12-0396 (DEMO)4
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 4/12/12
Application Number: 12-00000396 Owner:
(Property Address: 51230 EISENHOWER DR KATHRYN J CARLSON
APN: 773-072-019-12 -000000- PO BOX 1711
Application description: DEMO - COMML/OTHER LA QUINTA, CA 92247
Property Zoning: VILLAGE COMMERCIAL tRk
Application valuation: 12000
Contractor: i �Li �s y
Applicant: Architect or Engineer: THREE D SERVICE COMPANY INC
1551 EAST MISSION BLVD
POMONA, CA 91766��
(909)469-2600 — ----
Lic. No.: 252618
------------------
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: C21 / LicenseNo.: 252266/18
Date:�?�%C Contractor: OLS liC� V ' /0
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
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).:
(_) I, as owner of the lamperty, 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. for this reason
Date:
Owner:
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
---------------------------------------------
=—
WORKER'S COMPENSATION DECLARATION
1 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' compensation
insurance carrier and policy number are:
Carrier GREAT DIVIDE IN Policy Number WCA1524927-11
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, shall forthwith comply with' "se provisions.
Dater APPlicant.j
WARNING: FAILURE TO SECURE WORKE 'COMPENSATION COVERAG UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. 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 peison 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.
1 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 county to enter upon the above-mentioned property for inspection purpose
Date%W .Z Signature (Applicant or Agen
Application Number . . . . . 12-00000396
----=- Structure Information DEMO COMMERCIAL -----
----------------------------------------------------------------------------
Permit DEMO PERMIT
Additional desc J
Permit Fee . . . . 45.00 Plan Check Fee ..00
Issue Date . . . Valuation . . . . 12000
Expiration Date 10/09/12
Qty Unit Charge Per Extension
BASE FEE 45.00
----------------------------------------------------------------------------
Special Notes and Comments
DEMO ENTIRE COMMERCIAL BUILDING
INCLUDING FOUNDATION PER PLANS.
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
Iffi,LLAGE PARK
ANIMAL HOSPITAL,
March 29, 2012
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92253
To whom it may concern:
77-895 Avenida Montezuma
La Quinta, CA 92253
(760) 564-3833
Please accept this letter as my authorization to demolish the building I own at 51230
Eisenhower in La Quinta. If you have any questions, you may contact Emily Downing or
Tonia Zangger at the number listed above.
Thank you
STr1/ MART TITLE -Riverside
REOGi DING REQUESTED BY:
Re/Max Peal Estate Consultants/Escrow Division
AND WHEN RECORDED MAIL TO:
AND MAIL TAX STATEMENT T0:
Kathryn Carlson
m
Order No. 507276467
Escrow No. 04 -03985 -KT
Parcel No. 773-072-019
--0-- OZV-- 01 lP .
00C a 2005-0118693
02/14/2009 08:00A Fee:13.00
Page 1 of 3 Doc T Tax Paid
Recorded in Official Records
County of Riverside
Larry W. Ward
Assessor, County Clerk 8 Recorder
1111111111111111 1111111111111111111111 III 1111111111111
M
S
U
PAGE
SIZE
DA
PCOR
NOCOR SMF misc.
A
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I L 11COPY
LONG
REFUND
NCHG EXAM
GRANT DEED
THE UNDERSIGNED GRANTOR(S) DECLARE(S) THAT DOCUMENTARY TRANSFER TAX IS $973.50 and CITY $ /
X computed on full value of property conveyed, or
computed on full value less liens or encumbrances remaining at the time of sale.
unincorporated area: OR _City of La Quinta and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, T�
Joseph Rounaghi and Malakah Rounaghi, husband and wife as joint tenants
+i,ereby GRANTS to Kathryn J- Carlson, A MARRIED WOMAN AS HER SOLE AND SEPARATE PROPERTY
the following described real property in the County of Riverside, State of California:
AS PER LEGAL DESCRIPTION HERETO DESCRIBED AS,"EXHIBIT A" AND MADE A PART,HEREOF.' "'
Commonly known as: 51230 Eisenhower Drive, La Quinta, CA 92253
Date
Joseph R na Malakah Rounaghi
STATE OF CALIFORNIA )
) S.S.
