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11-0046 (RER)],i t 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 Application Number: 11-00000046 -j Owner: ) O Q Property Address: 52685—AVENIDA VALLEJO LA QUINTA REDEVELOPMENT l+j APN: 773-292-020-8 -000000- 78495 CALLE TAMPICO . Application description: REMODEL - RESIDENTIAL LA QUINTA, CA 92253 I Property Zoning: COVE RESIDENTIAL t JAN 312011 Application valuation: 3060 Ctry of � 44wNrA Contractor: rtAI.Aw E 0 pr Applicant: Architect or Engineer: CRYSTAL CLEAR MIRROR & GLASS 72330 QUARRY TRAIL THOUSAND PALMS, CA 92276 (760)343-1633 . Lic. No.: 653336 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. Licens ass: C17 . License No.:. 653336 ate: 31 .Il ontractor: OWNER -BUILDER DECLARATION I. hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the- following hefollowing 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).: 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 _ 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 affirni'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 SOUTHERN INS CO. Policy Number WSIO02130502 _ 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 370/0 of the Labor Code, I shall forthwith comply with those provisions. at � 3 � �/ leant: • _ 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 employeesforany 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 an state laws relating to building construction, and hereby authorize representatives of this untty to enter upop4e above-mentioned property for inspection purposes. ate: 3i �� ignwure (Applicant or Agent): �i Application Number . . 11-00000046 Permit . . . BUILDING PERMIT Additional desc . Permit Fee 63.00 Plan -Check Fee 40.95 Issue Date . . . . Valuation . . . . 3060 Expiration Date 7/10/11 Qty Unit Charge PerExtension BASE FEE 45.00 2.00 9.000.0 THOU BLDG 2;'001-25,000 18.00 --------------------------------=------------------------=------------------ Special Notes and Comments INSTALL 7 NEW WINDOWS AND 1 SLIDING GLASS DOOR. SEE ATTACHED DOCUMENTATION. 2010 CODES. -----=------------------------------------------------------------ ---------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 t ENERGY;REVIEW FEE 4.10 Fee.summary Charged Paid Credited. Due Permit Fee Total 63.00 .00 .00 63.00 Plan Check Total 40.95 .00 .00 40.95 Other Fee Total 5.10 .00 .00 5.10 - Grand Total .109.05 .00 .00 ,109.05 LQPERMIT Oct 29 10 10:34a 1 To: R Kirk Kirkland City of La Quinta From: Gary Lange Re: 52-685 Avenida Vallejo White Vinyl window retrofit replacements with Low a glass Windows are from MMgard with full lifetime wananty from Manufacture 3@59x47 2@ 47 x 11 Sliding Glass Door 95 x 79 1@71x47 1@35x41 Total price Installed $ 3,060.00 ' APPROVED: Dat `Gireg tier, Kanager City of La Qu.inta Building & Safety + 4 1 - 72330 Owrry Trail ' Thous" PaNM CagTomia, 92276 Phone: 760.3431633 Fax 760-343-1634 Emad.- Ul/'L//'LU11 lb: by /bolttt/dll LA UUINIA HLUU L.1LV1 IAUL t11/MI Ce Residential CF -IR -AL' __ (Page 2 of 4 TClimate Looe N p of Stories Indicate the type of assemblyto include, Hollow Unit Masonry Walls, Solid Umi Masonry. ,Solid Concrete WalLr. Etc. found ReAddiriara/ assemblies can ference Joinr Appendu JAi. This is the U -Factor bayed on the thickness of the assembly in orches. The R-ba/ue of the imulation to be added on the i.utrior or exterior of the assembly. The Calculated R -c glue is the R-vo/ue of the fwrred out section of Me assembly. -6. The Final