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04-5367 (DSF)ce .444 t�(ticV ^ BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . .04--2O005367----=> Date. .7/07/04 Property Address . . . . . . 46390 JEFFERSON ST APN: 649-090-006-34 -2190 - Application description . . . DEMO - SINGLE FAMILY Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ CITY OF LA QUINTA EMERY LAND CLEARING & GRAD INC 78495 CALLE TAM_PICO P.O. BOX 1009 LA QUINTA- CA -92253 THERMAL CA 92274 (760) 391-5840 WCC: STATE FUND WC: 0460011653 04/12/05 CSLB: 600283 11/30/05 CCC: 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 Expiration Date 1/07/05 Qty Unit Charge Per. Extension BASE FEE45.00 ....................................................... > Special Notes 'and.Comments COMPLETE DEMOLITION OF EXISTING HOUSE AND ALL IMPROVEMENTS Fee summary Charged Paid Credited Due Permit Fee Total 45.00 .00@10 45.00 Plan Check Total .00 .00 (� ,,.0 .00 Grand Total 45.00 0, '� 00 *1R 5.00 ' i - P.O. BOX 1504• 1��^� 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: Applicant: Applicant's Mailing Address: LAI INA, Date: 7 - b- U 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 licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals ,Qode and my License is in ull force and effect. /� Q License Class_ �" �, i License No. CV 000)6 ,,-- Date ` 0.4 ciCct q `f � (IC , OWNER -BUILDER DECLARATION l 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. 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 t is, ued. 1v1y worl�ers' compensation i nce carrier and o icy num r are• ' mer A -`L I t/�LC� olicy NumberC��1I 3 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 at, if I should be ubject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / Datea �6 �,o\ ` Applicant WARNING: FAILURE TO SECURE WORKERS' COM NSATION COVERAGE IS UNLA FUL, 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. 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.j. Lender's Name Lenders 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 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 above information is cor cI. I agree to comply with a and county ordinances and state laws relating to building construction, andel hereby authorize representatives of this county to en r upon the ve mentio�d propert or inspection purposes. /Date V ignature (Applicant or Agent): SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT ,. NOTIFICATION OF DEMOLITION OR ASBESTOS REMOVAL MAIL FORM AND FEE TO SCAQMD, ASBESTOS NOTIFICATIONS, FILE # 55641, LOS ANGELES CA 900745641 '„�s`r�a`�f�^�%�: a} �. K„n�s� ,�.�• d r ;.:''�,q ,& � - � AQMD USE ONLY t5q SCREEN BYP RECENED�aPOSTMARK �f ENTERED BY, NOTIFICATION # f � Y COMPLETED BY COMPANY EMERY LANDCLEARING PHONE 760/391-5840 .yla J, ^1'F5 N'4 Vr ti LORI EMERY V.P. AND GRADING, INC. DATE 6/30/04 CHECK # Ia FEE $ 118.41 PROJECT # NOTIFICATION TYPE ORIGINAL REVISION DATES REVISION OTHER (highlight) CANCELLATION PROJECT TYPE DEMOLITION ORDERED DEMOLITION RENOVATION (reMOVah EMERGENCY REMOVAL PLANNED RENO (annuah SITE INFORMATION SITE NAME SITE ADDRESS 46-390 JEFFERSON STREET CROSS STREET VISTA GRANDE CITY LA QUINTA STATE CA ZIP 92253 COUNTY RIVERSIDE DESCRIBE WORK AND LOCATION DEMOLISH REMOVE AND DISPOSE OF HOUSE BUILDING SIZE (SQ FT) 2,518 NUMBER OF FLOORS 1 BUILDING AGE (YEARS) 24 NUMBER OF DWELLING UNITS 1 BLDG PRIORI PRESENT USE TC; ERCULL HmPrrAL INDUSTRIAL Other ONCE PUBLIC BLDG. HOUSE SCHOOL SHIP UNMCOLLEGE SITE OWNER CITY OF LA QUINTA ADDRESS 78-495 CALLE TAMPICO CITY LA QUINTA STATE CA ZIP 92253 CONTACT MR. TOM HARTUNG PHONE 760!177-7013 REQUIRED BUILDING INFORMATION ASBESTOS YES NO PRESENT? ASBESTOS YES NO SURVEY? • ASBESTOS YES NO REMOVED? - BUILDING TO BE YES NO DEMOLISHED? PROJECT DATES START 715104. END 7/30/04 WORK SHIFT (Lal swing, night) ASBESTOS AMOUNT TO BE REMOVED (in square feed FRIABLE ' CLASS I CLASS II TOTAL AMOUNT (add row) ASBESTOS REMOVAL FROM SURFACES PIPES COMPONENTS AMOUNT OF EACH TYPE OF ASBESTOS (n square feet) ACOUSTIC CEILING LINOLEUM INSULATION FIRE PROOFING DUCTING STUCCO MASTIC FLOOR TILES (VAT) DRYWALL PLASTER TRANSITE ROOFING OTHER (describe) CONTRACTOR INFORMATION CSLB LICENSE # 600283 OSHA REG # AQMD ID # 100435 NAME EMERY LANDCLEARING AND GRADING, INC. ' ADDRESS P.O. BOX 1009 CITY THERMAL STATE CA ZIP 92274 SITE SUPVR JAMES C. EMERY PHONE 7601774-9493 WASTE TRANSPORTER #1 LANDFILL ADDRESS ADDRESS CITY. STATE, ZIP r CITY t STATE, ZIP Asbestos survevs are required prior to Demolition