9703-088 (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
4ti.'.ititi 1.i.
713108 -
/te,:nature of Contractor vNER-BUILDER DECLARATION
I hereby affirm under penalty of.perjury that I.am exempt from the Contractor's
License Law for the following reason:
( ) 1, 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.
CAL CC:NIT I", _1
(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 toithe workers' compensation provisions of Section 3700 of the Labor
Cjode I hall fo�r.hwith comply ply.with those provisions.--
16.
��
ate: �� A Ican �tt~a �,)wiF�t....xi
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or puisuarit to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize represent$tives.of this City to enter upon
the7above-mentioned property for inspection grposes.
Signature (Owner// gentJA f
PERMIT# CONTROL'#
BUILDING PERMIT
2 2
DATE Al Y97 VALUATION $86,646,70 LOT ArQ— TRACT - '-1.! 3 j
JOB SITE
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
r, CO HQA1F0
:NCO HOMES 111011P.
tMW.ARP,0W1-iixi"Y
1282 W. ARROW 14WY
��° Y,A ��t�► CA +0:1785
1, I CA sT1785
-
np1.1.�thtfIili3OpAApp�f i!�
t,009)g81-8989 F BL# 3310
USE OF PERMIT
SRR
Ct:•f X I'FX% HEPUCM) FOR MUI..`;i' PLP ISSUE OF StWE PLAN,
',i'.RAC,T i;'0NS'.k'I2Wi 101 1,411.00 SF
$'Ci]tC:.# A CIi�J is 1.00 't
0Ai,AG...WCA14NORT 416,00 SF
0 WATED COSTOFC STRU MON
86,646.20
Vw'(tMU fig'XR' 140MMrA.kV
'318
PLAN C`NF,CK FEE 101-00(V439418
C10N3`if r_-1'fCYl`4 CO3 101.W-418,0 )
MLCI-bVNICAL €''ii1 3.0l�01u3 � ,-00i? Sr1?,ftft
Li t,i^ 1`tilC;a1(. 61 .. 101. -OW 420-000 $106.11 1
PLUMBI O Emir 101 -yid - 19AW $148,(W
3`,,3M11 tt17 4) 1014(") 74l -11M 66
C;RARING, .t t:k 101-000-423-000 S210100
k,Nt iti�:t`f'.k+tft:`I'C1.l�E, t�3 tN 225-007 443_342 $1,1907.3,5
PA ID tlR�"CEJ 1.1t� CON, TON AND Pt AN CHECK
g"y9-0.3(j
LE -R.5 P—E-PtAD FEES
�O.Ofk
APR3 1997
'
.0 t/y `y r'�3� y �� p { 1�f yr
. i�q.F•'��.:ii� ��f.A{.14`�7 ,�' S:C.9 moi,/. 0UC {9�.��'Y
s97rp�17.Y�%
�T O
RECEIPT
DATE
j Y
DATE FINALED
INSPECTOR
INSPECTION RECORD
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
Exhaust Fans
O.K 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 g7
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
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test /p
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:
-
Residence Address -T) Pn dt- hDi q P la
HS - CIdD Say-InQkrnc k Chi LOQU I V-12 t GA 9 27S3
JA
CERTIFICATION. This is to certify that atter insulation has been installed in conformance with
the coverage chart recommendations on the opposite side of this card using, 9 2-- bags to
cover I L4 sq. ft to obtain anR-v" of 30
Contractor's authorized signature
Data
Installed by:
_j 74-741 JQN1 DRIVE
PALM DESERT, CA 92260
(619) 346-2339
r+vf wsuLA riom SPECIALIS10
Builder.
..
R --PRO PU
S.
