0312-0209 (WALL)49350 Avenida Anselmo
LICENSED CONTRACTOR 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 # Lic. Class ` Exp. Date /
(AP69 BM , 05/331/2(
pate 'r - Signature of Contractor
OWNER -BUILDER D.fCLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
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.
( ) 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 & policy no. are:
Carrier STATE FUNIF) Policy No. 2211•0020N7-2003
(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 prov&stons.
Date: Applicant 't _4
Warning: Failure to secure Workers' Compensation 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 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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, 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
thabove-mentioned property for inspecti ;purposes.
Signature (Owner/Agent) • -✓ '':-iDate
1
Y
BUILDING PERMIT PERMIT#
DATE^ VALUATION LOT 0312-209 TRACT
"2 12 ' 2 2t 84,87..5.00 13819 I.Q43131
JOB SITE APN
ADDRESS 49-350 Air'KMA AN.MMO 5.-3a1 Oita
OWNER CONTRACTOR /DESIGNER / EN &NEER
PE ERRE COSIIETT
49.350 AVEIM ANSE MO
1.A (7i13N'1;A CA 92253
USE OF PERMIT
M'GFtAT. F1UiMIN'0
J.A. ;,00LAN CONMUCTI01,T
74-040 HWY 111 ?ffl
PAI AMDESERT CA 92260
r,760a340.0905 CSL4 5248
195 LP 6' WAJ. L ALONG' FWr & ui2liTH P/L PEP CITY STA.NI1.t !RD.2001
CDC.
6 Fri'. 'WALL
199,00 Lr
Eby' 113'A:1F-J LX353." OF CO S•J721'J'CHON
CONSTRUCTION FEL 10 1-01130.418-000 10211300
D Q a
DEC
.22 2003
CITY OF LA QUINTA
FINANCE DEPT.
Sibs-aMAL COl'8:r .Ur,,'T.I;O.N AIM PLAN CT-MCK
LESS PR E -PAL :► FM
4,8 75.00
$72.100
$0.00
$ 72.011
— I IIIIIII VIII III VIII IIII 54
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RECEIPT DAT t /1 By` ' DA FI = u INSPECTOR At
INSPECTION RECORD
OPERATION
DATE
' INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS s
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
BLOCKWALL APPROVALS
steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
—,�3 �� . C—
Main Drain
Bond Beam
- 2 —
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
14—
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Mste Lines
Heater Final
Water Piping
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
i
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
€4 .
CITY OF LA QUANTA
BUILDING & SAFETY DEPT.
I APPROVED
FOR CONSTRUCTION
DATE ,C� BY
�A Q,uitoT
LOOT-�3�13�.
DF L.Q,���'�47 I
195 61.1, ,=T. V/416H
(9 A,G C) rO v�lA r�tl
7? A -C (o - 13 4. � �-� TO
GL 7-,/ S i AKA` )S
r �� IIIIIIVIIIIIIVIIIIIII 55
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5
TRUCTURAL AND CIVIL ENGINEERING t. �
DENISE R. P0ELTL ER, INC.
73.661 Highway I I I Suite is 4 PoIr'n Dosed, Callicynia. 02260
x
24 September L996
r
I
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Por. Toni Hartur:g
C;1`I'Y OF LA hUINTA
78-4:95 Calle Tampico t
La, Quinta , CA 9"2543
RE: Letter of AcceptaTice
As --built Fireplace Construction ,
49.350 Avenida Anselmo, La Quanta, Country Club
Smith Remodel; DodCo Construction
Dear Mr, Hartung: �
On 1.6 September 1996, 1 observed the as -built. constructi-on of
the ti.zeplace located in the corner of the living room at the
Smith. residence. I also interviewed, the masonry coati: actor ,
:Bill, of STEVE ELLINGTON MASONRY, who verified the vertical
and horizontal rei.riforcing and lintel support steel. At the
-time of
of irty site vi�',it', the, fireplace was completed to a
heig11t O'� 91-10",
I recomr,iended two vertical reinforviixq bars at the front of
-lie fireplace be retrofitted into the new footinq and tied to
the ex=sting vertical reinforci.nq or) each side of ttir lintel
operting. The details of the fireplace are attached.
Pending completion of the retrofit :isist:alla.ti.on, I" believe
the fireplace construction is in substantial conformance with
current industry standards.