and Renovation A SCAQMD NOTIFICATION OF DEMOLITION OR ASBESTOS REMOVAL MAIL FORM AND FEE TO SCAQMD, ASBESTOS NOTIFICATIONS, FILE # 55641, LOS ANGELES CA 900745641 WASTE TRANSPORTER #2 WASTE STORAGE SITE ADDRESS ADDRESS = ' CITY STATE ZIP CITY STATE ZIP CONTROLS: DESCRIBE WORK PRACTICES AND CONTROLS TO BE USED AT THE RENOVATION AND DEMOLITION SITE. Procedure# 1, 2, 3, 4, 5 or Other. For asbestos removals circle the combination of Rule 1403 procedures used. Procedure 4 and 5 submit plans for AQMD prior approval. ASBESTOS DETECTION PROCEDURE: CIRCLE THE PROCEDURES AND ANALYTICAL METHODS USED TO DETERMINE ASBESTOS IN THE BUILDING: Survey, Bulk Sampling, Inspection, PLM, PCM, TEM, Assumed as Asbestos-PACM, Describe Other. FOR DEMOLITIONS GIVE THE COMPANY NAME AND DATES OF THE ASBESTOS REMOVAL: TRESIERRAS 7/2/04 FOR ORDERED DEMOLITION SEND A COPY OF THE ORDER AND GIVE THE AGENCY NAME & PHONE # AUTHORIZING PERSON: TOM HARTUNG TITLE BUILDING AND SAFETY DIRECTOR r DATE OF ORDER JUNE 30, 2004 DATE ORDERED TO BEGIN: JUNE 30, 2004 FOR EMERGENCY ASBESTOS REMOVAL GIVE THE NAME AND PHONE NUMBER OF THE PERSON DECLARIN6iUTHORIZING THE EMERGENCY, DATE AND HOUR OF EMERGENCY AND DESCRIBE THE SUDDEN, UNEXPECTED EVENT: EXPLAIN HOW THE EVENT WOULD CAUSE UNSAFE CONDITIONS, EQUIPMENT DAMAGE OR UNREASONABLE FINANCIAL BURDEN: CONTINGENCY PLAN: DESCRIBE ACTIONS TO BE FOLLOWED IF UNEXPECTED ASBESTOS IS FOUND DURING DEMOLITION OR ASBESTOS MATERIAL BECOME DISTURBED, CRUMBLED, PULVERIZED, OR REDUCED TO POWDER., r STOP PROJECT HAVE CERTIFIED ASBESTOS REMOVAL CONTRACTOR REMOVE AND DISPOSE OF. ' TRAINING CERTIFICATION: I oer6fy that an individual trained in the provisions of regulation AQMD Rule 1403 and NESHAP will be on site during the removal and evidence that the required training has been accomplished by this person will be ilable far inspection during normal business hours. Company Name EMERY Print name of owner/operat Signage 1 owner/ t Tdde of owner/operator Date 6130/04 LANDCLEARING AND LORI EMERY GRADING, INC. VICE PRESIDENT INFORMATION CERTIFICATION: I certify that the above information is t and I have enclosed a squired attachments. Company Name EMERY Print name of owner/operator of / t . J ' Tittle of owner/operator Date 6130/04 LAADCL.EARING AND LORI EMERY VICE PRESIDENT GRADING, INC. Notifications can not be accepted without the required fee (AQMD Rule 301). Asbestos removals Qss than 100 square feet are exempt from notification and fees. Please make checks payable to'SCAQMD". Fees are per notification, not refundable, and vary according to the project size. Fees are as follows: DEMOLITION OR ASBESTOS REMOVAL PROCEDURE 4 OR 5 PLAN $ 331.21 FROM 100 TO 1,000 SQUARE FEET $ 29.52 SPECIAL HANDLING FEE $ 28.17 FROM 1,001 TO 5,000 SQUARE FEET $ 90.24 REVISION OF NOTIFICATION $11.94 FROM 5,001 TO 10,000 SQUARE FEET $211.22 RETURNED CHECK CHARGE $ 29.28 MORE THAN 10,000 SQUARE FEET $331.21 CANCELLATION OF NOTIFICATION $ 0.0 DEMOLITION OF LESS THAN 100 SQ FT $ 29.52 ASBESTOS REMOVAL AT owner- $ 29.52 occupied, single -unit dwelling MAIL FORM AND FEE TO: SCAQMD, ASBESTOS NOTIFICATIONS, FILE # 55641, LOS ANGELES CA 900745641 Page 2 of 2 TELEPHONE: I" 396.2336 FAX: (909) 396,3342 Form REV 20030627 FORMS, INSTRUCTIONS, AND THE RULE 1403 CAN BE OBTAINED FROM AQMD WEB SITE AT HTTP://WWW. AQMD.GOV QP,%r%tm 1 0.. b...s..d ..4 71pRrz C P^rjl a rbivn rlien.,M Per PA 0179M, A101 ronoi ,4oa onnn i` LA` 1 f ] f CA307937 Dated j�DcnSAFE("/ 07/12/04 7114 7389 6621 0861 3601 qj y —[ tf AP—T( k(r7 1 CALIFORNIA PRELIMINARY NOTICE In accordance with sections 3097 and 3098, California Civil Code This is not a Lien, This is not a reflection on the integrity of any contractor or subcontractor Reputed Owner 1 - You are hereby notified that 07/12/04 CA307937 BDC SPECIAL WASTE SVCS -LA CITY OF LA QUINTA 766 S AYON 78-495 CALLE TAMPICO AZUSA CA 91702 LA QUINTA CA 92253 2 - Has furnished or will furnish labor, Reputed Construction Lender or Lessee CO# RESIDENCE BOND NOT REQUIRED Reputed Original Contractor TRESIERRAS CONSTRUCTION 2235 N LAKE AVE #211 ALTADENA CA 91001 A.D.C. UNKNOWN NOTICE TO PROPERTY OWNER IF BILLS ARE NOT PAID IN FULL FOR THE LABOR, SERVICES, EQUIPMENT, OR MATERIALS FURNISHED OR TO BE FURNISHED, A MECHANICS' LIEN LEADING TO THE LOSS, THROUGH COURT FORECLOSURE PROCEEDINGS, OF ALL OR PART OF YOUR PROPERTY BEING SO IMPROVED MAY BE PLACED AGAINST THE PROPERTY EVEN THOUGH YOU HAVE PAID YOUR CONTRACTOR IN FULL. YOU MAY WISH TO PROTECT YOURSELF AGAINST THIS CONSEQUENCE BY (1) REQUIRING YOUR CONTRACTOR TO FURNISH A RELEASE SIGNED BY THE PERSON OR FIRM GIVING YOU THIS NOTICE BEFORE MAKING FINAL PAYMENT TO YOUR CONTRACTOR OR (2) ANY OTHER METHOD OR DEVICE THAT IS APPROPRIATE UNDER THE CIRCUMSTANCES. OTHER THAN RESIDENTIAL HOMEOWNERS OF DWELLINGS CONTAINING FEWER THAN 5 UNITS, PRIVATE PROJECT OWNERS MUST NOTIFY THE ORIGINAL CONTRACTOR AND ANY LIEN CLAIMANT WHO HAS PROVIDED THE OWNER WITH A PRELIMINARY 20 -DAY LIEN NOTICE IN ACCORDANCE WITH SECTION 3097 OF THE CIVIL CODE THAT A NOTICE OF COMPLETION OR NOTICE OF CESSATION HAS BEEN RECORDED WITHIN 10 DAYS OF ITS RECORDATION. NOTICE SHALL BE BY REGISTERED MAIL, CERTIFIED MAIL, OR FIRST. CLAS'S MAIL,;EVIDENCED BY A CERTIFICATE OF MAILING. FAILURE TO NOTIFY°WILL EXTEND THE DEADLINES TO RECORD A LIEN. services, equipment, or materials of the following general description: DEBRIS DISPOSAL 3 - An estimate of the total price of the labor, services, equipment, or materials furnished or to be furnished is: $ 5,000.00 4 - The building, structure or other work of improvement is located at: 149-117744/RESIDENCE 46390 JEFFERSON AVE LA QUINTA CA 92253 5 - The name of the person or firm who contracted for the purchase of such labor, services, equipment or material is: TRESIERRAS CONSTRUCTION 2235 N LAKE AVE #211 ALTAD ENA CA 91001 6 - Name and address of Trust Funds to which Supplemental Fringe Benefits are payable (if applicable): 7 - Jobsite is Federal Public Work Title 40 USC Sec. 270A -270E. Contract # Bond Co: .Signed 'Authorized Agent 1-800-366-5660 FROM :BRICKLEY ENVIRONMENTAL FAX NO. :909 381 3433 Jun. 11"2004 10:14AM P1 iw B11ZK-'/K I_,E Y" 1ENVMOINN[)(a N°ICAL Environmental Remediation Contrletor FAX COVER SHEET DATE: June 11, 2004 TIME: TO: CITY OF LA QUINTA REDEVELOPMENT PHONE: 760-777-7013 ATTN: TOM HARTUNG FAX: 760-777-7011 FROM: $WANE BRICKLEY (FOR IAN GORDON) ATTACHED IS THE PROPOSAL AND CONTRACT YOU REQUESTEC. IF ACCEPTABLE PLEASE SIGN AND RETURN TO US AS SOON AS POSSIBLE. WE APPRECIATE THE OPPORTUNITY TO BID THIS PROJECT FOR YOU. PLEASE CALL IF YOU HAVE ANY QUESTIONS OR WISH TO HAVE AN ORIGINAL MAILED. THANK Y BRICKLEY PROJECT MANAGER KEI I Number of pages including cover sheet: 3 959 .R.ec:cc Strwt, San Bernardino, CA 92411, Lie. No. 610914 CATJOSHA No. 49 909-888-2010 800-530-3366 FAX 909-311-3433 FROM :BRICKLEY ENVIRONMENTAL FAX NO. :909 381 3433 Jun. 42004 10:14AM P2 R1(-",1KTEY ENVIRONMENTAL, Environmental Remediation Contractor PROPOSAL & CONTRACT June 11, 2004 CLIENT: CITY OF LA QUINTA REDEVELOPMENT ATTN: TOM HARTUNG ADDRESS: P. 0. BOX 1504 CITY: LA QUINTA, CA ZIP: 92253 PHONE: 760-777-7013 FAX: 760.777-7011 PROPOSAL VUMBER: 11009 JOB NAME: SFR - VACANT SITE ADDRESS: 46390 JEFFERSON AVENUE CITY: LA QUINTA, CA ZIP: 92253 PROPERTY OWNER: CONTRACT AMOUNT: $16,675.00 REMOVE AND DISPOSE OF ASBESTOS CONTAINING MATERIALS (ACM) PER SITE INSPECTION ON 6/10/04 AND SCOTT MORRISON & ASSOCIATES SURVEY 40524-1234. IN QUANTITIES AND LOCATIONS AS OUTLINED BELOW; • APPROX. 2,500 SQ, FT, OF STUCCO THROUGHOUT EXTERIOR WALLS. COST $16,575.00 SOUTH COAST AQMD NOTIFICATION FEE FOR THIS PROJECT: / COST $100.00 CLIENT/OWNER TO PAY ALL RE -NOTIFICATION FEES (MINIMUM $25,00 EACH) AND TO BE RESPONSIBLE FOR ALL FEES IF THE PROJECT IS CANCELLED. THIS PROPOSAL IS BASED ON PREVAILING WAGE DETERMINATION SC -102-882-1-2003-1, ISSUE DATE FEBRUARY 22, 2003 AT THE RATE OF $29.90 PER HOUR. BRICKLEY ENVIRONMENTAL WILL PROVIDE ALL OSHA REQUIRED PERSONAL AIR MONITORING AND HAVE SAMPLES ANALYZED BY AN INDEPENDENT AND CERTIFIED LABORATORY, AT THE COMPLETION OF THIS PROJECT AND UPON PAYMEN'r, BRICKLEY ENVIRONMENTAL WILL PROVIDE COMPLETE DOCUMENTATION Le. NOTIFICATION LETTERS, WASTE MANIFEST, CERTIFICATE OF INSURANCE, SUPERVISOR'S DAILY LOGS ETC. ALL REGULATED WASTE GENERATED FROM THIS PROJECT WILL. BE PROPERLY DISPOSED OF AT AN EPA, STATE OR LOCAL REGULATORY AGENCY APPROVED DISPOSAL FACILITY, UTILIZING THE APPROPRIATE WASTE DISPOSAL MANIFEST. OWNER TO PROVIDE WATER AND ELECTRIC AT JOB SITE, BRICKLEY ENVIRONMENTAL WILL PROVIDE NECESSARY CONNECTIONS. M 957 Reece Street, San Bernardino, CA 92411. Uc. No. 611 414 CALIOSHA No, 49 PR90 t or e 909.888-2010 800.530-3366 FAX 909,381-3433 5 FROM :BRICKLEY ENUIRONMENTAL FAX NO. :909 381 3433 Jun. 11 2004 10:14AM P3 WORK SHALL BE PERFORMED IN ACCORDANCE WITHIN OSHA, EPA, AND STATE REGULATIONS. THE ABOVE WORK TO BE COMPLETED IN A SUBSTANTIAL AND W ORKMANLIKE MANNER ACCORDING TO STANDARD PRACTICES FOR THE SUM OF: SIXTEEN THOUSAND SIX HUNDRED SEVENTY-FIVE"A*"***'""*"""""""""""*"'*DOLLARS ($16,675.00) A. TERMS: DUE UPON RECEIPT UNLESS OTHERWISE ARRANGED B. THIS PROPOSAL MAY BE WITHDRAWN BY BRICKLEY ENVIRONMENTAL. IF NOT ACCEPTED WITHIN 30 DAYS, C. CONTRACTOR WILL MAINTAIN INSURANCE IN THE AMOUNT OF $1,000,000.00 OR AS REQUIRED BY SPE=CIFICATIONS, D. CONDITIONS: THE TERMS AND CONDITIONS AS FOLLOW ARE EXPRESSLY INCORPORATED INTO THIS CONTRACT. 4� y IAN J JORD09 PROJECT MAN E 2 / ES IMATOR K- -EH -- ACCEPTANCE OF PROPOSAL, THE ABOVE PRICES, SPECIFICATIONS, AND CONDITIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK SPECIFIED. PAYMENT WILL BE MADE AS OUTLINED ABOVE. CLIENT - CITY OF LA QUINTA REDEVELOPMENT AUTHORIZED SIGNATURE #11009 DATE TITLE ADDITIONAL. TERMS & CONDITIONS OF CONTRACT TERMS: DUE UPON RECEIPT UNLESS OTHERWISE ARRANGED. INTEREST AT THE RATE OF 1!/2% PER MONTH WILL BE CHARGED ON ALL PAST DUE ACCOUNTS. IN THE EVENT OF FAILUR I'TO PAY ANY OF THE AMOUNTS DUE ON THIS INVOICE, ALL COLLECTION COSTS, AND/OR ATTORNEY'S FEES IN --HE COLLECTION OF ANY SUCH AMOUNT, WILL BE PAID BY THE CLIENT. UNLESS OTHERWISE STATED IN THIS PROPOSAL, BRICKLEY ENVIRONMENTAL WILL PROVIDE ONLY THE OSHA REQUIRED PERSONAL AIR MONITORING. THE OWNER SHALL PRCVIDE, AT THEIR CAST, ALL ADDITIONAL TESTING AND ALL FINAL CLEARANCE TESTING OR RETESTING ON THIS f ROJECT. THIS. BID OFFER IS BASED ON REMOVAL OF CERTAIN TYPES AND DUANTITIES OF HAZARDOUS AND NON- HAZARDOUS MATERIALS AS LISTED IN THE PROPOSAL. IF ADDITIONAL DR CONCEALED HAZARDOUS MATERIALS ARE FOUND AND THE OWNER CHOOSES ABATEMENT, A CHANGE ORDER WILL BE REQUIRED TO ALLOW THE ADDITIONAL COSTS AND TIME TO COMPLETE THE ADDITIONAL WORK. PLEASE BE ADVISED THAT THE OWNER OF THE PROPERTY AND GENERATOR OF ANY HAZARDOUS MATERIALS MAY BE SUBJECT TO MANIFEST / EPA NUMBER FEES ISSUED BY THI: DEPARTMENT OF TOXIC SUBSTANCES CONTROL (DTSC). ALL FEES ISSUED BY DISC ARE THE RESPONSIBILI" Y OF THE OWNER I GENERATOR. FEES ARE BILLED DIRECTLY FROM DTSC AND ARE NOT INCLUDED IN THE CON'rRACT AMOUNT; ALTHOUGH BRICKLEY ENVIRONMENTAL TAKES PRECAUTIONS TO AVOID DAMAGE TO FINISHED SURFACES, SOME DAMAGE MAY OCCUR. BRICKLEY ENVIRONMENTAL SHALL NOT BE RE; PONSIBLE FOR ANY SUCH REASONABLE COSMETIC DAMAGES NOR SHALL PAYMENTS TO BRICKLEY ENVIRONMENTAL BE REDUCED OR WITHHELD AS A RESULT THEREOF, Le. DAMAGES STEMMING FROM PLACEMENT OR REMOVAL OF POLYETHYLENE AND WOOD/DRYWALL BARRIERS AND FASTENING MATERIALS WHICH ARE REQUIRED TO HOLD BARRICADES IN PLACE DURING ABATEMENT, ALL REPAIRS OR REFINISHING WILL BE PERFORMED ONLY UNDER SEPARATE WRITTEN AGREEMENT OR CHANGE ORDER BETWEEN BRICKLEY ENVIRONMENTAL AND OWNER. THE OWNER, BY ACCEPTANCE OF BRICKLEY ENVIRONMENTAL BID DFFE:R, HEREBY AGREES TO ABSOLVE BRICKLEY ENVIRONMENTAL OF ANY AND ALL RESPONSIBILITY FOF ITEMS OR OBJECTS WHICH MAY BE REPORTED DAMAGED, DESTROYED OR MISSING, UNLESS OWNER CAN PROVE BEYOND A REASONABLE DOUBT THAT AN EMPLOYEE OR SUB CONTRACTOR OF BRICKLEY ENVIRONMENTAL IS THE RESPONSIBLE PARTY. CONTRACTORS ARE REQUIRED BY LAW TO BE LICENSED AND REGULATED BY THE CONTRACTORS' STATE LICENSE BOARD. ANY QUESTIONS CONCERNING A CONTRACTOR MAY BE REFERRED TO THE REGISTRAR, CONTRACTORS' STATE LICENSE BOARD, P.O. BOX 26000, SACRAMENTO, CALIFORNIA 95826. `" . Pape 2 of 2 ti Project/Case ��t 0 `'Z- - YGWO '.600 and VACANCY WALKTHROUGH Any and all personal property left on the project premises located at L0— O'1 T�� is to be considered abandoned as of AS EVIDENCE BY SIGNATURE AND DELIVERY OF KEYS I HEREBY AGREE THAT OCCUPANCY OF THE LISTED ADDRESS HAS BEEN ABANDONED AND THATNO FURTHER ENTRANCE TO THE ABOVE ADDRESS WILL BE MADE. Claimant(s) Name Claimant(s) 8ignature Date REPLACEMENT ADDRESS: - NEW PHONE ON THIS DATE I PERSONALLY INSPECTED THE DISPLACEMENT AT THE ABOVE ADDRESS AFTER THE OCCUPANT HAD MOVED AND FOUND THE PREMISES TO BE IN SATISFACTORY CONDITION AND THAT ALL PERSONAL PROPERTY, EXCEPT FOR TRASH OR DEBRIS PLACED FOR REMOVAL, HAD BEF� `VED FROM THE ACQUISITION AREA EXCEPT FOR THE FOLLOWING: ❑ There are tenants remaining on tl 's property PROPERTY MANAGEMENT Keys given to: Date: Received by :X. S� -a �/ Date property is now vacant ❑Abandoned property remains on site Overland,Pacific & Cutler, Inc. 07/03 notes: P.O. Box 1504 78-495 CALLE TAMPICO LA QUINT-, CALIFORNIA 92253 June 30, 2004 SOUTH COAST AIR QUALITY MANAGEMENT DIVISION 21865 East Copley Drive Diamond Bar, CA 91765-4185 ATTN: Mr. Mohan Nagavedu BUILDING DEMOLITIONS – ASBESTOS ABATEMENT Project Address: 46-390 Jefferson Street, La Quinta, CA (7 60) 777-7000 FAX (760) ,777-7101 We are requesting that SCAQMD waive the usual 14 -day notification waiting period for the project listed above. The subject building must be abated to make room for a road expansion. There is also concern for the unsafe condition of this building and the potential for unlawful trespassing and illegal activities on these sites. Please feel free to contact me at (760) 777-7019, if you have any questions or concerns. Thank you for your attention to this matter. Sincerely, Tom Hartung Building & Safety Director "PROPOSAL" EMERY LANDCLEARING AND GRADING, INC. P.O. BOX 1009 THERMAL, CA 92274-1009 7601391-5840.FAX.- 760/391-5839 LIC. #600283 JUNE 23, 2004 CITY OF LA QUINTA 78495 CALLE TAMPICO LA QUINTA, CA 92253 ATTN: MR. TOM HARTUNG 760/777-7013 - FAX: 760/777-7011 SUBJ: DEMOLISH REMOVAL OF HOUSE 46-390 JEFFERSON STREET LA QUINTA, CA EMERY LANDCLEARING AND GRADING, INC., PROPOSES TO DEMOLISH REMOVE AND DISPOSE OF ONE HOUSE AND DEBRIS, WORK TO BE PROVIDED AS SPECIFIED BELOW: UPON ASBESTOS REMOVAL (BY OTHERS) 1. TO DEMOLISH REMOVE AND DISPOSE OF ONE HOUSE STRUCTURE. 2. TO REMOVE AND DISPOSE OF MISC. TRASH AND DEBRIS LEFT FROM -PREVIOUS OWNER. 3. TO REMOVE AND DISPOSE OF CONCRETE FOUNDATION. 4. TO PUMP AND REMOVE SEPTIC SYSTEM IF APPLICABLE TO CAP OFF SEWER 5. TO PUMP REMOVE AND DISPOSE OF POOL. 6. TREES TO BE LEFT INTACT. 7. SITE TO BE LEFT AT GRADE UPON COMPLETION. 8. FENCING ALONG GOLF COURSE TO BE LEFT INTACT. NOTES: 1. OWNER TO SUPPLY WATER FOR PM -10 DUST CONTROL (EMERY TO SUPPLY HOSE). 2. OWNER TO SUPPLY ANY ADDITIONAL REQUIRE1vIE NTS FROM CITY, STATE OR COUNTY. 3. THIS IS A PREVAILING WAGE JOB. 4. -IF-ANY--BEES; WASPS OR RODENT -LOCATED -O WNER TO H VE - - - - PROFESSIONALLY REMOVED. 5. IF ANY BASEMENTS OR BURIED DEBRIS LOCATED, ADDITIONAL COSTS TO BE DETERMINED ON-SITE. TOTAL PROPOSAL: ACCEPTED BY: EMERY BY: $15,000.00 DOLLARS PAYMENT TO BE MADE AS INVOICED. GRADING, INC. TITLE: VICE PRESIDENT ! 1 DATED: JUNE 23.2004 BID GOOD FOR 30 DAYS. v CITY OF LA QUINTA BY: TITLE: DATED: J -i_,PTS yQK.reque v.S(�_OPE OF W 1�cmoval all P P 2 - Provide fiilt A, -j 1'6�ided b 4 t: 3 Nqfif cat' ton 4: Disposal of 5," r6vide G 6: This pi h' rojec. i7 C60 MctQr T tfiiq' price P 7 Pf ! � 1146.390 Jeff 2� .!2 960 Vis 61 .1 K I �a TRESIERRAi3CONST 626 289 2085. P.02 Treslerras'ConsYuctlon, Inc. General toptractors AJ 2235 Northtake Avenue, Suit' 107, Altadena, CA 9001 Fax: (626 '7�4,3.339 • Stele Licenst 725996 Tel: (626) 794-3333 V.. I" i'AR? A. jjaRc'deve* 1_3 if, 92253 t Av'e, 8092q Vista'Grande, 46-145 Jefferson Avc -3 pleas to submit for ;your ump "d Tresierr�% Constriction Inc is pl r review a. I' .�um i,, prop M lik iFope of work. ;:M Q designated in you survey provid.ed On June 2, 2004 014wl Of asbestos materials des ,M0.524#1#4,:Prqje`pt # PIM 0510#16' ' 11, PrOicet # PLM 050#1'.136 cc stage.dec.on system, Negative air stem to remain ninning'.uneil final ak clearance is 'ggieni yjadustrial )4 SL fq --r R1 jes, Cal all regul.qed agencies, -OSHA, S5AQM 1) and City permiTng. m tlazar61is waste piaterials at Licenqd Land fill A2usa Land.Recla 'ation. ,4eml Liability lnsur�,me and Workman yompensation --ertificati0n.: A q- t. �s perfortn�d.undqr �revailiilg wages sc`?cduIed for Reieveloptnint'Agency. power to Project 1�catidn. orovid6 water an A -T not h0uide Thq industrial Hygieqist Set -vices. $8,499.00". on Ave $13,634.00' to Grande Aive 6n.Ave iv o.py Quedi ns regarin &this proposa please do not hesitate t4 CA me at Mow ng Iiis I 37 d ..�tjoMI ;�"257�9"? Occ 626-794-3333 t'slia,11 s all days fr -st wriaen,.at wych! time it 'shall foj thirty (30) d, in the fust qy1,any'fur&t notiC@. J U vv' W 06/29/2004 12:56 6267943339 TRESIERRAS INC PAGE 01 1Wslerras Construction, Inc. General Contractors 2235 North Lake Avenue, Suite 107, Altadena, CA 91001 Tel: (626) 7943333 • Fax: (626) 7943339 - State License 725996 PROPOSAL ATTN: TOM HARTUNG COMPANY: CITY OF LA QUINTA ADDRESS: P.O. BOX 1504 CALLS TAMPICO CITY OF LA QUINTA, CA 92253 MONE: (760) 777-7000 *AX: (760) 777-7101 JOB SITE: 46-390 JASON AVE., LA QUINTA, CA 0ESCR71ION OF WORK TO BE PERFORMED: 1. SEWER CAP, DEMOLITION DOWN TO DIRT, REMOVE SWIMMING POOL AND SACK FUI-t ROUGH GRADE 2. TRANSPORTATION OF CONSTRUCTION DEBRIS TO AN APPROVED LANDFILL, 3. PROJECT IS ONE (1) MOBILIZATION. 4. CAL OSHA, SCAQMD, AND/OR DEMOLITION PEANUTS AS REQUIRED ARE INCLUDED. 5. CONTRACTOR TO CARRY NO MORE THAN $2 MILLION AGGREGATE GENERAL LIARMITY INSURANCE. 6. CITY TO LA QUINTA TO REIMBURSE CONTRACTOR FOR WATER USAGE 1N ADDITION TO THE CONTRACT PRICE SET FORTH HEREIN BELOW. 7. 'THIS IS A PROPOSAL ONLY. THIS PROPOSAL IS GOOD FOR THIRTY (30) DAYS. ALL WORK WILL BE PERFORMED IN ACCORDANCE, WITS FEDERAL, STATE AND LOCAL REGULATIONS. TOTAL PKICE PAYABLE UPON COMPLETION $ 17,940.00. SUBI4IITTED BY: DATE: ADRIAN 5;;gBRAN(626) 7 333 P.O. Box 55329 SCOTT MORRISON & ASSOCIATES r Riverside, CA 92517 31855 Date Palm Drive, Ste. #3-507 (909) 624-1665 Cathedral City, CA 92234 (760)323-7743 INVOICE Date: May 28, 2004 Client: Tom Hartung's .Office Project/ P.O# ,..City of La Quinta Redevelopment P.O. Box 1504 La Quinta, CA 92253 Project:. 46425 Jefferson Ave. File name: PLM0519#1233 46170 Jefferson Ave. PLM0510#1132. 46390 Jefferson Ave. PLM0524#1234 Inspection dates: May 19 and. May 24, 2004. asbestos inspection/ bulk sampling: 3 single-family homes @$125.00 ea...= $37-5.00 35. total. bulk samples for analysis (PLM) @ $20..00 each $700.00 # hours of travel time @ $ each -'included Total amount due = $1,075.00 Please send .payment to:. 31855 Date Palm Drive,..Ste. #3-507 Cathedral City, CA 92234 Terms:. Net 15 days Thank you. APP VE FOR PAYMENT BY BY- DESCRIPTIO AMT. TO PAY ( 0 SCOTT MORRISC&r&CX99& ATfES P.O. Box 55329 31855 Date Palm Drive, Ste. #3-507 Riverside, CA 92517 JUN 10 RECD Cathedral City, CA 92234 (909)624-1665 Hi BUILDIiN(760)323-7743 CAi-40SAFETY ASBESTOS SURVEY REPORT Completed On June 2nd, 2004 PLM0524#1234 Client: Tom Hartung's Office City of La Quinta Redevelopment P.O. Box 1504 La Quinta, CA 92253 Project: 46390 Jefferson Avenue La Quinta, CA 92253 (single family home with attached garage) _ t kt Ow May:'24th, '2004 'an, asbestos``inspection -'and'"bulk sampling was conducted at the above, project address -Bulk'samples were`takeri•of'all suspect asbestos containing building mate'rials'(ACBM) at the request of the client named above. A' total *of (12) 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 &'Associatescoriducts- 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 i SCOTT MORRISON & ASSOCIATES P.O. Box 55329 31855 Date Palm Drive, Ste. 43-507 Riverside, CA 92517 Cathedral City, CA 92234 (909)624-1665 (760)323-7743 The results on the following page(s) indicate that asbestos was detected in 04 of the 12 samples analyzed. PLM0524#1234 Sample #QT -150 Type of material: acoustic ceiling- white Location: interior ceiling of east -central livingroom Area: approx. 2000 total sq. ft. Friable:yes Results: none detected Sample #QT -151 Type of material: acoustic ceiling- white Location: interior ceiling of northeast master bedroom Area: approx. 2000 total sq. ft. Friable:yes Results: none detected Sample #QT -152 Type of material: acoustic ceiling- white Location: interior ceiling of west -central diningroom and garage Area: approx. 2000 total sq. ft. Friable:yes Results: none detected Sample #QT -153 Type of material: drywall Location: interior south wall of northeast bedroom Area: throughout interior walls Friable:no Results: none detected Sample #QT -154 Type of material: ceiling drywall Location: interior ceiling of west -central hall bathroom Area: throughout interior ceilings of bathrooms (2) Friable:no Results: none detected Sample #QT -155 Type of material: stucco- tan (1 rst layer) Location: exterior east wall Area: throughout exterior walls Friable:no Results: 3% Chrysotile asbestos Sample #QT -156 Type of material: plaster- grey (2nd layer) Location: behind sample #QT -155 Area: throughout exterior walls Friable:no Results: 3% Chrysotile asbestos (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 PLM0524#1234 Sample #QT -157 Type of material: stucco- tan (1 rst layer) Location: exterior south wall Area: throughout exterior walls Friable:no Results: 3% Chrysotile asbestos Sample #QT -158 Type of material: plaster- grey (2nd layer) Location: behind sample #QT -157 Area: throughout exterior walls Friable:no Results: 3% Chrysotile asbestos Sample #QT -159 Type of material: roof felt- black Location: exterior roof under wood shingles Area: throughout exterior roof Friable:no Results: none detected Sample #QT -160 Type of material: sprayed on fireproofing Location: exterior north -central water heater closet Area: approx. 60 sq. ft. Friable:yes Results: none detected Sample #QT -161 Type of material: penetration mastic- grey Location: exterior east roof penetration Area: 9+ roof penetrations Friable:no Results: none detected 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. Inspectore ' �""�--- Scott C. Morrison Certified Asbestos Consultant DOSH#92-0248 (3) Jun -01-04 09:31am From -CAROLINA ENVIRONMENTAL CAROL& E"ON1VIWAL, INC. 107;NeW Wt1on CQUI% Cam NC 27511 Phom (919),A81.1413 Fmc: (919) 481.1442 Client: Scott Morrison $ Associates 31855, date Palm Dr. Suite 3-507 Cathedral City, CA 92234 Project, PLM0524#1234 +4811442 7-738 P.02/05 F-297 LABORATORY REPORT ASBESTOS BULK ANALYSIS CEI Lab Code: A04-3947 Received: 05-28-04 Analyzed: 06-01-04 Reported: 06-01-04 Analyst: Edwin J. Stager CLIENT ID CEI LAB ID HOMOGENEITY, DESCRIPTION ASBESTOS. QT -150 A266729 SURFACE TEXTURE &PAIN T Heterogeneous, Off-white, Fibrous, Loosely Bound NO SIND 45% CELL <1 % PAINT 10% FOAM 20% MICA 25% QT -151 A266730 'SURFACE TEXTURE & PAINT Heterogeneous, Off-white, Fibrous, Loosely Bound No BIND 45% CELL <1 % PAINT 10% FOAM 20% MICA 25% QT -152 A266731 SURFACE TEXTURE & PAINT ND Heterogeneous, Off-white, Fibrous, Loosely Bound BIND 45% CELL <1 PAINT 10% FOAM 20% MICA+ 25 %' QT -153 A266732 DRYWALL PLASTER ND Heterogeneous, Off-white, Fibrous, Loosely Bound PLAS : 95% CELL 5% QT -154 A266733 DRYWALL ND Heterogeneous, Brown, Off-white, Fibrous, Loosely Bound PLAS 75% CELL 25% QT -155 A266734 STUCCO CHRY 3% Heterogeneous, Tan, Fibrous, Bound CHRY 3% PLAS 95 % CELL 9e Page 1 Jun -01-04 09:32ai From -CAROLINA ENVIRONMENTAL +4611442 T-736 P.03/05 -F-297 CAROLINA ENVIRONMENTAL, INC, 107 New Edition Court Cary, NC M11 project: PLM0524#1234 Phone. 919.481-1413 Fac: 9'19-081-1442 Lab Code: A04-3947 CLIENT ID CEI LAB ID HOMOGENE=ITY DESCRIPTION °% . ASB.E:STO.s QT -156 A266735 ROUGH PLASTER Heterogeneous, Grey, Fibrous, Bound CHRY 3% CHRY 3% PLAS 95% CELL 2 QT -157 A266736 STUCCO L� Heterogeneous, Tan, Fibrous, Bound CHRY 3°i° CLARY 30% PLA$: 95%. CELL 2% ' QT -158 A266737 ROUGH PLASTER Heterogeneous, Grey, Fibrous, Bound CHRY 3% CHRY 3% PLAS 95% CELL 2% QT -159 A266738 OOFING FELT Heterogeneous, Brown, Off-white, Fibrous, Loosely Bound ND TAR 15% CELL 85% QT -160 A266739 SPRAN' ON FIREPROOFING Heterogeneous, Off-white, Fibrous, Loosely Bound ND BIND 45% CELL <1% PAINT 10% FOAM 20% MICA 25 QT -161 A266740 PENETRATION MASTIC Heterogeneous, Black, Grey, Fibrous, Tightly Bound ND TAR ' 75 % CELL. 25% Page 2 Jun -01-04 09:32am From -CAROLINA ENViRONaIENTAL +4811442 T-738 P.04/05 F-297 The following definitions apply to the abbreviations used in the ASBESTOS BULK ANALYSIS REPORT: CHRY = Chrysotile CELL = Cellulose DEER =Debris AMOS = Amosite F8GL = Fibrous Glass BIND =Binder CROC = Crocidolite ORGN = Organics SILI TREM = Tremolite SYNT = Synthetics =Silicates GRAV =Gravel ANTH = Anthophyllite WOLL = Wollastonite MAST =Mastic ACTN = Actinolite CERWL = Ceramic Wool ALAS =Plaster N D = None Detected NTREM = Non-Asbestiform PERL = Perlife NANTH = Non-Asbestiform Tremolite Anthophyllite RUBR =Rubber CLIENT, Scott Morrison & Associates t PROJECT: PLM0524#1 234 cei LAS CODE: A04-3947 Stereoscopic microscopy and polarized light microscopy coupled with dispersion staining is the analytical technique used for sample identification. The percentage of each component is visually estimated by volume. These results pertain only to the samples analyzed. The samples were analyzed as submitted by the client and may not be representative of the larger material in question. Unless notified in writing to return after 30 days, samples, Carolina Environmental, Inc. will discard all bulk samples t Viany vinyl floor tiles have been manufactured using greater than 1 % asbestos. Often the asbestos was milled to a fiber iize below the detection limit of polarized light microscopy. Therefore, a "None Detected" (ND) reading on vinyl floor tile loss 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 .1rograrn (NVLAP) for the analysis of asbestos in bulk materials. The accredited test method is EPA/ 600 / M4-62 / 020 for he analysis of asbestos In building materials. Procedures described in EPA / 600 / R-93 / 116 have been incorporated there applicable. The detection limit for the method is 0. % (trace amount). Carolina Environmental, Inc.'s NVLAP accreditation number is 4101768.0. '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. ANALYST 3 REVIEWED BY Tianbao Bai. Ph.D. Laboratory Director Ena of Report From: Scott Morrison & Associates ti P.Q. Boa 55329 s- E Rivenide, CA 92517 (760} 323-7743 Client: C LA .lob No. 05 boy, S 7 �.� CHAINnF c�vsr4u� '4a('o 67'�y-�9�� To: Carolina Environmental, los. 7Y6 107 New Edition Court Cary, %C 27511 (919) 481.1413 NVLAP Cats 101768.4 CA ELAP 1iM Eurr Person Taldng Samples: 1r-• rsi ti ��cR� 50 �C� Jaz-3 �Z SiteAddress: *% 3Qo 3gr- AVF-WJE74 LA 0UiWTA Sample 4 Sample Date Material & Description LM AA -Pb Other Information QT- '�5D D. -2� • Z� ou fie, eFr <<+�G-- rt9#,/ Loy r7ff- _ *L� �►+�� pZ �4.� OTS I4C ous-ri c- C4:1bAjq-- 1.x11! t � - 15-3 _ it — � ,9 T- / SS- -- 7L, C C a - Q-rII5+�� OT �yr-w — 6-x 07- &T - L6a &pq i Fax in Results a No LAkAp.� DatelTime: r -6 i /aoo ��►+ Relinquished Sy: _ Datell'ime: o o - 12,'060 Received BT: Mail/Fax To: Scott Morrison Asociates, 31855 Date Pshn Dr., Ste. 0-507, Cathedral City, CA 92234, (760) 323-7743 , P.O. BOX 1504 APPLICATION ONLY Building 7&105 CALLE ESTADO Address �� - 2 �0 ,l ErF�Y So,v' LA QUINTA, CALIFORNIA 92253 Owner ire Mailing // r Address V3 -�/ <0 4m RP2 l HtyZip Tel. l LM &5e27 9 Z ZGO 3 g o�8 J Contractor ` /7 Address oiz6L Address -1 �O �s 1 pity Tel.. > - ys l State Lic. City & Classif. Lic. # Arch., Engr., " Designer Address Tel. City 1 Zip State 1 Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 71100) of Division 3 of the Business and Professions Code, and my license is in full force and effecI. _SIGNATURE DATE OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,9usiness and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he 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 ch d penalty of not more than five hundred dollars (8500). ❑ 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, Buisness and Professions Code: The Contractors License Law does not apply to an owner of property who builds or unproves•thereon and who does such work himself or through his own employees, provided that such 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 N4 1, that he did not build a improve for the purpose or sale.) 4 I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec B. & P -C- fo this reason Date , dOwner / WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No Company - ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. e CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed ff the permit is for one hundred dollars (8100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any pperson in any manner so as to become subject to the Workers' Compensation Laws of CalifOrnia- Date Owner NOTICE TO APPLICANT: ft, after making lids Certificate of Exemption you should become subject to the Workers' Compensation provisions or the Labor Code, you must forthwith comply with such provisions or this pemM shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's 'Name Lender's Address This is a building permit when property filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 100 days. 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 city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip -_i BUILDING DIVISION r BUILDING: TYPE CONST. OCC. GRP.. A.P. IYumtier `61L-14 D — Oo//7 Legal Description lit T. 36 `Th290,1i�rg/1 l Project.Description 4401A / Yrr4 Sq. Ft./ No. No. Dw. Size / 00 Stories. Units New -V Add ❑ Alter ❑ Repair 0' Demolition ❑ stimated Valuation ( C U1 1 Minimum Setback PERMIT AMOUNT Plan Chk. Dep. 'L 5'0 o J Plan Chk. Bal. rO'l -7 , Const. FINAL DATE r cw Mech. Date Permit Validated by: Electrical ?i t Plumbing t S.M.I. 1 t'7� Grading Z4.040 - Driveway Enc. oop Infrastructure i TOTAL U p O REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE GROUND PLUMBING NO. ELECTRICAL FEES NO. < NG FEES 1ST FL. SO. FT. ® sojogIlto AV- UNITS BONDING HEATING (ROUGH) STORAGE TANK FORMS YARD SPKLR SYSTEM 2ND FL. SQ. FT. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) ZO MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (FINAL) TEMP. POLE GAR. SO..FT.,@ GROUT POWER OUTLET ROOF DRAINS FINAL INSP. BOND BEAM DRAINAGE PIPING CAR P. SQ. FT. ® GRADING cu. yd. $ plus x$ =$ LUMBER GR. WALL SQ. FT. ® IO FRAMING DRINKING FOUNTAIN - SO. FT. ® ROOFING URINAL ESTIMATED CONSTRUCTION VALUATION $ REMARKS: WATER PIPING NOTE: Not to be used as property tax valuation VENTILATION FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LATHING LAUNDRY TRAY AIR HANDLING UNIT CFM IKITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP FINISH GRADING POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. CERT. OCC. SO. FT. ® c BATH TUB FENCE FINAL SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/.c 0 HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. ' SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL