04-3558 (AR)�x �F •fwQ�t«ra
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 . . . . . 04-00003558
Property Address 53945 EISENHOWER DR
APN: 774-165=024-12 -000000-
Application description ADDITION - RESIDENTIAL
Property Zoning COVE RESIDENTIAL:
Application valuation 75000 n�
Date 6/18/04
Owner- Contractor
----------------------- ------ -----
JUSTIN CARTER OWNER ' y ------
53 94 5 EISENHOWER DR07
(�U1c�iA
LA QUINTA . CA 92253 cvi y
Structure Information
W1
Construction Type TYPE V - NON RATED
Occupancy Type DWELLG/LODGING/LONG <=10
Flood Zone NON -AO FLOOD ZONE
Other struct info CODE EDITION 2001
# BEDROOMS .3.00
FLOOD ZONE NO
GARAGE SQ FTG 461.00
PATIO SQ FTG 581.00
FIRST FLOOR SQ FTG 599.00
Permit . . BUILDING PERMIT
Additional desc
Permit Fee . . . 414.50 Plan Check Fee 269.43
Issue DateValuation 50000
Expiration Date 12/18/04
Qty Unit Charge_ Per Extension
BASE FEE 252.00
.25.00 6.5000 THOU BLDG 25,001-50,000 162.50
----------------------------------------------------------------------------
Permit . . T
ELEC- ADD/ALT/REM
Additional desc
Permit Fee 45.19 Plan Check Fee 11.30
Issue Date Valuation 0
Expiration Date 12/18/04
Qty. Unit Charge Per Extension
BASE FEE 15.00
599.00 :0350 ELEC NEW RES - 1 OR 2 FAMILY 20.97
461.00 .02-00 ELEC GARAGE OR NON-RESIDENTIAL 9.22
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
ineer:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760)'777-7153
Date:
ineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that 1 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 License No.
Date Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or.that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
e applicant to a civil penalty of not more than five hundred dollars ($500).):
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. fo is son
r ' dof�h WORKERS' COMPENSATION(QECLARATION
affirm hereby arm under penalty of perjury one a 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 Policy Number
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 sh Id become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
,forthwith comply with those provision1_�')
WARNING: FAILURE TO SECURE WORKOW COMPENSATION COVERAGE IS UNLAWFUL, 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.).
Lender's Name
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnity 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 correct. 1 agree to comply with all city and county ordinances and state laws relating to building
construction, and hereauthorize representatives of this county to ent upon the above -me ntio properlyfor inspection purposes.
ate �/ ignature (Applicant or Agent):
Fee summary Charged
----------------- ----------
Permit Fee Total 645.69
Plan Check Total 327.24
Other Fee Total 31.94
Paid Credited Due
---------- ---------- ----------
.00 .00 645.69
.00 .00 327.24
.00 .00 31.94
Page
2
Application Number .
. . . . 04-00003558 Date
6/18/04
----------------------------------------------------------------------------
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee . . . .
85.50 Plan Check Fee-.
21.38
Issue Date . . . .
Valuation . . . .
0
Expiration Date
12/18/04
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 9.0000
EA MECH FURNACE <=100K
18.00
2.00 16.5000
EA MECH B/C >3-15HP/>100K-500KBTU
33.00
2.00 6.5000
EA MECH VENT FAN
13.00-
3.001.00
1.006.5000
EA MECH EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit . . . . . .
PLUMBING
Additional desc
Permit Fee . . . .
100.50 Plan Check Fee
25.1.3
Issue Date . . . .
Valuation . . . .
