pt`J.R01tl'ri'1`IO 141.00 3V
OAR A(W- C,11itPORT 416.00 SF
i��'��riNtl►.'i'1pi? C;. ”. T OF C'gN�1'�CIC .Ti�hr
86,646.20
-PERMIT fIINIMARY
PLAN( HT!(,`KFPli 101-Ot10-$39-318 5490,72
4"'ONt3'1`ftt tt-V ION 3: Tz? 1014 0-4)1140. $,-A 1.00
A4114ANICAL RE $471.00
iSLkt."I:Rtt'ihl.l�f1::. i()1-{!l'N,,f-�3'.tl--tifll) 7,tf.�.2!
PLilMt3Xt.FCt b f F YA -000-40-OW 51.4:1.0li
O t t)NC7 kf"CION FF1*" - RR810 101. _("1-1-11 _000 � �G
ORAI:}.IN41.2,: 10 t • t1W423.000 S�i.txi
tN1 HA8't'tt►.jt `1'CA0!1 H1 224)00-443-342 31,+�t17.35
St_ROM .At, t.'( NN'rR1.10,1 N AND KAN f'I�)) (""t�
$3,.V-8,94
MSS PU-PAID PEES
$0,00
TWA!, OERMI T FlUeS DUC NONV
,1991
s�,�x.+I►�
PR o 3
REC DATE
'y
BY'
DATE FINALED
INSPECTOR
V_
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Underground Electric
Ducts
Slab Grade
Final
Return Air
Steel
Gas Test
Electric Final
Combustion Air
Roof Deck
_$'
Exhaust Fans
OX to Wrap
I&I
F.A.U.
Framing GTd
Compressor
Insulation
Vents
Fireplace P.L. I
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
nrvwall _ Int I ath ZLw,wsni i
rwl vwci
Sewer Connection Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Utility Notice (Gas)
ELECTRICAL APPROVALS
TemD. Power Pole
Main Service
Sub Panels
Exterior Recepta<
G.F.I.
Smoke Detectors
Notice
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
I OX for Finish Plaster
rwl vwci
Sewer Connection Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Utility Notice (Gas)
ELECTRICAL APPROVALS
TemD. Power Pole
Main Service
Sub Panels
Exterior Recepta<
G.F.I.
Smoke Detectors
Notice
Residence Address: 1 c, 20 Cie Lot I P10 h
YS - 05S Seri nq brook La Quink,) &A 9 Z2E3
CERTIFICAT101% This is to certify that attic insulation has been installed in conformance with
the coverage chart reeotnmendations on lire opposite side of this card using �- bags to
cover 19 00 sq. fe to obtain an R -value of 30
Contractoes authorized signature
Date.
Installed by.
24.741 InNI nRIVF
IPAiLM DESERT. CA 92260
i..
-rL#E rNSULAWN SPECIALS)
Builder.
.. R -PRO PLUS
(Formerly Cordex)
STABILIZED INSULATION
MANUFACTURED BY
GREENSTONE INDUSTRIES
Atlanta, Georgia • Elkwood, Yrginia • Ft: Wayne, Indiana
Norfolk Nebraska •Phoenix, Arizona • Rortland, Oregon
ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART
3.5
39.6
Net Coverage
Gross Coverage
R -Value at
Minimum
No Adjustment for Trusses
Based on 2 x 6'
Maximum
Minimum
75-F Mean
Thickness
Trusses on 16'
Temperature
Net
Weight Per
Centers
Coverage
Square Foot
To Obtain
Installed
Square
Minimum
The Weight Per
Suare
Bags
an Insulation
Insulation
Feet
Bags
Sq. Ft. of
Feet
Required
Resistance
Should Not
Per
Required
Installed
Per
Per 1,000
(R) of
Be Less Than
Bag
Per t,000.
nsulation Should
Bag
Square Feet
(inches)
Square Feet
Not 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
1.172
26.9
37.2
R-38
10.3 '
27.0
37.1
1.113
28.4
35.2
R-32
8.6
32.0
34.1
.937
34.1
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
19.5
R-19
5.1
53.9
18.5
.556
59.6
16.8
R-13
3.5
78.8
12.7
.381
87.0
11.5
R-11
3.0
93.2
10.7
.322
102.8
9.7
Sidewalls (pressure Filled -density 2.6 PPCF)
-13 (2 x4)
3.5
39.6
25.3
.758
R-20 (2 x 6)
5.5
25.2
39.7
1.192
Note: This coverage chart compensates for settfing and is for estimating purposes only.
Stated R -Value is provided by installing the required number of bags per 1000 sq. ft. at a
minimum installed thickness. Installation of the required number of bags may yield more
than the specified minimum thickness and minimum weight per sq. ft. Actual coverage will
be influenced by job conditions and application techniques, and 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. R and at least the minimum thickness may result
.n I...m. �cMllerl 4_\leh.e elver c.w;nn (`mmnnminn may ry e4 or As vine incMllofinnc ohnro R_
'L
Fiber Glass Blankets when
installed according to the
manufacturer's recom-
mendations will provide the full
rated thermal resistance value.
Blanket Insulation
R
Value
Minimum
Thickness
To obtain an
insulation
resistance
(R) of: -
Installed
insulation
should
not be less than:
R-38
13" Thick'
R-30
9Y4" Thick'
R-26
83/4" Thick
R-22
71/2" Thick
R-19
61/2' Thick"
R-13
3%" Thick -
hick"R-11
R -1 1
31/2" Thick
'Thickness varies, check bag
label for producing locations
thickness.
