9703-089 (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
C `r.
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.
(.) 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 Policy No.
(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, Ih I fo hwith comply with,those prCov�islons.
Date: Applica,t
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 phis
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 propLert�yfor inspection{p1 rposes.
h Date
Signature (Owner/Agent).
BUILDING PERMIT PERMIT# CONTROL#
(V=1 PERMIT 111■II �
) �tAaiV
DATE 41 3M7 VALUATION 5+� UQ4•�D S'% , I� LOT R —� TRACTJOB
SITE
ADDRESS LFA 01,L�) ` i aVld''��WIIJ�� (i���'
APN
OWNER
CONTRACTOR / DESIGNER / ENGINEER
ft a'( ) 10 jf-1Rif,4,
ti<I:'t:) f ft")MI'S E111"N''.
126LNV 1fYTRO tAVY
1'1162W.Awki_)wit%T
I (VI,AN1 i t -'A 0,1783
UPLAND CA 01185
f��(3s1iR1��1't3L# 318
USE OF PERMIT
,S0) "44t j64t 1 Wit.811(i'1 1�*ar- Jri �t7L' 3`Li X iw lv Al,#.5 c tlt .l'Cx)4.. PLAN
F-�-fNt `ti 9�1;�:' 1tk�f�iS4:9�'1� b -t �€t s��ti 11,`1t���,i: U�Si►� t,�h :Sr��1f;.1�'.E,AN.
IFLAN� 4 pa 3
rRAC"r. Z60.00 :.r
PC W.11,tF'A't't0 - 124,00 SF
c1r RA,(+;d"ARP()>1Z`f,' %1.00 SY
E15fI IATED MSTOV CONSTRUCTION
120,647.40
PE,fKi1Iff FEEStlt�,�MAR1
r'�+1+F�iT�ttrr°;ria' 4.(^!111�n1lfi-fes 5�'13.t19)
t141301ANk!AL 1.11 101-000421-000 - Sxt7.00
1+c,IsC"i'iii4�Af :4•t 161 -WO -4204M $130.44
PLOMOIN(_4 FVIC 101-M-4194119 14 �ffi
3i'C))VO MOTION k"F' RF ira 10ft}t1t)=24i (1 31,66
c,;.�`,ia);dz 1 1� t.O1 �S10-•1�3 �fC)0 S200)
d+i1�I A.s` i'ltCit `.i'i6Kh k# tia 5-Oi?ii-4�ii- �3Z "No",13
ART IN YOWIC:' "PLAOVS - R SfV 701.OW2�S-(100
St 7ANO JY!,AN t' 1 C N
$3,4?p 14
�. of v
RECEIPT
r_ W
DATE
BY F
D9 FI ALE R�FjINSPECTOR
s. INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
f
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
to
Exhaust Fans
O.K to Wrap
/ 7
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 ILZ
BLOCKWALL APPROVA ,S
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
I
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
D
Appliances
''t,
01
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: e+'f Vri cue Ln+ 11(� P IQ h
S11 V)61b0k Ln he a LA) Ou i n la, CA 92253
CERTIFICATION This is to certify that attic insulation has been installed in conformance with
the covnnom
eram chart mendations on the opposite side of this card using S9 bags to
cover J'8 S 1 s% k w obtain an R -value of 3n
} Contractoes authorized signature ljtl Q &'17c'x W6
Date-.
k.
Installed by: Builder.
Kum INSULRTON
Jd_741 _IONI DRIVE
PALM DESERT, CA 92260
t^ .-2339
.. R -PRO PLUS
•
(Formerly Cordex)
STABILIZED INSULATION
MANUFACTURED BY
GREENSTONE INDUSTRIES
Atlanta, Georgia • Elkwood, Vrginia • Fc Wayne, Indiana
Norfolk Nebraska •Phoenix, Arizona • Portland, Oregon
ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART
3.5
39.6
Net Covetage..
Gross Coverage
R-Vallue at
Minimum
No. ���nt T
W russes
Based on 2 x 6'
Maximum
Minimum
weight Per
751F
Temperature
Thickness
Trusses on 16'
Centers
Net
Coverage
Square Foot
To Obtain
Installed
Square
Minimum
The weight Per
Suare
Bags
an Utsulation
Insulation
Feet
Bags
Sq. Ft. of
Feet
Required
Reftiance
51`1011I0 Not
Per
k6mvea
instailuu
PW
fel 1,000
(R) of
Be Less Than
Bag
Per 1,000
nsulation Should
Bag
Square Feet
(inches)
Square Feet
Not Be Less
-
Than: (lbs)
R 60
13.6
20.6
48.8
1:464
21.3
46.9
R-42
11.4
24.4
41.0
1.230
25.6
39.1
A-46
10.8
25.6
38.0
U72 i 72
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
342
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-1 9
5.1
53.9
118.5
.556
59.6
16.8
R-13
3.5
78.8
12.7
.381
87.0
11.5
R-11
3.0
932
10.7
.322
102.8
9.7
Sidewalls (pressure Filled -density 2.6 PPCF)
-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
.n � In...er �..elellei R.\/eb.n eRu. ce»Iinn i�mm�o/AiM rnav /W'v h rinn �nctalhfinnc ot�nvn Q -
:G
:.�,.,y.
:•.�zew�w,cr�<,:.p�n'yF°n+a�.-..o: wo-cna-a:.';rfi�a•..�r�++Nxwac rr.•.tw:Hytsr"+.cryyl`�: ; -. y:�.'�l?�S,a•;i... •, v.
