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08-1346 (DEMO)P.O. BOX 1504 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: �C08_00001346 —� Owner: Property Address: 51410 CALLE -JACUMBA GREEN MARK APN: 770-166-025- - - Application description: DEMO - COMML/OTHER DEI Property Zoning: MEDIUM DENSITY RES 77 - _ _ _ D _Application valuation: 0 ContractorAUG o 8 2000 Applicant: Architect or Engineer: Owner .CITY CF.LA �UINTA FINANCE CE'IT; I--------=-------------- —x 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: License No.: Dote: Contractor: 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 aapplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 155001.: (y �) 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.). (_ 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.). (_) I am exempt under Sec. , B.&P.C. f3Hhis reason Date: "IF U /� caner: �T 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: 8/07/08 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' compensatlon insurance carrier and policy number are: Carrier Policy Number 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 'be subject to the wor , pensation laws of California, and agree that, if I should be a bject to the com sation provisions of Section ,��/�,C of the Labor Code, I all f wi h com tho ro Bions. ' te: !/ plicant: 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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. - I certify that I have read this application and 0alh the above information iscorrect.Iagreetocomply with all city and county ordinances and sta laws reo "ding cc struc ' and hereby' authorie representatives ofthi/s�:,n7enler upon t ove-mentipro a f�e��r o es. at$ e: S' ature (Applicant or Agent . LQPERMIT Application Number . . . . . 08-00001346 Permit . . DEMO PERMIT Additional desc . Permit Fee . . . . 45.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/03/09 Qty Unit Charge Per Extension BASE FEE 45.00 ---------------------------------------------------------------------------- Special Notes and Comments TO CLEAR ASSESSOR RECORDS, DEMO OF POOL, CARPORT & GREENHOUSES. SEE COUNTY PERMITS #235704, #214431, #21077. THIS WORK HAS ALREADY BEEN COMPLETED. 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 RECORDING REQUESTED BY: MARK GREEN MAIL TAX STATEMENTS TO: MARK GREEN Td� a a , DOC N 2005-0063341- 01/24/2005 08:00A Fee:7.00 Page 1 of 1 j Recorded in Official Records j County of Riverside Larry W. Ward Assessor, County Clerk 8 Recorder � I IIIIII IIIIIII III IIIIII VIII IIIIII (IIII III VIII III �, I IIII M $ U PAGE SRE DA PCOR NOCOR SMF MISC. A R L COPY LONG REFUND NCHG EXAM THIS SPACE FOR RECORDER'S USE ONLY GRANT DEED CID ASSESSOR'S PARCEL NO.: The undersigned Grantor(s) declare that the DOCUMENT TRANSFER TAX IS: 770-166-022-1 $ -O-County computed on the full value of the interest of property conveyed, or computed on the full value less the value of liens or encumbrances remaining thereon at the time of sale. OR transfer is EXEMPT from tax for the following reason: FOR A VALUABLE CONSIDERATION, receipt of which is hereby -acknowledged, MARK GREEN, AN UNMARRIED MAN hereby GRANT(S) to MARK GREEN, AN UNMARRIED MAN all that real property situated in the City of , County of , State of , described as: Lot 17 , Block 2, of Desert Club Tract Unit 2, as per map recorded in Book 20, page 6 of maps, in the Office of the County Recorder of said County. Dated December 28, 2004 State of California } County of _Riverside_} On Dec. 28, 2004 , Before me Judy Stinson, Personally appeared Mark Green Notary Public (or provided to me on the basis of satisfactory evidence) to be the person(s) whose name(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 person(s) acted, executed the instrument. WITNESS my Wnd and Signature — z k� d rI,(- � Mark Gr JUDY STINSON Commission s 1301731 Notary.Pubfic—Calfomia RivenOde Courtly My COmm. Fires May 17, 2005 (This area for official notary seal) 41-800 Washington Street B-105, #201 Indio, CA 92203 H- Tel.(70;226»-654 ENVIRONMENTAL, INC. May 4, 2007 Mr. Mark Green Re: Asbestos Inspection, Sampling and Report Site: 51-420'Calle Jacumba, La Quinta, CA 92253 Dear Mr. Green: On May 1, 2007, a Certified Asbestos Consultant from J&H Environmental, Inc. conducted a limited inspection for asbestos -containing materials at the above referenced location. This report is intended to only identify the asbestos containing building materials and is not to be used for bidding purposes or specifications. The inspector is certified by the California Department of Health Services. The, inspector extracted five 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 asbestos found in the sampled materials. 1.02 Please be advised that roof penetrations are assumed to be asbestos containing. 1.03 J&H Environ mental, 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 Five 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). U IV. Definition of Asbestos -Containing Building Materials 4.01 Asbestos -containing building materials are those who contain more than one percent (1%) asbestos by weight: They are classified as follows: 1) Friable materials that may be crumbled, pulverized or reduced to powder by hand pressure; 2) Non -friable materials (Class I), that may potentially be broken, crumbled, pulverized or reduced to powder in the course of demolition or renovation activities; and 3) Non -friable materials (Class II), that cannot be crumbled to powder by hand pressure. V. Work Authorization 5.01 This report, alone, is not intended for asbestos abatement purposes. The survey and sample analyses were performed and the report was prepared under authorization of Mr. Mark Green. Neither J&H Environmental, Inc. nor any of its employees, nor any contractors, subcontractors, or any of their employees make any warranty, expressed or implied, or assume any legal liability or responsibility for any third party use of or the result of such use of any information, apparatus, product or process disclosed in this report, or represent that its use by such third party would not infringe on private held rights. 5.02 The work completed has been performed on behalf of and exclusively for the use of Mr. Green. J&H Environmental, Inc. warrants that our services are performed within the limits prescribed by the client, with the usual thoroughness and competence of the Environmental Consulting and Testing profession.. No other warranty or representation, either expressed or implied is included. 5.03 The judgmental considerations necessary for the performance of this work have been made by trained professionals, in accordance with generally accepted practices of Engineers and Scientists undertaking similar duties and performing similar projects. 5.04 Although comprehensive in nature, results of this survey should not be extrapolated to include areas not specifically mentioned. VI. Friable Building Material 6.01 Friable building materials are those which can be crumbled to powder by hand pressure. Fiber release is, therefore, more likely under these circumstances. The EPA indicates that the following factors should be considered when assessing the potential for fiber release: a) Condition of Material, evidence of physical and water damage, debris or deteriorating connection to the substrate. b) Potential for Future Disturbance, erosion or damage -proximity to air stream, visibility and accessibility, type and intensity of activity in the area, sources of vibration, air movement and building users. VII. Non -Friable Building Materials 7.01 Non -friable materials cannot be crumbled to powder by hand pressure. If these materials are intact and in good condition, fiber release is unlikely. Significant fiber release and asbestos exposure can occur, however, if the surfaces of these materials are broken, drilled, sanded, scraped, cut or otherwise abraded. If this occurs, the SCAQMD Board Rule 1403 requires that asbestos containing (Class I) non -friable materials be treated as friable. VIII. Sample Results Sample Location Material Sampled Results 1 Casita — Ceiling Off -White Semi -Fibrous Material 5% Chrysotile Asbestos Paint No Asbestos Detected 2 Casita — Drywall Mud Off, White Skimcoat/Joint Compound 3% Chrysotile Asbestos Paint No Asbestos Detected 3 Casita — Drywall White Drywall No-Asbestes- Detected Off -'Whim Sicirneu o etffysui .Asbestos Paint No Asbestos Detected 4 Casita — Exterior Grey Plaster No Asbestos Detected Stucco Paint No Asbestos Detected 5 Casita — Roofing White Non -Fibrous Material No Asbestos Detected Material Black Tar No Asbestos Detected Black Felt No Asbestos Detected Beige Foam No Asbestos Detected IX. Laws & Regulations 9.01 Federal, state and local laws require that building owner(s) and/or their representative(s), prior to any demolition and/or renovation operation that ,may disturb any asbestos -containing material(s) in their building(s), to meet the following requirements: A. Notification; B. Removal techniques for asbestos -containing material(s); C. Clean-up procedures; and D. Waste storage and disposal requirements. 9.02 Federal and state rules and regulations required that asbestos removal be carried out only by licensed and certified asbestos abatement contractors by the State Contractors License Board and currently registered by the State of California Division of Occupation Safety and Health. If you have any questions or need additional information, please contact us at (760) 772-1263. Sincerely, _A-t_� Brad Sullivan Certified Asbc UWW011'200/ 14:52 3107641136 FORENSIC ANALYTICAL Forensic Analytical Bulk' Asbestos Anal si ,S 4� PAGE 01/03 Final Report r (EPA. Mcthod 600/R-93-:.16, Visual Area J: stimatiorr) J&H Envirc imental Tom Sullivan 41800 WasF 1201 St. Client iTi; 4172 o5, 201 Report dumber: B098514 fnd India, CA 9; 203 A 9' Date Received: 05/02/07 Date Ani lyzed: 05/03/07 Date 11,riltted: 05/03/07 Job iD/Site: Green Pro 51420 Prop., Calle Jacumba First—_"Reported; 05/03/07 Date(sjColl, :ctcd: 05/01/2007 FAST Jo,t, ID: 4172 Total Sar,;,ples Submitted: 5 - Sample ID Asbestos —^--�, Lab Number Type Percent in Asbestos Layer Total aIniples Analyzed: 5 Percent in Asbestos Percent in ( 50383038 y Type _ Layer Type Layer -- Layer: of White Semi -Fibrous Material "/" Layer: Pai itCltrysotilc g Total. Co.m 10site'Values of Fibrous Compgnents: NI) Asbestos (5"/,r) Cellulose (17race) z 50383039 Layer: Off White Skiincoat/Joint Compound Chrysotile ry Layer: Pair t 3 Total Coml. osite Values of Fibrous Components: Asbestos (3 ND Cellulose ("race) 3 50383040 Layer: Whi. c Dry-.vall Layer: Off ' Vhite Skimcoat/Joint Corn ound p Chrysotile NDLayer. Pain. 3% Total COMP )site Values of.Fibrous Components: Asbestos (Trace) ND Cellulose (2) %} Fibrous Glass (10 %) 4 50383041 Layer: Grey Plaster Layer: Paint ND Total Comp( site Values of Fibrous Cpmponents: Asbestos (ND)ND Cellulose (Ti ace) 5 50383042 . Layer: White Non -Fibrous Material Layer: Black Tar ND Layer: Black (:elt - ND Layer: Beicc Foam ND Total Compo: ite Values of;;ibrous Components: ND Asbestos (ND) Cell.u.lose (25 %) Synthetic (3 %) 2y_",') I'�cific Cnrt�n er(:CTJri t kanr.ho Dr)Min8uei, CA 9022 7112 lcfc:�,hcnr:: 31017Fi3 •L:f7q • full Frc�: 888/81-3-T417' g8/81.;- q1?(2 _ r - r3 Rfiri.� C)3/ U'J. ZU01 14: 5'G 3107641136 _ - FORENSIC ANALYTICAL PAGE 02/03 - Forensic Analytical ClientName.- ne: J&.H Environmental Report Number: 8098514 Date Priinted: 05/03/07 Sample ID Asbestus Percent in Asbestos '�� Lab Number Type Layer Percce: in Asbestos Percent in y TYpr' Laye r y:. Type Layer 4L d�d4 Steven Takahashi, Laboratory Superviso-, Rancho n Note: Lit tit of Quantification 'LOenotcs otnin€vel- Laboratory reports or results ani reports are generated by Forensic Analytical r t ttcice quest of and the �for the exclusimsence of vcb use of dile pars nhOr entity cllient named oil such rcporL reports or copiex of, arae will not he released by Forensic Analytical to ally third Q• iV011e Detected'. tested. Supporting lal oratory dOcumentntion is available upon request. This report must not be reproduced except ro full, unless approved by Forensic Analyt cal TI e Rcsndts, solely responsible for the use and interpretation of test results and reports rc party w clout prior tt�iftcn request from cl;ent. This repot applies only rn the sumple(s) cndttrscmcnt by yVl AP or Any other aFcncy of the U.S. (?nvcrnmcnt, PorcnsieieAnalyticalois not ahtrmsic o to Analytical, Qtrgte degreemust of rd restating from client to u1n analyzedt rs P t not be user.! by the client to claim prod Forensic Analytical n serves the right. to dispngc of all sarnplcs aftcr a period o f thirty (30) gays, according to all State and fctieral guidetittcs, u,t'ng r')Tn materials speAlt samplav were receive( in acceptable condition unless otherwise noted. . 2959 !?aciFir Cr.!mrtrr,_E flrivr • Ranci�n f)rnningu�;, C:A 90221 p Tcachhr.nc; 310/7(,:;-2374 • TollgH8/1;73-8417 2 of 2 • F?x:3101,763-8684 e5/ IJ3, 1007 14:52 3107641136 04-,7-'07 10:56 FROM - SP F Drenaic AngMical FORENSIC ANALYTICAL PAGE 03/03 T-105 P001/001 N-063 G5n ; Name & Addr¢ss: —� --W--b•, _-.•_ jN 4faJl Fulitl J&J Fnvironmen.tal, Inc. �---� --. 11 urn Around T7ms Q Jif y 24hr t 4.9 hr r ext: - - 41300 Washington St., B-105, #203. - ~'- --- oue: 1T1at@: t •_ J Qua• Tinrn•• arnJgm PI : �^�nclarr) / C� Point Count © PCM; NIDSh17400 In ti,o, CA 92203 ;nnrac t: Thomas Sullivan ITEM Air: 0 i f :RAJ ISI Yamala? I C� r1iQSH 7802 0 T•EMBulk: ❑ QuantitatMed [9 QUelitotl"ct 0 Chatfield 0 TEM Water. 0 P41atNa NMPolpbl e t Q wt % 'hor•12 Y< (7(0) 772-1263 0 TEMMlcrovac (1``(1//0) 777.-�67,,5� 1`E Spacial Projnat:�" m ``.1•' ��- ) ItMrtttts Anaiyslst blethad .•..- --.. —.,,. �_..• CAUE f.1 /GVAL 8-A T _ _ ,neater tanr$: _- Sample iiT P - flatt�l Sample FOR �.P;a!;.Y Sempla Area or Ti.me IVII Type Time OnR t; Ap� -- Avg. L.R,, Toin1 — Time, Air r Volume ------ —i C V) ASC AP 7 �ff �� � A A -- . C A C t "l C Date: nwnm•.: F l�fi1AGS Fid x Airborne 0 I,PS ® LAS IVl�il 0 Laurier t=► Drop Oif O Other. —'• -- A ul ah la ,r845 Rcltngwlshed bv: - Ro1111i lrlaWmc] )yy:'_ - Dazs t Time: Ltate d "ilmn: -a'C LN. �� Rece3 red by; Qatf t TE: nE- aato 17iraso; nme: Con. 1160 , nee pra rraa .Yrs ❑ No Congltlon A o rep F° p • tc'• ©`rea �fl 110 Condlri01 Accepticj1:,? Q Yee 0 N en ::ranciscw Office: 3777 Dcpet Road, Suite 409, HAYward, CalifOrnin 9454S / Tetephon�: i510)gg7.g�;ag Lc D Angalca. Orfrce; 295Q PaCif1C CemmCrco Ariva, RartCho Domingriay-- California 80221 Telep]toner. t31(Q)783 q t)caX yt� 14}807 421 B Porilal d Cfttce; 17404 9W Uppor Bonnos Perry I�oscl, Suitt, 245. Dutham. C gon 97224 ! TEhaph•onEl: (bl)�)Ftisl6-1001 (S7r)e 1 7.1f39R 1 f yc (fi43)69�-100Es Lis VeVzs 01Ttce' 3900 farad sa Rcad. 3uirn 181, 1_aa Vegne, NevAdA II9108 Tmouhona: ha�),a4_p0a0 t F ,;, i702)784ru: ( B`° # City of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit . g Application and Tracking Sheet Permit # Project Address:' ��I �. �Q CA - J_ U Owner's Name:. rn A - f- k G A. P. Number: -7 _/ O - Address: " ('�► Legal Description: Contractor: ���� �� ( City, ST, Zip: Telephone: ,� cra Address: Project Description: City, ST, Zip: 001 O f Telephone: rA State Lie. # : City Lie. #: Arch., Engr., Designer: .1k 24 44 11 Address: City, ST, Zip: Telephone: 4 Construction Type: Occupancy: State Lie. #: Project type (circle one): New Add'n . Alter Repair Demo. Ft.: #Stories: # Units: Name of Contact Person:Sq. Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACEM PERMTT 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 2' Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. 4.'., H.O.A. Approval Plans resubmitted a Grading IN HOUSE:- '"' Review, ready for corrections/i sue Developer Impact Fee Planning Approval u= Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Too Permit Fees 01<Af 70. Issue 01 C6