9801-109 (SFD)LICENSED CONTRACTOR DECLARATION
I heseby affirm under penalty of perjury that I am licensed under provisions of
F— Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04 W professionals Code, and my License is in full force and effect.
O =) M License # Lic. Class Exp. Date
LLJ
t`
oZ r- /Date Signature of Contractor
0 1�
J U C) OWNER -BUILDER DECLARATION
WWd I hereby affirm under penalty of perjury that I am exempt from the Contractor's
0 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).
co () I am exempt under Section , B&P.C. for this reason
LO
N Date Signature of Owner
ON
0)
Q WORKER'S COMPENSATION DECLARATION
C:) 2 Z I hereby affirm under penalty of perjury one of the following declarations:
LID Fa— O () 1 have and will maintain a certificate of consent to self -insure for workers'
X w 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 U 1 have and will maintain workers' compensation insurance, as required by
O U Q Se, tion 3700 of the Labor Code, for the performance of the work for which this
li 0)Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
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
subject to the workers' compensation provisions of Section 3700 of the Labor
ode, I shall forthwith comply with those Qvisio.
Date: AlZ Applicant
Warnin . 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
Zheabove-mentioned property for inspection purposes.
ature (Owner/Agent) —f ti�4� Date ����" ,,;,
d .
BUILDINGPERMIT PERMIT# CONTROL#
DATF VAI UATION � # LOT. TRACT H y l
TO
fa
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ADDRESS~ 44 i3s0 SUNHRO OJ;; LAM,
APN . 6"341 -NS
OWNER
CONTRACTOR/DESIGNER/ENGINEER
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1120,647.40
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RECEIPT
DATE
BY C '� "`
DA7E NA DINSPECTOR
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
,3 — —
Exhaust Fans
0. K. to Wrap
_ o
F.A.U.
Framing
- (-
Compressor
Insulation ova 4S
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
- Z —
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 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
-_3 —
Encapsulation
Gas Piping
Gas Test
Q
Appliances
Final
COMMENTS:
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
Real
Utility Notice (Perm) _67,72 ,,,.T
-z,
Residence Address: Desert Pride Lot 8 Plan 4
45-230 Sunbrook La Quinta, Ca
CERTIFICATION: This is to terrify that attic insulation has been installed in conformance with
the coverage chart recommendations on the opposit side of this card using 56 bags to
cover 1, 91 sq. ft to obtain an R.value of
Contractor's authorized signatu�F" TQ d4 Q W AA
Date: May 14, 1998
Installed by:
ROVER INSULATION
74 741 j0NI BRIVE
PALM DESERT, CA 92260
Builder:
.. R PD t`l 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
.758
R-Nelue at
5.5
No AdiU*tmenl 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
Feet
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: (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.b
42./
23.4
./U3
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 j
10.7 1
.322 j
102.8 j
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. 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. ft. and at least the minimum thickness may result
Builders Desert Pride Lot 8 Plan 4
CertainTft-Oil
Insulation Statement
Sunbrook
La Quinta, Ca
Insulsafelli
Fiber Glass Insulation
InsuWwfo UP 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
1Q,slaller Conuaaor (SO)
Das
Batts and Blanket
R -Value
Insulation Thickness
R-36
10', 12'
R-30
81/4'. 10'
R-22
6'/:
R•21
5'/:
R-19
6'/:
R-15
3'/:
R-13
3'/:
R-11
3'/:
Comptes with ASTM C 666
Fiber glass batty or rolls have been
Installed In accordance with the manu-
facturer's recommendation to provide
an FI -value of 38 In the ceiling, 13 In
the exterior walls, . In the floor
awl spa imeter.
idauuw Convaaor (Sign).
ROVER INSULATION & Am1STTC`, Tnr
May 14, 1998
&Uk w (SV)
Company N"
Date
Thermal Performance — Attic Blowing Application
■ In ecoordanoa with the chars below, you mural Install Me minimum number of""Psi 1,000 sq
of net area for each R•Value baled.
Is The maximum net coverage must not exceed Ihat speciliad for each R -Value.
s The installed insulation must be at or above the specdied minimum Ifuckness for a=. R-V"A.
is Failure to install the required min mum weight per sq. ft. of insulation at or above the dwtinu iln
thickness will result in reduced R -Value.
■ This product should not be mixed with other blown insulations or the V*mW daima will beoom
invalid.
R -VALUE
BAGS PER
1000 So. FT.
MAXIMUM
SO. FT. PER BAG
MINIMUM WEIGHT-
POUNDS PER So. FT.
.IINIMUM
THICKNESS
To obtain a
tlanrnal res1sunca
(R) of:
Bapc par
1000 64. ft.
0t net area:
Contents 01 bag
should not cover
mots than: (sq. IL)
V" IN sq. 101
insol�d .euulabon sr"
cot be lass than: (Cs.)
Siould not b
less 1144.
(naw)
FI -60
42.6
23
1.064
23'
R-40
34.3
20
0.868
191/4,
R-44
31.1
32
0.778
17 V4
R-38
28.6
38
" 0.666
15'/0
R-30
20.8
48
0.521
R-26
18.1
55
0.452
11'
R-22
15.0
67
0.374
0.4'
R-10
13.2
76
0.330'
R-13
0.0
111
0.225
6'N'
R-11
7.4
136
0.184 ,
44 --
R -Values are determined in accordance with ASTM C 687 and 516. Canlplies wish AST1 7
es Type I insulation.
'R' means resistance to heat flow. The higher the R -Value, (he grater the Insulating poww.
get the marked FI -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 APPLY
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. tL of net area 6hol,
reduced as tolwws:
•.Joist Slis
Bags b Deduct / 1000 iq. L
Jafsti tli'O.C.
to Deduct . 10M sq.
Joildll2l'O.C.
2' x 4'
0.5
0.1
2- x 6'
0.9
0.5
2- x 8'
1.1
0-9
2' x 10'
1.4
1.0
CartainTeed Corporation, P.O. Box 8601 Valley Forge; PA 18482
Coos No.30-24-002 01995 CenainTead Coir; tion