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) 01•
not be less than:
R-38
13" Thick'
R-30
9V4" Thick'
R-26
831/4" Thick
R-22
7V2" Thick
R-19 61/2" Thick'
R-13 3%" Thick"
R-11 3V2" Thick
To meet the thermal resistance value (R), the mariufactFu r has speclfleo the numoer or nags 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 Ib. nominal net weight
Rich Rlm Fiber Glass Blowing Wool Attic Insulation -40 lb. Bag.
66 sq. ft. 0:604 lbs. 3W Thick 3 "
label for producing locations
thickness.
Average
R Bags per Maximum Minimum Minimum
Installed
Valuet 1000 sq it Net Coverage Wt./sq. ft. Thickness
Thickness-',
To obtain The number of Contents The wei ht Installed
bag sq. ft..0of Insulation
Average • '".
installed ,
an insula- bags per 1000 of this per
sq. ft. of net should not installed insul- should
thickness, ';
tion resis-
tance area should not cover ation should not not be
will ,
be:
(R) of be less than• more than: be less than: less than:
typically
R-44 291/2 .34 so. ft. 1.188 lbs. 15";Thick
161/2"
R-38 251/2 39 sq, ft. 1.029 lbs. 13" Thlck .
141/4"
R-30 20V2 49 sq. ft. 0,811 lbs. 10V4"Thick
` 11t/4" "
-
R-22 t 5 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-Rlm Fiber class Blowing Wool Sidewall Insulation--40-lb. Bag.
2x6
161/2 60 sq ft. 0.667 lbs. 4" Thick
4"
'Thickness varies, check bag
n-10
15
66 sq. ft. 0:604 lbs. 3W Thick 3 "
label for producing locations
thickness.
R-14
R-14 141/2
68s !ft. 0.583 lbs. 31/2" Thick
"R-12.7 in a 31/2". cavr �Q fly
�u
Average installed thickness is provided as a guide to installers. Actual thickness will vary
the time of installation. To obtain a specific R-value,.insulation `: , .
p�} n- C1el�F
Sllnilrlpk a�
depending on conditions at
should not be applied over a larger area than specified on the coverage chart:
of
���
Net wt./bag, minimum 37 lbs. This
product conforms to the performance requirements
Lo U j J CP
Federal Specification HH -I -1030B. Type 1, Class B, and DOE RCS Standards. Also meets the-, . -
92253
Insulation Quality Standards of the State of California.
Framing, 16" on center. Framing 24" on center.
Framing Correction for 40 Ib.
R Joists
Bags per 1000 sq. ft. Bags per 1000 sq. ft. "
Bag Rich -R Blowing Wool
Valuest Dimensions
(gross) (gross)
When installing in attics of new
R -q 2x8
28.2 28.6
28.8
homes or existing homes where
2x6
28.5
no insulation is present, it is
20
28.9 29.1 •
acceptable to adjust the
R-36 2x8
24.2 24.6 ;••,,', : s ws
coverage figures to compensate
2x6
.24.5 24.8
for the presence of the framing
2x4
24.9 25.1
members as indicated in the.
following table.
R-30 ' 2x8
19.1 19.6 r: •;
j
..
• ..
2x6
19.5 19.8
2x4
19.8 20.1
R-22 2x8
13.6 14.1
14.3
t R -values indicated obtained "'
2x6
2x4
14.0
14.3 14.6 f `
when property.installed with : '.G R-19 2x8 _
11.8 12.2 ;•, • ::' : ,: ;
•:. ° :..-.
pneumatic equipment.'. 2x6
12.0 12.3. ;::: : ,,,, .
t.
2x4
12.3 12.6
The higher the R -value, the
R-11 2x8
6.8
greater the insulating power.
2x6
6.8 7.1
Ask your seller for the fact sheet
2x4
6.8 7.1
on R -values. .
Blowing wool has been installed in the ceiling or sidewall in con-
Batts and rolls have been installed in conformance
with the above
formance with the above recommendations to provide an R -value
recommendations to provide thermal resistance value of
� 13
of R- using bags of this insulation to cover
R-30 at inches in sq. ft.
of ceiling, R•' at
square feet of area ata
• inches in L sq. ft. of exterior
walls, and R- at
inches in sq. iL of floors or crawl space perimeter.
minimum thickness of inches.
Date signature
Date Signature
9 KGZ!6 7W
insulation Contractor 74-741 Joni Drive
RT, CALIFORNIA 92260
PALM DE�jq ) 346-2339 Printeci in USA
06/20/1997 11:09 9096899524 ... HOOD'PLUMBING PAGE 02r'•�-'.=
h 1
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An installaion Oni(mo is required to tie pound at the duldl sifa nor
may ba usod to moot 188154 r ^� D �i'tlf� iS8(Iertpe rrr 1h19-ocvP'alcY POimit. This torte
eQ6lramontr. Atl appJiarloo catog-orj•a risted
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b64*-ard he artuaI'44U--0ment in=afled.. Ndts•that
tho ohicfanty ttnd' of tha apprianea irswlfed must be oqunralent or arta • ;' liarpciiapeufr+td on tho',Cortd$doto of
COrnplianoo (CF•1 iilff CAnlir�do;(Or its oQUNdlentl Rttal! bC *411at'Od
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r•sponsibiliry for the apphanoe In,Zallcil;oti
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i(Cerfffica*-te of Occupancy
City of La. Quinta..
Building and Safety Department OF
.This Certificate. issued pursuant to the'requirements of Section 109 of the Uniform Building 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:
BUILDINGADDRESS:-
78-880
SUNBROOK LANE
Use Classification:
y
SINGLE FAMILY DWELLING
Bldg. Permit No.: 9703-089
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
�yy� ►..� .
By-
DANIEL P.. CRAWFORD JR.
Date:
7/11/97
Building Official
POST IN A CONSPICUOUS PLACE