(Formerly Cordex)
STABILIZED INSULATION
MANUFACTURED BY
GREENSTONE INDUSTRIES
Atlanta, Georgia • Elkwood, Yrginia • Ft Wayne, Indiana
Norfolk. Nebraska • Phoenix. Arizona •); aand, Oregon
ATOMIZED PNEUMATIC APPUCATION COVERAGE CHART
3.5
39.6
Net coverage
Gross Coverage
R -Value at
5.5
No Adjustment for Trusses
Based on 2 x 6'
75-F Mean
Minimum
Thickness
Trusses on 16'
Maximum
Minimum
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
(RI of
Be Less Than
Bac
Per 1.04
mul.a ri ShQuI4
Bao
Sgilare Feet
(inches)
Square Feet
Not Be 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
1.172
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 1
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
1 .758
R-20 (2 x 6)
5.5
25.2
1 39.7
1 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
in n i-cr;nelnttnrl nrinr emo;nn rmmnne-linn may rs v" if nit frinn inctaltalinn¢ ohm,a Q.
a
06/:20/1997 11:09 9096099524 HOOD PLUMBING ,
CEC Calcined
C)oollrlg;Eguip. Con'aproavior unit ' . A'Mill Olalrlbestlon taros ai;,, '
Type (sill oond,. Unnut. Maka
i
t .
>'
b ••Eftlotertc
heat.. UMP. -Ile') .tAodolMumbar y ljrpeand.
fSliEA). 010a400 IYa'
: ':!
�:'•
..p;;
fustal(a'tiort Certificate:' Residential
3ignaafro Dan HVAC 8t6giascetir'.(, r f�„)tjtli�)'Ai C 0ryliriq,Coe'.riaar.o'rCiirsiter
rM-'
�
a•
z;•
Ufa. c)"lnlf: lorrn to.aavaafY ilia ..., ,.• ,.• .._ ��. sees ...n
r�q'vir�m«.aa.p/ t1Y• at.tmlw►ir., 1v Ui,• ..�.%1. dt%f•ltr� (�{:.,,.. ': n m,.•....,, {. :tdad Auld aos.,.a i4
WATER HEATING SYSTEMS
F
Nta Aeer.oa
="
:• • . '
An irtstsllation certt(icato is required. !0' be. ' ' '
9 posrod a(tho but dl siie oriel b'.
may be used to moot tttece requlry 44 iS.q�oiype rif N'9-,goVwpprtcy PQrMiL ThLt form
mgntr, All apQGanoft categories fisted beki5ir aro:{he,-=UAf.gqupmont inmailad.
tho.aNiclenq
: H
'..
+:•
Note -that
and.type of the appGar9e+o-;nstalled mtest be oqurvsjenl Or bogdr•. . a/f'11tip ttppliiirnCe epoeifiecl,on IAi Cor}i1L�yto of .
rrompliant» (CF• t This ceriifirrr3ij`ter as oquivWsm) Chats by prepared eid.by '
' ;r
;�•. '
tfk)rrtiiti the pBi�if(c) aseufn(ng ovoraJl
res�on;ibifitylor'the apo+ianoo Instal(atibn, ,
r
,Y
:'. thl+ underagnsd, lass that the
'Y oquipm4r•: i ttad w tho category above rrry,•wnw re is•the ,act.y.al oqulpme(n Irtstaltod and
shat the equipment'moata or axcyad'S•1h.Q ro' uiramanis '
0
X
of the rr�o 1_lf
Ilia o ul Atlfsl ka�r(cY'".I ntfardrt_, .In.aadition, !have vor'� at
q fxnpnt Is oqutvatant rn or mora elfi�ient than the equipment .poellednrF tA6;• .4rlificata p(. �ompliaiir,P submits
demonsfrate compllartco with the Enorgy Efficiency Standards
, .
..
for•rosid'6anUl'i?u ldirtga.
a
NVAC SY.STEMa •. .; , :'. .. ' '
'?
y;
Neto: Hydropic heifer information is e'tTl•grW hire, Other hydropic or combineff:fiydtilrtia equtpritdm Is listed under
Water Heating Systems_
...
