0206-065 (AR)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions. of
HChapter 9 (commencing with Section 7000) of Division 3 of the Business and
CN W Professionals Code, and my License is in full force and effect.
O ch License# y Lic. Class Exp. DateLO
LU 380 B MC
/� pq
rZIY1'�
Z r- /Date of Contractor ^�
CD 0
J U C OWNER -BUILDER DECLARATION
Ha I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
Z; ( ) 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
4 sale (Sec. 7044, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
co () Lam exempt under Section , B&P.C. for this reason
LO
N Date Signature of Owner
OC\I
dWORKER'S COMPENSATION DECLARATION,
Z '
p 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.
.(fes) I have and will maintain workers' compensation insurance, as required by
OU
Section 3700 of the Labor Code, for the performance of the work for which this
ImH permit is issued. My workers' compensation insurance carrier & policy no. are:
Z Carrier , , Policy No.
r C)
g (This section need not be completed if the permit valuation is for $100.00 or less).
( ) I certify that in the performance of the work for which this permit is issued,
I shall not employ any person in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
,,,Date: Applicant-
Warning:
pplicant Warning: Failure to secure Workers' Conf ensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application,
1. Each:persomupon 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 appllcaton agrees to, & shall, indemnify
& hold harmless the City of La Qulnta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
b
'-Signature (Owner/Agent) — Date
PERMIT#
BUILDING PERMIT
'
DATE VALUATION LOTS TRACT 14496'3
JOB SITE
•
ADDRESS 4 4;*fy ! CAL y: i S. a r agtd�
APN
`6!58-2,C"30
OWNER
CONTRACTOR/ DESIGNER / EN (NEER
DOUGIASALMMIM
iAta A 1E J36RDEM 1
49.960 CALLS EVrRXI
79-w myl mumm-
LA QUINTA CA 922$3
I3F"R.W11= ADDHES CA 92201
(160)25 0.13036 C BLO T.13 D
USE OF PERMIT
:FtERDEN'rim., ADIDl'. ION
KITCHEN ADDIT1014 (16 s.A) & .t1EMODEI, REMODE1, INC:I,►)DINO
"S1'I+M .DATR 2N D BATH AND 1 I ,l1.E'I OCA T f ON,
ADDITION 16.01 3F
p1mbu"t'.M1% kit3��/.'iMARY
PLAN CHECK li`M 101 -000-4359-318 M68.031
u1aS�I�L3L^IYCy1J ��: 1 d91-tFtl0�8 i f��000 �q��. ��
1 1 t 11>~ak3IC 1.k sls 1C31'�0flt?-421.0'p0 MOM
9I.•ECTRICAE, IPM: $:30.00
PLUMIRM FIRE WIN
s1R.010p•IiO' ION FRE -P.:( D i•Ltl-000-W-000 $].50
W u
iiia
/JI
A♦Y +��p�,���
e-1 p� �•s th�,y AND
V i���d� Ca`>� .. r 1.Ri.�,J`�+, dWF.�i F'1a.` D �,�i. X (,rA3fLi ...G
PL
c�,�n ,y +�
$49.3.53
PINANCEDEPT. LrW PRE-PAIDI'. S
k0loo
RECEIPT
DATE +
BV `
DATE F NALEQ
INSPECTO
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final Z—
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Pining
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
-Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
Ir-
,
Bin #
City of La Quinta
Building S Safety Division
`` P.O. Box 1504, 78.495 Calle Tampico
�� to Quints, G4 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permrt N
44, Mp 0&5-
"Project Address: 0 CZ11e r elf
Owner's Name: o Lt°C
A. P. Number:
XAddress: _ 041(e- rSTeelllt
Legal Description: q& w
XCiry. ST. Zip: 4 h h SA eOe— Z Ai?�T1
ontractor: ft IV1 F e SL JlR,
'Telephone: ' (
A7-
ddress: ]!� - (� ,C e ;�,
Project Description:
City, ST. Zip: R N P1' 1 LQ (
►7 '— iq S�LTt
elephone: 71_ Dlie
`tJ L D e-/4 T ,O T e o f
FState Lic. # : Citv Li #:
Arch.. Engr.. Designer:
e %'j C )- e— fft-t,TRY D UD Q.
