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9909-171 (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 # Lib. Class Exp. Date t✓l,.rffc Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 1 License Law for the following reason: ( y`) 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)," ` ()/ram exempt under Section B&P.CAor this reason' 1,Date /`7 qel Signature of Owner Av.l) r ' 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. (f 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 .1D-Cia0MJR fNS C Policy No. -B20074370 r+ (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 workeJy9 compensation laws of California, and agree that if I should become sldct to the workers' compensation�provi"sions�of Section 3700 of the Labor C�*ode, I shall fo ith comply with those provisions. 'ate: c! ,i` eJ Applicant ,�`c f <� r r.S �'l•� '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. E 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/1 agree to comply with all City, and State laws relating to the :building construction, and hereby authorize representatives of this City to enter upon /thi/above-mentioned property for. inspe((ction purposes.,/gnature (Owner/Agent) i/ p �f •t y; ✓1✓ "'� Date ��� f� e i / ji BUILDING PERMIT PERMIT4�,71 DATE 1 VALUATION $91942'4'20 LOT it) TRACT 4� JOB SITE 51-W AIVENI DA HE.RI ERA APN 773-06 4.0" ADDRESS OWNER CONTRACTOR / DESIGNER / ENGINEER OC:TAVIO VAZQUEZ OWWER / BIALDER MTH C -MC i2 -Q} FRED •iWAMG DR_, #1471. 45701 MONROE ST SM 0 RKLM DESERT CA 9�w264 IND10 CA 92201 (7a)347-3157 C81.0 USE OF PERMIT tiPIGME FA,A4tI Y.t WEL,1,MCr SF'17 (1371) AO) - PF RMF :t3t?ES M-Yf INCLr DE3.8LOCK WALL OR F►i.?OL, Txi.AN (:,TMX Rl DUCED 79,!4 FOR NRYL11PLE 1"WANCE OF SAME 1YLAN• TYPE,. 1'R.AC"17 CONS'1RIJC'VON 1,320.00 S.F -7 K)RCHMA."TIO 114-00W GARAC:WARPORT 420.00 91% ESi'Yll9A d"ED COST OF CONSTRUCTION N 53,424.20 PERMIT FEE I5l5.ZMMM COti5TRUCT10rf:F1M 101-0W-418 4,0071 $536:5ff rjLAN CHWIK Mt 101=,coo-439-318 $1A.61 W10", 41CAl. FEE 101-000-421-000 $53-54) 1w1.1C RICA3,M; 101 -00,4264090 PX [ t143B1tv;C11• ; ' 10,4 -00o -4.1.9-00o S M.7: ' S'1'RGrI90 MOTIONFEE - REM 1, 01-000-241-M) 18.14 GRADING FFX- 101 -MO -473-000 �w:4.4t4 �'F 4'f�LG:1��.1A�lrlR,.C."P .C.1i'1~ •$1,94`,*.1� PRF.I-11.4E PLAIN 101-0017-441.345 $100.00 � d. 51,1k3-'iUFAL C©N.ME){TITON AND PLAN CHECK $3,01160 €1 PR' EES X00 TOTAL PERMI FEES DUE NOW S3.012.60 r t YA RECEIPT DATE BY DATE FINALED INSPECTOR 4 INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings re LDucts Slab Grade Return Air Steel Combustion Air Roof Deck _ Exhaust Fans O.K. to Wrap Framing y� - - co 4517 F.A.U. Compressor Insulation Quo S7 Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath .8® 9 RW Finalr�. ✓_. ov BLOCKWALL APPROVALS Final POOLS - SPAS Steel Set Hacks 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 _ °_571 Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection -7 _ oo Encapsulation Gas Piping Gas Test �j dtJ Appliances Final COMMENTS: Finat- Utility Notice (Gas) p� ELECTRICAL APPROVALS Temp. Power Pole Lola Qr/ rj Underground Conduit Rough Wiring Low Voltage Wiring Fixtures -Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors I -Temp "Use of Power Final _ Utility Notice (Perm) � '.''vat �, :� r'{�1� " ° �.r •f; ;, '�j' tr+' n .'.� .-"!�'fJrl � ,• '�45 ;; ".