-:
Heauno.Equlp. CBCCartflled .Ac'tual Dlatrlb".tin
Type (turnace, Qsnuf. fl/oke b EHtclon Ocie qr- H.ftt(l p't:oa� ,Hosting.
cY TYpe d,d ' R''I kIQ.;: f3atora.atirar..
�^
.
,.
heal pNnlp,evo t .Madel Number (AFUf,.atal L-ocaAoit `R��atue Sizl'g(Btuh) C�aaacny(Htuh1
...
s`
:s
CEC Calcined
C)oollrlg;Eguip. Con'aproavior unit ' . A'Mill Olalrlbestlon taros ai;,, '
Type (sill oond,. Unnut. Maka
i
t .
>'
b ••Eftlotertc
heat.. UMP. -Ile') .tAodolMumbar y ljrpeand.
fSliEA). 010a400 IYa'
: ':!
�:'•
of the rite is usod for •
aq.!rrpr+rsnl'taltilt9 eolectiairr'..
t .
>'
T)14 building deatgn h9iM ION and design heat gain lite have been aet�tntiited • ' ' • r
the Enurq •Eflfdon�► Standards. and ar'e:tw+o e;��h0d'st�o�ed in.SeNo'n 150(h)' of
: ':!
�:'•
of the rite is usod for •
aq.!rrpr+rsnl'taltilt9 eolectiairr'..
3ignaafro Dan HVAC 8t6giascetir'.(, r f�„)tjtli�)'Ai C 0ryliriq,Coe'.riaar.o'rCiirsiter
?
�
WATER HEATING SYSTEMS
A '-
Water Hsetlnq 6�C Goftffl�d' trfiri= Eractrntat
Raced Tank r. :.. Tank
6ystam Type, Itlfinul.. Mtt+ica 6 '
'..
+:•
(r+pfn (kW t',at
macre e e ''etc:. odes Nu her ' • or 4duk IawrY ' 14 ovary • :Startd� t. Irtatrlat)ti'n
641 a. • Efffsbf !"
;�•. '
R•V.alus
�4 } Y-e;w Al r. 4.
r
t': ..
44,
--..._-- .-_sees... ' T..,:_..� •,..r.-_.,. • ;�;� .,,."'.,'_`_" sees.,
?','
::
-
t . For aatall aai atenpe (rated aist S 76.0(X1°BtIUAr). atesWe raatat nw'and Mat pufftpiriifa►lHjter*, 60 F
tar++rae,aea frlerpe tglKtlaatere
FoNnwAs (noof7a 42 476 CW 1lkAr), clot Amari Irsput,'Aodg�' erfd
Moue palswsar hwftara, 6e;tRsasd k*cfi &M Row." Gl6cierny, . �in!%�^°?' 4osa.
Parinstinhweow• eheMo waw heaters.
r14{i'am input
-:
FAuC&TS `& SJtowER HEADS A.
:..
3?
i'
A!I faucela app allowerMtatfs Instated' are fisted In Ihe.Commieeon'o Ottractory d
qurauarll -toUbC4latner 2. Siction'111, ►�off�'aficiof arb�$Ffenrarheads.
TJtlo 2a, Pari 6.9
z
t}are PlUmbirV -&6=wM1w=w :tCo., ()v.tio) m Crtilieral Concsomro �icm'er
''
to �' •;r: 19?' 08: 32AM
51513. 7305
P-02
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 83/4" Thick
R-22 71/2" Thick
R-19 61/2" Thick'
R-13 3%"Thick-
R-1 1
hick"R-11 31/2" Thick
'Thickness varies, check bag
label for producing locations
thickness.
"R-12.7 in a 31/2" cavity.
De5ptrt el, i d e LDf g Pla o I
(S- 08o Spr -05 b r-oo k C+
•l..Q Qutnto , CA q 2253
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.
