9801-182 (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
��...
ate Signature of Contractor
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.
(af 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.
!)'TNITFUND Al 490911 - 97
(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
z6ode, I sh II forthwith comply with thoselprpvisio sS
Date: 4n . Applicant—
Warning:
pplicant Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify, ,.
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property fo Inspection, urposes.
/Signature (Owner/Agent) Date
BUILDINGPERMIT PERMT#P . °°NTR°`
DATE VALUATION LOT ,,, TRACT /� �77Y
�',?f►
JOB SITEI
ADDRESS •�J1� :► !'�I i1�t�t�i A eF�i�
APN
.�[► -��
OWNER
CONTRACTOR /DESIGNER /yyENGINEER
A�tt
i�€i � . E iLC:f�Y iiiir�`
1 �°� a VV. ARRC:;4Y .illy V
I)1"LANO (!A 91 3y
OMAN)) C*A yi`Pr s
iWWII13:118
USE OF PERMIT
'T 3. k. i Um 11, 1A,; k' 1N .fi IR1_, i4)L, 11!_t5f K. IYi1( i,
OR t1001–
'K�1it 11lC�ti`C.9.f.a I11.00 tit
C3Aft&(J1JC`ARla(A!('i' S )•Fpir st
!►' T iR'3s1`$ :8' C(WT Oar CONSTRATi':,-110N
I(I;H AdiT FCL'`aar.iAlAlAkV
PL AIq 1'TY, hili.^tM?t1��1.iA. }$`►' 3`i ti; :�
i-ONSTI iAITTC)N ►? t.lT1a, _�Ti'K-chin S iifi
NiMAIJIAt• ICAL l -f7,
.t_ `!jtltYALWii.7 IUt AU-12,041~t;C;
' °i`ZCc`►XIO NI"Of i.11W - dt?Sjr} tt)j•t)(tt ? 1drNFt) IS9ii8
4,_PR lf_XN0 ME 101-000•4D-00) �:ft,Ctii
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a r
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�:�,nEs•' �?
T:FIS,. P R II--' 11) V 1.1
TOTAL PERNOT FERSARIF NOW
S3.692.31
�b
RECEIPT
DATE
BY"
D E IA D
INSPECTOR
INSPECTION. RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Z -/;z-
Return Air
Steel
Combustion Air
Roof Deck
-9 _q7
Exhaust Fans
O.K. to Wrap
Framing
,21:
F.A.U.
Compressor
Insulation wQ,%S o(D
Q. - -1
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
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
3 -3- Q
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final I
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voftage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
4
f
'Final
Ulillty Notice (Perm) .�-
COMMENTS:
Residence Address: Desert Pride Lot 7 Plan 2
45-250 Sunbrook La Ouinta Ca
CERTIFICATION: This is to terrify that attic insulation has been installed in conformance with
the coverage chart recommendations on the opposite side of this card using 51 bags to
cover 1:377 sq. ft to obtain an R -value of 38
Contractors authorized signature4a R
Dace: May 14, 1998
Installed by: Builder:
ROVER INSULATION
74 741 J10NI DRIVE
1 PALM DESERT, CA 92260
onR -PRO PLUS
(Formerly Cordex)
STABILIZED INSULATION
MANUFACTURED BY
GREENSTONE INDUSTRIES
Atlanta, Georgia • Elkwood, Virginia • Ft. Wayne, Indiana
Norfolk, Nebraska • Phoenix, Arizona • Portland, Oregon
ATOMIZ-FD PNFI IMATIC APPI lr..ATION rnVFRAr_,E CHART
3.5
39.6
Net Coverage
.758
R-ValiiP at
5.5
No Adjustment for Trusses
Gross Coverage
75°F Mean
Minimum
dasea on 1 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 NotPer
Required
Installed
Per
Per 1,000
(R) of
han
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
6.5
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
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. ft. and at least the minimum thickness may result
r
Builders Desert Pride Lot 7 Plan 2
45-250 Sunbrook CertainTe�'�
Insulation Statement La Quinta, Ca
Insulsafeill W
2:2
Fiber Glass Insulation
tn&W-Safe UP has been Installed with the
manufamurer's recommendation• to pro-
vide a value of R using bags
of Insulation to cover square feet of
area at a minimum thickness of
Inches.
44Lstaxar Conuacsor (Sign)
Batts and Blanket
R -Value
Insulation Thickness
R-38
10', 12'
R-30
8,1. , 10-
R.22
6'/;
R-21
5'l;
R-19
42.8
R-15
-3'/;
R-13
3'/;
R-11
20
Compttae wan ASTM C 666
Fiber glass batt& or rolls have been
Installed In accordance with the manu-
facturer's recojmjmendatlon to pr9XIde
an R -value of in the ceiling, in
the exterior walls, in the floor
awI spa ximeter.
I •falter CanUeQOr (S,gn).
ROVER INSULATION & ACYX_1STTr_ Tnr-
Company tQMT*
May 14, 1993
13"Ad t (SV)
company Name
Due
Coo@ No.30-2+-062
Thermal Performance —Attic Blowing Application
• In sodordanoe wlln the than twiow, you must malas ow nWllnlum number of "0 per 1
of net area for each R•Valua listed.
• Tire maximum net coverage must not exceed that epecilied for each R -Value.
• The installed insulation must be at or above uw specified minimum thickness Aon each I
• Failure to install the required muwrwm weight per sq. h. of insulauon at or above the nu
thickness will result in reduced R -Value.
p This product should not be mixed with other blown insulations or t1w thermal :•role will
Invalid.
R -VALUE
BAGS PER
1000 S0. FT.
MAXIMUM
S0. R. PER BAG
MINIMUM WEIGHT-
POUNDS PER SO FI.
Mi
Thi
1n l (6516
tnel(tlal faS�itanGa
(R) of:
Bapc pot
1(100 iq. ft.
of nal seas:
Conlonu of oap
should not cover
mors than: (sq. 1L)
Y.tgnt µ+r sQ. It d
nsaYud ouuLwon 0.4
. dot bs loss 11Hri (Cat
IBM
b:
(i
R-60
42.8
23
1.064
1.0
R-40
34.3
20
0.866
R-44
31.1
32
0.779
R•38
26.6
38
0.666
R•30
20.8
48
0.521
R•26
18.1
55
0.452
R-22
15.0
67
0.374
R-10
13.2
76
0.330
R-1.3
9.0
111
0.225
R•11
7.4
136
0.184 r
R-Valuea are detem-jined in accordance wiM ASTM C 687 and 518. Complies wuh AS
as Type I insulation.
'R' meana resistance to heat flow. The hlgner the R -Value, the greter Vw nsufating
gat the marked R•Value, it is essential that the insulation is Irutalled propany.
DANGER: RECESSED LIGHT FIXTURES — TO PREVENT OVERHEATING, DO
INSULATE ON TOP OR WITHIN 3' OF SUCH DEVICES. DOES NOT A
TO TYPE IC LIGHT FIXTURES OR TO FLUORESCENT FIXTURES W1
THERMALLY PROTECTED BALLASTS.
Framing Adjustment
To compensate for framing members Uw number of bags per 1000 sq. tL d net area
reduced as follows:
Joist SIL
Bags to DwW 11000 sq. L
Joists 16'O.C.
BJ.gt u Dadw / 1
Joists 24_t
2' x 4'
0.5
0.4
2'x 6'
0.9
0.6
2'.; B'
1.1
0.8
2' x 10'
1.4
1.0
CertainTeed Corporation, P.O. Box 860, Valley Forge; PA 18482
019a5 t erlain "d Carpo