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04-5107 (DSF)0 4 s BUILDING & SAFETY DEPARTMENT P�-3Box 1504 (760).777-7012 :OFT1� 78-496,1CALLE TAMPICO \�, ' FAX (760) 777-7011 111 4 JUN 2 5 2�� TA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 U ClTYOFLAoUNTA BUILDING PERMIT ; FINANCE DEPT- . f , Application Number . . . . . X04-000051071 Date 16/23/04 Property Address . . . . . 46280 JEFFERSON ST M APN: 64.9-090-004-36 -2190 - Application description . . . DEMO - SINGLE FAMILY Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 0 Owner ------------------------ Contractor CITY OF LA QUINTA ------------------------ TRESIERRAS CONSTRUCTION, INC. 78495 CALLE TAMPICO 2235 N. LAKE AVENUE, #107 LA QUINTA CA 92253 ALTADENA CA 91001 (626j.794-3333 WCC: STATE FUND WC: 1454302 07/01/05 CSLB: 725996 02/28/05 CCC: B -C21 -------------------------- Structure Information ------------------------- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone NON -AO FLOOD ZONE Other struct info . . . -.--------------------------------------------------------------------------- . . NUMBER OF UNITS . 1.00 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 COMPLETE DEMOLITION OF EXISTING HOUSE AND ALL IMPROVEMENTS `Fee.summary Charged Paid Credited Due ----------------- ---------- Permit Fee Total ---------- -------,i-i-',---------- 45.00 .00 0.0 , 45.00 Plan Check Total .00 .00 .00 .00 Grand Total 45.00 .00 .00 45.00 P.O. Box 1504 /: , w VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Q Date: ' as -v LI Applicant: Applicant's Mailing Address: tole Architect or Engineer: Architect or Engineer's Address: /A Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 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 Lg s nse is in full force and effect. ` G / License Clas' - Z (- A-Sr�,cc -- ense No. 722 S Date -v actor r OV PER43UILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 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 Date 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. 1 have and will maintain workers' compensaf insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Mworkers' compensatio rance carrier and policy number are: �ers" rmg c �i�, Policy Number / 44M -.?p Z - (� I certify that, in Qie 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 shout come subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith complywith tthhos ' ions. �Dateti_,�-25 U� p�plicant WARNING: FAILURE TO SECURE WOR ERS' COMPENSATION QE GE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES'AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100, 00), 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 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.). Lenders Name Lender's Address 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 harhless 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 this cou upon the above o p�ropertyr inspection purposes. '--Date-2 S 7 Si� (Applicant or Agent): P.O. Box 55329 Riverside, CA 92517 (909)624-1665 SCOTT MORRISON & ASSOCIATES DOSH 92-0248 ASBESTOS SURVEY REPORT Completed On March 8th, 2004 PLM0226#4025e Client: c/o Tom Hartung's Office City of La Quinta Redevelopment P.O. Box 1504' La Quinta, CA 92253 Project: 46280 Jefferson Street La Quinta, CA (single family home) 31855 Date Palm Drive, Ste. #3-507 Cathedral City, CA 92234 (760)323-7743 On February 26th, 2004 an asbestos inspection and bulk sampling was conducted at the above project address. Bulk samples were taken of all suspect asbestos containing building materials (ACBM) at the - request of the client named above. A total -of (5) bulk samples were submitted to Carolina Environmental, Inc. 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 by 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 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 homogeneous 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: Timothy Morrison,:DOSH #02-3142 BULK SAMPLES ANALYZED BY: Carolina Environmental, Inc., NVLAP #101768-0 (1) P.O. Box 55329 Riverside, CA 92517 (909)624-1665 SCOTT MORRISON & ASSOCIATES DOSH 92-0248 31855 Date Palm Drive, Ste. #3-507 Cathedral City, CA 92234 (760)323-7743 The results on the following page(s) indicate that asbestos was detected in 00 of the 05 samples analyzed. PLM0226#4025e Sample #QN-36 Type of material: drywall only Location: interior east wall of livingroom Area: throughout interior walls Friable:no Results: none detected Sample #QN-37 Type of material: texture ceiling Location: interior ceiling of west entrance Area: throughout interior ceilings Friable:no Results: none detected Sample #Q N-38 Type of material: stucco- biege (1rst layer) Location: exterior north wall Area: throughout exterior walls Friable:no Results: none detected Sample #QN-39 Type of material: plaster- grey (2nd layer) Location: behind sample #QN-38 Area: throughout exterior walls Friable:no Results: none detected Sample #QN40 Type of material: roof felt- black (2nd layer) Location: exterior east roof under clay tiles Area: throughout exterior roof Friable:no Results: none detected Note: The floors of 46280 Jefferson Street are cement throughout. Note: All asbestos containing building material(s) containing greater than 1.0% asbestos by volume or weight, must be removed by a state certified asbestos abatement contractor prior to any demolition or renovation of the