Assembly is calculated r�dng Equation I-2 or F,quarlan Hof the Reference Joint Appendix JAl. The equation is rhe inverse of (,Alun Added to Column 1. Column Kis the inverse franc column J. lasers the calculated (1 -factor value On to the ue Surface Details in Column J ALTERED FENESTRATION ALLOWED AREAS (IC est If awn= MAA SW pf arestnatiow is arid4 R! A B C U E F G CFA of Entim Allowed % of Uisting Fenestration Fenestration Total At= Ll Dwelling CFA Area Fetstration . Allowed Proposed Area! Total Fenestration Area Area Removed Arca Added A x B E -D * C 20 > West Fenestration Area (Required in .O5 CZ's2.4&7-1s L: > 1. Wert Fenestration Argo includes west-slapitg sAyllghts and any sAyligks with a pitch less than 1:12. 2. West facinggllm il-rg Area remond connot-be "wanted'=Afire. " In -order to disrribule-lhe wei►g/cei*garac reniaved io the oihei Mieniations, 6wi the west glaring area removed in the Total Fenestration Arta -row; column O, 3. Include the Proposed Area of the West foci 4. To meet com lance, the Pr ed Area must be lea them or fifffeStration in bola equal Arta the Total Allowed Arrajor BOTN the Tara/ and Wear Fenestration Aneaf Registration Number: Registration Dale.Time: 2008 Residential Compliance Forms — -_ _ f►ERS Provider Aetgresr 2009 01/27/2011 16:09 7607777011 LA OUINTA BLDG DEPT HA(*- MIMI CcetiHcate of Com liaoce: Residential CF -IR -ALT lleradons (Faze 5 of 31 a 10 1 1 A I It) i, T I Climate Zone a f Stories HEIS VERIFICATION SUMMARY 77?e enforcement agency should pay Welal antero/on tothe HERSMeasures specified in this checklisr below. A completed and signed C.'%!R Form for all rhe measures specified shall be submitted io the budding inspector before final ins crion, Duct Sealing & Testing HERS verification is "aired for this measure. O YES 13 NO YES: In Climate Zones 2 and 9-16. if more than 40 linear feet of new or replaccr, cnt ducts are installed in unconditioned space. the ducts air to be scaled per 015Z(b)lDii and the newly installed ducts are to be insulated per 0151(f)10. EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or seated with asbestos. 13 YES El NO VIES: In Climate Zones 2 and 9-16. if the existing space -conditioning systcm (HVAC equipment and ducting) is replaced, the ducts air to be scaled per 1152(b)Ini. Cl YES 17 NO YES: In Climatc Zones 2 and 9-16. if the existing HVAC equipment is reptaecd (including the replacement of the' air handier. outdoor condensing unit of a split system. cooling or heating coil. or the furnace heat exchanger) the ducts are to be sealed per § 152(b)1 E. 4 EXCEPTION: Duct systems that are documented to have been previously seated confirmed through HERS verifwtion in accordance with procedures in the Reference Residential Appendix RA3. O EXCEPTION: Duct syetems with less than 40 linear feet in unconditioned space - El EXCEPTION: ERistia duct systems constructed, insulated or sealed with asbestos. Refrigerant Charge - Split System' HERS verification is required for this measure. 13 YES d NO VES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacetncrm of the air handler. outdoor condensing wit of a split system A/C or heat pump. cooling or heating coil. or the fumace heat tacchan et a refri erant mesurememr shall be verified 1 S b)c F. Fan Iwtegrat Central (CFI) Ventilation System and FaA Watt Draw The ventilationiretttarts of 5 o do not W!Z to cxiftit residential homes. Ducted Split Systems - Air Conditioners mad Hat Pumps: Ab clow HERS n7 frcat;on is requirrd for this Measure. 