60 COUNTY OF� J�AV
V�
On 51 Qt)1r1 S before me, the undersigned, a Notary Public in and for said County and State,
personally appe ed Joseph Rounaghi ' personally known to me (or proved to me on the basis
of satisfacto�e) to be the person Mbse name( ace subscribed to the within instrument and acknowledged
►� to me tha a executed the same iheAhetrauthorized capacity4jeo, and that by!9herfflTe signatur" on
the instrument the per nW, or the entity upon behalf of which the person je) acted, executed the instrument.
WITNESS my Ic I seal.
GINA M. REYES
Signature _ Commission # 1452278
-ai Notary Public - California
Riverside County
My Comm. Expires Nov 21, 2007
STATE OF CALIFORNIA }
COUNTY OF o?fi S.S.
On t 3`�W Sr— , before me, the undersigned, a Notary Public in and for said County and
State, personally appeared Malakah Rounaghi p or proved to me on the basis of
satisfactory evidence) to be the erson(s) whose name(s)t',�/ re subscribed to the within instrument and
ackn ledged to me that he/"e they executed the same in his r/ eir authorized capacity(ies), and that by
his
er eir signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted,
eA uted the instrument.
WITNESS my hand and official seal.
Signature
SUKEiU R. BHATT
141
Commission # 14] 6933
.� Notary Public - California
'
Orange Cr•inty
My Comm. Expires Muy 23, 2007
.%� '%� 507276467
EXHIBIT "A"
LEGAL DESCRIPTION
The land referred to herein is situated in the State of California,
County of RIVERSIDE, City of LA QUINTA, described as follows:
LOTS 9 TO 12 IN BLOCK 128 OF SANTA CARMELITA AT LA QUINTA UNIT
NO. 14, IN THE COUNTY OF RIVERSIDE, STATE OF CALIFORNIA, AS PER
MAP RECORDED IN BOOK 18 PAGES 82 AND 83 OF MAPS, IN THE OFFICE
OF THE COUNTY RECORDER OF SAID COUNTY.
EXCEPTING THEREFROM THOSE PORTIONS AS CONVEYED TO THE COUNTY OF.
RIVERSIDE BY DEED RECORDED OCTOBER 25, 1979 AS INSTRUMENT NO.
227970 AND RE-RECORDED DECEMBER 3, 1979 AS INSTRUMENT NO.
256939, BOTH OF OFFCIAL RECORDS.
End of Legal Description
e p�
Aspen Tree
ENVIRONMENTAL
PH: (800) 209-1665 FAX: (760) 251-4540
ASBESTOS SURVEY REPORT
Completed On
August 19th, 2011
ASR0812#2001
Client: Dr. Katherine Carlson
51-230 Eisenhower Drive
La Quinta, CA
Project: 51-230 Eisenhower Drive
La Quinta, CA
(Demo: Approximately 2500 sq. ft. commercial building)
On August 12"', 2011 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 (20) bulk samples were submitted to EMLab P & K located
at: SS55 Garden Grove Blvd., Suite 275, Westminster, CA (NVLAP Code 435127) to estimate the
percentage of asbestos by volume and determine the type(s) present.
EMLab P & K 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 samplesare 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. Aspen Tree Environmental conducts asbestos inspection
surveys following the A.H.E.R.A inspection protocol.
ASBESTOS INSPECTION BY: Timothy Morrison, DOSH #05-3842
BULK SAMPLES ANALYZED BY: EMLab P & K, NVLAP #435127
(1)
'"Aspen Tree
- ENVIRONMENTAL
PH: (800) 209-1665 f f k ,; FAX: (760) 251-4540
ASR0812#2001
Sample #DK -1 Type of,material: Stucco- light gray
Location: exterior east wall of building
Area: throughout exterior east wall
Friable: no Results: none detected
Sample #DK -2 Type of material: exterior plaster- gray
Location: exterior south wall of building
Area: throughout exterior south wall
Friable: no Results: none detected
Sample #DK -3 Type of material: drywall
Location: interior north wall of west -central room
Area: throughout interior walls of room
Friable: no Results: none detected
Sample #DK -4 Type of material: texture coat- white
Location: interior south will of west kitchenette
Area: throughout walls of kitchenette
Friable: no Results: none detected'
... .......... .
