9703-087 (SFD)LICENSED CONTRACTOR DECLARATION
Hhereby 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
C\I W Professionals Code, and my License is in full force and effect.
p Z) License # Lic. Class Exp. Date
d
W r
tv CC „
Z Date � 7 Signature of
_ -Or�
- I h/
r°F–°) OWNER -BUILDER DECLARATION
J U—
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
W -
~ U) License Law for the following reason:
Z_ ( ) 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).
cY) () I am exempt under Section , B&P.C. for this reason
LO
N Date Signature of Owner
O�
Q WORKER'S COMPENSATION DECLARATION
C) Z I hereby affirm under penalty of perjury one of the following declarations:
Lo H11
O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W LL compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
m Q I have and will maintain workers' compensation insurance, as required by
O U Q Section 3700 of the Labor Code, for the performance of the work for which this
Il rn H permit is issued. My workers' compensation insurance carrier & policy no. are:
NJ- Z Carrier Policy No.
O
J (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
sueject t¢ the wofkers' compensp�,ion provisions of Section 3700 of the Labor
AQ'ode, I 'h thio �vu� comply t J1-#1 ose pr �slons�„
te I�Applicant`� "`iiiia.. 1��-+Cy-
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
CS7of 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
co struction, and hereby au ihorize:representaiives of this City to enter upon
It e above-mentioned property for inspection purposes.
gnature (Owner Ageni)d ' 'Date
"Q l L'
BUILDINGPERMIT PERMIT# CONTROL#
921
DATE VALUATION LOT -- TRACT i ja;���
JOB SITE -
ADDRESS _ Cii3c� tiU b ii{, 7Qol.�z`�Qb� �I�� C QS G
APN
E�QD�i���Y•{Da��D
OWNER
CONTRACTOR / DESIGNER / ENGINEER
N,Q W i-kK Qi A' H t
124) W. �,Lk` .i AV "W Y
t pl'1.AV1) t'A 01'"41-0
t411.AND ('A 41 "'"'S
04'9931.1?80 '131 o f 3;31 €t
USE OF PERMIT
. �� x y •" ►=t�l^a�ti i/^.�N ai :� )I 4N('1JAJ11,01.f A °f. WALL',,* 1 PA V(4)1.
0'�*RA(- LA AitPi_RT 118,t.0 *zY
fI'ttS�4;it�1! tS c��flyi 5�9��SrVl�1��
PLAN V141 101 -000-113�019
Y•t`tgfryrp,iT -Ty)N t wp? t#1t (tiff?- bit =rye 1 (?t �fl
�.�,k s1A`4aI�.'Ata 1�hE: 1a,)l�t�tl�-�1�%-�f�O ��� �➢
141 1,.cTtt1C,1lt.. EHE ' '.101 -MO -42u-100 5111.6`1
PIATNIHINO FE1. 161-01i) X19-(0) S141,09
-€bFtrt fl�l�(lifC1�'i-11t1�? S9
T i V I T)T�t 1 (1)'NISNTKfJC't,ON AN1)1)1.At I F f I
PAIDLESS PIU1,141AID, FESTOVAL
`fit Ott
PERMIT MEN D1 i!-,' NOW
APR 0 3 1997
u
INTA
RgCEIPT
DATE
BY�
DATE FINALED
INSPECTOR
INSPECTION RECORD
4
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 s
Exhaust Fans
O.K to Wrap Z
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
POOLS -SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APP OVALS
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
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
Residence Address Df a � `C,�,✓ ��- P �r i n Z
LiS - OlDO SAn na hrnr- lc Lane, LQ L i i nio ,C A 9 22S3
CERTIFICATION: This is to certify that attic insulation has been installed in conformance with
the coverage chart cemmmendations on the opposite side of this cud using _ Ll 2 bags to
cover I y 3b sq. ft to obtain an R/v/allue of. 30
Contractor's authorized signature
Date l!J / 1112 2 -
Installed by.
ROVER INSUILAIMN
r. 74-74NMI DRIVE
PALM DESERT, CA 92260
T INSULA r1av VECLAIUSn
Builder.