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).
r Rich-Rlm Fiber Glass Blowing
Wool Attic Insulation -40 Ib. Bag.
Framing 16" on center.
Framing 24" on center.
R
Average
R Bags per
Maximum Minimum Minimum
Installed
Valuet 1000 s9. 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. 1.188 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-RTm Fiber Glass Blowing
Wool Sidewall Insulation -40-1b. 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/V
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 Fl -value, insulation
should not be applied over a larger
area than specified on the coverage chart.
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-30 2x8
19.1
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
14.3
2x6
28.5
28.8
12.2
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 R -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 R -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 sq. ft. of ceiling, R- 13 _ at of R- using bags of this insulation to cover
inches in $ Q sq. ft. of exterior walls, and W at -____ .- square feet of area at a
inches in sq. ft. of floors or crawl space perimeter. minimum thickness of inches.
Date Signature
Date Signature
HG -616 7/86
C
Insulation Contractor ROV 1NIULAT "4AGG
74-741 Joni Drive
PALM DESERT, CALIFORNIA 92260
019) 346-2339 Printed in USA
.;J••,.'.- •• •;•.�° �.'�•. :•`4���•`�� �•.,!:.•� ,:..
.:�•; �Y'= is >•,.::�: : � �
' ^Pi r•5� t; ..,+-. . ���..,.".y ' :•/• . ,.,t.e:••: ' ;moi
CR
af� a1;` !J11* :+f• �dnr<WwMtlrfCod ''4 fr butijflt+4�t!WITTry
I!�t!!'�"d:o°*"d I,
` 1
%%. Wird b� �i lltr Udlnp• Wta pciot&e`: liw+�+tv�rOf' R ?1 r0� :: J • ��; z
tifft: c'tA�: itiSow osb• are::: Ntst• •
rot. .�
4 ,
th �iid:tiito ntor in:tlu: lt4t,�l�v"d1
oi�kaioiit I lir F mit thri ' .;tiiif�ysrvirill
1 �1+ pP�lr�kak?if9
k f �' hsit'tht: ijiitt8i{�d.in:iho•c�iporysbeti!;: "Jfipn+i�:i�''tt�4`.,� ;:�itirRsid'artd :r;:a
th:! .:s a:ll�'�:ptNo� rtgii d lFtr Millan si�4+dlr ":wo
1ha�+
;w tho''rnrmo> h�.lwigrithosgfdprinM'o�tt'C�e..:.. !!!!�
o wil Erni!jt}fdrC'.5liitidWds'1o['r�8id ' 11dktQs:'' )s
"00w,:b t i�•fie Olbrr liyidronic.or,00�tlfititrti hyd�pnic'
�:' '. 1: •L. •.'. `4+����^���� S.M:��y,� ':ji .. moi. •iy:.��r �+•'•• •��•,••••
silot
f
. ^.�_. �'ry;, - ,y1L,:1: .•x..;15:::; /,•�' tip'.,.,; a�
e.
Cl
�,.. :.�>: ��t� 1,'�:::Aeawt�t:• � � D�ilivtlon.'.':...;Dual or� _ ��:
' !� ; o`lpy.+1: � '� I• : alb 'T�Rtifla �;`� l ":''i< ':,' •:•+: Z .
•i ,'• };, +i.t'�,:+;i}. V•; ;','• is V
'i r ..fir ♦ .'�� 1��.'1���, .:A ".�:�.,:, �� .�'
.softqu -
•the' aiwdoUilworMM .aq
••. ... •�; ' _ � •' Oal� • � 1dVA0.:(tro.':NtWiij.'� t:C,Mrt+9,►• •
• :':1'A,: 'S <I•_, .:•" •r,. it •
• • •�WmNq•'. .•,.�1���"s':?.'�M�� lily':�':�<•; .. '•IR/i�
4wM ' /���1k:� ::: ;�:�t'•Qi •.�. ;��• ' • �d•'1�.
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