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11-1013 (DEMO)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/20/11 Application Number: 11-00001013 Owner: Property Address: 48801 SAN LUCAS ST PAGE TOBY C APN: 658-310-001- - - 48801 SAN LUCAS STREET Application description: DEMO - COMML/OTHER LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 0 Contractor: Applicant: Architect or Engineer: GOLDEN CONSTRUCTION INC, PAUL i O 73710 FRED WARING DR STE 101 I PALM DESERT, CA 92260 (760)776-4215 ���� f AlA, Lic. No.: 786919 j ,© CITY OF I.A OUINTA 14 N- rflE rD mP` ---------------------------------------------------------------------------------- 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 Busin and Professionals Code, and my License is in full force and effect. Licen a Class: B Liens N : 786919 ate: C 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 1, 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.) (_ 1 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 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. 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 and policy number are: Carrier STATE FUND Policy Number 0000268-2010 1 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 shyldttrome subject to the w rPrs' compensation provisions of Section 3700 of the Labor, I Oall forth fith c_om1hh those provisions. ate: ✓/ pplicant: / 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 e i ormation is correct. I agree to comply with all city and county ordinances and state laws relating to buil ing con ruction, and hereb authorize representatives of th' county to enter up o the above-mentioned property for pec n Pur aft%&Cid/// ignature (Applicant or Agent): Application Number . . . . . 11-00001013 Permit . . . DEMO PERMIT Additional desc . . Permit Fee . . . . 45.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/18/12 Qty Unit Charge Per Extension BASE FEE 45.00 ---------------------------------------------------------------------------- Special Notes and Comments REMOVE POOL & SPA, PARTIAL REMOVAL OF STUCCO, FLOOR TILE, KITCHEN CABINETS, ROOF TILE, A/C'S & LANDSCAPE. 2010 CODES. 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 Bin. # • City of La ' Quinta Buildby 8T Safety Division P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92233 - (760) 777-7012 Building Permit Application' and Tracking Sheet Permit # Project Address: WP©/ `Owner's Name:.] A. P. Number. Address: Legal Description: City, ST, Zip: Contractor�/A/Z �� ,�,/���. i ��-Telephone:MAM OM' Address:;7f%/0,/2/'_b �y i� �� /O/ Project Description: rae-,,0Vx. �?,60C City, ST, ZiVJ/1t6.� Telephone:�j� 26 State Lie. #: City Lie #: C/�i✓T� /�Q� % a C �� Arch., P.ngr., Designer • . � .Ir t • h � Address: City., ST, Zip: Telephone: Construction Type: Occupancy: State Lie. #: ;w g Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Unit$: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE N Submittal Req'd Recd TRACKNG PERMITFEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit. . Tess Calcs. Called Contact Person Plan Check Balance Title 24 Calci. Plans picked up Constrnetion Flood plain plan Plans resubmitted.. Mechanical Giading plan 2'! Revlew, 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 Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees SCOTT MORRISON & ASSOCIATES P.O. Box 55329 31855 Date Palm Drive, Ste. 3#507 Riverside, CA 92517 Cathedral City, CA 92234 (909)624-1665 (760)323-7743 ASBESTOS SURVEY REPORT Completed On May 16, 2011 PLM0510#0601 Client: Michael Kiner Group 70-177 Hwy. 111, Suite 200 Rancho Mirage, CA 92270 Project: The Page residence 48-801 San Lucas (La Quinta C.C.) La Quinta, CA On May 10, 2011 an asbestos inspection and bulk sampling was conducted at the above project address location. Bulk samples were taken of all suspect asbestos containing building materials (ACBM) from the areas to be renovated only at the request of the client named above. Bulk samples were first analyzed by Scott Morrison & Assoc (DOSH #92-02480 and submitted to Carolina Environmental, Inc. (upon request) located at: 107 New Edition Court in Cary, NC (NVLAP Code 101768-0 and Cal. Environ. Lab. Cert. #2483) to estimate the percentage of asbestos by volume and determine the type(s) present. Carolina Environmental, Inc. determines percentages and type of asbestos by using EPA approved method 600/M4-82-020: Interim Method for the Determination of Asbestos in Bulk Samples. Bulk samples are analyzed by PLM (Polarized Light Microscopy). Asbestos is quantified using the visual arena estimation technique and can only determine the approximate percentage of asbestos present. After a thorough search is conducted and no asbestos is detected "none detected' will be noted in the report. The essence of polarized light microscopy is not to emphatically determine that no asbestos is present, merely that none was detected or, if it was, it was likely to be less than 1.0% of the sample. When findings reveal less than or close to 1.0% asbestos contained in a sample, further analysis may be called for on additional samples to confirm or denounce the initial findings. The California Code of Regulations (CCR 1529) requires bulk sampling to be conducted according to the