The URL can be used to link to this page

04-6134 (DEMO)H Lit Q•� BUILDING & SAFETY DEPARTMENT Dlr"�w� P.O. Box 1504 (760).777-7012 `OF7874.95 CALLE TAMPICO FAX (760) 777-7011 CITY i�A Qu I7 QUI;NTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 FINAt�e t)rPT. BUILDING PERMIT y 1 Application Number 04-0-0006134 `.Date 9/02/04 Property Address . . 8�"��OQ -"- HI • SHINNECOCK_HILLS APN: 762 -350 -016 -- Application description . . . DEMO - COMML/OTHER Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation 0 Owner Contractor CRV GOLF WEST EMERY LAND CLEARING & GRAD INC C/O ALEX Z.IKAKIS P.O. BOX 1009 9255 TOWNE CENTER DR 520 THERMAL CA 92274 SAN DIEGO CA 92121 (760) 391-5840 WCC: STATE FUND WC: 04611653 04/12/05 �. CSLB: 600283 11/30/05 CCC: C21 ----------------------------------------------------------------------------- Permit. . . . . . . DEMO PERMIT Additional desc-. Permit Fee . . . . •45.00 Plan Check Fee.. .00 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 45.00 Special Notes and Comments DEMO TO BARE GROUND EXISTING COMFORT STATION AT S.E. CORNER OF SHINNECOCK HILLS & BLACK DIAMOND Fee summary Charged --------------------------- Paid Credited Due Permit Fee Total 45.00 ------------------------------ .00 .00 45.00 Plan Check Total .00 .0.0 .00 .00 Grand Total 45.00 .00 .00 45.00 P.O. Box 1504• �� VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-701 1 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number. &134 Date: �' o;2 - O Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: A)/P 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 Code, and my License is n full force and effect. ' - �� /License Clals ----�s�� icense No. Date` VX) , 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 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 1 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. . R I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfonnance of the work for which this permit is issu My w ers' compensation m nce carrier and polity rtIber are: �arrier �i/l r olicv Number (') t0 _ I certify that, in the performance of the work for which this permit is issued hall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and a ree 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. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS 8NLAWFUL, 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, indemnify and hold harmless the City of La Ouinta, its officers, agents and employeesfor 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 becoMente 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 c I certify that I have read this application and state that the above s co ct. I agree c mply with all city and county ordinances and state laws relating to building construction a d h fifiby authorize representatives of this cou n a abo - enti property for inspection purposes. U nature (Applicant or Agent): 4 y 1 1� City .0 La',Qutn, ta Developers PM -10 Approval Form: .. Prior to the issuance of a Demolition Permit for the project listed below; Public Works approval must be obtained. Please returnthis form to the Building and Safety Department only after approval. Project Address: 81- 160 JNIAI;V &COC16 Applicant Name/Phone#: UL4 Scope Of Work: o . S k co V-1�or �acc, ' To limit dust at this jobsite I will: Maintain Adequate Watering at all Times. Prevent Trackout Tarp All Vehicles Removing Debris from Site -Limit Work in High Wind Conditions are 0_�_ w�c C 0 Public Works Pepartn*nt Approval is I -IJ• AL&K. and, Senior Engineer granted. r -I �;D_o SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT NOTIFICATION" OF DEMOLITION OR ASBESTOS REMOVAL MAIL FORM AND FEE TO SCAQMD. ASBESTOS NOTIFICATIONS_ RLE # S58L1_ LOS ANGFLF9 CA emMraAl AQMD USE ONLY, SCREENBY ,' RECEIVED P.O$TMARK ENTERED BY} NOTIFICATION #. COMPLETED BY COMPANY EMERY IANDCLEARING PHONE 760/3915840 LORI EMERY V.P. AND GRADING, INC. DATE 8118104 CHECK # I S Qj q FEES 36.90 PROJECT # NOTIFICATION TYPE ORIGINX REVISION DATES REVISION OTHER (Iligl fiA CANcEuATION PROJECT TYPE Dglpl/i10N ORDERED DBmurm RENOVATION ftffoval) EAuGENCY REMOVAL P ANNED RENO (amuah SITE INFORMATION SITE NAME PGA WEST PADASERA PROPERTY SITE ADDRESS WEISKOPF GOLF COURSE /LEGEND ENTRANCE CROSS STREET MADISON STREET CITY LA QUINTA STATE CA ZIP 97253 COUNTY RIVERSIDE DESCRIBE WORK AND LOCATION DEMOLISH REMOVE AND DISPOSE OF 1 COMFORT STATION BUILDING -ON GOLF COURSE BUILDING SIZE (SQ FT) 800 NUMBER OF FLOORS 1 BUILDING AGE (YEARS) 15 NUMBER OF DWELLING UNITS 1 BLDG PRIOR I PRESENT USE Cmaoa& HOSMAL INDUSTRIAL 06W OIC PUM BI G, HOUSE SOM SHIP UwwCouECE SITE OWNER CRV GOLF WEST, LP ADDRESS 5140 AVENIDA ENCINAS CITY CARLSBAD STATE CA ZIP 92008 CONTACT GREG CAROL -ASHBROOK PHONE 7602655380 REQUIRED BUILDING MFORIIATiON ASBESTOS YES NO PRESENT? ASBESTOS ESS NO SURVEY? ' ASBESTOS YES NO REMOVED? BUILDING TO BE YES NO DEMOLISHED? PROJECT DATES START -9/1/04 END 920104 WORK SHIFT@n swing, nigh ASBESTOS AMOUNT TO BE REMOVED (m square feel) FRIABLE CLASS I CLASS II TOTAL AMOUNT (add IoW) ASBESTOS REMOVAL FROM SURFACES PIPES COMPONENTS AMOUNT OF EACH TYPE OF ASBESTOS (in square feet) ACOUSTIC CEILING I LINOLEUM INSULATION I FIRE PROOFING DUCTING STUCCO MASTIC FLOOR TILES (VAT) DRYWALL PLASTER I TRANSTTE I ROOFING OTHER (desabe) 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 760/774-9493 WASTE TRANSPORTER #1 LANDFILL ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP Asbestos survevs are required prior to Demolition and Renov.s ion SCACMD NOTIFICATION OF DEMOLMON 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 WOR( PRACTICES AND CONTROLS TO BE USED AT THE RENOVATION AND DEMOLITION SITE. Procedure # 1, Z. 3, 4, 5 or Dow. For asbestos removals cele the combination of Rule 1403 procedures used. Procedure 4 and 5 submit plans for AQMD Fria' approval. ASBESTOS DETECTION PROCEDURE: CIRCLE THE PROCEDURES AND ANALYTICAL METHODS USED TO DETERMINE ASBESTOS IN THE BUILDING: Survey, Bulk Sw#jng, Inspection, PLY PCM, TEM, Assumed as A bestir PACM, Describe Ober (SEE SURVEY GUIDELINES CHECKLIST): FOR DEMOLITIONS GIVE THE COMPANY NAME AND DATES OF THE ASBESTOS REM(IVAL: FOR ORDERED DEMOLITION SEND A COPY OF THE ORDER AND GIVE THE AGENCY NAME & PHONE # AUTHORIZING PERSON: TITLE DATE ORDERED TO BEGIN: DATE OF ORDER FOR ICY ASBESTOS FOWAL GNE TW NAME AND PHONE NUMBER OF THE PERSON DECLARR"ALITHORONG THE EMERGENCY, DATE AND HOUR OF EMERGENCY AND DESCRIBE THE SUDDEN, UNEXPECTED EVENT: E)MN HOW THE EVENT WOULD CAUSE UNSAFE CONDITIONS, EQUIPMENT DAMAGE OR UNREASONABLE FINANCIAL BURDEN: OONTINGMY PLAN: DESCRIBE ACTIONS TO BE FOLLOWED IF UNEXPECTED ASBESTOS IS FOUND DURING DEMOLITION OR ASBESTOS MATERIAL BEGONE DISTURBED, CRUMBLED, PULVERIZED, OR REDUCED TO POWDER. STOP PROJECT HAVE CERT►FIED ASBESTOS REMOVAL CONTRACTOR REMOVE AND DISPOSE OF. TRAWJG (ERTIFICATM 1 oeft frac an individual haired in V e provisions of AQMD Rule 1403 and NESHAP will be on sile durirrg the removal and e kbrnce that fhe required Raining has been accorrW ed by ft Person wi be ramal business hoes. Canpany Name EMERY Print name of owner/apemt S 1i++e d l tar Tillie of owner/operator Date 8/18104 _ LANDCLEARING AND LORI EMERY GRADING, INC. CE PRESIDENT NMORMATION CE R I F CATION: I certify fist tfre above infonrmth is carect and I have enclosed any required altadmenls. Canpeny Narne EMERY Print name of owlerloperator Soni re of amen/operator Tittle of owner/operator Date 8f 18104 LANDCLEARING AND LORI EMERY VICE PRESIDENT GRADING, INC. No -; lions can not be aooepled wM" #m reglied fee (AEW Rule 301). Asbestos rernorals of I= #= 100 square feet are exempt from natMCation and fees. Please make checks payablei) =AQMID'. Fees are per notilicabon. not refirrdalk. and vary ww tbg to the project site.. Fees are as foNous: DEMOLITION OR ASBESTOS REMOVAL PROCEDURE 45 SERVICE CHARGE S 3650 1,000 a less E 36.9_0 $ 45021 SPECIAL HANDLING FEE $ 1,001 b 5.000 $ 112.80 $ 526.81 REVISION OF NOTIFICATION 5,001b 10,000 $ 264.03 $ 878.04 RETURNED CHECK CHARGE S 2928 10,001 b 50,000 $ 414.01 S 828.02 PLANNED RENOVATION $ 408.38 50.001 b 100,000 $ 600.00 $1,014.01 100.001 or more $1,000.00 51,414.01 MAIL FORM AND FEE TO: SCAQMD, ASBESTOS NOTIFICATIONS, FILE # 55641, LOS ANGELES CA 900745641 Page 2 of 2 TELEPWiE: (909) 30&= FAX (909) 3963342 Form REV 20030627 FORMS, INSTRUCTIONS, AND THE RULE 1403 CAN BE OBTAINED FROM AQMD WEB SITE AT HTTP : //WWW . AQMD. GO V CPArwn c. r—.A-A .+ 1)40= a uric.. rr;tm Marmnrf tier PA 0476x A4W) ronei %Oa 'Y= 09/22/2002 00:54 7603915839, A-1 Cesspool service,, Inc. P.O. Box Sol" Tform Palm sprinm CA ms"Im (760) 329-875 FAX 2.51-340 MLS TO EMay Land0eartng P.4. Box 1009 Thema!, CA 92274-1.009 EMERY TERM Due on recpt DESCRiP'MN Pmnpc. Tank, 2000 gallons on 9/7/04 Fuel Sur Chmp POSW F2x Note 787t TO / Yir7iis I PAGE 02 02 PAGE 01 Invoice DATE WMCE NO. 9/8/2004 10593 PROJECT 81165 Sb=eeftk Hilts, LQ AMOUNT 294.00 8.00 Total $298.00