Sample #DK -5 Type of material: caulk -white
Location: -around wall tile in southwest restroom
Area: localized around wall tile
Friable: no Results: none detected
Sample #DK -6 Type of material: caulk- gray/white
Location: around wall tiles in south-central dog bath
Area: localized around wall tiles
Friable: no Results: none detected
Sample #KDK-7
Type of material: smooth coat (1n layer)
Location: interior east wall southeast "alarm" room
Area: throughout interior walls of room
Friable: no Results: none detected
Sample #DK -8 Type of material: drywall (2"d layer)
Location: behind sample #DK -7
Area: throughout interior walls of room
Friable: no Results: none detected
ASR0812#2001
(2)
^ ^
/
Aspen Tree
rNV|R/lNMENTA|
ASR0812#2001
Sample#DK-9
Type ofmaterial: drywall mud
Location: interior east wall ofsoutheast large "rehab"
mom
Area: interiorjointuand seamy
Friable: no Results: none detected
Sample #DK -10 Type ofmaterial: tarred gravel
Location:'extehorflatnwof-underfoanm
Area: throughout exterior flat roof
Friable: no Resu|ts:nonedetected
Sampke#DK-1l
Type mfmaterial: duct mastic- gray
Locaton:extehorxxextnoof-a|ongductseanns
Area: less than 10Usq. ft. _
Friable: no
Results: none detected
Sampxe#uK'12.
Type onmaterial: parapet wall plaster ` '
Location: exterior roof- east parapet
Are'j:thirou0hout�ute�parapet
Friable: no ' �.
` Results: none detected
"*".pc#u^,1a
� `_ Type u//n*uc/m/.roof mastic- black
Locadon:extehornomf-eastductseams
Area: less than 1OOsq. ft.
Friable: no
Results: none detected
5amp|e#DK-14
Type ufmaterial: tarred gravel (1" layer)
Location:mxterorOatroof-unde,foam
Area: throughout -exterior flat roof
Friable: no
Results: none detected
Sample #DK -15
Type of material: tarred felt (2 d layer)
Location: under sample #DK'14
Area: throughout exterior flat roof
Friable: no
Results: none detected
Sa,nne#DK-16 Type ofmaterial: exterior plaster
Location: exterior west roof parapet
Area: throughout exterior roof parapet
Friable: no Results: none detected
/3\
R. A
sen Tree
ENViRONMEN 1/-,L
PH: (800) 209-1665 FAX: (760) 251-4540
ASR0812#2001
Sample #DK -17
Type of material: mastic- gray
Location: west roof ducts (HVAC)
Area: less than 100 sq. ft. -
Friable: no
Results: none detected
Sample #DK -18
Type of material: mastic- black
Location: east roof ducts (HVAC)
Area: less than 100 sq. ft.
Friable: no
Results: none detected
Sample #DK -19
Type of material: tarred gravel (1" layer)
Location: exterior flat roof- under foam
Area: throughout exterior flat roof
Friable: no
Results: none detected
Sample #DK -20
Type of material: roof felt -.-black (.21.dlaye7)
Location: under sample #DK -19
:.
Area: throughout exterior flat roof
Friable: no
- Results: none detected
Note: All asbestos containing 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
1'
Timothy S. Morrisbn
Certified Asbestos Consultant
DOSH #05-3842
(4)
EM Lab PSK
y gPSn
t;
Report for-
Mr.
or
Mr. Timothy Morrison
Aspen Tree Environmental
64969 Cotton Court
Desert Hot Springs, CA 92240
Regarding: Project: ASROB 12 #2001
EML ID: 817806
Approved by: '
Technical Manager
Miguel Ines
Dates of Analysis:
Asbestos -EPA Method 600/R-93/116: 08-19-2011
Service SOPS: Asbestos -EPA Method 600/R-93/116 (EPA -600/M4-82-020 (SOP 01264))
All samples were received in acceptable condition unless noted in the Report Comments portion in the body of the report. The
results relate only to the items tested. The results include an inherent uncertainty of measurement associated with estimating
percentages by polarized light microscopy. Measurement uncertainty data can be provided when requested_
EMLab P&K("the Company') shall have no liability to the client or the client's customer with respect to decisions or
recommends Ions made, actions taken or courses of conduct implemented by either the client or the client's customer as a result
of or based upon the Test Results. In no event shall the Company be liable to the client with respect to the Test Results except for
the Company's own willful misconduct or gross negligence nor shall the Company be liable for incidental or consequential
damages or lost profits or revenues to the fullest extent such liability, may be disclaimed by law, even if the Company has been
advised of the possibility of such damages, lost profits or lost revenues. In no event shall the Company's liability with respect to the
Test Results exceed the amount paid to the Company by the client therefor_
Document Number: 200091 - Revision Number. 5
EMLab P&K, LLC.