A.H.E.R.A. protocol provisions of 40 CFR Part 763.86. The A.H.E.R.A. protocol recommends three (3) or more friable surfacing samples from a homogenous area be collected and analyzed before any building material is determined to be non -asbestos containing. Scott Morrison & Associates conducts asbestos inspection surveys following the A.H.E.R.A. inspection protocol. ASBESTOS INSPECTION BY: Scott C. Morrison, DOSH # 92-0248 The results on the following page(s) indicate that asbestos (greater than 1.0%) was detected in (00) of the (06) samples analyzed. RECIEUVBD (�) a4 K0' AUG 2011 BYe � 1 .nspector C. Morrison Certified Asbestos Consultant DOSH#92-0248 (2) SCOTT MORRISON & ASSOCIATES P.O. Box 55329 31855 Date Palm Drive, Ste. 3#507 Riverside, CA 92517 Cathedral City, CA 92234 (909)624-1665 (760)323-7743 PLM0510#0601 Sample #ML -1 Type of material: drywall only Location: interior wall, pool pump room Area: throughout interior walls Friable: no Results: none detected Sample #ML -2 Type of material: exterior wall stucco/ creme Location: exterior wall, outside "family room" Area: throughout exterior walls -1" layer Friable: no Results: none detected Sample #ML -3 Type of material: exterior wall plaster/ grey Location: exterior wall, outside "family room" Area: throughout exterior walls -2nd layer Friable: no Results: none detected Sample #ML -4 Type of material: textured ceiling drywall Location: interior ceiling, kitchen Area: interior ceiling, kitchen Friable: no Results: none detected Sample #ML -5 Type of material: asphalt roofing felt/ black Location: roof, under clay roof tiles Area: roof, under clay roof tiles ' Friable: no Results: none detected Sample #ML -6 Type of material: textured drywall Location: interior E. wall, master bedroom Area: throughout interior walls Friable: no Results: none detected 1 .nspector C. Morrison Certified Asbestos Consultant DOSH#92-0248 (2) m x M INTEGRITY -BASED CONSELING September 16, 2011 Building Department City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 To Whom it May Concern, FAX NO. : 2143693319 Sep. 19 2011 07:43PM P1 With this letter l am authorizing Paul Golden Construction to act on my behalf concerning the issuance of any demolition or building permits for my home at 48801 San Lucas. please call me at if you have any questions. Yours truly, -1- ��'�� Toby ge i FROM : INTEGRITY -BASED CONSELING FAX NO. : 2143693319 4 RECORDING REOUESTCu BY:��(�L1`� .---AVD WHEN RECORDED, MAIL TO: Toby C. Page,c/o,Cantor&Fitzgerald 3811 Tutle Creek Drive #16 Dallas, TX 75218 T -7-A 0W - ova PAID Orx- Transfer Tax >Riv. 40. Ftec•7.rder Sep. 19 2011 07:43PM P2 540074 Rt_CEivtU FOR RECURU AT 2:00 P.M. Q E C 11 1998 Re=orOod In Offta) Rumds of Riverside cowry. Caiirotme, Recorder Fees THIS SPACEFOR RWoRDars u O. •L _ Notary. Publio, personally appeared PO-�IcR F.L. HANSELL Now, y .'ziblic -state of W=ud Coma::>;r,:=nsd in Jackson Courriy / Ly Co-.rm'm n Cxplf6s .�rpN 01/,91119apersonally known to me (or proved to me on the basis of / satisfactory evidence) to be the person(s) whose name(s) s is/are subscribed to the within instrument and acknowledged `to .me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the Instrument the person(s), or the entity upon behalf of - which the persons) acted, executed the Instrument WITNESS my han ol seal. - Signature MAILTAX STATEMENTS TO: (mt. *MdatnwAye*&q Toby C -Page, c/o Cantor/Fitzgerald-3811 Turtle Creek Drive #16, Dallas, Texas _752_19 NAME ADDRESS CRY. STAM & ZIP ASSESSOR$ PARCEL. NO.: 631-322-010-6 The undersigned Grantor(s) declare(s) that the DOCUMENT TRANSFER TITLE ORDER NO.•81010128 TAX 1�� � �-` 935-00 s County City M ESCROW NO.: 18420-00:X com on the full Value of the interest of propery eoriveyed, dr" '•'r,i Q _computed on the full value less the value of liens or encumbrances yremaining GRANT DE E D thereon at the time of sale EXEMPT l _ OR transfer Is from tax for the following reason: FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged, Y.arry E. Belger and Betty G. Bolger, husband and wife hereby GRANT(S) to Toby C. page and Lori Anne Page, Husband and Wife as Joint Tenants �p all that real property situated in the City of La Quinta COUpt.yd - R3 t eraiae - , State-&•Caftrnla; deQodbed as: _ Lot 62 of La Quints Golf Estates #1, as per map recorded in Book 37, Pages 96,97 and 98 of Maps, in the office of the County Recorder of said County. Dated --November 09, 1998 MISSOURI M STATE 0 } Larry E. Be ger COUNTY OF Mg.4/ On 16/ey.�'ir�„��.d-/_1�9�, before me ,s���Eiyl.4it�'LG Betty ger Notary. Publio, personally appeared PO-�IcR F.L. HANSELL Now, y .'ziblic -state of W=ud Coma::>;r,:=nsd in Jackson Courriy / Ly Co-.rm'm n Cxplf6s .�rpN 01/,91119apersonally known to me (or proved to me on the basis of / satisfactory evidence) to be the person(s) whose name(s) s is/are subscribed to the within instrument and acknowledged `to .me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the Instrument the person(s), or the entity upon behalf of - which the persons) acted, executed the Instrument WITNESS my han ol seal. - Signature MAILTAX STATEMENTS TO: (mt. *MdatnwAye*&q Toby C -Page, c/o Cantor/Fitzgerald-3811 Turtle Creek Drive #16, Dallas, Texas _752_19 NAME ADDRESS CRY. STAM & ZIP