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04-7972 (DEMO)P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760)777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . . . .0.4L0 -00:0r7972 Date 12/2 Property Address . . . . . 77'50 CO- DR APN:- 658-310-046- - - Application description . . . DEMO - COMML/OTHER Property Zoning . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 0 Owner Contractor -----------------------------------------------------------------= LA QUINTA GOLF ESTATES EMERY LAND CLEARING & GRAD INC P.O. BOX 162 P.O. BOX 1009 LA QUINTA THERMAL, CA 92274 LA QUINTA, CA 92247 (760)391-5840 WCC: STATE FUND WC: 04611653 04/12/05 CSLB: 600283 11/30/05 CCC: C21 ---------------------------------------------------------------------------- P.O. Box 1504�� VOICE (760) 777-7012 Taf 78-495 CALLS TAMPICo FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 04— -7q 19 I Date: 10 ' c57 3 '0 `�/ Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licens nder ions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License Ts ' full force and effect. /License Class Licens No. OWNER43UILDER DECOTION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License La o 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 Contractors' 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).): U 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 or 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.). U 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.). U I am exempt under Sec. . BA P.C. for this reason Owner_ WORKERS' 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. I have and will maintain workers' compensatj n insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is i d M w comp ation i rance carrier and _ 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, i s ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ,,, 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 i$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. CONSTRUCTION LENDING AGENCY 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 P A APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Builcing 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 Ouinta, 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 beccmes null and v ' 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 rect. I agree to comp) ' all city and county ordinances and state laws relating to building constructiion,nWndher by authorize representatives of this county to enter upthe abgve-m boned ope for inspection purposes. ate vd(�J/Sig/naturree (Applicant or Agent): ---------------------------------------------------------------------------- �, .: Application Number ---------------------------------------------------------------------------- . . . . . 04-00007972 Permit DEMO PERMIT Additional desc . . Permit Fee . . . . 45.00 Plan Check Fee .00 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 45.00 ---------------------------------------------------------------------------- Special Notes and Comments DEMOLISH EXISTING GUARDHOUSE 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 Ilk 05/02/2003 01:20 7603915839 EMERY PAGE 01 FAX EMEaRYLANDCLEARING AND GRADING, .INC. P. o. Box 1009 THERMAL, CA 92274 760/391-5840 FAX: 760/391-5839 DA'Z'E: PlAm 2005 ATTN: GARY SHOWATER COMPANY: CITY OF LA QUINTA - BUILDING AND SAFETY DEPT. FAX #: 777-7011 PAGES: 3 COMMENTS: ATTACKED IS THE COPY OF THE JOB INVOICE FROM A -I CESSPOOL SERVICE, INC., FOR THE