15214 (DEMO)Building
Address 47-250 Wash
Owner -
Jack Burkett
Addressp-. s Box 8 4.9
P.O. BOX 1504
�1 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
City Zip Tel.
Thermal 92274
Contractor
cwaer/buiider
'Address
p
State Lic.
& Classif. .
Arch., Engr.;
Designer
Lic. #
No. 15214-
WILDING:
521 -
WILDING: TYPE CONST.- OCC: GRP.
k.P. Number 627-070-006
-egal Description
)roject Description Demolition of hurned out
structure-.
Sq. Ft. No. ' .. No. Dw.
Size Stories, Units'
New ❑ Add ❑ Alter ❑ Repair ❑
Address
Tel.
I certify that in the performance of thg work for which this permit is issued; I shall not
City "
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of .Chapter.9 (commencing with Section
7000) of Division'3 of the Business and Professions Code, and my'license is in•full force and
effect:�rF•:•" - - •
Laws of California
_
SIGNATURE DATE
OWNER -BUILDER DECLARATION '
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 703.1.5,Business-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 applicanl.to a civil penalty of not more than five hundred dollars ($500).
AI, as owner of the property, or my employees.with wages as their sole compensation, will
dothe work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Code: The Contractor's. License Law does not apply to an owner or property who
builds or improves 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
of proving that he did not build or improve for the purpose of sale.)
O 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 wittra contractors) licensed pursuant to the Contractor's License Law.) -
• ❑ I am exempt under Sec. B. & P.C. for this reason
Estimated Valuation
PERMIT '
'
Plan Chk. Dep.
-
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
-
S.M.1.
Grading
Driveway Enc. -
Date • owner �"`"`�
Infrastructure
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that I 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.
Rear Setback from R
• WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND'
TOTAL
CERTIFICATE OF EXEMPTtON FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit Is for one hundred dollars ($100) valuation
' or less.)
I certify that in the performance of thg 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
Date_" Owner
NOTICE TO APPLICANT: n, after making this Certificate of. Exemption you should become
ZONE: '
BY:`
subject to the Workers' Compensation provisions of the, Labor Code, you. must forthwithMinimum
Setback
Distances: -
comply -with such provisions or this permit shall be deemed revoked.
Front Setback from'(
Rear Setback from R
• WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND'
Side Street Setback
SHALL SUBJECT AN EMPLOYER TO.CRIMINAL PENALTIES AND .CIVIL FINES UP TO ONE
z
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
Side Setback frori
DAMAGES AS PROVIDED FOR IN.SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES. ' . '
�SF
This is a building permit when properly.filled out, signed and validated; and"is subject to
FINAL DATE
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information• is correct.
Issued by:, -
Date—
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. -
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
Demolition
y"
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES ,
1ST FL. SO. FT. @ $
UNITS
SLAB GRADE
2ND FL. SQ. FT. Q
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
FOR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APP./EQUIP.
DRAINAGE PIPING
CAR P. SO. FT.
TEMP. POLE
WALL SQ. FT.
GROUT
DRINKING FOUNTAIN
SO. FT. ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
=$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ®c
BATH TUB
GAR. FIREWALL
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
MESH
SQ.FT.GAR ® V4c
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 APP./EQUIP.
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
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
SCOTT MORR;ISON & ASSOCIATES
3243 Arlington Ave., Suite 206 (909) 624-1665
Riverside, CA• 92506 DOSH #92-0248 (800) 824-3353
BULK SAMPLE ANALYSIS REPORT
Completed On
June 12, .1995.
PLM0607#1502
Client: Lary Burkett
78610 Avenue 41
Indio, CA 92201
Project: 47-250 Washington (4 structures)
Indio, CA
On June 7, 1995, an asbestos inspection and bulk sampling was conducted at the above project address.
Samples were taken of all suspect asbestos. containing building. materials at the request of the client named
above. The removed samples were examined using a Nikon Labophot-2 polarized light microscope and a Swift
stereo microscope to estimate the percentage of asbestos by volume and determine the type present.