` ' - `This Home is •
To meet the thermal resistance value (R), the manufacturer has specified the number of bags per
1000 sq. ft. of net area that must be installed to meet both the minimum design thickness and
minimum wt./sq. ft. requirements. Installing the correct number of bags/1000 sq. ft. is necessary to
meet the corresponding labeled resistance (R) value. (Based on 40 Ib. nominal net weight bag).
' R_ich-R'" Fiber Glass Blowing
Wool Attic Insulation -40 Ib. Bag.
I
depending on conditions at the time of installation. To obtain a specific Fl -value, insulation
R
Valuet
Bags per
1000 sq. ft.
Maximum Minimum
Net Coverage Wt./ sq. ft.
Minimum
.Thickness
Average
Installed
Thickness
To obtain
an insula-
tion resis-
tance
(R) of:
The number of
bags per 1000
sq. ft. of net
area should not
be less than:
Contents
of this bag
should not
cover
more than:
The weight
per sq. Wof
installed insul-
ation should not
be less than:
Installed
insulation
should
not be
less than:
Average
installed
thickness
will
typically be:
R-44
291/2
.34 sg_h.
1.188 lbs.
15" Thick
161/2"
R-38
251/2
39 sq. ft.
1.029 lbs.
13" Thick
141/a"
R-30
201/2
49 sq. ft.
0.811 lbs.
101/4" Thick
111/4"
R-22
15
67 sq. ft.
0.594 lbs.
71/2" Thick
81/4"
R-19
13
78 sq. ft.
0.514 lbs.
61/2" Thick
71/4"
R-11
71/2
135 sq. ft.
0.297 lbs.
33/4" Thick
41/4"
Rich -R'" Fiber Glass Blowing Wool Sidewall Insulation -40 -Ib. Bag.
R-16
161/2
60 sq. ft.
0.667 lbs.
4" Thick
4"
R-14
15
66 sq. ft.
0.604 lbs.
3%" Thick
35/a"
R-14
141/2
68 sq. ft.
0.583 lbs.
31/2" Thick
31/2"
"R-12.7 in a 31/2" cavity.Average
'DPSer'+ Pn de W+ -, Pin n i
installed thickness is provided as a guide to installers. Actual thickness will vary
I
depending on conditions at the time of installation. To obtain a specific Fl -value, insulation
1/5 _ OSS Spri n9 brook Ct
should not be applied over a larger area than specified on the coverage chart.
2x4
Net wt./bag, minimum 37 lbs. This product conforms to the performance requirements of
LO Ga i n �a / C. A
Federal Specification HH -1-1030B. Type I, Class B, and DOE RCS Standards. Also meets the
9225 3
Insulation Quality Standards of the State of California.
Framing Correction for 40 lb.
Framing 16" on center. Framing 24" on center.
R Joists Bags per 1000 sq. ft. Bags per 1000 sq. ft.
Bag Rich -R Blowing Wool
Valuest Dimensions (gross) (gross)
When installing in attics of new
R-44 2x8 28.2 28.6
homes or existing homes where
2x6 28.5 28.8
no insulation is present, it is
2x4 28.9 29.1
acceptable to adjust the
coverage figures to compensate
for the presence of the framing
members as indicated in the
following table.
R-38 2x8
24.2
24.6
2x6.
24.5
24.8
2x4
24.9
25.1
_
R-30 2x8
19.1
19.6
2x6
19.5
19.8
2x4
19.8
20.1
R-22
tR-values indicated obtained
when properly installed with -
pneumatic equipment. R-19
2x8
x4 6
13.6
14.1
2x6
14.0
14.3
2x4
14.3
14.6
2x8
11.8
12.2
2x6
12.0
12.3
2
12 3
12
The higher the R -value, the
greater the insulating power. R-11 2x8 6.8 7.1
Ask your seller for the fact sheet 2x6 6.8 7.1
on Fl -values. 2x4 6.8 7.1
Batts and rolls have been installed in conformance with the above
recommendations to provide a thermal resistance value of
R- at inches in sq. ft. of ceiling, R- 13 at
inches in sq. ft. of exterior walls, and R-.-* - at
inches in sq. ft. of floors or crawl space perimeter.
Dale Signature
in l /c? 7 tW Lx,; ,_lac.
Date Signature
HIG•616 7/86
Blowing wool has been installed in the ceiling or sidewall in con-
formance with the above recommendations to provide an R -value
of R- using bags of this insulation to cover
-_- square feet of area at a
minimum thickness of inches.
Insulation Contractor -1t0• W jN&tJU if)N "' " - -
US= INC
74-741 Joni Drive
PALM DESERT, CALIFORNIA 92260
(fv lq) 346-2339 Printed in USA
'06720/1997 11:09 9096899524
ltv;tallat.ion- Certificait.0"*',
HOOD PLUMBING
�X. I
Re-sidential
PAGE 9' -Z
CF -6R
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"t Number
An -Installation canificiato !sreqaF8dta:bepos(9da1 the bUading's'nia' nor b').-* y tMIL Thid-iorm
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.,i6i��40vdried an thwpoptl6w, of
-equivWsrlt) ch" W P(40a(ed aA*d'jiCj�` a.
responsibility .corllpffancd (CF-fr7'Als cenif
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%I(Orrif
1.6 ' a undomigried', Vtfey that the oqui�mon! -fivied in the =qgory fr.rf-4•4 toi*m'' lt,lhi 9'Quipment Initped.
n
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IUW:.' ' iumW�'
tf Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section ) 09 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: 45-055 SPRINGBROOK COURT
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9703-086
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: R-3
Owner of Building: INCO HOMES
Building Official
Address:
1282 W ARROW HWY
City:
UPLAND, CA., 91785
By:
DANIEL P. CRAWFORD JR.
Date:
6/27/97
POST IN A CONSPICUOUS PLACE