9811-115 (SFD)LICENSED CONTRACTOR DECLARATION
."I hereby affirm.under penalty of perjury that I am licensed under provisions of
`Chapter 9 fcofnmen g 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
0
u�il(i/�=1 1f �Ie�3iy
trate �". u Signature of Contractor + ``
T
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.
( 1 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 y ♦ y7 aYTINqr Policy No.
N i �"F t� 1D
(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_pCoovisions of Section 3700 of the Labor
%Code, I shall forthwith comply with those provi ions.
A/ Date: Applicant l Y 2 ,��
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
ttire above-mentioned property fo nspect'oneper oses.
/Signature (Owner/Agent) ' Date—
f
. CONTROLg#
PERMITU�} .
BUILDING PERMIT
71„5
DATE VALUATION LOT TRACT Z / 5 7
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OWNERCONTRACTOR
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USE OF PERMIT
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RECEIPT
DATE by
DATE F)tj LED
INSPECTOR
INSPECTION RECORD
17 OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
et Backs
o= 8 1.
Underground Ducts
orms & Footings
_
a
Ducts
Slab Grade
oZ -/,3 . ��
Return Air
tees
r2oof Deck
Combustion Air -
Exhaust Fans
O.K to Wrap
F.A.U.
Framing�./
Compressor
Insulation
�- - J
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 (Q -
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
Sewer Connection
_
3 - 3 -
Pool Cover
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:
Desert Pride Lot 13
Residence Address: P/A�✓ 3
45-215 Sunbrook La Quinta, Ca
CERTIFICATION: This is to terrify that attic insulation has been installed ineformance with
the cov ag -h0art recommendations on the opposite side of this card using bags to
cover / sq. ft. to obtain an Rvalue of 30
Contractor's authori:cd signature C�zlay_
Date: May 22, 1998
Instilled by: Builder:
ROVER INSULATION
.. R PD r`1 PLUS
•
(Formerly Cordex)
STABILIZED INSULATION
MANUFACTURED BY
GREENSTONE INDUSTRIES -
Atlanta, Georgia • Elkwood, Virginia • Ft. Wayne, Indiana"
Norfolk, Nebraska • Phoenix, Arizona • Portland, Oregon
ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART
3.5
39.6
Net Coverage
-
R -Value at
5.5
No Adjustment for Trusses
Gross Coverage
75°F Mean
Minimum
Based on 2 x 6'
Maximum
Minimum
Temperature
Thickness
Trusses on 16'
Net
Weight Per
Centers
Coverage
Square Foot
To Obtain
Installed
Square
Minimum
The Weight Per
Suare
Bags
an Insulation
Insulation
Feel
Bags
Sq. Ft. of
Feet
Required
Resistance
Should Not
Per
Required
Installed
Per
Per 1,000
(R) of
Be Less Than
Bag
Per 1,000
Insulation 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)
R-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 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. h. Actual coverage will
be influenced by job conditions and application techniques, and may vary as much as 10%
Builders Desert P=ide Lot 13
Insulation statement 45-215 Sunbrook QertainTeed%
La Quinta, Ca
InsulSafeill (9)
Fiber Glass Insulation
Insul-Safe Ili' has been Installed with the
manufacturer's recommendations to pro-
vide a value of R using bags
of Insulation to cover square feet of
area at a minimum thickness of
inches.
4sstaller Contractor (Sign)
Name
Batts and Blanket
R -Value
Insulation Thickness
R-38
10-.12'
R-30
8'/4', 10"
R-22
6'/*
R-21
5'/'
R-19
6'/:
R-15
3'h"
R-13
3'/"
R-11
31h I
Complies with ASTM C 665
Fiber glass batts or rolls have been
installed in accordance with the manu-
facturer's rec mendation to p ovide
an R -value of �� in the ceiling, T5 in
the exterior walls, in the floor
IT'awl spa imeter.
, llen Contractor (Sign)
ROVER INSULATION & ACOUSTTC,Tnr•
Company Name May 22,'1998
Date
Builder (Sign)
Company Name
Date
Code No.30-24-092
i
41.
Thermal Performance - Attic Blowing Appllcatlon
■ In accordance with the chart below, you must Install the minimum number of bags per 1,000 sq. ft.
of net area for each R -Value listed.
r 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-Valse.
is Failure to install the required minimum weight per sq. ft. of insulation at or above the minimu,n
thickness will result in reduced R -Value.
a This product should not be mixed with other blown insulations or the thamlal claims will become
invalid.
R -VALUE
BAGS PER' -'
1000 SO. FT.
MAXIMUM
SO. Ft. PER BAG
MINIMUM WEIGHT-
POUNDS PER SO. FT.
MINIMU.A '
THICKNE 3S
To obtain a
thernnal resistance
(R) ol:
Bags per
1000 sq. ft.
of net area:
Contents of bag
should not cover
more than: (sq. ft.)
Weight per sq. It. of
installed insulation should
not be less than: (lbs.)".'(inches.
Should no, be -
less that:
R-60
42.6
23
1.064
23"
R-49
34.3
29
0.858
19'/4
R-44
31.1
32
0.778
173/4"
R-38
26.6
38
0.665
151/2`
R-30
20.8
48
0.521
12'/a"
R-26
18.1
55
0.452
11'
R-22
15.0
67
0.374
91/:
R-19
13.2
76
0.330
8'/:
R-13
9.0
111
0.225
51/4'
R-11
7.4
136
R -Values are determined in accordance with ASTM C 687 and 518. Complies with ASTM'_764
as Type I insulation.
"R" means resistance to heat flow. The higher the R -Value, the grater the insulating powrf. To
get the marked R -Value, it is essential that the insulation is installed properly.
DANGER: RECESSED LIGHT FIXTURES — TO PREVENT OVERHEATING, DO NOT
INSULATE ON TOP OR WITHIN 3" OF SUCH DEVICES. DOES NOT APPLV
TO TYPE IC LIGHT FIXTURES OR TO FLUORESCENT FIXTURES WITH
THERMALLY PROTECTED BALLASTS.
Framing Adjustment
To compensate for framing members the number of bags per 1000 sq. ft. of net area should pe
reduced as follows:
Joist Size
Bags to Deduct / 1000 sq. Q
Joists 1n.c.
Bags to Deduct / 1000 sc. L
Joists 24"O.C.
2" x 4"
0.5
0.4
2" x.6"..
0.9
0.6
2" x 8"
—_ 1.1
.0.8
2" x 10. ..
_. 1.4
1.0
CertainTeed Corporation, P..O. BQx 860,,Valley EQrpe, PA 194.8.2
60, V
01995 CertainTeed Corporation 10/95