Address:
City. ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Dcmo
Name of Contact Person: FK Af J24 t4
Sq. Ft.: �,)
# Stories:
# Units:
?Tele hone # of Contact Person:
"Estimated Value of Project—
;.A. APPLICAN ITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING PERMIT FEES
ZPlan
Sets
Plan Check submitted ? tem
Amount
Structural Cafes.
Reviewed. ready for corrections Plan Check Deposit
Truss Cafes.
Called Contact Person (r/j ( Plan Check Balance i
ZTitle
24 Calcs.
Plans picked up Construction 0
Flood plain plan
Plans resubmitted 'S' —f 7/ 3 lechanical 0
Grading plan
2" Review, ready for correc ' s/issue �yy lectrical 0
Subcontactor List
Called Contact Person 7 R7 Plumbing
Grant Deed
Plans picked up 5.111.1. b
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
) 4 Review, ready for correctionslissue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue yo
School Fees
'
� N/s
Total Permit Fees
f1t- c'B S< Cf 0— - �/" ,
CERTIFICATE OF COMPLIANCE�s
Desert Sands Unified School District
47950 Dune Palms Road 4 0
Q BERMUDA DUNES r
Date 7/17/02 La Quinta, CA 92253 rn RANCHO MIRAGE b
No. 23390 (760) 771-8515 �� INDIAN
WELLS
PALM DESERT ESERT ti
,y
LA QUINTA
INDIO y�
Owner Douglas Lennick
Address 49960 Calle Estrella
City Palm Desert Zip 92260
Tract # 14496-1
APN #
658-260-030
Jurisdiction La Quinta
Permit # 0206-065
Study Area
,Type Residential Addition -No. of Units
Lot # No. Street S.F. Lot # No. Street S.F.
w
Unit 1 49960 Calle Estrella 16 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Commepts
At the pm2sent time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 50
square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile home
It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
Residential Addition 500 Sq Feet or Less
EXEMPT
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $0.00 X 16 S.F. or $0.00 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By Exempt - Fred Babineau/Sante Fe Builders Check No. -
ame on tne cneCK Telephone
Funding Exempt
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Crystal Scott
Payment Recd Over®
Signature
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or
other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which thos
amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting
May 29, 2002
Doug Lennick .
50087 AXP Financial Center
Minneapolis, MN 55474
Re: ' 49-960 Calle Estrella
Dear Mr. Lenriick:
Your Architectural request dated May 3, 2002 regarding extending kitchen into courtyard and changing single
door to double door per blueprint has been approved with the following stipulations: '
• Elevation of building must not be changed.
• Actual modification must conform to the plans and specifications submitted and approved.
• Competent and licensed professionals shall do all work in a workmanlike manner.
• All work is to be in compliance with local building codes and ordinances.
• All exterior stuccowork must be painted to match existing stucco (Dunn Edwards, Evershield-`Bone White").
• All electrical wiring, if applicable, must be contained within approved conduit painted to match the surface it
contacts.
• Any damage to the common area resulting from this modification and its construction shall be repaired at the
Owner's expense.
• If a construction bin is rented through Waste Management it must be beige in color and stored, if possible, in
the garage. All construction debris is to be removed from the site by the close of each day to maintain order
and retain the aesthetics of the Santa Rosa Cove.
• Prior to the commencement of any work the contractor and their subcontractor(s) must provide the Association
proof of worker's comp, liability and auto insurance; naming the Association as additionally insured.
• Prior to the commencement of any work you or your contractor must provide the names of the scheduled
workmen to the security guards,at the Mazatlan gate, (564-5414)..
• Prior to the commencement of any work your contractor must read and sign the Association's Contractor Rules,
which has been supplied to them.
• Prior to the 'commencement of any work you are required to pay a $ 500 refundable deposit for the patio
extension (received with application).
Please contact the Association office once your modifications are complete for a final inspection. A copy of the
approved variance will be mailed to you after the inspection. If you have any questions, please call.