PUMPING OF THE SEPTIC TANK AT 77-750 COACHELLA DRIVE, WE DID REMOVE THE SEPTIC TANK AND BACK FILLED THE AREA, I HAVE ALSO ATTACHED A COPY OF OUR DAILY TICKET AND A RECEIPT FOR THE CONCRETE DUMP FEES FROM SAM JONES MINE. THE PERMIT #04-7972. PLEASE CALL ME AT THE PHONE NUMBER ABOVE, AND CONFIRM IF THIS IS ACCEPTED, IF YOU HAVE ANY FURTHER QUESTIONS, PLEASE CALL ME. THANK YOU, LORI EMERY 0 IF YOU DO NOT RECEIVE ALL PAGES OR HAVE ANY QUESTIONS, PLEASE CALL THE ABOVE PHONE NUMBER 05/02/2003 01:20 7603915839 EMERY � I A-1 Cesspool Service, Inc.,. JOB INVOICE 191twe imp, (W) M"M Am (Y60 NVU05 1e Iic, #2m4 I R'nalammAl -- OV44 M 51 pav"Filopw IWO Waste DbdMp VMS per IODU "ous Lamfmg and Opeaft Fee (1br. No.) Out dAm ru Ind gf nn"m "e 4iummandaft ANN m a Of 93 Omm"'AL Lw 13z:MA2 b'w64 AUMNEWIMS MWW1%MTLjXWnJL29 1" W1441 ep Tote) PAGE 02 PAGE 01 Emery Landclearing INTERIOR 8 EXTERIOR MMOLMON • SITE PREPARATION • BACKHOE SERVICE • WATER TRICKS • WEED A$ATEME P.O. BOX 1009 • THERMAL, CA 92274 • (760) 3454746 • (760) 391-5840 • FAX (760) 393 -58: `FAMILY BUSINESS SERVING YOU SINCE 19760 DATE � X4-7 U , NAM E OF DEBTOR: !D923 JOB LOCATION: r�cl�C!/a TIME REPORTED FOR WORK END TME DOWN TIME FROM RECEIVED BY: X A.M.1P. M. A.M./P.M. TO i i 13 Emery Landclearing INTERIOR 8 EXTERIOR MMOLMON • SITE PREPARATION • BACKHOE SERVICE • WATER TRICKS • WEED A$ATEME P.O. BOX 1009 • THERMAL, CA 92274 • (760) 3454746 • (760) 391-5840 • FAX (760) 393 -58: `FAMILY BUSINESS SERVING YOU SINCE 19760 DATE � X4-7 U , NAM E OF DEBTOR: !D923 JOB LOCATION: r�cl�C!/a TIME REPORTED FOR WORK END TME DOWN TIME FROM RECEIVED BY: X A.M.1P. M. A.M./P.M. TO 4=4 .01 1 ; bb�1� i X43 PSE 02 SCOTT L1i1V1tMO & ASSOCIATES P.O. BOX $5329 3)trsS DWtP&knD m &L 03 -SSW Riverside, CA 92517 Cahedrst City, CA 9UM (909) 624-166&3 i7O)30-7743 0. ASBESTOS SURVEY REPORT Completed On November 27.2004 PLM1 BUBO'! Client J & W Management P.O. Box 1398 Palm Desert, CA 92261 rJo Lang Rogo"y Project: La Quints Golf Estates 77-7501/2 Coachella Drive (g"6rd shack only) On November 22, 2004 an asbestos Inscection and bulk sampling was conducted at the above project address. Bulk samples were taken of ail suspect asbestos containing bwIlding meler,als (ACBM) at ,he request of the client named above. Bulk samples wetti subml ed to Carolina Enviranmantal, Inc. located at; 107 New Edition Court in Cary, NC (NVLAP Code 101758.0 and Cal. Environ. Lab. Cert. #2483) to estimate the pereentop+s of asbaMs by volume end determins the type(s) present. Carolina Environmerttat's telephone number is (919K81.1413. Caroline 11 nvirortntesntal, Inc, determiner percentages and typ of eebiWas by using EPA approved axdhod 6004*.82-020: Interim Method for the Datermination of Asbestos In Bulk Samples, Bulk samples ere analyzed by PLM (Polarized Light Mi=3wpy). Asbestos to quantified by us;ng the Asuai arena estimation technique and Den only determine rile approxlnift percentage of asbestas present After a thorough search is conducted and no asbestos is detected "none detected° will be noted In the report. The essenes of polarized light rttiaroscapy is not to emphstically determIna that no asbestos la present, merely that none was detsded or, if it was, it was likely to be less then 1.0% of the sample. When findings reveal less than or olose to 1.095 asbestos contained in a sample, furtner analysis may be ratted for an additionai samples to contirrn or denounce the initial findings, The California Code of Regulations (CCR 1529) requires bulk sampling be conducted according to the A.H.E.R.A, protocoi provisions of 40 CFR Part 763.136. The A.H.E.R.A. prWocol recommends th•-ee (3) or more friable surfacing samples from a homogeneous area be. colliemed and analyzed before any builuing material is determined to be nonAsbastos containing. Scott Morrison A Associataa conducts jisbestos inspedon surveys following the A. H.E.RA. Inspection protocol. ASBESTOS INSPECTION BY: Soott Monism, DOSH #92-0248 HULK SAMPLES ANALYZED BY: Caraline Environmental, inc., NVtAP #101788.0 ThO results an the following page(4) indicate that asbestos wee detected in 00 of the I9 oempbs analyzed. 190-d £03/200'd 1££-1 6VOW091+ 11113ABDY A 18 r-W0a:1 Wd1V;Z1 VOOZ-20-Zi • •� ��-. '.V � V 1 � �uoca„ya , PAGE 03 P.O. Box 53329 SCOTT MORRISON & ASSOCI-ATES 624-1665 2517 31153 �> Dft &e. 43.507 Cfly. CA 9223A (7W)323-7743 PLM1 maws Sample #LR -1 Type of matanal:exwor wall stucco Location: exterior E. was Frleble:no AreathrotQ11MA gXWor Resuks: none deWcted Sample R-2 Type of materlal:extesriorcailing stucco Location:exterlor E. calling Friable= Area -exterior ceiling Results. none detected &Wnple Type of material:1"bwor Onat coati white Location: interlor W. wrap, bathroom Friabie:no Am:intahor wall -1st lay®r Results: none detected Sample #LR -4 type o:lmmncr drywall/ Location:trtorior W, wqjl, bat rpom k Fdable:rm AM: interior wadi -2nd Iayor Results: none detected Note: All ssti wtas Wntaining building maderini(s) cntltstningl prMater than 1.0% asbestos by volume or weight, trust be rernov9d by a State oertifed asbestos abatement contrcator prior to any demolftn or renovatlen of the property. Inspector • Y� I Scott C. Morrison COM11ed A$b& tos Consultant (2) 190-d COO/HO'd 16f-1 80099091+ 16130dNO M r -WOE j wdlp:zl V00NO-ti 211:071,2002 J"� f .l f SCAQMD NOTIFICATION OF DEMOLI7I(3N OR ASUSTOS REMOVAL MARL FORIA AM FIEE TO ISD, ASBESTOS NOTnCATXWS, FILE S 59841, LOS ANGELES CA 90074,%41 WASTE TRANBPOitTER 02 WASTE STOIgME SITE ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP CONTROLS: DEWAIi3E M1RK PRACTICES AND CONTROLS TO BE USED AT TIE F040VATION AND DEMOLITION SITc. P=odura # 1.2, 3, 4, 5 or Other, For ast+estoa re wob ca* flu coveacm of Rhe 1403 proimdtnes used. Pmce&n 4 aid $ Submit plans for AQMD prior gproval, ASBESTOS OEfECTION PROCEMM, CIRCLE THE PROCEDURES AND ANa1.YfWL METHODS USED TO DETERMINE ASBESTOS IN THE BUILDING: Sway, Brrltc fssMplirxa. Ineyaet w, PLM, PCM, TEM, Ammed as ft PACM, Daa:be parer (SEE SURVEY GUIDELINES CHECKLISTI: FOR MWOUTIONS GIVE THE COMPANY NAME AND DATES OF THE A°UEST08 REMOVAL: NIA FOR OBD DEMOLITION SEND A COPY OF THE ORDER AND {SIVE THE AGENCY NAME S PHONE # AUTHORIZING PERSON: TITLE DATE OF ORDER: I DATE ORI:iERED TO BEGIN: FOR EMEFMEWY'Y ASSTOS F"OVAL GIVE THE NAME AND R-iONE N MaER OF ?HE PUMM DECLARIWYALITHDF ONG THE EMERGENCY, DATE AND HOUR OF EMERGENCY AND DMNBE THE SADDEN, UNEXPECTED EVENT: EKPIAM HOW THE MNT WOULD CAUSE :AIrSAFE C040 170 S, EWRWidr DAMAGE OR UNREASONABLE. FINANCIAL ELRDEN; C0f(TRi MCY PLAN: DESCRIBE ACTIGC°S TO BE FOU_OWED IF UNEXPECTED ASBESTOS IS FOLK DURING DEMOLITION On ASBESTCW MATERW. BEcMF DISTIJFRED, CR11A1.ED, PVLYSIZED.OR REDUCED TO POWDER STOP PROJECT HAVE CERTIFIED ASBESTOS REMOVAL CONTRACTOR REMOVE AND DISPOSE OF. TRAIMNa CERTWICATION: I cw* that an v divicdal WhW m itte provie wo of regulation AOMO Ruta 1403 and NESHAP will be on Sib during to removal and ovidamGie that the r&pi*td iaWm