13 YES O NO YES: In Climate Zones 10 through 15. when the cxighrtg space -,conditioning system (HVAC equipment and ducting) is replaced. the air uw and fan watt draw shall be verified per I 152(b)ICi to meet the muiranerin of §151(f)7B. • i certI& that this Certificate of Coo fiance doe waentation is Company: Im 1] CEA or Responsible Building Designer's Declaration Statement • 1 am eligible under Division S of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • f certify that the entry, features andperformance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24. Patti I and 6 of ft California Code of Regulations. • The building design factures identified on this Certificate of Compliance are consistmt with the information provided to document this building design on the other applicable compliance forms, w•orksheds. calculations, plans and specifications suhmitted to the enforcement fora v with this buildine nennir znn1i~.- -- 1 t I/V1-r a-A.r. _ -/ r.. -6..m..— - .. . — _ .. -- - - - .... . - - - - '2 For a mislanee or gaestiom ^egarding the Energy S1rastd4arjs, confect the Ewergy Hotline at. Tso&;G-Too. Registration Number: Registration Aare,'Tinre: HERS' Provider: 2008 Residential Contplfart�ce Forms August 2009 Bin # CO. of. LaQuinta } Building &r Safety Division P.O. Box 1504,~78-495 Calle Tampico La Quinta, CA 92253 (760) 777-7012 Building Permit Application and Tracking.Sheet ° pP Permit # Project Address: Owner's Name: / A. P. Number: - . ' Address: 8 Legal Description: City, ST, Zip ICA Contractor: y Telephone: one: Project Description: Address: 06�;�/ City, ST, Zip: Telephone: State Lic. # : City.Lic. #•: Arch., Engr., Designer. , Address: City,'ST, Zip: Telephone: Sta to Lic. #. . Construction T e• Occupancy. type: P Y Pr oJect hPe (circle one): New Add' Alter n Repair. Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: - Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd' 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. Title 24 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 7a a 7a LIMITED ASBESTOS SURVEY -.DATE OF SURVEY:. October 26,1010 LOCATION: • 52685 Avenida Vallejo La Quinta, CA + BY:,'. Gregory Masters California Certified Asbestos Consultant # 03-3365 Masters Environmental 44719 Alexandria Vale Indio,* CA _92201 760-200-2900 Survey authorized by: Tom Hartung, City of La Quinta Methods: Selected' materials in the structure that were suspected of containing asbestos were sampled according to specified protocols. Samples were sent to a NAVLAP accredited laboratory, Patriot Laboratories, Garden Grove, CA —Lab code 200358-0. 'They were analyzed by Polarized Light Microscopy according to Bulk Analysis Protocol EPA 600/R-93/116.' The 'laboratory report is attached to this message for your inspection ' Site: This structure is a single -family residence. The scope of work is to determine the asbestos content of the textured ceiling, of the roofing, the drywall that is going to be repaired in two places, and the taping compound compound that.goes with the ceiling drywall: The deteriorated wallboard that will be repaired in the garage, is faced with a paper product that could have asbestos content --- so.it was tested also. The scope of work also was to include an inspection for mold above the, water-damaged bulging ceiling dry wall. It would'involve bringing down the ' drywall onto the floor. But, on reflection, if the textured ceiling really had asbestos