06-2360 (DSF)J �W
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00002360 Owner:
Property Address: 53430 AVENIDA CARRANZA MILLER D R
APN: 774-081-009-16 -000000-
Property Zoning: COVE RESIDENTIAL
Application valuation: 0
Contractor:
Applicant: Architect or Engineer: PADGETT' S CLEANING/RESTORATI
535 NEW JERSEY STREET
REDLANDS, CA 92373
(909)307-2769
Lic. No.: 679028
LICENSED CONTRACTOR'S 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/Class: B -C15 License No.: 679028
ate: 10')3^��O tractor: �-
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 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 and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.). ,
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 _) I am exempt under Sec. B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance'of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6%13/06
DU I�
JUN 13 206
LA
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.
Y-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 and policy number are:
Carrier AMER INS Policy Number W5734032
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 Code, I shall forts w• i%t comply with those provisions.
Dat��O 13 0� cant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this 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 application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
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 county ordinances and state laws relating to building construction, and hereby authorize representatives
of this Sgunty to enter upon a above-mentioned prop e y or msppction p p ses.
6 /
l ignature (Applicant or Agent):
Application Number . . . . . 06-00002360
Permit . . . DEMO PERMIT
Additional desc .
Permit Fee 45.00
Plan Check
Fee
.00
Issue Date
Valuation
. . .
. 0
Expiration Date 12/10/06
Qty Unit Charge Per
Extension
BASE
FEE
45.00
. ----------------------------------------------------------------------------
Special Notes and Comments
DEMO ROOF AND INTERIOR DRY"WALL
Fee summary Charged
Paid Credited
Due
-------------------------------------
Permit Fee Total 45.00
----------
.00
----------
.00
45.00
Plan Check Total .00
.00
.00
.00.
Grand Total 45.00
.00
.00
45.00
LQPERMIT
CITY OF LA QUINTA -PUBLIC WORKS/ENGINEERING DEPAR MENT
GREEN SHEET (PUBLIC WORKS CLEARANCE) F LDING PERMITS
Form updated & effective 8C SMO
Please DO NOT submit the Green Sheet (Public Work learance) Packet to the Public
Works/Engineering Department until ALL requirements listed be o e. Iricom lete
applications or applications which cannot be processed will be returned to Applicant. Green Sheet
approvals will be forwarded to the Building Department directly by Public Works.
Date: �`�� `a�O Developer: _
Tract No.: Tract Name:
Address(s): 519 3 O Y e n I'd A
Lot No.(s):
The following are the requirements for Public Works Clearance to authorize., issuance of a building
permit from the Building/Safety Department.
CUSTOM HOMES: PROVIDE ITEMS #2, #3, #4 AND #5 BELOW.-
TRACT
ELOW.TRACT HOMES: PROVIDE ITEMS #1, #2, #3,94 (AS APPLICABLEI AND #.6 BELOW.` .
COMMERCIAL BUILDINGS/OTHER:: PROVIDE ITEMS #1, #2,.#3 AND #5 BELOW.
1. Attach Pad Elevation Certificates in compliance with .the .approved design elevation for
building pad (maximum allowable deviation of +/- 0.1 foot). Pad Elevation. Certificates _must
be current (within 6 months of current date). If a precise grading plan creates the.pad for
approval, please withhold green. sheet submittal until a Pad Elevation. Certificate. can be
provided.
2. Attach geotechnical certification of grading plan compliance.
3. Attach recorded final map showing proposed building locations are legal lots:
4. Attach a completed <1 acre per lot or infill project Fugitive Dust Control project information
form, PM 10 -plan & agreement or provide alternative & valid City approved PM10 plan set
reference. number or hard copy plan. PM10 plans for cornmercial.arid residential developments
(beyond 1 lot) are. submitted separately .with grading plans and are subject to, additional
-requirements.
5. Attach an approved precise grading plan for the building' location(s). AO flood -zone
developments will require an approved flood plain development plan.