R -PRO PLUS
.0 (Formerly Cordex)
STABILIZED INSULATION
MANUFACTURED BY
GREENSTONE INDUSTRIES
Atlanta, Georgia - Elk od, II;Tnia • Fc. Wayne, Indiana
Norfolk Nebraska • 1?hcenix. Arizona • Fbrtland, Oregon
ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART
3.5
39.6
Net coverage
Gross Coverage
R-vah/e at
Minimum
No Adjustment for Trusses
Based on 2 x 6'
Maximum
Minimum
weigh Per
751F Mean
Temperature
Thicimess
Trusses on 16'
Centers
Net
Coverage
Square Foot
To Obtain
Installed
Square
Minimum
The Weight Per
Suare
Bags
an Uuulation
Insulation
Feet
Bags
Sq. Ft. of
Feet
Required
Aeii tCe
Snoutd N01
Per
Requued
Installed
Net
Per I,C)OU
(R) of
Be Less Than
Bag
Per 1,000
nsulation Should
Bag
Square Feet
(inches)
Square Feet
Not Be Less
Than: (lbs)
n.60
13.5
20.0
40.0
1.464
21,3
46.0
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
103
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-1 171
3.0
93.2
10.7
.322
102.8
9.7
Sidewalls (pressure Filled -density 2.6 PPCF)
-13 (2 0)
3.5
39.6
25.3
.758
20(2x6)
5.5
25.2
1 39.7
1.192
Note: This coverage chart compensates for settling 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
;... U+...or;..c+�rle�l q.\/eli n �Hor ceMlirwt r`mm�arfinn mau rvrr r+r rinn inetallatit,nc aFroe q.
Fiber Glass Blankets when
installed according to the
manufacturer's recom-
mendations will provide the full
rated thermal resistance value.
Blanket Insulation
R Minimum
Value Thickness
To obtain an Installed
insulation insulation
resistance should
(R) of:- not be less than:
R-38 13" Thick'
R-30 91/4" Thick'
R-26 8V4" Thick
R-22 71/2" Thick
R-19 61/2" Thick'
R-13 35/6" Thick"
R-11 31/2" Thick
'Thickness varies, check bag
label for producing locations
thickness.
"R-12.7 in a 31/2" cavity.
beserf Pri d e Ld ,3 p lan2
His - Orb spri 03brbok (.n
LoQui r4o, CAg22s3
Framing Correction for 40 Ib.
Bag Rich -R Blowing Wool
When installing in attics of new
homes or existing homes where
no insulation is present, it is
acceptable to adjust the
coverage figures to compensate
for the presence of the framing
members as indicated in the
following table.
tR-values indicated obtained
when properly installed with
pneumatic equipment.
Ttiis11fib ie
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 lb. nominal net weight bag).
Rich-Rr"" Fiber Glass Blowing Wool Attic Insulation -40 Ib. Bag.
Framing 16" on center.
Framing 24" on center.
Average
R Bags per Maximum Minimum Minimum
Installed
Valuet 1000 sq. ft. Net Coverage Wt./sq. ft. Thickness
Thickness
To obtain The number of Contents The weight Installed
Average
an insula- bags per 1000 of this bag per sq. ft: of insulation
installed
tion resis- sq. ft. of net should not installed insul- should
thickness
tance area should not cover ation should not not be
will
(R) of: be less than: more than: be less than: less than:
typically be:
R-44 291/2 .34 sq. ft. 1.18_8 lbs. 15" Thick
161/2-
R-38 251/2 39 sq. ft. 1.029 lbs. 13" Thick
141/4"
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 -Flim Fiber Glass Blowing Wool Sidewall Insulation -40 -Ib. Bag.
14.3
R-16 161/2 60 sq. ft. 0.667 lbs. 4" Thick
4"
R-14 15 66 sq. ft. 0.604 lbs. 3%" Thick
35/6"
R-14 141/2 68 sq. ft. 0.583 lbs. 31/2" Thick
31/2"
Average installed thickness is provided as a guide to installers. Actual thickness will vary
depending on conditions at the time of installation. To obtain a specific R -value, insulation
should not be applied over a larger area than specified on the coverage chart.