EMLab ID: 817806, Page 1 of 4
EMLab P&K
5555 Garden: Grove Blvd., Suite 275, Westminster, CA 92683
'(866) 465-6653 Fax (858) 569-5806 www.emlab.com
Client: Aspen Tree Environmental Date of Sampling: 08-12-2011
C/O: Mr. Timothy Morrison Date of Receipt: 08-16-2011
Re: ASR0812 #2001 iDate of Report: 08=19-2011
ASBESTOS PLM REPORT: EPA -600/M4-82-020 & EPA METHOD 600/R-93-116
Total Samples Submitted: 12
Total Samples Analysed: 12
Total Samples with Layer Asbestos Content > 1%: 0
Location: DK -1, Stucco light gray Lab ID-Versiont: 3626449
Sample Layers Asbestos Content
Light Gray Stucco ND
Sample Composite Homogeneity: Good
Location: DK -2, Exterior plaster Lab ID -Version$: 3626450
Sample Layers Asbestos Content
Gray Plaster ND
Sample Composite Homogeneity: Good
Location: DK -3, Drywall
Lab ID -Version#: 3626451-1
Sample Layers Asbestos Content
White Drywall ND
Composite Non -Asbestos Fibrous Content: 2% Cellulose
2% Glass Fibers
Sample Composite Homogeneity: Goad
Location: DK4, Texture coat white ...
'Lab.L7-Version$: 3626452-1 .
Sam le Layers Asbestos Content
White Texture Coat ND
Sample Composite Homogeneity: Good
The results relate only to the items tested. Interpretation is left to the company and/or persons who conducted the field work The test report
shall not be reproduced except in full, without written approval of the laboratory. The report must not be used by the client to claim product
certification, approval, or endorsement by NVLAP, NIST, or any agency of the federal government.
All samples were received in acceptable condition unless otherwise noted. EMLab P&K reserves the right to dispose of all samples after a
period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified.
Inhomogeneous samples are separated into homogeneous subsamples and analyzed individually. ND means no fibers were detected. When
detected, the minimum detection and reporting limit is less than I% unless point counting is performed.
$ A "Version" indicated by -"x" after the Lab ID# with a value greater than 1 indicates a sample with amended data. The revision number is
reflected by the value of "x".
EMLab P&K, LLC EMLab ID: 817806, Page 2 of 4
EMLab P&K
5555 Garden Grove Blvd., Suite 275, Westminster, CA 92683
(866) 465-6653 Fax (858) 569-5806 www.emlab.com
Client: Aspen Tree Environmental Date of Sampling: 08-12-2011
C/O: Mr. Timothy Morrison Date of Receipt: 08-16-2011
Re: ASR0812 #2001 Date of Report: 08-19-2011
ASBESTOS PLM REPORT: EPA -600/M4-82-020 &EPA METHOD 600/R-93-116
Location: DK -5, Chaulk white Lab ID -Version$: 3626453-1
Sample Layers Asbestos Content
White Caulk ND
Sample Composite Homogeneity: Good
LUCUL10n: LOW -U, l.nanlK gray wnlre Lab ill-VerSlon;: jbib4S41
Sample Layers Asbestos Content
Gra /White Caulk ND
Sample Composite Homogeneity: Good
T.nratinn• nW27 k—nn+l. —+
Sample Layers Asbestos Content
White Coating ND
Sample Composite Homogeneity: Good
Location: DK -9, Drywall mud Lab ID -Version$: 3626456-1
Sample Layers Asbestos Content
White Drywall Mud ND
Sample Composite Homogeneity: Good
Location: DK -10, Tarred gravel Lab 1D-yersion1: 3626457-1
Saenple.Layers Asbestos. Content
Black -Tar ND — _--
Sample Com�osite �olalogenei God
The results relate only to the items tested. Interpretation is left to the company and/or persons who conducted the field work The test report
shall not be reproduced except in full, without written approval of the laboratory. The report must not be used by the client to claim product
certification, approval, or endorsement by NVLAP, NIST, or any agency of the federal government.
