HomeMy WebLinkAbout07-2177 (DSF)(I W"{rpwP.O. BOX ls04
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
vorcE (760) 777-70r2
FAX (760) 771-tjtr
TNSPECTTONS (7 60) 777 -7 t53
Date: 1/25/07
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant
07-00002717
46150 DUNE PALMS RD
649-040-003- -000000-
DEMO - SINGLE FAMILY
MEDIUM DENSITY RES
0
Architect or Engineer
Owner:
CITY OF LA QUINTA
18-495 CALLE TAMP]CO
LA QUINTA, CA 92253
Contractor:
EMERY LAND cLEARTNG/cnaoruc rNC
P.O. BOX 1009
THERMAL, CA 92274
(760)391-s840
Lic. No-: 500283
TICENSED S DECLARATION
I hereby affirm under penalty of perjury that I am under provisions of Chapter 9 (commencing with
Section TOOO) of Division 3 of rhe B and ls Code,License is in full force and effect.
0283Licensec2
Date:ontractor
OWNER-BUILDER
I hereby affirm under penalty of per.jury that I am exempt from the Contractor's Slate 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 structurg, prior to its issuance, also requires the applicant for the
permit Io 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 TOOOI 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 7O31.5 by
any applicant for a permit sublects the applicant to a civil penalty of not more than five hundred dollars ($5OO).:
( _ ) l, 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 through his or her own employees, provided that the
improvements are not intended or offered for sale. lf, 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.).
( _ ) l, as owner of the property, am exclusively contracting with licensed contractors to construct the proiect (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.).
{ _ ) | 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. 3O97, Civ. C.l.
Lender's Name:
Lender's Address
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 37O0 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 STATE FUND Policy Number 045115532005
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any ma to to the workers' compensation laws of California
to the workers' compensation provisions of Section
comply with those provisions.
Date:
WARNING: FAILURE TO SECURE WORKERS. CO 'ERAGE IS UNLAWFUL, AND SHALL
S UP TO ONE HUNDRED THOUSANDSUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND FINE
DOLLARS (S1OO,OOO}. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPIICANT 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 perlormed 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 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 18O days from date of issuance of such per or cessation of work for 18O days will subject
permit to cancellation.
I certify that I have read this application and state that the agree to comply with all
LQPERI\{IT
pu
is
representatives
Application Number 07-00002]-77
PermitAdditionalPermit FeeIssue Dat.eExpiration
desc
Date
DEMO PERMIT
45.00
t/21_/08
Per
PIan Check Fee
Valuation
.00
0
Qty Unit Charge Extension
45.00BASE FEE
Special Notes and Comments
DEMO TO BARE GROUND SFD
Fee summary Charged Paid Credit.ed Due
Permit Fee Tot.al
Plan Check Tot.al
Grand Tota1
45.00
.00
45.00
.00
.00
.00
.00
.00
.00
45.00
.00
45.00
LQPERMIT
Bin #
Permit
n-1
Building u Safety Division
P.O. Box I 504, 78-4gS Calle Tampico
Ia Quinta, CA922St - (T60) TTT-7O12
Building Permit Application and Tracki
City of La Quinta
ng Sheet
Project Address:t lm Owner's Name:
A. P. Number:Address:
Legal ,n-q_a_-city, sT, Zip:
It/ll.14^T
Address:0 Project Description:
Telephone:0 o o SF-
State Lic. # :00>tr Lic. #:
Address:
City, ST, Zip:
Telephone:Construction Type:Occupancy:
State Lic. #:Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:# Stdries:# Units:
# of Contact Person:
APPLICANT: DO NOT WRTTE BELOW THIS Lt NE
#Submittal PERMIT FEES
Plan Scts PIan Check submitted Item Amount
Structurrl Celcs.Reviewcd, reedy for corrections Plan Check Dcposit
Truss Calcs.Celled Contact Person Plan Check Balance
Energy Celcs.Plans picked up Construction
Flood plain plan Plans resubmitted Mechanical
Grading plan 2d Review, ready for correctionVissue
Subcontactor List Called Contact Person Plumbing
Grant Deed Plans picked up s.M.r.
H.O*4,. Approval Plans resubmitted Grrding
IN HOUSE:-'d Review, rerdy for correctionVissue Developer Impact Fee
Planning Approvel Called Contact Person A.I.P.P.
Pub. Wks. Appr Date of permit issue
School Fees
Total Pcrmit Fees
IrrIIIIIIIIIIII
HIIIrrIIII
IIIIIII
III
I
MIIIIII Electrical
TRACKING
City, ST, Zip:1
Sq. Ft:
Estimated Value
,tt CITY OF LA OUTNTA . PUBLIC WORKS DEPARTMENT GREEN SHEETPUBLIC WORKS CLEARANCE FOR RELEASE OF BUILDING PERMIT. Form updated & effective 1111112006
r al re ard to B rdi &e a e di bti WorPlease DO NOT submit the Green Sheet (public Works Clearance) packet to the Public Works Departmentuntil ALL requirements risted berow are comprete,
be processed will be returned to applicant.
lncornplete appli catlons or applications which cannot
G
Date:
Tract
Developer:rvt{"
Tract ame:J L -br, c .
Address (s):
Thefollowingare^therequirementSforPubIicWork,k.Fffi
from the Building & Safety Department:
TO HO ES OV DE MS##3 4A #B LOW
Lot No. (s):
t+v,+(
ssuance of a building
(F-
N (r-
permrt
c HOM IT s#1 4 AP CAB E A D #6 BELO
c ME IA UI GS PRO S##2 3AN #5 W
W LLS:PROV IDE I MS#7 BELOW
SIG N S: PR OVIDE ITEM s#88 ELOW
1 ' Attach Pad Elevation certificates in compliance with the approved design elevation for buildingpad (maximum allowable deviation of + i_ O..t foot). pad Elevation Certif icates must be current(within 6 months of curent datel. lf a precise grading pran "r"","" ,tr"
-f
r-Jil, approvat, preasewithhold green sheet submittar untir a pad Erevatlon certificate
"un u" p-riauu.2. Attach geotechnical certification of grading plan compliance.3' Attach recorded finar map showing propo.-"a buirding rocations are regar rots.4. Attach a compreted < 1 acre per rot or infir p'oj""t irgiiir;H;;;;i;;i;;;ject information form,PMlo plan & agreement or provide alternative & valid city approved prrrl o pl"" set referencenumber or hard copy plan. PMlo plans for commercial & residential o"rui.p.Jn," (beyond .l lot)_ are submitted separatery with grading prans & are subject to additionar ."qrliu-unt..5. Attach an approved precise griding ftan for the building location(s). AO itooJ zone developments_ will require an approved flood plain development plan.
9: tlllxl ffi '#:t'jttl il1lff"5';L::l J
n
: *:''' "
n r ocat i on (s )' t*w>> e.,n u e'rq/
B. Attach sign iuvouiip;n L related precise grading/landscape plan. lr'q6 a'/Qp t
I have reviewed and confirmed the r equirements listed above as presented and find the i mprovements tobe sufficiently complete for constru ction o the proposed buildi ngs/structures/walls/signs on the su bjectlot(s). Pursuant to my tn the bov roject may be released for building permit issuance.
Recommended by:Dated:
aoaa'
olra
ooao
aO'o
ooao
o
Public Works Distribution: t{Creen Sheet to Building & Safety counter(_) Green Sheet to Community DevelopmentDeclined for approval for reason{s) as follow(s), please correct and resubmit:
k?1'n
La inta - PM OP ct lnform on <1 re r Lot lnfill ro
Form updated & effective 8/25/2OOs
of3
I
\.,
Project lnformation
Proiect Phase
Project Contractor:
Project Name:u \.\
Project Tract
Number:
Lot Number(s):
Project Phase
(Check One):
f] Construction
ed Start Date:S-o-1
Total acres in active
construction (< I acre
per Lot):
An
*
emolition
ipat.-z
Anticipated
Completion:
O;Q
Project Street
Address:s ed
{
.\-
,+b,- (so
to- 0-wl.
Proiect Contact
lnformation
P ae NSE Deot US cot ntr o S U edr oh SUTreq da a 7 a wee kvdays
r a rd e SS cof nstoeg cru iont tusta s rSPe no ta st bed e ow S res sibn lepofordustcnootrdurnbusiSSenandnobuSensSohruS
Name:tI Ltre
Title:5
Company Name:
Mailing Address:b
City l^<-
State
Zip Code:
Primary Telephone
Number:I -Sta{o\)3
Fax:6
24 Hour
Access/Emergency
Phone:Io 3e{S-Ll-l Yb
Cell Phone:LZ3
PMlO Certificate
Number:6 - 01- l3L{{
'3' Expanded PMlo plans for commercial and residential developments ) 1 acre are required bythe City of La Ouinta.
1
unx,
24
-l
/
PM o acre _er Lot or lnfill F ve Dus Control Plan
Plan updated & effective 8/25/2OOs
e2of3
This plan shall take into account applicable scAoMD Rule 4o3 regulations. Training may be obtained bycontacting SCAOMD (sharon Zamora - phone: (9O9) 396-21g3). This plan shall consist of rhe followingaction items:
* WATERIN G:Continuous watering is required to prevent dust and must occur a minimum of 4Water shall be applied to dry soils to stop:. Visible dust emissions over 2Oo/o opacityo Visible dust emissions that travel over 10o feeto Water source % nch water meter at front (south) side of pad.
times daily.
* EDUCATION:Responsible Dust control lndividual and key personnel shatt attend scAoMD pM 1oain PM 1o certificate number prior to construction activity.
* WEATHER MONITORING: Wind predictions shall be monitored.
* SIGNAGE: Use coachella Valley Fugitive Dust control ptan
Guidelines.
Handbook Construction Site Signage
TRAFFIC: construction traffic shall not be allowed on the pad, unless absolutely necessary. lfvehicles operate on pad, pad shall be kept firm and moist through hose watering or sprinklers,Fugitive Dust shall be prevented by fencing off site to prevent unauthorized traffit on pad. fismph maximum traffic speedl.
.l PARKING: Parking is not allowed on the pad.
areas only).
* TRACK O UT:
class and obt
aoa
.|'. DIRT PILES:Dirt piles shall be limited to 5O cubic yards and built per California Buildin g Codegrading requi rements. Piles shall be kept moist or covered with tarp material.Larger dirt piles willrequire stockpile or grading perrnit.
* FENCING:
Works lnspec
hour of incide
fencing can
apply. Bloc
Provide 24 hour street cleaning and track out system as approved by City publictor. (No dirt on public or private roads). Track out shail be cteaned up within one
nt.
Provide PMlO fencing at perirneter of public roads and where applicabte. Wood slat
be installed at rear of property and retu rn 20 feet on either side if HOA restrictions
k walls can replace PMlo fencing during the construction phase.
* EOUIPMENT: Extra hoses and sprinklers shalt be maintained on site.
*AVATION SURES All areas to be excavated or graded shall be pre-watered. Water shall
be applied during excavation or grading operations also.
{. DUMP TRUCKS: Open top dump trucks to be wet down, moist and tarped prior to leaving site.
* INACTIVE SIT
required.
E:Within 1O days of ceasing of activities, re-vegetate or permanently stabitize as
All vehicles must park on street (at designated
of S c Pha 1 ent 3of3Agreement updated & effective g/25/2OOs
The siqnat ure of the propertv owner or autho rized re sentat ive):
*Shall act as his/her acknowledgement of dust control requirements and their enforceability,pursuant to AOMD Rules 403 and 4O3.1;
Shall constitute and agreement to comply with all project conditions as identified in the approveddust control plan;
*
ow ora e ative
* Acknowledges that dust control is required 24 hours a day,7 days a week, throughout the periodof project performance, regardless of project size or status;
* Shall ensure that each and every contractor/subcontractor and all other persons associated withthe proiect shall be in continuous compliance with all requirements of the approved dust controlplan;
'3' Shall take all necessary precautions to minimize dust, even if additional measures beyond thoselisted in the dust control plan are necessary;
{' shall authorize representative of the city/county to enter upon the above mentioned property forinspection and/or abatement purposes; and
t Shall hold h less the City/County and its representatives from liability for any actions related toI plan or a[y city/county initiated abatement activities.this dust o
t
Signature of o rty Ow ner or Auth Representative
,f r'
\
Printed Name
Vi
(\
DT 4r -Zq - 01
Title Date
)I('(-.[*aJ,(
Company
I
I
J
4| --,
.{ffiil#ffit-
SOUTH COAST AIR QUALITY iIANAGE]UIENT DISTRICT
NOT|F|CATION OF DEiiOLmoN OR ASBESTOS REIilOVAL 90e/3e6'2336FNt 909'39S3342
TAIL FORT AiID FEE TO SCAOilD, ASBESTOS NOTIFEANONS,F|LE # 55641, LOS ANGELES CA 9007+5641
I
AQIID USE O]{LY
NOTIFICATION #ENTERED BYSCREEil BY FOSTTARKRECETI'ED
COMPANY EMERY TSNDCLEARING
AND GRADING, INC.
PHONE: 76891-5840
COMPTETED BY
LORIEMERY V.P.
PROJECT#FEE $144.68DATE JULY 2,2007 CHECK#
Cnrcsu,motREvrsron OrHen (highlight)Rruspx DeresOruemlIIOTIFICATIOII TYPE
Onoenrp Derrctmot Rrncnrartm (removal) EwneExcv Rucvnr- Puuneo RrNo(annudlDeuounotPRO.'E TTYPE
SITE I,IAME CITY OF IA QUINTAS]trE IilFORI{ATION
CROSS STREET WESTWARD HO/t&150 DUNE PALMS ROADSITEADDRESS
COUNW RIVERSIDEaP9?2:53STATE CACITY I.A QUINTA
DESCRIBE WORK AND LOCATION DEMOLISH REMOIE AND DISPOSE OF ONE HOUSE STRUCTURE
CortcRCnL
BUILDINGSIZE(SOFr) 1,200
NUMBER OF DWEUING UNITS 1BUIIDING AGE gems) 40NUMBEROF FLOORS 1
HOUqE So{oCI- SttP Uxv0ot-rceeOFnCE R.BLEB.DG.l,bsPnAr lt{x}srRnL Otler
ADDRESS P.O. BOX 1504SITE OWNER C]TY OF I.A QTJINTA REDEI'ELOPITENT AGENCY
BLDG PROR
'
PRESEilT USE
PHONE 760m2-2322STATE CACITY I.A QUNTA
-T
I
AP gM3 CONTACT JON MCMII,IEN
BUILDING TO BE YES NO
DEMOLISHED?
ASBESTOS YES I.IO
REMOVED?
ASBESTOS YES NO
SURVEY? 'ASBESTOS YES NO
PRESENT?
REQUIRED BT'ILDI}IG
TNFORtA'roil
WORK SHIFT G!gJ. ${ing, nigh$END 84{7START 7-2ffi7PR(UECT DAIES
TOTALAtOt l{t (add row)cLASS llCI-ASS IFRIABLEASBESTOS At(xrilt To BE
REilO\rED (in square ftet)
COMPONEI.ITSPIPESSURFACESASBESTOS RETOVAL FROII
MASTICSTUCCODUCTINGFIRE PROOFINGINSUI.ATIONUNOLEUMACOUSTIC CEILINGAI[q'ilT Of EACH TYPE OF
ASBESIOS (in squarefeet)
ROOFINGTRANSITEPI.ASTERDRY WALLFL@R TIIES (VAT)
AQMD tD# 100435OSHA REG #CSLBUCENSE# 600283CONTRAfiOR IIIFORTATPN
NAME EMERY I.AI'IDCLEARING At{D GRADING, INC'ADDRESS P.O. BOX 1OO9
PHoNE 760m+9493STATE CA AP92N4 SITE SUPVR JAlvlES C. EMERY
LAilDFILL
CITY THERMAL
WASTE TRANSPORTER #t
ADDRESSADDRESS
ZIPSTATECITYAPSTATECITY
* Asbestc sun eys are Iequird prior to Dernolition and Rerpvatbn
Forms, insrrrctioni,and the Rule i+Os crrn be obtained fiom AQMD rrreb sib ffipJrww.aqmd'gov Pry1d2 FormREV20030627
I
OTHER
(&sclibe)
WASTE STORAGE S]tEWASTE TRAIISFORTER fl2
ADDRESSADDRESS
STATE zlPCITYSTATEztPCITY
co{IRoLs: DEscRtBE woRK pRAcncEs AND co}.IrRo$ To BE trsED AT THE RENovATIoN AND DEMourloN sffE Proceture
Fu asbestos renrovds 6* r1g cqntindixr d Rub 1a00 gooednes used. hocedure 4 and 5 $brnit pHE fu AQMD priff 4provd'
#1,2,3,4, SorOther
ASBESTOS ItEIEcItOil PROCEITT RE: ClRCl.E THE PROCEI)IJRES AND AI'IALYTISL MEIH@S USED TO DETERMINE ASBESTOS lN
survev. Brrlk sandlng, lnspeditm, pLM, pcM: TEM, Assurned i aroetmpncu, Dessibe offH (sEE suRVFr GUIDEUNES CHECKUST):
THE BUILDING:
FOR TIEI()I.Ifl(nE GIVE THE COMPAI.IY t.lAME AND DATES OF THE ASBESTOS REII'TOVAL N/A
FORORDEffiD TErcUNOOI
AIJTHORIZNG PER,SON:
DATE OF ORDER
SEND A COPY OF THE ORDER AND GIVE THE AGENCY I{AME & PHONE #
TTTlf
DATE ORDERED TO BEGIN:
K'R *RGErCf, ASSESIqS REIoVAL G[l/E IIf I{AIE A'{) PHO{E MNER OF I}G PERSOI DECURIIG'^I'ftOREf,C IHE BERGE}ICY' DAIE AIID }IC['R OF
EICRGaTY lrc DESCRIBE ItC gDlEt{' I.nEGECIED EvE}r:
B(PI.AIN HowTHE E\,ENrwc[,1I) cAt,sE I,NSAFE CONDITIO.IS, ECII,FIIGNT MMAGE M UNREASOMRE FII.IAI.ICIAL BI,.R[EN:
O(IIITIGEICY PUiX: DESCTTEE ACNOTISTO 8E FCII(NED F IiE}FECIED ASEEST(E S F( TD UNiG DETl(f,INO{ M ASEESIC iIAIERIAL EEC(IE
OENNEqCR[IA.O,R'LVBCE',GREDItrOTOPOIIIER
SrOp pnOiCr-m,h Cen:nrEO ASSESrOS REIIOVAI OOIIIRACTOR REIIOVE AllD DISPOSE OF.
t
business hours.
Titte d owner/operator
VICE PRESIDENT
Dale 7-247Siqatureof
andremovalthesiteonwillNESHAPbeRuleandduring403AQMDdmheanthdindividualregulatftmprwisbnsGERTIFIGATOil:TRAIIIIT|G certih/
normdtuduringwillbefrisbeenhasbypersqrfiehatffinpllsMiledlaUeevidencetainingrequired
Print nale of owner/operat
LORIEMERY
Compary Nane EMERY
I.ANDCTEARING AND
GRADING, INC.
any required ffitnents.
Ddlp- 7-247Tit$e of wner/operato
VICE PRESIDENT
NF(ntA'Ilol{ cERTFICATpil: I certify hat he above inhnndbn b cofred ap I have
Print nare d wna/oPerdor
LORI EMERY
Compaty Nane EMERY
I.ANDCTEARING AND
GRADING, INC.
DEMOUTION OR ASBESTOS REMOVAL
1,000 or less
1,001 to 5,000
5,001to 10,m0
10,001 to 50,000
50,001 to 1fi),fi)0
vry mrding to he Pnled sire.
SERVICE CI{ARGE
SPECIALI{ANDLING FEE
REVISION OF NOTIFICATION
REf URI,IED CHECK CHARGE
PI.ANNED RENOVATION
PROCEDURE4OR5PI.AN
$
$
$
$
$
t{dificatius car ncl be reded wt$Put fie requircd fee (AQMD Rule
PBe m*e drecks payde to'scAQMD'. Fees ae pef tff'ficatilm,
fees.andarefriunnotification100feetthanexemptlesssquareAsbestos301).follorc:areFeesandretrndaHe,not
ormqe
47.32
47.32$ 47.32
$ 144.68
$ 338.64
$ 531.01
$ 769.56
25.00
531.01
531.01
-.?
I
SCAOITID NOTIFICATION OF DEMOLITION oR ASBESTOS REilIOVAL
HAIL FORH A}ID FEE TO SCAOTD, ASEESTOS }IOTIFEAIpDITi, FA..E T fli6{1, LOS A}IGEI"ES GA 9M7+564I
tAtL FORX AND FEE TO: SCAQuD, ASBESTOS 1{OTlFlCATtOl{S, FILE * 55041, LOS AiTELES CA 9107{'56'll Page?of 2
Form REV 2N306n
TELEPHONE: (909) 39cR36 FAX: (9Bl3sffi342
SITE AT IITTP
FORMS, INSTRUCTIONS,AND THE RULE 1403 CAN BE OBTAINED FROM AQMD WEB
SGAQilD is hcated at21 865 E. Copby Drive, Diarurd Bar, cA 91765'4182 (9()9) 39e2000
lvID v
tained
zrs