2x6
Net wt./bag, minimum 37 lbs. This product conforms to the performance requirements of
Federal Specification HH -1-1030B. Type I, Class B, and DOE RCS Standards. Also meets the
Insulation Quality Standards of the State of California.
R-38
Framing 16" on center.
Framing 24" on center.
R Joists
Bags per 1000 sq. ft.
Bags per 1000 sq. ft.
Valuest Dimensions
(gross)
(gross)
R-44 2x8
28.2
28.6
2x6
28.5
28.8
2x4
28.9
29.1
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
2x8
13.6
14.1
2x6
14.0
14.3
2x4
14.3
14.6
R-19
2x8
11.8
12.2
2x6
12.0
12.3
The higher the Fl -value, the 2x4 12.3 12.6
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 Blowing wool has been installed in the ceiling or sidewall in con -
recommendations to provide a thermal resistance value of formance with the above recommendations to provide an R -value
R- at inches in 9(0- sq. ft. of ceiling, R --O- at of R-_ using bags of this insulation to cover
inches in $ab sq. ft. of exterior walls, and R- at square feet of area at a
inches in sq. ft. of floors or crawl space perimeter. minimum thickness of inches.
Dale Signature
&119/17 /U &Otx.t Clica
Date Signature
I*
,IGc16' r66
Insulation Contractor • M►WL-tT-1e 1
74-741 Joni Drive
PALM DESERT, CALIFORNIA 92260
(fv 19) 346-2339 Panted rn USA
t ,
•1
06720/1997 11: 09 9096899524 'HOOD -PLUMBING PAGE
ta ti Qh Certificatv-:- 'Rd-.qidentjQ*1
QF -6R'
7
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,'dad and Poo'
god.
4-4.
An: inataWiO*m cenft-wo is required to be pasted at the bUqdlr,6 Sao prior So
MAY bo Used to Meet these require
.q;uparwy pormiL rhjS.jOrM
mQnl,%. All.appGaAce catagori4j. ristod 09,1000 ar*04ho. a4tuiVoq*4jprnont inssalled: Nato thaj*.-
tho -efficle CY Bills t, I the POPFJarli insizilliad -mtm be equtvaisnt. ol, twit
9f•'diifi it a'a DJI 62POcirl4d bn.-Ihe ConoloW9 of
C4ryipfian a (OF.-IRNis anhaw. (. its ei uivaiient) kt%-w b� P(bP&!ed
�esiijonsjbidixy for the aDolion.Oo iWiftd--.6; the 0'.r0n(&) assuming overall
in" in".oat
undomigned.:'vvir.:-y-that the oci*rnmi'dsisd in the
:ha! the eqU'DmGnl C;M990above.my X1011stwe is the iiiaual
pent irtuaitemd ang
MPQt3 Of 6X080ds-Ahe roquiremerris of thory &,NMnrp EJ11Cf06LY.SI;tnd&rds.--- 1444dition I have-yariflod
0041,1valent: to or morm 9 ubent 'thin the eoucpn that
iont spoc&&.jA:th��Oertfiicai ikdooMP4
domonstrate compliance with the En6 ` , 0 axx:yb sudmitt6d to
t
B: WAC SYSTEW
NOW 'HOwnio boiler information is a-mered hero. Other hydmnic -ar comb
Water-16162fing Sycisms. -eqwOrnom is riatw U
rkdar
• Hosung Equip. CEC Carliflod 'A . ctual satiNy Wed
•
Type (furnace, Mitnuf hid 'Ib - V -:14
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heat pump, and %Arn d
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SiQ:►it:YfY1 W'; QBI: Plumbil���iltt MmetOr•(Ce. N �:br• fl8QE11•�`i(tfl0i366arOrolllfMlr
Certificate -of -Occupancy
City of La Quinta
Building.*and Safety Depa.rtment-
This'
Certificate issued pursuant to the requirements of Section 109 of the Uniform Bui/ding 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 AD -DRESS: 45-060 SPRINGBROOK COURT
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No,:. 9703-087
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: R-3'
Owner of Building: INCO HOMES Address: 1282 W ARROW HWY
City:, UPLAND, CA., 91785
.By: DANIEL P. CRAWFORD JR.
Date: 6/27/97
Building Official
POST IN A CONSPICUOUS PLACE