All samples were received in acceptable condition unless otherwise noted. EMLab P&K reserves the right to dispose of all samples after a
period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified.
Inhomogeneous samples are separated into homogeneous subsamples and analyzed individually. ND means no fibers were detected When
detected, the minimum detection and reporting limit is less than 1% unless point counting is performed
$ A "Version" indicated by -"x" after the Lab ID# with a value greater than 1 indicates a sample with amended data. The revision number is
reflected by the value of "x".
EMLab P&K, LLC EMLab ID: 817806, Page 3 of 4
EMLab P&K
.5555 Garden Grove Blvd., Suite 275, Westminster, CA 92683
(866) 465-6653' Fax (858) 569-5806 www.emlab.com
.Client: Aspen Tree Environmental Date of Sampling: 08-12-2011
C/O: Mr. Timothy Morrison Date of Receipt: 08-16-2011
Re: ASR0812 #2001 Date of Report: 08-19-2011
ASBESTOS PLM REPORT: EPA -600/M4-82-020 & EPA METHOD 600/R-93-116
,ocanOn: Llt-lt, Duct mastic gray Lab U)-VersionT: 3626458
Sample Layers Asbestos Content
Gray Mastic ND
Sample Composite Homogeneity: Good
,ocation: DK -12, Parapet wall plaster Lab ID Version$: 3626459
Sample Layers Asbestos Content
Gra /White Plaster ND
Sample Composite Homogeneity: Moderate
Location: DK -13, Roof mastic black Lab ID -Version#: 3626460-1
Sample Layers Asbestos Content
Gray Non -Fibrous Material(Rubbery) ND
Sample Composite Homogeneity: Good
The results relate only to the items tested. Interpretation is left to the company and/or persons who conducted the field work. The test report
shall not be reproduced except in full, without written approval of the laboratory. The report must not be used by the client to claim product
certification, approval, or endorsement by NVLAP, NIST, or any agency of the federal government.
All samples were received in acceptable condition unless otherwise noted. EMLab P&K reserves the right to dispose of all samples after a
period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified.
Inhomogeneous samples are separated into homogeneous subs amples and analyzed individually. ND means no fibers were detected. When
detected, the minimum detection and reporting limit is less than 1% unless point counting is performed.
$ A "Version" indicated by --"x" after the Lab M# with a value greater than 1 indicates a sample with amended data. The revision number is
reflected by the value of "x".
EMLab P&K, LLC EMLab ID: 817806, Page 4 of 4
CHAIN OF CUSTODY�4;� EM Lab P&K y4 _ ASBESTOS ANALYSIS
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Btdlaft 8T Safety Division
P.O. Box. 1504, 78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
(�
Project,Address: — Q 30 �`i/r
Owner's Name:.
A. P. Nuinber.
Address: FC) ("(I L
Legal Description:
City, ST, Zip: L a QU14a c4r 70241
Contractor. i
Telephone:
Address:
Project Description:
City, ST, Zip:yyy0
Telephone:
State Lia #: City Lie. #;
Arch, Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lic. #: °
Construction Type: _ Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: k— j an
Sq, Ft.:
# Stories:
# Units:
Telephone # of Contact Person: ' Estimated value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Pilin Sets
Req'd
Recd
TRACMG PSRWr FEES
Pian Check submitted Item Amount
Structund CaIcs.
Reviewed, ready for corrections Plan Check Deposit. .
Truss Calcs.
Called Contact Person Plan Check Balance
Title 14 Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted.. Mechanical
Grading plan
Z'! Review, ready for correctionsfissue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Pians picked up Shu
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
'i° Review; ready for torreetionsAssae Developer Impact Fee
Planning Approval
Called Contact Person AA .P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees