Loading...
BDEM2019-002578-495 CALLETAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: NICK NIETO 78155 CALLE ESTADO #105 LA QUINTA, CA 92253 c%4�PQw4trw DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT DEMOLITION/COMMERCIAL/OTHER BDEM2019-0025 78080 AVENIDA LA FONDA 770121005 KELSEY / INTERIOR DEMOLITION ONLY $31,200.00 0 L� OCT 0 / 2019 G YOF LA QUINTA DESIGN & DEVELOPMENT DEPARTMENT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions 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 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 sines, and Professions Code) or that he or she is exempt therefrom and the'l basis the alleged exemption. Any violation of Section 7031.5 by any applicant for a pe subjects the applicant to a civil penalty of not more than five hundred dollars as owner of the property, or my employees with wages as their sole ensation, 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' ended or offered for sale. If, however, the building or improvement is sold wit 6as one yearofcompletion, the owner -builder will have the burden of proving that hdid not build or improve for the purpose of sale.). 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 ther . 6' and who contracts for the projects with a contractor icensed pursuant to ontractors' State License Law.). I am exempt under Sec. B.&P.C. for eason CONSTRUCT19N LENDING AGENCY I hereby affirm under penalty of perjur that there is a construction lending agency for r the performance of the work fowhi this permit is issued (Sec. 3097, Civ. C.). Lender's N Lender's VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/7/2019 Owner: AARON KELSEY 78080 AVENIDA LA FONDA LA QUINTA, CA 92253 Contractor: OWNER BUILDER - AUTHORIZED SIGNEE JIMMY ABSMEIGR Llc. No.: WORKER'S 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. have and will maintain workers' compensation insurance, as required by Sect ltin 37 f the Labor Code, for the performance of the work for which this permit IS issued, workers' compensation insurance Carrier and policy number are: Carri Policy Number: l certify that in the performance of the work for which this permlt is issued, I play any person In any manner so as to become subject workers' co pensation laws of California, and agree that, if I should beco Ubject to the workers' compensation provisions of Section 3700 of the Cade, I shall forthwith comply with those provisions. App WARNING: FAILURE TO SECURE WORKERS'C PENSATI0N COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRI AL 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. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official 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 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 thZinformatlon orrect. I agree to comply with all city and countyordinances anuilding construction, and hereby authorize representatives of th above-mentione pr erty for inspection purposes. 0 �• 5lgnaturi's(Applicant or Age Application Number: BDEM2019-0025 Property Address: 78080 AVE NIDA LA FONDA APN: 770121005 Application Description: KELSEY / INTERIOR DEMOLITION ONLY Property Zoning: Application Valuation: $31,200.00 Applicant: NICK NIETO 78155 CALLE ESTADO #105 LA QUINTA, CA 92253 Date: 10/7/2019 Owner: AARON KELSEY 78080 AVENIDA LA FONDA LA QUINTA, CA 92253 Contractor: OWNER BUILDER - AUTHORIZED SIGNEE JIMMY ABSMEIGR Llc. No.: Detail: DEMOLITION OF EXISTING NON -LOAD BEARING PARTITION WALLS AND MISCELLANEOUS INTERIOR FIXTURES FOR PREPARATION OF FUTURE TI. SEPARATE PERMIT IS REQUIRED FOR FUTURE IMPROVEMENTS AND BUILDING OCCUPANCY. 2016 CALIFORNIA BUILDING CODES. DESCRIPTION ACCOUNT CITY AMOUNT DEMOLITION, INTERIOR 101-0000-42404 0 $40.25 DESCRIPTION ACCOUNT CITY AMOUNT DEMOLITION, INTERIOR PC 101-0000-42600 0 $107.87 Total Paid for DEMOLITION 2019: $148.12 DESCRIPTION ACCOUNT CITY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 F3 r AI try_; NIA — Project Addre��ss: 7 ?Oro U G APN #: 7.7}- 17, J - 0 Applicant Name: I ,' L [ +ek Address: 7 9 jr�SuC u City, ST, Zip: V Telephone: 74 0 �-(' t Email/V fC ",1c,0/1 \ � ., cam, PLAN LOCATION: Project Description: Project Valuat�on $ 22)60 Architect/Engineer Name:&J1`[-\ Vvec,ot. ❑nstruction Address: 0 /- A F Grading: City, St, Zip Telephone: C _ �J Bedrooms: Email: :�f,u Cov-1 r State Lic: City Bus Lic: Property Owner's Name: Address: 7 o At° City, ST, Zip L,,, /) Telephone: -� Email: Stories: o/d,)vn 71�14 tl� Occupancy: # Units: e New Commercial / Tenant Improvements: n Total Building SF Construction Type: Occupancy: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 U0-: OFFICE USE ONLY # Submittal ride i JCLJ Pia Required Received 1 Structural Calcs Truss Calcs i Title 24 Calcs CVWD Fire Flow Letter Soils Report Grading Plan (PM10) Landscape Plan Subcontractor List Grant Deed HOA Approval School Fees Burrtec Debris Plan Planning approval Public Works approval Fire approval City Business License about:blank P.O. Box 1504 ^ LA QUINTA, CALIFORNIA 92247-1504 BUILDING & SAFETY DEPARTMENT 78-495 CALLE TAMPICO (760) 7 77-7 012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 PROPERTY OWNER'S PACKAGE Disclosures & Forms for Owner -Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a buildin permit has ben submitted in our listing yourself as the builder of the property improvements specified at a i5 n �SL•,srnlQ yvl•!DA We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. Read and initial each statement below to signify you understand or verify this information. _t.. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. 1, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property, My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers A my pr9perry. I understand building permits are not required to be signed by property owners unless, they are responsible for the :tion and are not hiring a licensed Contractor to assume this responsibility. I understand as,an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my �i4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on puts and contracts. f understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" state and federal law. U�1 understand if I am considered an "employer" raider statc and federal law, I must register with the state and federal overnment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment mpensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial ttruct7. I understand under California Contractors' State License Law, an Owncr-Builder who builds single-family residential ures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 1 of 2 9/30/2019, 12:33 PM about:blank I understand as an Owner -Builder if 1 sell the property for which this permit is issued, I may be held liable for any i • cial or ersonat injuries sustained by any subsequent owner(s) that result from any latent construction defects in the wo ip or materials. _9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at I - -321-C (2752) or www.csib.ca.gov for more information about licensed contractors. 0. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the pa legal and financially r�ponsib)c for oposccl�, gvtistruCtiott activity at the following address: `111. IUagre'Ce]that, as the party legally and financially responsible for this proposed construction activity, I will abide by all icable laws and requirements that govern Owner -Builders as well as employers. 12. 1 agree to notify the issuer of this form immediatcly of any additions., deletions, or Changes to any of the infortttation I have provided on this torm. Licensed contractors are regulated by laws dexigned to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be rouble to assist you with any financial loss you may sustain as a result of a complaint, Your only retnedy against unlicensed Contractors may be in civil court. It is also important for you to understund that if an unlicensed Contractor or employee of that individual or firm is injurcd while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issu Nis form must be completed and signed by the property owner and returned to the agency responsible for issuing t pe mil. te..! copy of the property owner's driver's license, form notarization, or other verification acceptable to th agen is equi d e presented when the permilvj]'N'e-sl to verb the property owner's signature.Signature of property owner Date: r Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACTON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work)A 6—V/ 110 Project Location or Address Name of Authorized Agent: Address of Authorized Agei 9 1,9 PAL�s I declare under penalty of perjury that I am the pm wncr for the address listed about and I personally filled out the above information and certify its accuracy, Note• �l o , of the wner's drivers license, form noturiza 'on, or other verification acceptable to the agency is required to pre F. d whet r; it is issued to verify the pro �rl_y`.ow er', signature. Property Owner's Signature: Date: L ,N 2 of 2 9/30/2019, 12:33 PM Aaron Xehey, DDS 79W Avi?. Mida La Fond t Li Quinca. CA 922 53 949.:Fs 44h4 &., llrTc. I or Dvrri'll k A f�;,'y u. A 77T St. pq em bef 25, zu: �v GtN Os':�G ,603G A;�46011 . I�GWL vAgz � �O a 6��Z L Z 83S U INSPECTION REPORT ASBESTOS Conducted at 78080 Ave. La Fonda La Quinta, CA Prepared for Steve Nieto Prepared by MASTERS ENVIRONMENTAL INC. 44719 ALEXANDRIA VALE I N DI O, CA 92201 ASBESTOS CONSULTANT # 03-3366 — GREGORY MASTERS CALIFORNIA LEAD INSPECTOR/ASSESSOR #18638 MASTERS ENYIRONMENTAI September 25, 2019 CITY QUINTA BUILDING DIVISION REVIEWED FOR CODE COMPLIANCE DATE 4 10 t0fk4Ujej . uflLY RECEIVED SEP 2 7 2019 CITY OF LA QUINTA DESIGN AND DEVELOPMENT DEPARTMENT DATE OF SURVEY: LOCATION: MAMRS ENVIRONMEN7AL ASBESTOS SURVEY September 20, 2019 78080 Ave. La Fonda La Quinta, CA BY: Gregory Masters California Certified Asbestos Consultant # 03-3365 Masters Environmental Inc. 44719 Alexandria Vale Indio, CA 92201 760-200-2900 Survey authorized by: Steve Nieto Methods: Selected materials in the structure that were suspected of containing asbestos were sampled according to specified protocols. Samples were sent to a NAVLAP accredited laboratory, Patriot Environmental Laboratory Services, Fullerton, CA — Lab code 200358-0. They were analyzed by Polarized Light Microscopy according to Bulk Analysis Protocol EPA 600/R-93/116. The laboratory report is attached to this message for your inspection. Collection of suspect ACM's followed the National Emissions Standards of Hazardous Air Pollutants (NESHAPS) protocol for sample collection for a demolition/renovation survey. Bulk Sampling of Asbestos Bulk samples of all homogeneous materials from identified areas containing suspect JM were collected. A homogeneous material is defined as a surfacing material, thermal system insulation (TSI), asbestos -containing construction material or miscellaneous material that is uniform in use; color, texture and age of construction. As materials were identified, bulk samples were placed into individual sampling bags. Each sample was given a discreet identification number and recorded on chain -of -custody forms. Sampling Table: Sample Location Description Friable Quantity Condition Asbestos 01 Reception Drywall F TBD Good ND 02 F Good ND 03 F Good ND 04 Reception Taping F TBD Good ND 05 F Good ND 06 V V F Good ND In lieu of a diagram where samples were taken, the locations were marked on each wall with a marker. Results: All ceiling materials that were suspected of containing asbestos were sampled for analysis of asbestos content by Patriot Environmental Laboratory Services, Fullerton, CA. All samples tested negative for asbestos. Masters Environmental can find no asbestos in any of these building mateerials. Therefore REMOVAL of these ceiling materials can be done by UNLICENSED workers. p. 3 This survey was visual. Investigation requiring demolition or special testing equipment was beyond the scope of this survey. It should be understood that our findings reflect these limitations and that no warranty or guarantee is implied or expressed. We appreciate the opportunity to serve your asbestos needs, and look forward to working with you again. a Y W. No OM365 74 �9{1PgpgAA Masters Environmental Inc. 760-200-2900 44719 Alexandria Vale Indio, CA 92201 mastcrsraisonic.nct Certificate of Analysis PLM Asbestos Identification Masters Environmental 44719 Alexandria Vale Indio, CA 92201 tel - 714-899-8900 free - 888443-0998 fax - 714-899-1188 Pattlallabsom 1041 S. Placentia Avenue, Fullerton, {A 9I831 Report Number: Project Number: Project Name: Project Location: 784721 2018 PATRI& Environmental Laboratory Services, Inc. 7080 Ave La Fonda La Quinta, CA Date Collected: 9/20/2019 Collected By: Date Received: 9/23/2019 Claim Number: Date Analyzed: 9/23/2019 PO Number: Date Reported: 9/23/2019 Number of Samples: 6 Lab/Client ID/Layer Location Material Description Color Composition (%) 784721-001 Reception Drywall White 88% Non- LQ-01 Fibrous Material 10% Cellulose 2% Glass Fibers Total Asbestos None Detected 784721-002 Reception Drywall White 88% Non- LQ-02 Fibrous Material 10% Cellulose 2% Glass Fibers Total Asbestos None Detected 784721-003 Reception Drywall White 88% Non- LQ03 Fibrous Material 10% Cellulose RECEIVED 2% Glass Fibers Total Asbestos None Detected SFP 2 7 ?D19 784721-004 Reception Tapjlpg, Beige 100% Non- LQ04 UU�r�Y � OF INTA Fibrous Material DESIGN AND DEVELOPMENT DEPARTMENT Total Asbestos None Detected 784721-005 Reception Taping Beige 100% Non- LQ05 Fibrous Material Total Asbestos None Detected Page 1 of 2 I" Certificate of Analysis PLM Asbestos Identification Masters Environmental 44719 Alexandria Vale Indio, CA 92201 Report Number: Project Number: Project Name: Project Location: td - 714-899-8900 free - 888-743-0990 fax - 714.899.1188 Patriollab.com 10415. Placentia Avenue, Fullerton, CA 92831 784721 2018 7080 Ave La Fonda La Quinta, CA Date Collected: 9/20/2019 Collected By: Date Received: 9/23/2019 Claim Number: Date Analyzed: 9/23/2019 PO Number: Date Reported: 9/23/2019 Number of Samples: 6 Lab/Client ID/Layer Location Material Description Color Composition (%) 784721-006 Reception Taping Grey 100% Non- LQ06 Fibrous Material Total Asbestos None Detected Lyn Terry - Analyst - Ian Reyes - Approved By Bulk sample(s) submitted was (were) analyzed in accordance with the procedure outlined in the US Federal Register 40 CFR 763, Subpart F, Appendix A; EPA-600/R-93/116 (Method for Determination of Asbestos in Building Materials), and EPA-600/M4-82-020 (US EPA Interim Method for the Determination of Asbestos in Bulk Insulation Samples).Samples were analyzed using Calibrated Visual Estimations (CVES); therefore, results may not be reliable for samples of low asbestos concentration levels. Samples of wall systems containing discrete and separable layers are analyzed separately and reported as composite unless specifically requested by the customer to report analytical results for individual layers. This report applies only to the items tested. Results are representative of the samples submitted and may not represent the entire material from which the samples were collected. "None Detected" means that no asbestos was observed in the sample. "<I%" (less than one percent) means that asbestos was observed in the sample but the concentration is below the quantifiable level of 1%. This report was issued by a NIST/NVLAP (lab Code 200358-0) and CADOHS- FLAP (Cert. No. 2540) accredited laboratory and may not be reproduced, except in full without the expressed written consent of Patriot Environmental Laboratory Services, Inc. This report may not be used to claim product certification, approval or endorsement by NIST, NVLAP, ELAP or any government agency. Page 2 of 2 !fir CHAIN OF CUSTODY Page of tip'Only, MASTERS ENVIRONMENTAL 44719 ALEXANDRIA VALE Moot Name- Maio, CA 92201 Location: 70'30 L c, 760-2110-2900 CA Contact Phone: i�seserva �� qr� �y � D333GS -- --- --- .• ...., rc Claim #: Special Instructions: Time u (fMarcounQ NIOSH 7400A. — 72HR HR CARE 435 Ej Point Count 400 ❑ Note., -STLC. C L. WET requires a minimram of 52 hrs turnaround Point Count 1000 ❑ -TCLP requires a minimum of22 hrs tumaround Gravimetric Reductionri I -Cultma mgwrs 5-7 days fummund by Flame AA Paint, Air Cassette, Duet Wipe, Waste Water, Soils, Misc. Solids EPA 3050Bl7420mad, NIOSH 7082mod Waste Profile As neess"ry for dloposal Lj 'Note: Pleese pmvWe at least 200-5p0 grams (approx. ill -11b) wed by Flame AA of sample fornecassary analyses. -or individual tests by request- 1: TfLC Total Threshold by EPA 3050B mod 13 2: STLC/CAL WET Title 22 CCR Ch11 Article 5 App 2 [D 3: TCLP EPA 1311 SAMPLE # I LOCATION DESCRIPTION CiIANTRY CONDITfON (Print) t .7 f "l Q S ff) By: (Print) (Sion) MASTERS ENVIRONMENTAL 44719 ALEXANDRIA VALE iNDiO, CA 92201 760-200-2900 Contact Phone: 760.399-676910EL 760.200-2901 (FAX) Special Instructions: CHAIN OF CUSTODY Page of Lab use only Report Number: Project #: -z- U Proiect Name: Location:7 D ��I Q�c� �c� K�i..�^ Authorized By: PO#: Claim #: Time Rosh Same Day) �� Othar ❑ Mtos 24HR (specify): {/dbercouny NIOSH 7400A ❑ 48HR ❑ (bulk asbestos) EPA 600/R-93/116 Ga 7:2HR CARE 435 ❑ Point Count 400 ❑ ftta : 47LCICAL WETrequims a minimum of 52 hrs tumaround Point Count 1000 ® -TCLP requires a minimum of 22 hrs turnaround Gravimetric, Reductionn-Cullums require 5-7 days turnaround I by Flame AA Paint, Air Cassette, Dust Wipe, Waste Water, Sails, Misc. Solids EPA 3050BR420mnd, NIOSH 7082mod I Waste Profile As necessary for disposal * Note. Please provide at least 200-500 grams (appwx.112 -11b) wed by Flame AA of sample fornecessary analyses. -or lndlvidual Nests by r+equest- 1: TTLC Total Threshold by EPA 3050B mod ❑ 2: STLC/CAL WET Title 22 CCR Ch11 Article 5 App 2 ❑ 3: TCLP EPA 1311 �] SAMPLE 0 LOCATION •� DESCRIPTION I QUANTtTy CONDITION 0 .-L ■r L•­- 101911) ti77W Recelved By: (Print) (sign) Relinquished B : Print} (Sign)Received S : (Print) (Sign)Relinquished B y: (Print} (Sign) z LL, 0 Ul c) 0 I L, r W U 78-115 Calle Estado, Ste.105 La Quinta, CA 92253 P: (760) 564-4707 P (760) 564-4955 www.swconcepts.com TENANT IMPROVEMENTS DR. AARON KELSEY, D.D.S. 78-080 AVENIDA LA FONDA LA QU I N TA, CA 92253 APN: 770-121-005 Date / Description Number Stephen R. Nieto Date Date: 9/25/2019