RespQctlully s fitted,
Denise R. Poeltler
R.C.E. 33446
DRP/ Im
CC, DudCo Construction
0
(„19) 7,.79-0.405 ®� FAX (619) 779-1317
r
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BY QM DATE_
73.661 NlghwtTf 1.i 1 0 SUlto 0 � CKDDATE
Palm D05erl, CaWom!a M60 _
(oi'r} 77�-405 � i�P.X tAi9► 7J9.1�17 �
PPEP.ARBD �UR:
c/yaV.p / •' � ��Af..
k�u
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4
STRUCTURAL AND CIVIL ENGINEERING
DENISE R. POELTLER, INC.
73.661 Highway 111 • Suite G • Palm Desert, Califomia 92260
15 July 1996
Mr. Mark Harold
CITY OF LA QUINTA
Building Department
78-495 Calle Tampico
La Quinta, CA 92253
RE: SMITH REMODEL
49-350 AVENIDA ANSELMO, LA QUINTA COUNTRY CLUB
Dear Mr. Harold:
I have reviewed the dead and live loads used for the design
of gang -nail roof trusses provided by A.C. HOUSTON and found
them to be in substantial conformance with my original design
loads.
Respectfully submitted,
104 /Yy
Denise R. Poeltler
R.C.E. 33446
DRP/ lm
W.O. #96-145
CC: DOD CO CONSTRUCTION SERVICES
(619) 779-0405 0 FAX (619) 779-1317
I IIIIIII VIII III VIII IIII
58
IE
I have reviewed the dead and live loads used for the design
of gang -nail roof trusses provided by A.C. HOUSTON and found
them to be in substantial conformance with my original design
loads.
Respectfully submitted,
104 /Yy
Denise R. Poeltler
R.C.E. 33446
DRP/ lm
W.O. #96-145
CC: DOD CO CONSTRUCTION SERVICES
(619) 779-0405 0 FAX (619) 779-1317
April 25, 1996
IIIIIIIIIIIIIIIIIIIIIIIII
59 "
JE
General Environmental
Management Services
Dodco Construction Services
P.O. Box 1012
La Quinta, Ca. 92253
Re: Inspection for asbestos containing materials (acm) at; 49350 Ave. Anselmo, La Quinta, Ca.
On April 15th, 1996 General Environmental Management Services (GEM Services) visited the
above referenced location to confirm or. deny the presence of asbestos containing materials
(acm) in the ceiling materials in the kitchen/family room and the master bedroom. The
inspection was requested to to the eminent demolition of the ceilings at these locations.
Our inspection revealed ceiling plaster was located in the kitchen/family room. This material
was suspected of containing asbestos. The ceiling in the master bedroom was constructed of
wood and no suspect acm was identified at this location. Three samples of the ceiling plaster
were collected in the kitchen/family room. The samples were subsequently submitted to the
laboratory for analysis by Polarized Light Microscopy (PLM) to determine if asbestos was
present and if so, to determine the percent composition in which it was present. Current State
and Federal laws and regulations classify any material that contains greater than one tenth of one
percent (0.1 %) asbestos as ACM. The sample results showed that no asbestos was detected in
the samples. .
Our findings on this project were obtained using the generally accepted practices and procedures
followed by the asbestos survey industry. The number of samples collected for homogeneous
materials may not have been in accordance with the requirements found in the EPA's A14ERA
Regulations. The inspection was performed in substantial compliance with applicable sections of
the South Coast Air Quality Management Districts (SCAQMD) Rule 1403, Asbestos Emissions
from Renovation and Demolition Activities. GEM Services cannot be responsible for
sub -surface or inaccessible materials that may not have been identified during the survey
although a reasonable effort will be made to ascertain their presence. We recommend that any
asbestos removal be performed by a contractor trained and experienced in asbestos removal
operations and who is registered with the State of California's Division of Occupational Safety
11394 Azure Ct. 9 Fontana, CA 97337 9 (800) 88(5-2'589
and Health as well as being licensed with the Contractors State Licensing Board for asbestos
removal.
We have included copies of the laboratory reports and the applicable certifications of the
asbestos building inspector for your records. This concludes our report, please call if we can be
of further assistance.
Joseph Johnson
'::k
Certified Asbestos Consultant, #92-0698
GEM Services
11394 Azure Ct. • Fontana, CA 92337 • (800) 886-2589
04 "22,,96 (17 :.52 FAX 714827(695 HI TECH ENVIRi'i`'I U )2
I
HI-TE;CH ENVIRONMENTAL AND LABORATORY SERVICES
WBE ♦ ASBESTOS # LEAD # PHASE I SITE ASSESSMENTS
PAT #10978 # NVLAP #102013 # ELAP 02073
BULK SAMPLE ANALYSIS
CLIENTIC.E.M. ENVIRONMENTAL
PROJECT:49350 AVE ANSELMO
LA QUINTA, CA
REPORT NUMBER:4C286
REPORT DATE: Argil 19, 190-6
JOB # FF06352C01
DOLITE A=ACCTINOLITE
=IIC.11E D E 7 P C, Ef)
2 . The samples l 4ted above are suspected of containing asbestos, The results of analysis ars for the sample er samples
delivered to Hi -Tech Environmental and may not represent the entire material from. whicn the sa,-iple was taken. On a negative
sample the EPA recommends three or more samples from a homogenous sampling area before it is considered non asbestos containing.
Percentages and typ3 of asbestos were determined by using the principles of polarized light microsoopj anc di5per5ion staining
using NIOSH approved Method 7403. This method is further defined in the EPA 600;M4-62-020, "Interim Method for the Determination
of Asbestos in Bulk Insulation Samples." Non -friable materials, such as floor,tile, mastic, roofing and transite do not have
prepping methodology specified in the ASTM Committee "Standard Method of Testing Asbestos containing materials by Polarized Light
Microscopy." These materials are prepped for analyses by non -documented methods. Polarized light microscopy has been known to
miss asbestos in•a.small percentage of samples which contain asbestos. Wipe samples, and floor the samples with negative
results may be further tested using SEM or TEM. Asbestos is typically ovantified using the visval area estimation technique.
This method involvk* visually comparing the asbestos versus the non asseztvs materia' present in the sample or sample layer.
This is accomplished by gross examination of homosenous slide preparations under the �h)larizetj ligtit ni•.ros:• pe, Each sample
is initially examin�d under a stereo microscope at a magnification of d to 50 times. Fibrous material r different fated based
upon morphology. P'rtions of each sample was examined under polarized light using a Nikon microscope with a hi„ Crone dispersion
staining objectivender 100 times magnification, Optical characteristics of the fibrous material were eyanined to determine
the mineralogy of he fiber. The observed optical characteristics include angle of extinction, sign of elongation, and
dispersion staining colors. None detected is only reported after a thorough search utilizing appropriate sample preparation
techniques is condu�ted•and no asbestos is detected. The result does not imply no asbestos -is present: the method is not capable
of making that determination. Rather. it implies that either asbestos is not present, or if it is, it is likely to be less than
one percent of the ,sample. All samples submitted to this laroratory facility will be disposed of, unless client specifically
+e +Me c,.htnr't camnloc ro+..rnAtl_ Hi-Tx_h must he notified at time of recelot. or there is no civarhnte*9 the samples will
CLIENT
LOCATION OF
SPECIMEN
TYPE
-.PECIMEN
SPECIMEN j
SPECIMEN
DESCRIPTION
ASBESTOS
COMPOSITION
ID
DETECTED
1 1
KITCHEN NEAR
INTERIOR
ND
CELLULOSE
HALLWAY CEILING
PLASTER
10%
I
CEILING
MINERALS
40%
BINDER
2 I
KITCHEN NEAR
INTERIOR
DID
MINERALS
DIVIDING BEAM
PLASTER
60%
j
CEILING
CEILING
BINDER
'
40%
3
DINING ROOM
INTERIOR
ND
MINERALS
CEILING
PLASTER
40%
CEILING
BiNDER
DOLITE A=ACCTINOLITE
=IIC.11E D E 7 P C, Ef)
2 . The samples l 4ted above are suspected of containing asbestos, The results of analysis ars for the sample er samples
delivered to Hi -Tech Environmental and may not represent the entire material from. whicn the sa,-iple was taken. On a negative
sample the EPA recommends three or more samples from a homogenous sampling area before it is considered non asbestos containing.
Percentages and typ3 of asbestos were determined by using the principles of polarized light microsoopj anc di5per5ion staining
using NIOSH approved Method 7403. This method is further defined in the EPA 600;M4-62-020, "Interim Method for the Determination
of Asbestos in Bulk Insulation Samples." Non -friable materials, such as floor,tile, mastic, roofing and transite do not have
prepping methodology specified in the ASTM Committee "Standard Method of Testing Asbestos containing materials by Polarized Light
Microscopy." These materials are prepped for analyses by non -documented methods. Polarized light microscopy has been known to
miss asbestos in•a.small percentage of samples which contain asbestos. Wipe samples, and floor the samples with negative
results may be further tested using SEM or TEM. Asbestos is typically ovantified using the visval area estimation technique.
This method involvk* visually comparing the asbestos versus the non asseztvs materia' present in the sample or sample layer.
This is accomplished by gross examination of homosenous slide preparations under the �h)larizetj ligtit ni•.ros:• pe, Each sample
is initially examin�d under a stereo microscope at a magnification of d to 50 times. Fibrous material r different fated based
upon morphology. P'rtions of each sample was examined under polarized light using a Nikon microscope with a hi„ Crone dispersion
staining objectivender 100 times magnification, Optical characteristics of the fibrous material were eyanined to determine
the mineralogy of he fiber. The observed optical characteristics include angle of extinction, sign of elongation, and
dispersion staining colors. None detected is only reported after a thorough search utilizing appropriate sample preparation
techniques is condu�ted•and no asbestos is detected. The result does not imply no asbestos -is present: the method is not capable
of making that determination. Rather. it implies that either asbestos is not present, or if it is, it is likely to be less than
one percent of the ,sample. All samples submitted to this laroratory facility will be disposed of, unless client specifically
+e +Me c,.htnr't camnloc ro+..rnAtl_ Hi-Tx_h must he notified at time of recelot. or there is no civarhnte*9 the samples will
n
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Contractor:. Aesthetics. Unlimited
'Client: Robert Smith
49350 Avenida Anselmo
La Quinta, CA
Proposed rock placement and waterfeature -
gunite substructure steel.doweled into existing bondbeam,
see attached engineering detail
RESIDENCE
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CARLOS ELIAS
Civil Engineer
.38825 Charlesworth Dr.
Cathedral Cig, CA 92234
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CARLOS ELIAS
Civil Engin6er
38825 Charlesworth Dr.
Cathedkal Cityy, CA 92234
(619) 32S•7271
POOL a"O D5 -L
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CONDITIONALLY
ACCEPTED FOR CONSTRUCTION
SUBJECT TO INSTALLATION AS PER
AND ALL APPLICABLE CODES
DATE "711dr-6 B0
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Cent rdctor: Aesthetics unlimiLeu 441672
Client:IRobert Smith
4930 Avenida Anselmo
La Quinta, CA
I Remodel of existing 20'x40' rectangular pool w/offset
steps - renovation and addition of spa and rock waterfeature
shaded area indicates new
gunite floor at
fi property line 4 1/2 ft. depth A
I13.9'
wall
I
equipment
pit area
I
proposed gunite
shelves 8" -10"
below water level
new skimmers,
suction lines and
return lines in
2" PVC
I
I proposed gunite spa 4 1/2'
I x 7 1/2'
j 8"dam wall, 17"bench,
utilize existing steps
CITY OF
40.0'
20. 0' FOR C•09STRU IMM
SUBJECT TO INSTALLATION AS PER
AND ALL APPLICABLE CODES
`DATE
-6 BY
!RESIDENCE
Contrd'c'tor:.Aesthetics Unlimited
Client': Robert Smith
49350 Avenida Anselmo
La Quinta, CA
Rendering.of proposed rock placement and waterfeature -
gunite substructure steel doweled into existing bondbeam
new equipment
installed in
existing vault
ll
40.0'
1; if IIGRi 1,14 ,; - I
. nmana�pGt�l1AA A poN
20.0' �U��d9 A� o -v
�'RESIDENSE
A-PTED FOR CONSTRU�-�DFum
SJQ,IECT TO INSTALLATION AS PER
I
AND ALL APPLICABLE CODES t(
BY
/�. '
DATE -71 r - - --- .,
I`
O
ll
40.0'
1; if IIGRi 1,14 ,; - I
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20.0' �U��d9 A� o -v
�'RESIDENSE
A-PTED FOR CONSTRU�-�DFum
SJQ,IECT TO INSTALLATION AS PER
I
AND ALL APPLICABLE CODES t(
BY
/�. '
DATE -71 r - - --- .,
NOT TO SCALE'- FOR ILLUSTRATION PURPOSES ONLY
I property line
F-1 �� AS 9 � 3�Ld�
� �q
pool a ui pment N S3000 31GV311ddV 11V ON
I I U 3d SV NOl TM,1SNI.01 iO3MAS
1 NO MO ISMM HOA 033MSOX
A11VNC WONO3
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1-1-114ino-vi J0 A110
11 1
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1 proposed 2" gosline to pool
equipment, approx. 1601
,
I I proposed 1" electrical conduit, 170' -
100 amp, 4- #8 THHN.
II
I1
II .
1 1 _
carport
gas meter
elect..
panel
�i CARLOS ELIAS
Civil Engineer
38825 Charlesworth Dr.
Calhedral City, CA 92234
(619) 328-7271
POOL RE,440DEL
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IN 9"D !V E w FCOOR
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