-f . ;�,�1 0-.4 ,,�'-��;,��� RESIDENCE ADDRESS: • `,�� 4�6-3 THIS ATTIC HAS BEEN INSULATED T0: ® �U IT This attic has been insulated to the R -value indicated above, with Cocoon-, the high -efficiency �V. 0 insulation. Made from a minimum of 80% recycled Q 4 i � materials, Cocoon is scientifically formulated to deliver greater efficiency per inch than other r� i insulation materials. R -value is a measure of resistance to heat flow — the r '� . 4�1"� '` i► } higher the R -value, the greater the insulating power. If you would like to add more insulation to our Y Y °.. home, contact your Cocoon authorized dealer. IN 81-77 Indio, CA 92.201 BUILDER: s CERTIFICATION: This is to certify that attic insulation has been installed in conformance with the coverage chart recommenda- tions on lithe opposite side of this card using bags to covlleo s ft to o tain an R -value of r�� te fit' t r. r 4• 7 Z/ e I. TA R'S AUTHORIZED SIGNATURE DATE A TM Cocoon Stabilized Insulation 30 lb. bag t d9unujuuured /31e GREENSY®WEC•%Y" A LOUISIANA PACIFIC COMPANY NOTE: This coverage chap compensates for settling 7 e : and is for estimating purposes only. Stated R -value is provided by installing the required number of bags - q per 1000 sq. h. at a minimum installed thickness. Installation of the required number of Ings may yield more than the specified minimum thickness and mininwm weight per sq. ft. Actual Coverage will be innuenced by job conditions and application techniques, and c may vary as much as 10% without significantly affecting the stated R -value. Failure of the installer to provide :n least the required number of bags per 1000 sq. ft. and at least the mininwm thickness may result in a lower installed R -value. Compaction may occur during installations above R-30, requiring more than the stated number of bags to obtain the minimum installed thickness. GreenStone and Cocoon are trademarks of GreenStone, a Louisiana-Pacific company. ©1997 ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART R -Value at Net Coverage No Adjustment for Trusses 751 Mean Minimum Gross Coverage Based Maximum Net R-13 (2 x 4) Minimum Weight Temperature Thickness 2' x 6' Trusses an 16' Centeto rs R-20 Coverage Per Square Foot Installed The Weight Per To Obtain an InsulationMinimum Bags Square Foot of Bags Required Insulation Should Not Be Square Feet Required Per Installed Square Feet Per 1,000 Resistance (R) of: Less Than: per Bag 1,000 Square Feet Insulation Per Bag Square Feet (inches) Should Not Be Less Than: (IUs.) 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 1.171 26.9 37.2 R-38 10.3 27.0 37.1 1.113 28.4 35.2 R-32 8.6 32.0 31.2 .937 34.0 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 19.6 R-19 5.1 53.9 18.5 .556 59.5 16.8 R-13 3.5 78.8 12.7 .381 87.0 11.5 R-11 3.0 93.1 10.7 .322 102.8 9.7 19.4 .583 56.7 17.6 GreenStone Industries, Inc. All rights reserved. Printed in USA. RV 30M 8/97. Sidewalls (pressure filled -density 2.0 PPCF) o , 8-97•TT/G-A R-13 (2 x 4) .917 3.5 51.4 R-20 ■ ■ (2 x 6) 5.5 32.7 30.6 .917 36.1 27.7 ■ ■ 1� Certificate of 06cupancy- City of La'Quinta Building and Safety Department 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.- BUILDING ollowing. BUILDING ADDRESS: 51-090 AVENIDA HERRERA Use Classification: SFD Bldg. Permit No.: . 9909-171 Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC Owner of Building: OCTAVIO VAZQUEZ Address: 77-600 FRED WARING DR. #1401 City: PALM DESERT, CA 92260 By: STEVE TRAM Building Official Date: 09-27-00 POST IN A CONSPICUOUS PLACE