Scott Morrison & Associates determines percentages and type _of asbestos by using NIOSH approved
method 7403, the principles of polarized light microscopy and dispersion staining. 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% of the sample.
When findings reveal less than 1% present contained, further analysis may be called for on additional samples to
confirm or, denounce the initial findings. The South Coast ; Air Quality. Management District (SCAQMD)
recommends three or more samples from a homogeneous area be analyzed before any building material is
determined to be nam -hazardous.
The samples listed and described below were taken from reasonably accessible areas of the building. Any,
materials located in areas of the building that are inaccessible were not tested. Such areas include, but are not
limited to, narrow.crawl spaces and unstable/dangerous roof or floor areas.
ASBESTOS INSPECTION BY: Robert W. Bates III
BULK SAMPLES ANALYZED BY: Scott Morrison
The results, on the following pages indicate that asbestos was detected in 0 of the 15 samples analyzed.
SCOTT MORRISON & ASSOCIATES
3243 Arlington Ave., Suite 206
(909) 624-1665
Riverside, CA 92506
DOSH #92-0248 (800) 824-3353
PLM0607#1502
----------------------------------------------=-----------
Sample #1
a ---- --------- '
Type of material:brown 12- X12 vinyl floor tile
Locatiowliving room of residential unit
Area: N/A
Friable:no
Results:none detected
----------- -------------------------------------------------------------
. Sample #2 .
Type of material:yellow mastic
Location:floor of kitchen and dining room, residential unit
Area:N/A
Friable:no
Results:none detected
------------------------------------------------------------------------
" Sample #3
Type of materialArywall
"
Location: kitchen
Area:N/A
Friable:no
Results:none detected
-------------------------------------------------------
Sample#4
9 - - - - - - - g ------
Type of material:white ravel roofing material
Location:top roof layer, residential unit
Area: N/A
Friable:no
Results:none detected
---------------------------------------
Sample #5
--------------------------------
Type of material:black asphalt mastic roofing
Locatiomsecond roof layer, residential unit
Area: N/A
Friable:no.
Results:none detected
-----------------------------------------------------------------------
Sample #6
Type of materia' Wrown'roofing felt
Location:third roof layer, residential unit
Area: N/A
Friable:no
Results:none detected
-----------------------------------------------------------------------
Sample .#7
Type of material; black asphalt roofing
Location:garage roof
Area:N/A.
Friable:no
Results: none detected
---------------=--------------------=-----------------------
Sample #8
------------
Type of material: roofing felt
Location:garage roof
Area: N/A
Friable:no
------------------------------------------------------------------=-----
Results:none detected
(2)
SCOTT MORRISON & ASSOCIATES
3243 Arlington Ave., Suite 206
(909) 624-1665
Riverside, CA 92506
DOSH #92-0248 (800) 824-3353
PLM0607#1502
--------------------------------------
Sample #9
----------- ==----------- =---------
Type of material:green flooring'felt
` Location:shack east of garage
Area:N/A
- Friable:no
Results:none detected
------------------------------------------------------------------------
Sample #10
Type of material:drywall
Location:shack east of garage
Area: N/A .
Friable:no
Results:none detected
-----------------------
Sample #11
Type of material:red linoleum
Location:west side of east'shack
Area: N/A
Friable:no
Results:none detected
---------------------=--------- -
Sample #12
----------------------------------------
Type of material: interior plaster
Location:shack east of garage
Area: N/A
Friable:no
Results:none detected
---------------------
Sample #13
_
Type of material:grey.roofing shingle
Location:roof of shack east of garage
Area: N/A
Friablemo
Results:none detected
--=--.----------------------------------------------------
Sample #14
---------------
Type of material: roofing felt
iocation:second layer roofing, shack east of garage
Area: N/A
Friable:no
Results:none detected
------------------------- -----------------------
Sample #15
---------------- =---=---
Type of material:green shingle
Location:wall of shack directly next to the garage -
Area: N/A
Friable:no
-------------------------------------------------------------------------
Results:none detected
Analyst_ .�
------------ -------------
Scott C. Morrison
Certified Asbestos Consultant .
DOSH Certification #92-0248'