0
Expiration Date
12/18/04
Qty Unit Charge
Per
Extension
BASE FEE
15.00
5.00 6.0000
EA PLB FIXTURE
30.00
6.00 6.0000
EA PLB ROOF DRAIN
36.00
1.00 7.5000
EA PLB WATER HEATER/VENT
7.50
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
3.00 3.0000
----------------------------------------------------------------------------
EA PLB GAS PIPE 1-4 OUTLETS
9.00
Special Notes and Comments
ADD MASTER BED AND BATH
RASIE ROOF
ENTIRE HOSUE. THIS PERMIT•DOES
NOT
INCLUDE BLOCK WALL, POOL
AND SPA OR
DRIVEWAY.APPROACH.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . ENERGY REVIEW FEE
26.94
STRONG MOTION (SMI) - RES
5.00
Fee summary Charged
----------------- ----------
Permit Fee Total 645.69
Plan Check Total 327.24
Other Fee Total 31.94
Paid Credited Due
---------- ---------- ----------
.00 .00 645.69
.00 .00 327.24
.00 .00 31.94
Page 3
Application Number . . . . . 04-00003558 Date 6/18/04
Grand Total 1004.87 00 .00 1004.87
+A _ ,
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City of La Quinta
Building ez Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit
��
D
Project Address:
i S J� l 5•enk
Owner's Name:
A. P. Number: -1— ��5 --0-2
Address: L y
Legal Description:
City. ST. Zip:
Contractor: bw(\Q� %�l�(
FTelephone:
Address:
Project Description: , l 6 ��— n� e"r
City, ST. Zip:
tI
— 0i
Telephone:
State Lic. # :
City Lic. #:
Arch.. Engr.. Designer:
Address:
City. ST, Zip:
Telephone:
'=G'^,_- .... -
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo'
Name of Contact Person:' S
Sq. Ft.:
#Stones:
#Units:
Telephone # of Contact Person:
stimated Value of Proiect: . D ON U ,
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Z
Plan Sets
Pian Check submitted
Item
Amount
Structural Calcs.
Reviewed. ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
-Abnergy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review. ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
GrAnt Deed
picked up
SAI.t.
H.O.A. Approval
[P1211S
s resubmitted
Grading
IN HOUSE:-
eview, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Y((6�� Cin/ /1Q,G�to'r Of" T7wsSC� � �Na � v ryv,vZ [aF ,..o tn.ss �'% y-ZI Sr�� gn.rvay J
yjzi/s y sr�uc.� Q �eouz D � tIff" r/&
T/s S4 -R t�u� R FI✓
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patioskvalkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.24 X 599 S.F. or $1,341.76 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 Cash - Justin Carter Check No.
Name on the check Telephone
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected 1e*empted/W S
N Payment Recd
$1,341.76
So.00
Over/Under
NOTICE: Pursgp6t to Government Code Secti n 66030(d)(1), this will senMo notify you that the 90 -day approval period in which you may protest the fees or
other payment4dentified above will begin to run he date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the DistnctCs) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building DepartmenUApplicant - Copy - Applicant/Receipt Copy - Accounting
ZrCURDING REQUESTED BY:
Stewart Title Guaranty.
WHEN RECORDED MAIL TO:
JUSTIN CARTER
53945 Eisenhower Drive
La Quint&, California 92253
ORDER NO. 501228577
ESCROW NO. 30- l 02221 LS
APN. 774-165.024
U II PAGE I SIZE I DA I PCOR I NOCOR I SMF I MISC.
COPY 1 LONG I REFUND I NCHG I EXAM
GRANT DEED .7741- 16 -' - 011�1-
THE UNDERSIGNED GRANTOR(s) DECLARE(s): t� d 0/
DOCUMENTARY TRANSFER TAX.is: $193.60 CITY TAX
❑ Monument Preservation Fee is:
❑ computed on full value of property conveyed, or
-AM --- computed on full -value -less -value ofliens..or-encumbrances remaining -at time of -sale.__.
❑ Unincorporated area: ® City of La Quintet
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Linda R. Laird, as Trustee of the Linda R. Laird Living Trust dated October 19, :1998
hereby CRANT(S) to
Justin Carter, AN UNMARRIED MAN
the following described real property in the City of La Quints, County of Riverside, State of California:
LOT 11 AND 12 IN BLOCK 246 OF SANTA CARMELITA AT VALE LA QUINTA UNIT NO, 23, AS SHOWN BY MAP
ON FILE IN BOOK 20, PAGE 25 OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA.
DATE: May 27, 2003
STATE OF CALIFORNIA
On it 3 before me'
'
person Uy a ej ed
personally known to me (or proved to me on the basis of satisfactory
evidence) to be the person(4, whose name() is/are subscribed to the
within instrument and acknowledged to me that4w_/she/+ey executed
the same in hWherAt eir authori2ed capaclty(les), and that by
his/her/thair signature() on the instrument the person($) or the entity
upon behalf of which the person acted, executed the instrtunent.
�mammmcr.®
��.. .� OFFICIAL SEAL
JANE M. REILLY
NOTARY PUBLIC- CALIFORNIAm
co t COMM. NO.1279794
SAN DIEGO COUNTY
WITNESS my d and offic�i�Jal'lsea�l. •• MY COMM. EXP. NOVA, 200s
Signature / /4e(This arca for official notarial scap
MAIL AxSTATE A3 D,,,CTED ABOVE
2003-426182
2 0308
■ M mm"Ma M
Son _ZITLI�
Ifto%wo'"
LABORATORIES
2033 Heritage Park Drive / Oklahana City, OK 73120 / (405) 756-7272 / Fax (405) 7552058
Polarized Light Microscopy Asbestos Analysis Report
QuanTEM Lab No.
111756
Account Number.
A050
Date Received:
04/30/2004
Received By:
Michelle Bailey
Date Analyzed:
04/30/2004
Analyzed By:
Joe Melton
Methodology:
EPA 600
QuanTEM Client
Sample ID Sample ID Composition
Melton, Analyst
Client: Master Search, Inc.
Cash Account
44719 Alexandria Vale
Indio, CA 92201
Project:
Project Location:
Project Number.
Color /
Description
53945 Eisenhower
La Quinta, CA
1030
Asbestos (%)
4/30/04
Date of Report
Non -Asbestos
Fiber (%)
QuanTEM is a NVLAP accredited TEM and PLM laboratory (Lab Code: 101959). This report relates only to the specific items tested NVLAP
accreditation applies only to AHERA analysis [40CFR Ch. 1 (1-1-97 ed) Part 763, Appendix A to Subparts E and F)., This report may not be used
to claim product endorsement by NVLAP or any other agency of the US GovemTei* This report may not be reproduced except in full, without
the written approval of the laboratory.
Page 2 of 2
1VIay 3,� 200,4 � , • � � � .. ,
'�y..•:. +,+y i:3ra ':'�.''a.:r;.. %F,',"t l.f:�m.i� ct S �:'y' do � ., .11.;• �'"
:.,�.. - .� i+. .. i;» i+ !Y 'ii �3': a+. -. si. ,^ t r• V, .�,
53945 Eisenhower "
31, ,t > E LajOuinta.,-CA., 92253
FROM: Master Search Inc.
44719 Alexandria Vale
Indio, CA 92201
RE: . Asbestos Survey
Justin Carter:
On April 29; 2004, at your request, Master Search Inc. performed an asbestos
survey on the single. family, residence at 53945 Eisenhower, La Quinta, CA.
Gregory Masters, .Certified: Asbestos Consultant # 03-3365, inspected the building
materials in the structure -that were scheduled for removal, and sampled those that
could contain asbestos. The sampling was performed according to current
:sampling, uidelines and mandated procedures. Accordingly, three samples were
taken in each homogeneous area.
These samples were sent to Quantem Laboratories, a NAVLAP certified laboratory,
for analysis by PLM (Polarized Light Microscopy). The laboratory report is attached
to this letter for your inspection.
Conclusions: (1) The drywall joint compound ("mud") used in the ceiling and walls
of each room contain asbestos. In this case, the amount of asbestos is less than 1%, but
still present, and able to present a danger to the person who removes it, as well as a
possibility of contaminating the rest of the structure, and being hazardous to the other
occupants. (2) The gray 9" floor tiles contain asbestos, as does the black mastic under
them.
Recommendations: As an owner/builder, you are permitted to remove the asbestos
containing materials yourself alone. If anyone assists you, even unpaid, it is a whole
new situation. (1) You must protect yourself with at least a negative pressure
respirator having the proper filters. (2) You must wear a protective overgarment
"bunny suit" to prevent contamination of your clothes. (3) You must isolate the removal
area with plastic/duct tape walls and floors. (4) Air that is exhausted from the removal
area must pass through a HEPA filter ----otherwise the surrounding property and
neighbors could be contaminated with asbestos fibers. (5) During the removal
process, the work site should be liberally misted with water to keep fiber levels in
the air under control. (6) Asbestos containing debris and plastic isolation materials
should be bagged in 6 mil transparent plastic bags, and transported to a hazardous
materials dump.
Mr. Carter, good luck on the completion of your project. If I can answer any questions
you might have, please call me at 760-200-2900.
No guarantees are given or implied.
Sincerely,
Gregory Mastrs
Master Search Inc.
760-200-2900
gESTOS C
\�Q OPY s
W. 'IitP
W
U No. 03-3365 -A
�NOF�V,'
iq
M I.�
FOIL
LABORATORIES
2033 Heritage Park Drive / Oklahoma City, OK 73120 / (405) 755-7272 / Fax (405) 755-2058
Polarized Light Microscopy Asbestos Analysis Report
QuanTEM Lab No. 111756 Client: Master Search, Inc.
Account Number. A050 Cash Account
44719 Alexandria Vale
Date Received:
04/30/2004 Indio, CA 92201
Received By:
Michelle Bailey
Date Analyzed:
04/30/2004 Project: 53945 Eisenhower
Analyzed By:
Joe Melton Project Location: La Quinta, CA
Methodology:
EPA 600 Project Number. 1030
QuanTEM
Client Color/
Non -Asbestos
Sample ID
Sample ID Composition Description Asbestos (%)
Fiber (%)
001
001-001 Homogeneous White Asbestos Present
Cellulose 15
Joint Compound Chrysotile <1
002
001-002 Homogeneous White Asbestos Present
Cellulose <1
Joint Compound Chrysotile <1
003
001-003 Homogeneous White Asbestos Present
Cellulose 20
Joint Compound Chrysotile <1
004
002-004 Layered Gray Asbestos Present
NA
Floor Tile Chrysotile 3
004a
Black Asbestos Present
NA
Mastic Chrysotile 10
005
002-005 Layered Gray Asbestos Present
NA
Floor Tile. Chrysotile 3
005a
Black Asbestos Present
NA
Mastic Chrysotile 10
006
002-006 Homogeneous Gray Asbestos Present
NA
i
Floor Tile Chrysotile 3
QuanTEM is a NVLAP accredited TEM and PLM laboratory (Lab Code: 101959). This report relates only to the specific items
tested: NVLAP
accreditation applies only to AHERA analysis [40CFR Ch. 1 (1-1-87 ed.) Pan 763, Appendix A to Subparts E and F]. This report may not be used
to claim product endorsement by NVLAP or any other agency of the US Government This report may not be reproduced except in full, without
the written approval of the laboratory.
Page 1 of 2
I
I
j
the/ jqly� 1).mWre�
STRUCTURAL AND CIVIL ENGINEERING
DENISE R. POELTLER, INC.
73.661 Highway 1.11 •` Suite G Palm Desert, California 92260
www.theflyingbuttress.com
03 June 2004
Mr. Tom Hartung, Building Director.
CITY OF LA QUINTA
Department of Building and Safety
78-495 Calle Tampico
La Quinta, CA 92253
RE: CARTER REMODEL
Job Site Address: 53=945 Eisenhower Drive
Subject: Truss Acceptance Letter
Dear Mr. Hartung:
I have reviewed the total deflection, live, dead, and drag loads used for the design of the
.gang -nail roof trusses prepared by TRUSSWORKS (dated 6-04-2004), and found them
in substantial conformance with my original design loads.
Respectfully submitted, '
- OQROFESS/pN
Q� SER. P.D.o_'9f„
Denise R. Poeltler
R.C.E. 33446
W.O.. 04-123
cc: Mr. Justin Carter, Homeowner
(760) 779-0405 0 FAX (760) 779-1317