Very truly yours,
Carl McCullough
Association Manager
On Behalf of the Architectural Committee
THE SANTA ROSA COVE ASSOCIATION
49.991 Eisenhower Drive
La Quinta, California 92253
(760) 777-7621
Fax: (760) 777-7622
Mailing Address:
Post Office
SANTA ROSA COVE ASSOCIATION Palm D sert,
Californiaa 92255
07/02/2002 12:33 7603237743 SCOTT MORRISON & ASS
SCOTT MORRISON & ASSOCIATES
3243 Arlington Ave., Suite 206
Riverside, California 92506
(909) 624.1665 DOSH 92-0248
ASBESTOS SURVEY REPORT
Comphiftd On
June V, 2002
?LM062MMI
Client: Santa Fe Suilders
C/0: Fred Babiiesu
Project: 494880 Calle Estrella
Le Duinte, CA
(Remodel: single famlly horse)
PAGE 02
1130 E. Fuerte Circle
Calm Springs, CA 92262
(800) 824-3353
On June 25, 2002 an asbestos inspection and bulbs sampling was conducted at the above project
address. Bulk sa rnples were taken of all suspect asbestos containing building materials (ACBM) st the
request of the` client named above. A total of (4) bulk samples wens submitted to Carolina
Environmental, Inc. in Cary, NC (NVLAP Code 101768-0 and Cal. Environ. Lab. Cert. 42483) to estimate
ft>a percentage of asbestos by volurtte and determine the types) present.
Carolina Environmental, Inc. determines percentagss and type of asbestos by using EPA approved
method 600V M42-020: Interim Method for the Determination of Asbeeoe in Bulk Samples. 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 eked and no asbestos is deteded "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 ft was, It was likely to be teas than 1.0% of the sample.
When findings reveal less then or dose to 1.0% asbastos contained In a sample, further analysis may be
casted for on additional samples to confirm or denounce the initial Wings. 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 rec:om mends . "m (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_
ASBESTOS INSPECTION BY: Scott Morrison, DOSH 082-0248
BULK SAMPLES ANALYZED BY: Carolina Environmental, Inc., NVLAP 010178"
The results an the following page(s) indicate that asbestos was detected in 00 of the 04 samples
analyzed.
(1)
07/02/2002 12:33 7603237743 SCOTT MORRISON & ASS PAGE 03
3243 Arlington Ave., Suite 206 SCOTT MORRISON & ASSOCIATES 1130 E Fuerte Circle
Riverside, California 92506 Palm Springs, CA 92.262
A909) 624-1665 DOSH 92-0248 (800) 8243353
PLMOU50=1
Sample IIISF-1
Type of material: drywall- white
Location: interior west wall,' just inside entrance
Area throughout interior walls
Friabiemo
Results: none detected
Sample #SF -2
Type of material: rolled floor linoleum -brown (1ra3t layer)
Location: furor of west closet and bathroom
Area: approx. 70 total sq. R.
Friable:no
Results: none detected
Sample 08F -a
Type of material: Moor mastic- yellowfarown (2nd layer)
Location: under sample #SF -2
Area: approx. 70 total sq. ft.
Frisbla:no
Results: rwne detected
Sample NSFA hype of material: exterior skxzo- tan
Location: exterior west wall outside entrance
Area: tivoughout exterior walls
Friablemo Resufts: 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 oentl'ied asbestos abalement contractor prior to any demolition or
nsrovation of the property_
Inspector " -/#04r
Scott C. Morrison
Certified /asbestos Consuftent
DOSHM-0248
(2)
• 07/02/2002 12:33 7603237743 SCOTT MORRISON & ASS PAGE 04
INVINONMENTAL, INC.
nnronrdeeli Court, Cary, NC 27511
' , p� � (f19'pyt'14q t�[�01i1Y1.14tT
LABORATORY REPORT
Ctlon,. Scott Morrlson & Associates cel Lab Cods: A02.4044
1130 Fume Circle Received: 06-26.02
Palm Springs CA 92262 Anslye.d: 06.27.02
lieported: 08.27.02
>rrolsos: 49.980 Calle EstsmK La Quints Analyst: Tlanbao dei
Project S PLM 0625/10401
Cal:....
CuffmT 0 LAB ID SAAAM DCbGRIPTION AUMT08-
SF -1 A53667 13AYW ALL NO
Heterogeneous. white. Fibrous•Loosoly Bound
81Nb 90% CELL 2%
3F-2 A63668 LINOLEUM No
Heterogeneous, Brown, Fibrous. Bound
BINO 20% CEI. 20% .
VINYL W%
SF -3 A53859 UASTr— NO
Hersopeneous, Tan, Fibrous,Qound
MAST 95% CELL 5%
SF -4 A53660 x. NO
Heterogeneous, Tv, Non-fibrous, Bound
i1Nn 90%
PAINT 10%
Pape 1
i
110-6 I1/c0'1 111-1 ditlll>+ 1YlN'J4Y0 IAM3 V111OW-04 wdivi0 t0-lt-mr