content, that action would contaminate the whole house with airborne asbestos fibers: I decided that it was too risky to do that. Sampling Table: Sample Location Description Friable Quantity Condition Asbestos 001 Living Rm Textured F 750'sq.ft., Good ND ceiling 002 Front Bedrm Textured F 156 sq.ft Good, ND ceiling 003 Kitchen. Textured F 90 sq.ft Good ND ceiling 004. Living Rm Drywall F 2 sq.ft, Dam ND 005 Roof BI-roll-rfg `NF 1,900 sq.ft -Dam ND 006 Roof BI-roll=rfg NF Dam ND 007 Insulation Tan insul. NF 39 sq.ft Good - ND 008 Garage Taping C. F 2 sq.ft Good ND 009 Garage Drywall F 2 sq.ft. Good ND 010, L.R. Ceiling Tapinc C. _ F 4 soft Dam' ND 011 Garage Surface sheet NF " 32-64 sq ft Dam , ND on garage wall Masters Environmental 760-200-2900 44719 Alexandria Vale 760-200-2901 FAX ` Indio, 'CA 92201 gmasters@sonic.net Of Masters Environmental 760-200-2900 44719 Alexandria Vale 760-200-2901 FAX Indio, ' CA 92201' gmasters@sonic.net . i� • r , • t � I No guarantees are offered or implied. r • r • We appreciate the' opportunity to serve your asbestos needs, and look,, ` forward to working with you again. s R . * •• "' *.rte VO POP�W•YJ CO�/ 1 * • `r-_ iF .-+ 9 ,r, • ' LU No. 03-3365. -zi r . —Masters Environmental : " 7607200-2900 , 44719 Alexandria Vale ' r 760 -200 -2901 -FAX Indio, CA :92201. - _ gmasters@sonic.net ` tsl AIN U3 - CUSTODY Page Of Lab Usa onlyr 1 /� Report Numbe . ` ) J Q• MASTERS ENVIRONMENTAL Pro'eCtr: % 44719 ALEXANDRIA VALE PrQ ect Name: L -a ' INDIA, CA 92201 Location: 5 2_ L'79 A -v -e- • ��,>' L• 2 �, 760-200-2900 Sample Collection Date: C Contact Phone: Preservative: 760-399-6769 (CELL) Authorized By: 760 -200-001 (FAX) po#: CIaim #: Special Instructions_ nalysis eques-E • rb tos - :M (7iercount) NIOSH 7400A M (bulkasbastos) EPA 600IR-93/116 CARE 435 Q Point Count 400 E3 Point Count 1000 Gravimetric Reduction Q Turnaround Time Rush Same Day) Other (sps-cify): 24HR 48HR 72HR Note : 3iLC/CAL WE—i rzgdIsse minimum of 52 hrs 'naround ?CLP requhas a n9nfmurrt of -22 hr tumaround -Cu,Yures rayuhz 5.7 days fumaround ad byFlameAA Paint, Air Cassette, Dust Wipe, Waste Water. Soils, Misc. Solids EPA3050817420mod NIOSH 7082mod ad Waste Profile As necessary for disposal Q Note: Please provide at least 200-500 grams (approx 112-11b) flowed by Flame AA of sample for necessary analyses. orindivldual fes sbyrequest- ' ,1: Ti1C i otal Threshold by EPA 30508 mod 2: STLCICAL WEI-Ti e, 22 CCR Ch11 Article 5 App 2- 3. 3: T CLP EPA 1311 g _ SAMPLE NUMBER LOCATION' DESCRIPTION � QUAN Tilt , CONDITION D O t L.r vin a ei r' o y 0 2-• Fero r l 5 4 s f C> D n. rP0 5 rt o �- • lZ m I Vr . lm. z s I O ®K. Q.1 (l, f S f 0014 O ar~ 7 m Z O© 40r- 2510 ®1,0 L Kei in + s 0 l I 17 Pee- I iho . -5 k I 3 2 - to ri $0. Vf- Relinguislto0y.. (Print) C 65 (sign (nate} ,/10--Z RBC81V@Ei_$y: (Print) ( 9n} (0�)Q Z U Relinquished By. Pring (Date) Deceived PX- (print) (sign) (Date) lRe'linquished 8y. (Print) (-q 1-0) (Date) Certificate of Analysis PLM Asbestos Identification - . • * . F , :;.: ,, _x , TeC 714.899.8900 J _ " FroO:888.743.0998 Q Fax: 714.899.7098 ht W/V#WW patrfoUab.fom '. ` 7271 Garden Grave Blvd; Suite Garden Grave, CA 9280 Patriot:EninronmeAtal Laboratory Services, Inc. `Repo"A urn er394638 Masters Environmental z ..• `'^ 44719 Alexandria Vale f w ' ` , Mit < 1 Project Number 1671 Indio CA 92201 * "} - ' - Project Name: La Qumta { N. Project Location 52685 Ave Vallejo ' r La Qumta, CA ' Date Collected: F> t } 7 .+Collected By t Date Received: 10/27/2010, L Claim:Number Date Analyzed 10/27/2010:: ' >PO Number . Date Reported 10/27/2010 Number of Samples Lab/Client ID/Layer Location 4`-L Material`Description .` Color' A . ; Composition (%) 394638-001. , Living Room Textured Ceiling White '74% Carbonate 001 s „ 23% Foam 3% Paint Total Asbestos None Detected r 394638-002 Front Bedroom Textured Ceiling White 74% Carbonate 002 • 23% Foam 3% Paint F Total Asbestos None Detected . 394638-003 'Kitchen Textured Ceiling White 5 74% Carbonate - 003 23% Foam -'1 • s 3% Paint Total Asbestos None Detected 394638-004. L_ Room Drywall Patch Loc Whiter 90% Sulfate 004 - y i 8% Cellulose 2% Glass Fibers Total Asbestos None Detected 394638-005 Roof Roofing Felt 4 Black . 70% Cellulose 005 i .. 30% Tar 1 4 e A Total Asbestos None Detected 394638-006 Roof_ Rolled Roofing Black 63% Minerals 006 35% Tar 2% Paint Total Asbestos None Detected Page 1 of 3 ' Certificate of Analysis.,.:::" ; PLM Asbestos Identification :Tel:: 714.89.9.8900 Fom, 888.743,0998 .•: Fax: 714.8".7098 . http:/%nn">►vPatriotMb_coin Patriot Environmental Laboratory Services, Inc. t:. 7271 Garden &64 13W. ; S61te A Id Airderi Grave, CA 92841 Masters Environmental :` r ReportNumber 394638 44719 Alexandria Vale Project Numfier 1,671 Indio, CA 92201 3 Project Name La.Qumta Project Location 52685 Ave Vallejo ;."r . La Quetta, CA Date Collected: Collected By ` Date Received: 10/27/2010 Claim Number ; Date Analyzed 10/27/2010 ' PONumber 1 Date Reported: 10/27/2010 '. ;Number of Samples ,11 Lab/Client ID%Layer Location Material Description . '.:, .;; Color' Composition (%) 394638-007 Insulation At CeilingBulge Brown Y ' 100% Cellulose x 007 .:. .. '. Total Asbestos None Detected 394638-008 Garage Taping Compound White 92% Carbonate 008 8% Paint Total Asbestos None Detected ; 394638-009 Garage Drywall Patch Loc White 90% Sulfate 009 8% Cellulose' .2% Glass Fibers Total Asbestos 'None Detected , 394638-010 Living Room Ceiling Taping Compound at White 82% Carbonate 010 Bulge 15% Cellulose 3% Paint Total Asbestos None Detected ` 394638-011 Garage Peeling Surface Sheet White 80% Cellulose O l l on Drywall 20% Paint Total Asbestos None Detected Page 2 of 3 Certificate of Analysis PLM Asbestos Identification T&;714.899.8900 " Free 888.743.0998 Fax: 714.899.709 8 t1t1P;/-PamotWtkOM' ' Patriot Environmental Laboratory Services, Inc. ":7271 Garden Grove 81id.; Suite:A Garden Grove, CA 92841 Masters Environmental RepohNumber 394638 " 44719 Alexandria Vale Proj ect:Number: 1671 Indio, CA 92201 , Project Name: La Quetta Projec Ucation52685 Av' .Nallejo .. a: La Quanta, CA` r Date Collected: Collected By Date Received: , 10/27/2010';' Claim Number Date Analyzed:;:,: 10/27/201.0.' PO'Number Date Reported: 10/27/2010: Number of Samples 11 Lab/Client ID/Layer Location 1VVlaterial Description . Color": = Composition M Bulk sample(s) submitted was (were) analyzed in accordance with the proceduie'outlined`.in the US Federal Register 40 CFR 763, Subpart F, Appendix A; EPA -600/R-93/116 (Method for Determination of Asbestos in Building katerials),and EPA -600/M4-82-020 (US EPA Interim Method for the Determination of Asbestos in Bulk Insulation Samples).Samples were analyzed'using Calibrated Visual Estimations (CVES); therefore, results may not be reliable for samples of low asbestos concentration levels. Samples of wall systems containing discrete and separable layers are analyzed separately and reported as composite unless