property. Inspector Scott C. Morrison Certified Asbestos Consultant DOSH#92-0248 (2) i tar -04-04 II:34am From -CAROLINA ENVIRONMENTAL +4911442 T-420 P.02/04 F-547 CAROUNAE MIMNMENTAl,1NC. LABORATORY REPORT 10'7.NiRk& onCowtCwy,NC27511 ASBESTOS SULKANALYSIS Phone: (919) 481.1413 Fac: (919) 481.1442 - Client: Scott Morrison & Associates, CEI Lab Code: A04-1459 31855 Date Palrn Dr. Suite 3-507 _ Received: 03-03-04 Cathedral City, CA 92234 Analyzed: 03-04-04 Reported; 03-04-04 Project: PLM0226#4025E Analyst: Gary A. Swanson, CLIENT ID LAAO 1D HOMOGENEITY DESCRIPTION ASBESTOS ON -36 A234276 DRYWALL NO Homogeneous, Beige, Fibrous, Bound BIND 93% CELL 7% QN-37 A234277 TEXTURE NO Homogeneous, White, Non-fibrous, Bound BIND' 100% QN-38 A234278 STUCCO NO Homogeneous, Beige, Non-fibrous, Bound BIND 100% QN-39 A234279 PLASTER ND Homogeneous, Grey, Non-fibrous, Bound BIND 100% QN-40 A234280 ROOF FELT NO Homogeneous, Black, Fibrous, Bound TAR 25% CELL 75% Paye 1 4 Nar-04-04 11:34am From -CAROLINA ENVIRONMENTAL +4911442 T-420 P.03/04 F-547 The following definitions apply to the abbreviations used in the ASBESTOS BULK ANALYSIS REPORT: CHRY = Chrysotile CELL = Cellulose DEBR = Debris AMOS = Amosite FBGL = Fibrous Glass BIND = Binder CROC = Crocidolite ORGN = Organics SILI = Silicates TREM = Tremolite SYNT = Synthetics GRAY = Gravel ANTH = Anthophyllite WOLL = Wollastonite MAST = Mastic ACTN = Actinolite CERWL = Ceramic Wool PLAS =Plaster N ID = None Detected NTREM = Non-Asbestiform PERIL = Perlite NANTH = Non-Asbesliforrn Tremolite Anthophyllite RUBR =Rubber CLIENT: Scott Morrison & Associates PROJECT: PLM0226 #4025E CEI LAB CODE: A04-1469 Stereoscopic microscopy and polarized light microscopy coupled with dispersion staining is the analytical technique used 'or sample identification. The percentage of each component is visually estimated by volume. These results pertain only ;o the samples analyzed. The samples were analyzed as submitted by the client and may not be representative of the larger -naterial in question, Unless notified in writing to return samples, Carolina Environmental, Inc. will discard all bulk samples after 30 days. Aany vinyl floor tiles have been manufactured using greater. than 1 % asbestos. Often the asbestos was milled to a fiber size below the detection limit of polarized light microscopy. Therefore, a "None Detected" (ND) reading on vinyl floor the foes not necessarily exclude the presence of asbestos. Transmission electron microscopy provides a more conclusive `orm of analysis for vinyl floor tiles. t is certified by the signature below that Carolina Environmental, Inc. is accredited by the National Voluntary Accreditation grogram (NVLAP) for the analysis of asbestos in bulk materials. The accredited test method is EPA 1600 / M4-82 / 020 for he analysis of asbestos in building materials. Procedures described in EPA 1500 / R-931116 have been incorporated vhere applicable. The detection limit for the method is 0.1 % (trace amount). Carolina Environmental, Inc.'s NVLAP accreditation number is #101768-0. This report is not to be used to claim product endorsement by NVLAP or any agency )f the U. S. Government. This report and its contents are only valid when reproduced in full. Dust and soil analyses for asbestos using PLM are not covered under NVLAP accreditation. a . ANALYST REVIEWED BY Tianbao Sai, Ph.D. Laboratory Director Et1d of Repot t CHAIN OF CUSTODY From: Scott Morrison & Associates P.O. Bog 55329 Riverside, CA 92517 (760) 323-7743 Client: C 1'r V 1,a-yk 1 •r� C-= �a ,lob No. LM0 *V025-aSite Address; It -0 I—/ Y6 s A.2 3�1.976 -, f a2? 9,�2 j To: Carolina Environmental, Inc. o 107 New Edition Court o Cary, NC 27511 (919) 481-1413 NVLAP Code 101768-0 CA FLAP #2483 Person Taking Sampl�_T1 022 Safi all bC HMaSn) Y 4. /A Q ' Ur o Sample # Sample Date Material & Description :M AA -Pb Other Information S 00-39 Fax in Results ? V s No Relinquished By: Date/Time: OZ CV — 1000 Received T Date/TimeD 3140 3140 41 -, Mail/Fax To: Scott Morrison & Asociates, 31855 Date Paton Dr., Ste. #3-507, Cathedral City, CA 92234, (760) 323-7743 111 1,7UPAI P.O. Box 55329 Riverside, CA 92517 (909)624-1665. INVOICE . - , SCOTT MORRISON & ASSOCIATES 31855 Date Palm Drive, Ste. #3-507 Cathedral City, CA 92234 (760)323-7743 .Client: Tom Hartung's Office City of La Quinta Redevelopment 'P.O. Box `1 504 La Quinta, CA 92253 " Project: 461.15, 46280, 46365, 46395; and 4.6450 Jefferson St. La Quinta, CA (5 single-family homes) Inspection date: February 26, 200 Date: March 16, 2004 Project/ P.O# File name: PLM0226#4025a-e asbestos inspection/ bulk sampling: 5 single-family homes @ $125.00 ea. _ $625.00 40 total bulk samples for analysis (PLM) @$20 .00 each $800.00 # hours of travel time @ $ each = included Total amount due =.$1,425.00 Please send payment to: 31855 Date Palm .Drive, Ste. #3-507 Cathedral City, CA. 92234. Terms: Net 15 days Thank you. APPR VE FOR PAYMENT BY BY O /O " S /• � � -� `ate-`- J r ACCOUNT N a� S reloG DESCRIPTION V# AMT. TO PAY Any and all personal property left on the project premises located at 46-280 r Jefferson Street, La Quinta, California 92253. (Project/Case) Jefferson WideningPhase H Project, is to be considered abandoned as of December 2. 2003. rd I Aw C aimant(s)_Name- '�a D= C aimant(s) Signature Date Relocation Representative Pacific Relocation Consuttanis • Nov 98 Date