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06-1421 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application Valuation: Applicant: 0.6-0 0 0 0-1421 52700 AVENIDA RUBIO 773-313-001-26 -000000- REMODEL - RESIDENTIAL COVE RESIDENTIAL 3000 way/ 4 4 Q" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: LARRY WALTER 28830 93 AVE NE BELLEVUE, WA 98004 Contractor: Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/07/06 ----------------------------------------------- LICENSED CONTRACTOR'S DECLARATION --- ----------------------------------------------— WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: Contractor: _ 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier _ Policy Number following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to I certify that, in the performance of the work for which this -permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with those provisions. .. 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) ' - 4- ADate: —6A� Aooli�L..,,- Ws 11--1 (_ I 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 hisor 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 11. —iimprove for the purpose of sale.). `I / 1, 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 Coritractors' State License Law.). ( 1 I am exempt under Sec. , B.&j P.C. for this reason Date: "1,� / _U b Owner: {., 01 �Ll.� (nJa.�'}'� 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 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 thithissccounty to enter upon the above-mentioned property to inspection purposes. Dates e: Ll- 6-o4 Signature (Applicant or Agentl: _ �j�T� �..t'],ar— � —G Application Number . . . . . 06-00001421 Permit . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 54.00 Plan Check Fee 35.10 Issue Date . . . . Valuation . . . . 3000 Expiration Date . . 10/04/06 Qty Unit Charge Per Extension BASE FEE 45.00 1.00 9.0000 THOU BLDG 2,001-25,000 9.00 ---------------------------------------------------------------------------- Special No and•Comments RESTUCCO EXTERIOR OF HOUSE. ASBESTOS REPORT NEGATIVE FOR ASBESTOS IN STUCCO. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 3.51 Fee summary Charged Paid Credited Due ------------------------------------- Permit Fee Total 54.00 ---------L .00 ---------- .00 54.00 Plan Check Total 35.10 .00 .00 35.10 Other Fee Total 3.51 .00 .00 3.51 Grand Total 92.61 .00 .00 .92.61 LQPERMIT Bin # City Of. La Quin a Building & Safety Division P.O. Box 1504, 78-49.5.Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building.-Perrrt Application and Tracking Sheet Permit # Project Address: " Z Owner's Name: A. P. Number: Address: g3 O i9 v L A./er Legal Description: City, ST, Zip: 6CG i ltie— gU[) Contractor: ��7 f LIJ, d,l t' Telephone: Address: P 1, H 3 Project Description: City, ST, Zip: R� �.a�. �,r c17.-2 �0 C C p Telephone: 76, -3-1-J -221D State Lic. # Arch., Engr., Designer: Address: City, ST, Zip: Telephone:" " State Lic. #: Name of Contact Person: Construction Type:_ Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Projec �J APPLICANT:. DO. NOT WRITE'BELOW THIS LINE' # Submittal Req'd Rec'd TRACKING . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked-up Construction Flood plain plan. Plans resubmitted Mechanical Grading. plan' 2n' 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 CITY OF LA QUINTA UB_ -CONTRACTOR LIST .JOB ADDRESS Z G� PERMIT NUMBER ® W l OWNER BUILDER", This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or theiyr employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of .work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" ,is not an acceptable response. Trade /Classification Contractor 77777 :..:..::::...:.:.. ;:;.:.:•;:•State:.Contractots License . ::..,:.. a cation:Insurance:.:::::.,':;;,:..:<:: , . Workecs.Comp. n a Cit .. Biis�ess License: `.:•::: Y _____ _ Company Name Classification License Number Exp. Date Carrier Name Policy Number Exp. Date License Number Exp. Date (e.g. A, B, C-8) (xxxxxx) (xx/xx/xx) (e.g. State Fund-CalComp) (Format Varies) {xx/xx/xx) (zxxx) (xx/xx/xxl - EARTHWORK (C!-12)...'. CONCRETE,(C-8). FRAMING (G-5) STRUCT. STEEL (G-51) MASONRy-(C 291 . �. e PLUMBING f C 361: LATH,yPLASTER (C 35) .. 33 2 0 Z HVAC (C-201 ELECTRICAL (Q-4 0)' ....:: - ROOFING IC 391 , SHEET FLOORING IC 15):. _ GLAZING (C-171... , INSULATION ;IC -21. .: . : SEWAGE ;DISP- (C-42) . ` PAINTING,(C '33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13) F 9 LANDSCAPING (C=27). POOL (C-53) .. 41-800 Washington Street c B-105; #201 Indio, CA 92203 Tel. (760) 772-1263 Fax (760) 772-6254 ENVIRONMEN.TAL, IN.C. April 5, 2006 Mr. Larry Walter 2830 93`d Ave: NE Bellevue, WA 98004 Re: Asbestos Inspection, Sampling and Report Site: 52-700 Avenida Rubio, La Quinta, CA Dear Mr. Walter: On March 27, 2006, a Certified Asbestos Consultant -from. J&H Environmental, Inc. conducted a limited inspection for asbestos -containing' materials at the above referenced location. A. The inspector is certified by the California Department of Health Services. The inspector extracted two bulk samples from assumed' asbestos' -containing materials and forwarded them to Forensic Analytical to be tested for asbestos -content. The following is a recap of this inspection and our. findings: I. Executive Summary 1.01 There was no asbestos found in the sampled materials. 1.02 J&H Environmental, Inc: ,recommends that prior to disturbing any areas that were not sampled, these areas should .be sampled .to ascertain the presence, of any and all asbestos -containing materials and that all samples obtained be sent to an accredited laboratory for analysis. II. Bulk'Survey Limits 2.01 This report is not" intended to identify all hazards or unsafe conditions or imply that others do not exist, but is merely .an. indication, of. the condition of the suspect asbestos -containing materials in the building at the time of the survey. III. Bulk -Samples 3.01 Two samples of suspected. asbestos -containing materials were taken and submitted to the laboratory for analysis. The _ analyses' were performed using the polarized -high microscopy technique described in the EPA Interim Method of the Determination of Asbestos in Bulk Insulation Samples (40 CFR Part 763, Appendix A). .