6. Attach an approved rough grading plan for the building location(s).
I have reviewed and confirmed the requirements listed above as'presented and find the improvements..
to be suffi complete for construction -of e proposed building(s)/structure(s). on the subject
lot(s). Pursu
""ant to my s, abov prole t ay be released for building permif'issuance.
Recommended by Dated:
Declined for approval for reason(s) as follow(s), please correct and resubmit:
TAPWDEPMTAFF\G.MiXGran Shit PW RCI=CW50824GREEH SHEET COVER.d. -
City of La Quinta - PM 10 Proiect Information (<1 acre per Lot or Infill Project)* Page 1 of 3
Form updated & effective MUMS
Project Information
Project Contractor:
PA CiPgn;
.,y strofA, d P
Project Phase
Project Phase
Project Name:
(Check One):
Project Tract
❑ Construction
Number:.
,Demolition
Lot Number(s):
4-5%V V
Anticipated Start Date:
—Y
Anticipate. Completion:
Project 'StreetI
Address:
3936 Ca r rd h z6
Total acres in active
. construction (<Facre per
Lot):
Project Contact
Please Note: Dust control is required 24 hours a day, 7 days a week,
:.. Information
regardless of construction status. Person listed below is responsible for
dust control during business :and non- business hours.
Name:
Title:
Company Name:
-e,.,� vt ed h h
Mailing Address:
City:
State:
V <
_
&1 7,32
Zip Code:
0q 36 -7 -2 76.q .
Primary
Telephone
Number:
Fax:
qp4 307- ZZ7S"
gtilt ' 3 d 2
24 Hour
Access/Emergency
Phone:
Cell Phone:of
0ej - Zcxs --3 ss1
PM1.0 Certificate
Number:
* Expanded PM 10 plans for commercial and residential developments > 1 acre are required -by the
City of La Quinta.
T:\PWDEPT`STAFRGoblc\Green Sheet PW Ret=6050824MIN1 PM 10 PACKET GREEN SHEEr.doe
PM 10 (<1 acre per Lot or Infill Proiect) Fugitive Dust Control Plan Page-! of 3
Plan updated & effective 8/25/2005
This plan shall take into account applicable SCAQMD Rule 403 regulations. Training may be obtained'by.
contacting SCAQMD (Sharon Zamora (909) 396-2183). This plan shall consist.of the following action items:
• WATERING: Continuous watering is required to prevent dust. and must occur a minimum of 4 .
times daily.
Water shall be applied to dry soils. to stop:
• Visible dust emissions over 20% opacity
• Visible dust emissions that travel over 100 feet.
• Water source 3/4 inch water meter at front (south) side of: ad
• EDUCATION: Responsible Dust Control Individual and key personnel shall attend SCAQMD
PM10. class and obtain PM10 certificate number prior to construction activity...
• WEATHER MONITORING: Wind predictions shall be monitored.
• SIGNAGE: Use Coachella Valley'Fugitive Dust Control PlanHandbook Construction: Site,Signage
Guidelines.
i
• TRAFFIC: Construction traffic .shall. not be allowed on the pad, unless absolutely necessary..If
vehicles operate on pad, pad shall be kept fine and moist through hose. watering, or. sprinklers:
Fugitive Dust shall be prevented by fencing off site to prevent unauthorized trafficon pad. (.15 mph
maximum traffic speed).
I
PARKING: Parking isnot allowed on -the pad. All:vehicles must park on street (al. designated areas-.
only).
• TRACK OUT: Provi& 24 hour street cleaning and track out system, as approved by CityPublic
Works Inspector. (No dirt on public or private roads). Track out shall be cleaned.up within .one hour
of incident.
• DIRT PILES: Dirt piles:shall be limited to 50 cubic yards and built per California:Building Code .
grading requirements. Piles shall be keptmoist or covered with.tarp material. Larger dirt piles will
require stockpile or grading permit.
• FENCING: Provide PM 10 fencing at perimeter of public roads and_ where applicable. Wood .slat .
fencing can be installed at rear of property and return 20 feet on either side if HOA restrictions apply.
Block walls can replace PM IQ' fencing during the construction phase.
• EQUIPMENT: Extra hoses and sprinklers shall be maintained on site.