specifically requested by the customer to report analytical results for individual layers. This report applies only to the items tested. Results are representative of the samples submitted and may not represent the entire material from which the samples were collected. "None Detected" means that no asbestos was observed in the sample. "<10/o" (less than one percent) means that asbestos was observed in the sample but the concentration is below the quantifiable level of 1%. Elaine Wai - Analyst Ian Reyes - Approved By This report was issued by a MST/NVLAP (Lab Code 200358-0) and CADOHS- ELAP (Cert. No. 2540) accredited laboratory and may not be reproduced without the expressed written consent of Patriot Environmental Laboratory Services, Inc. This report may not be used to claim product certification, approval or endorsement by MST, NVLAP, ELAP or any government agency. Page 3 of 3 • �rAV 21,E ci;i&uQUI �, INVOICE 1673' MASTERS ENVIRONM 7 Division of Master Search Inc. - OCT 2 8 2010 CITY OF LAQUINTA FINANCEOEPT.-A!P — '44719 Alexandria Vale, Indio, CA 92201 (888)485-2900 gmasters@sonic.net FOR P914 ENT, To: City of La Quinta By -i ; ' � , P. O. Boz 1504 BY La Quints CA 92247 1 – 18 Yg SS . � - ACCOUNT ;";l Attention: Tom Hartung DESCRIPT1 . AMT TO PAY '45 -co asbe skos ser.. For: ASBESTOS SERVICES •r�$5 Date October 28, 2010 A rf. . Vail For asbestos inspection, sampling, and report for structure at $ 300.00 52685 Avenida Vallejo, La Quinta, CA 11. samples.of suspected asbestos containing materials for laboratory analysis by Polarized Light Microscopy @ $20/sample 220.00 Terms: Due and payable on receipt 7 .ra ..�•.. � ,•. ���•, /. .. .v.. ...a r ;li ,rr'.•-,( 1. ` v_. ',)d. ,, . lr^�,�. ,.`., nr-.7w: a..�s�;h'kj1�c�•Y'� .-'tWr'%•1 ,i,. EMERGENCY REQUEST FOR PREWRITE� CHECKS .jt X lReturn check to requestor D. Aaker' Name / Title of person requesting check .T. Hartung Department individual is associated with: Building & Safety Mail Date check required by: Nov 05 ?010 Al2 1,4 Friday, Nov. d, 2010 Check payable to: MASTERS ENVIRONMENTAL dS-T UA Amount: $ 520.00 (Name) (Vendor o. 44719 Alexandria !tale (Address) Account Number: 401-1848-551.45-01 Indio. CA 92201 Project Number: Home foreclosure rehabilitation @ 52-685 Vallejofsbestos ser) Check description.and invoice number: Check requested for environmental contractor following completion ofbestos inspection and sampling per attached invoice at 52-685 Vallejo. Describe emergency in detail: Check requested before next warrant run cycle since work has been completed and report received. Signature's: ' � • Yf r. equestor � y�4 (Fin Ance.Direct :g 4 t• a �-Fj J y .� '(Date) „*. i * . r; ate); Cityo�oCa Quinta -- CHECK NO. -- 89529 - MASTERS ENVIRONMENTAL 5406 11/05/2010 DATE INVOICE ACCOUNT DESCRIPTION. AMOUNT 10/28/10 1673 401-1848-551-45.01 REHAB 52685VALL 520.00 II'89 5 2911' 11:1210002484 4 L 5 9 28 2 48 211' 520.00 DOCUMENT HAS A COLORED BACKGROUND. SECURITY FEATURES LISTED ON BACK. :... ;.:::.,:::-,..:..: i _.... :::.:;:.:::.::.: • ;::: < <::z .. .: . . ...:... ..:.:::' WELLS;FARGO BANK `':?:' -2411210.1) 21018) >':.''i: ... ` i.::':; rx: i= . =::..: , . CHECK NO S PoBdX 1504 78 495 CALLS TAMPICO LAQUINTACA,92253 `: DATE . . a AMOUNT M 11/05/2010 $******5.20.00 , of TN 1760). 7.7.7;7150 • 0 ti di w _ TOy, F or t THE MASTERS ENVIRONMENTAL ORDER 44719 ALEXANDRIA VALE - U HORIZE IG AT RE '0F INDIO CA 92201 - �AUTHCIRIZID SIGNATURE II'89 5 2911' 11:1210002484 4 L 5 9 28 2 48 211'