tem bm m=wormhoduir Otis paw w1l be '!able fa itwpecfw during ru t l business hour. CGxnparry Nim EMERY FMrri "me of o wofopomt Slgm ue Tillie Of oww/opomtsr Date 1717104 L1Ah1DCLEARM AND LORI EMERY Chi NG, VICE PRESIDENT r O;WATION CERTIFICATM: I car* that ft same m mdm.. is end I lava tltwivzed anp abt :tw ends. `I Cor VmW Nmm Eft Print rmme eloYbrl2t *m ab' Saprahtae Tala of o4a�trlVmbr Date 12!1104 IANDCI,EARRdGAND L.OIT1 EiMERY � VICE PRESIDENT CAADINO, INC. NG>tiiis ebm Gxrn rat be ac copbd wbout ft refilmed be (AQMD Rule WA6mdm nerals of bm tl 1 square feat we exempt from nali5mmh and fees. Plt� matte G: mks payable to SCA D". Fees we pfx no>!ltoittlon, nct reb&*, sW Vtlfy aa�or Br8 ib project 9i2?. Fres are as fellows: Dt MOLIT CtN OR AWE61'DS REMOVAL PROCEDURE 4$ WjWICE CHARGE 1.000 Gr Im S 313.90 i 45021 SPECIAL HANDUNG FEE 4 39.80 11,001 to.,000 $ 1f2.I;0 $ R6.81 REVWAONOF NOTIFMTiON S 36.90 51001 to 10.000 $ 264.03 S 678.04 RETURNED CHECK CHARGE $ 29.28 10,00' to 50.WD S 414.01 S VA Al2 PLANNED IENOVATION $ 408.36 50,001 to 100,w $ 600.00 =1,01.1.01 100 001 or more _ 61;000.04 $1,414.01 � J MAIL FORMA ANO FEE -TO: SCALD, ASBESTOS NOTIFICATIONS, FILE 0 55641: LOS ANUELES CA W074441 Page 2 of 2 TF IM: (DOD) 3*2'= FAY:PW3R9Br&W Fours REV 2003M7 -.ii FORMS, INSTFWTIONS, "Mb THE RtULL 1403 CIN BE OBTAINED FROM AQMD tlilEB SITE AT HTTP -6LNA tiW AQM S 14029 C Mrs4m, MA: Na -- 4147r par rh 04799 94129 10WI ^*W 'A"M 12/07/3002 01:41 ?503915339 M SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT NOTIFICATION OF DEMOLMON OR ASBESTOS REMOVAL PACE U IML FORM AND FEE TO SCAQMD, ASUSTOG NOTIFICATIONS, FILE # 55841, LOS ANGELES CA 90074.5611 i' LL�L..�. a-, :rv;.�•.r: ".:1Cr.':'d''a :;,,:y 14 COMPLETED BY COMPANY EMERY L414DCLEARING PHONE 7601 I -M LOFD EMERY V.P. AND GRADING, INC. DATE 12.7-04 CHECK# 1908 FEE S38.00 PROJECT# NOTIFICATION TYPE ORN11ML Revkvm DAM Rt`VISICM OTHER "Wight Cmce- ATION PROJECT TYPE Daamoti ORDEPE D DEmoLmoN RENWATIDN ftITIMMI) • EMEpwo RE wk PLw,,m Rao (amml) SITE INFLATION SITE NAME LA QUNNTA GOLF ESTATES SITEE AOORESS 77-75015 COACKU.A DIANE CROSS STREET E)SENHOWER D" CITY LAQUINTA STATE CA ZIP 87153 COUNTY RIVERSIDE OESCRIBE wM AND LOCATION REMOVE AND DISP08E OF ONF OLIARD SRAM BUILDING SIZE (SO FT) LMER 800 SQ FT NUMBER OF FLOORS 1 BUILDING ACE (YEARS) 19 NUMBER OF DWELLING UNITS 1 e= PRIORI PRESENT USE COMMKIk Eb TAL INDUS IM 011`0 OMM ALWC RIX. HOLISE SCHW Swiv Ur1MCOLLEGE SITE OWNER LA QUrNTA GOLF ESTATES COMMUNITY ASSOC: ADDRESS 48805 AVENIDA EL NIDO i CITY LA QUWA STATE CA ZIP 92263 CONTACT MR LWWRENCE ROGOWAY PHONE 760" 46 RiI:T.TIflRED RBI ILDING Df�=ATtON ASBESTOS YES NQ PRE8ENT7 ASBESTOS YES NO SURVEY? ` A68ESTOS YES tQ RMOVED? BUILDING TO BE YES NO DEMOLISHED? PROJECT DAM START 12!2.1104 m 12/3tu WORT( SBFT Wft SWITV, Highs} ASMSTDS AMOUNT TO BE } R1 MOVED On aquae feet) FRABLE CLASS I CLASS II TOTAL MOUNT (Obd W) i ASBESTOS REMOVAL FROM SURFACES PIPES COMPONENTS ANDUNT OF EACH TYPE OF ASBESTOS (a► soon bell ACOUSTIC C©LING LINOLEUMINSULATION FIRE PROOFING DUCTING STUCCO MASTIC FLOOR TI`.ES (VAT) DRYWALL PLASTER TRANSITS Ro- OTHER �COAR wToRi RNF'ORmAT ow CSLB LICENSE # 60D283 OSHA FIEG # AQMD IDN 100435 NAME EMERYLANDCLEMNO AND GRADING, INC. ADDRESS P.O. BOX 1009 CITY THERMAL STATE CA ZIP 92274 SITE SUPVR JAMES C. EMERY PHONE 76017749493 WASTE TRANSPORTER A4 U#MFL L ADDRESS ADDRESS , I .CITY I STATE ZIP CITY STATE ZIP Asbes(as surveys are Required Dior to De=lloon and Ranova(iarl