• EXCAVATION MEASURES: All areas to be excavated or graded shall be pre -watered. Water shall
be applied during excavation or grading operations also.
• DUMP TRUCKS: Open top dump trucks to be wet down, moist and tar ped prior to leaving. site
• INACTIVE SITE: Within 10 days of ceasing of activities, re -vegetate or permanently stabilize as
required.
City of La Quinta - Site Specific Construction Phase PM 10 Agreement Page 3 of 3
Agreement updated & effective 8/25/2005
The signature of the property owner (or authorized representative):
• Shall.act as his/her acknowledgement of dust control requirements and their enforceability,
pursuant to AQMD Rules 403 and 403.1;
• Shall constitute and agreement to comply with all project conditions as identified in the
approved dust control plan;
...'The property owner (or authorized representative):
• Acknowledges that dust control is required 24 hours a day; 7 days a week, throughout. the
period of project performance, regardless of project size or.status;
• Shall ensure that each. and every contractorlsubcontractor and all. other persons associated
:. with the. project shall be in continuous compliance with all requirements of the approved dust
control plan;
• Shall take all necessary precautions to minimize dust, even if additional measures beyond
those. listed in the dust control plan are necessary;
• Shall authorize representative of the City/County to enter upon the above mentioned property
for inspection and/or abatement purposes; and
• Shall hold harmless the City/County and its representatives from liability for any actions
related to this dust control planor any.City/County initiated abatement activities.
Signature of Property Owner or Authorized Representative
Printed Name
Title Date
1
Compan
Bin #
City of. La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application, and Tracking Sheet
Permit #
Project Address:: J LZeA
Owner's Name: (,(, 0)e
A. P. Number:
Address:
Legal Description:
Contractor: P 5 �`4 Yi�rTrD �i
City, ST, Zip: (:�
Telephone:
Address: Sa s N,0V , S.F sir
Project Description: .
City, ST, Zip: A-0- 1 Ctc -, C &7 z-3% -3
Telephone: 6r 36 — Z%
A
State.Lic. # :
City Lie. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: `I U
State Lie. #:
Name of Contact Person:k� tJ1 p yj 1j
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Dem
Sq. Ft.: # Stories:. # Units:
Telephone # of Contact
Estimated Value of Project: �j�Q71b
APPLICANT: DO NOT WRITE BELOW THIS LINE
Req'd
Recd
TRACKING.
PERMIT FEES
F#Submittal
Plan Check submitted
Item
Amount
l Calcs.
Reviewed, ready for corrections
Plan Check Deposit
lcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan'
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading '
IN HOUSE:-
''" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit.Fees
Jun 15 057a
•
2956 ROOSEVELT ST.
UNIT 3
CARLSBAD, CA 92008
.June 13, 2006
Pad eats Com ..any., R_
53430 Avenida Carranza
Re: Authorization to being cleaning & restoration
S
CONSTRUCTION
& DEVELOPMENT, INC.
PHONE: (760) 730-7431
FAX: ' (760) 730-9106
EMAIL: pacifictrades@sbcglobal.net
p.2
David Ross Miller, president of Pacific Trades Construction & Development, Inc.
authorizes Padgetts to being demolition of trusses and interior drywall, at the property located
in the city of La Quinta.
T k You
A
�1
DavidRos Miller
President
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL
Received From:
Address:.
Account
co"
Service Address
Meter(s)
l Service(s)
❑ Backflow(s) — —
❑ House Lateral(s) _
❑ DetectorCheck(s)_.
❑ Meter Surcharge
Sanitation Capacity Charge - —
❑ W.S.B.F.C. — — — -- —
❑ Temporary Construction Meter
❑ Turn on Charge—
❑ Uncollected Account-N2r,ie — — —
Cl Inspection Fee -Tract -
Fee— -- -- —
—
❑ Plan Check Fees Water 1 Sewer -
Tract-
0 Bond Payment - A.D. - Bond —
❑ Customer ueposit
❑ Other
Remarks:
❑Copy to:
Cash
Money
Order
A
TOTAL
WaterServlce
Cashier
CV W D-438111180