HomeMy WebLinkAboutRIVERSIDE DRIVE 32281_04-00002093 A!
CitV of Lake Elsinore
200
PERMIT -_,---f`-130 South Main Street
PERMIT NO: 04-000020931 DATE: 8/17/04
JOB ADDRESS . . . . . : 32281 RIVERSIDE DRf
DESCRIPTION OF WORK . : DEMOLISH ALL OTHERS
OWNER CONTRACTOR
LEE JOHN ENVIRONMENTAL CONTROL
3564 CENTRAL AVE
RIVERSIDE, CA 92506
909-788-1483
LIC EXP 0/00/00
A.P.# . . . . . . 379-315-033 0 SQUARE FOOTAGE 0
OCCUPANCY . . . . GARAGE SQ FT 0
CONSTRUCTION FIRE SPRNKLR
VALUATION . . . . 1, 000 ZONE . . . . . R-3
DEMOLITION PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 30 . 00
1 .00 X 30.0000 DEMO PERMIT PER UNIT 30 . 00
1 .00 X 5.0000 PROFESSIONAL DEV FEE 5 . 00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
DEMOLITION PERMIT 65.00 .00 65 . 00
OTHER FEES
PLAN RETENTION .FEE . 01 . 00 . 01
PLAN RETENTION FEE 3 .49 .00 3 .49-
TOTAL 68.50 .00 68 . 50
SPECIAL NOTES & CONDITIONS
DEMOLITION OF EXISTING SPA STRUCTURE.
ALL ASBESTOS MATERIAL HAS BEEN REMOVED
PER SCOTT MORRISON AND ASSOCIATES
REPORT.
AUG 16 2004
City Of Lake Elsinore
Building Safety Division please Read and Iniflal:
I. I am Ucensed under the provisions of Business and Professional
Code Section 7000 et seq.and my license is In full force.
Post in conspicuous place s. i,as owner of the property,or my employees w/wages as their sole
compensation will do the work and the structure is not intended or
on the job offered for sate. -
3.-1,as owner of the property,am exclusively contracting with licensed
contractors
You must furnish PERMIT NUMBER and the 1 havea ce construct the project r
_ 4. I have a certificate of consent to edtlnsure or a certificate of Workers
JOB ADDRESS for each respective inspection: compensation Insurance or a certified copy thereof.
Approved plans must be on job 5.•l shall not employany person in any mannersonstobecomeaubject
PP P ) to Workers Coompensstlon Laws in the performance of the work for
at all times: which this permit is Issued.
Note: If you should become subject to Workers Compensation after
making this certl8ratlon,you must forthwith comply with such pro-
visions or this permit shall be deemed revoked.
J
ovals Date Inspector
T Elec Services
Soil PI UrMergmund
Elec Conduit Underground
Vol Footings
SP02 Steel Reinforcement
BP03 Grout.
BP04 Slab Grade
PLOt Underground Water Pipe
SS01 Rough tic System
SW01 On Site Sewer
EIP05 Floor Joists
BPQ7 Roof Framing
BPQ8 Roof Sheathing
RPn9 Show Wall A Pro-Lath
EL04 Rouah Electric-Wiring
EL05 Rough Electric-T-Bar
ME01 Rough Mechanical
ME02 Ducts,Ventilaft
PI.04 Rauch Pipe-Test
BP12 Insulation
BP13 Drywall Nailing
B1311 Lath &Siding
PL99 Final PlumbkV
EL99 Final Electrical
ME99 Final Mechanical
BP99 Frnal Building
Cade Pool&Spa Approvals Date Inspe`t& OTHER DEPARTMENT RELEASES
Department Approval required prior Io the
P001 Pool Steel Rein./Forms bang being released by ft Gity
P001 Pool PlurnbinWPross.Test
P003 Pre-Gunite
Date Inspector
EL06 Rough Pool Electric
Planrdng
Sub List Approval
_ Landsce
P004 Pool Fend Access Fi
nanoe
P005 I Pre-Plaster
Engineering
P009 I Final Poo
-City of .Lake E s•1no,re.
_
130 South Main Street 4Ci9 e 'AC #2-5ydgy6
APPLICATION FOR "0'
BUILDING PERMIT, Lo1wcY �E.Rs s 04 20q.3
- _--.. 11S.- (E-t1�9 -T';t � �i199 UT ISM(P- W Sec 2 o FICA
T .�7.I0�}
(oS'
VALUATIGN•CACCULATIONS Apo 3 71 -3/S - D 3 3• er Q�!
twiwa+ .
�r7000. c"°°ass 1�
i:1.RooR -r---SF 322B/ iD� � 111or K'C� .�
2rnd FLOOR SF r�wtt uoalxwcE abta uael
3rd FLOOR
'GARAGE
STORAGE --------SF
DECK 8 84CONIES SF
OTHER:
163oi:l 644.o:7 of+..0.:4....:•.d-r w—*;wm t:.i.•tine.wt 4r wY..xin t:A t«�
00
VALUATION: .,
FEES r,w�tr.c
BUILDINGPERMiT $ a"V- 19Iv SWMIE ZO
PLAN•CHECK
ADDITIONAL PLAN CHECK
GRADING PLAN CHECK � wooass
< OFT StAtE.Zlp IfWt+f
i]NEW 17REPAI1tOtt
a. SIbN=• TYPE '_
MICRORLM :3AOOITION biAbVE NU e. Of "H-MB 'OF
-� stb IES:. EOR<'jOMS;
0ALTERATPH ',DEMOLISH
-COPIES L.OTt1ER _ ' ' ZONE_
L?Stik- E•fAliAllYARQ/►11EI1? - YES NO
ihW90 FEES O SCHOOL FEES O L.APARTMENTS'" units _ -
:.CONOOWNIUMS "is SPRINKLERSREwitEO? YES NO.
.-.TOWNNOAKES r units PrtOPo EtialSE OIL BtllLQil+G:
� �NOUSTRIAI PRESFNT USES#BIIILQING_
PAID
DATE
JOB DESCRIPTION
13 J cerwr lliat 1 ha"rend this op�lion andstate'thot the
abo WoMiatio.i is correct.I ogree to compllr wfth off ci f
And.cowft ocd2noncei.and store fd.vs r'elatin§ to b"Icang
eoasswcliop. w4 hprebp ovtoilce iepresensadiaes of-this
day 10 ealcr trppn the*bore-owns ed propwV lot inspec-
Gorr-
Ate q
Sigl.atilre of «Agent ogle
*413 TFOR -0(0fNVR*CT0R -O OWNER _
AdWrS NAME ( /'��� ,r -
- •AGENTS A�DRSStGY.G��R aCr-STE a�-RI�6/ er?G
STREET CITY SPATE' ZIP pfy.OwYE tl•f90
(9M 624•1663 s
09/14/2004 05:03 768323'743
SCOTT MORR1SON & ASSOCIATES
>r.0.Bat sf324 7lilS Dims galas Dive,9ts.N�-307 -
Bi"rdit CA 0017 Catbs*w Cky,CA 9=4
INVOICE do
May 24 . 2004 nd
de
mono John Lee Proms P.00 of
1800 ll o Ave. ty
LA..CA 90006 a
re
Prv�sct: 3224t Riverside Drive Rill narr+s: P(,JlRp4210210t le
LOW EWM". CA
i
Fuld Got dates:Apnl 21 thru May 21. 2004 '
Asbastm 8fbe Ans"moM find Requsat for Prooadurs 5 tDWI = $3,500.00
(IrtNudss bulk Mr4*ooisotbn and . daft oo*dlon. reports. trawl. str—)
Air sanmpfft and"Ysfs Lo CvMPIY with Proosd"5 Rsquest ■ 41,500-00
ToM arnotmt duo
ArreouM due UW tMS"of 1"0108•t2,b00" t t t" (/*W"
AMunt dw uPnn 4011*1000+Of P''0il P't a
Pbmo rind Psyarsert 1Go: 311W Date Palm D&M, Oft-43-507
Csd-edM City,CA 92=4
Thank you.
--
SCOTT MORMON & ASSOCIATES
P.O.Box SS329 31 833 Dee P01m Drta.Ste.A-307
Itimuddey CA 92317 CV)k9 W City.CA M34
(WO Ut.M (760)323-7743
August 12.2004
Jahn Les
1800 Moab Ave.
L.A.,CA 90006
AU asbestos coataiving veiling acoustic spray, pipe insulation, exterior wall stucco. and
trer=w pipes were adequmly removed from the former beef spa located at: 32281 Itive rade
Drive,Labs Edmore.CA between July 15 sad August 06.2004 by EEC 11.
Sectiosl 04 of tbt PtWAdute S Asbestos Abatement Plan written by Scott C. Morrison of
Scow Morrison & AssocWm as required and approW by the South Coast Air Quality
Menasement District,specified that all removal work of friable ACBM was to be performed in a
mamter as to prevan air conoeaustions from exoee rig the Cal-0S IA per missable exposure
level(PEL)of0.1 %eWcc,aid flnal air elearsaom were not to eocoeed 0.01 fibeWcc. To insure
imb did not exceed the PEL on any one day. Scott Morison & Associates collected
represeumve ambient air samples in and around the work area during numal of friable
ACM
The tnautts m&cated on tk enclosed air due sheets Mcstc that the fiber caaceevations
of the air samples collected t3om the former health spa located at: 32281 Riveaside Drive.Lake
Elshm, CA wars e4d icwuly below the PEL of 0.1 fiberslcc each of the work days6 and air
clearwim were sip ficsmly below 0.01 fibers/oc.
Scott C.Morrison
C4M&dAsbWwC4m=dm
DOSHM-o"
SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT'
NOTIFICATION OF DEMOLITION OR ASBESTOS REMOV
MAL FORT!AND FEE TO SCAQMD,ASBESTOS NOW(CATIONS,FILE i NMI,LOS ELES CA liOClt MM
C0WLETED BY Lu hW COMPANY E-E G 7M PHONE ,i• -,F: ffYYyy- :
DATE 0 _ -o cHECic I a la(08 LwvFEz S Is - y PRO.IECT O D(v—vq--
MORIF7CATION TYPE OWWK sloN DATES REwsKm OM(hofghO CANCELLATION
PROJECT TYPE IDEMW K ORDEREo DDAwnoN jAnON)( EMEmENCr REwvAL PLANNEo REwo(amud)
SITE Ntf CRMATM SITE NAME F 4viQ M 6 R Ft EA L-M !SPA
SlTEADDRESS 3 2.2 ( A wee.SWE .DAW6 CROSS STREET
CITY LAKE BLSInbRZV- STATE CALtF:'vAPJIA ZIP 2SZo COUNTY A�v�Rsr
DESCRIBEWORKANDLOCAT" FMP6fZ REMOVAL eF AS8 Tb5 CONIX-114MG1 Ck-INCIOR. W4u-f
BUILDING SIZE(SQFT) - -- NWABER OF FLOORS BUILDING AGE(YEARS) NUMBER OF DWEUJNG UNITS
BUG PRIORI PRESEM USE ® HoSwAL 4lDtbMK Ocher 0MM PUKX W)rl HOUSE Saga SNP IAi A OUAGE
SITE OWNER �p LEE ADDRESS✓I g0 0 Mil LD E U 6-
CITY LpS A,04FtgS STATE CA ZIP 900(,P CONTACT %ADC j,Y► PHON(rog) -*Lj
REQVRED BULDING ASBESTOS Q� NO ASBESTOS (gD NO ASBESTOS YES BUILDING TO BE ® NO
NFORNATION PRESEN77 SURVEY? • REMOVED? DEMOLISHED?
PROJECT DATES START L la �. g Zpp WORK SHIFT de swkvl noo
ASBESTOS AMOUNT TO BE CLASS II TOTAL AMOUNT(add row)
RBIWO M square feel) 12 ) ��75
ASBESTOS REifOVjM FROM ® PES COMPONENTS
AMOUNT OF EACH TYPE OF ACOUSTIC CEILING LWOLEUM I INSULATION I FIRE PROOFING DUCTING STUCCO MASTIC
ASBESTOS (n sWn fast) 2 AW p 0 i 00 /S b
FLOOR TILES(VAT) DRYWALL PIASTER TRANSITE ROOFING OTHER
.01 .00 9-j5' (doaaft)
CONTRACTOR INFORMATION CSLB LICENSE S 8 0 j4(0 9-7 OSHA REG N g!(p AOMD ID tf 13 g 95Z
NAME 6 E r-- 1�. ADDRESS 112 PvSWUL - AgFNU£
G1Y L.OrICz$t }C.!{ STATE C� DP 9pg SRESUPVR !4-IV ivNro £S7pA PHONE 2�5�-S
WASTE TRANSPORTER#1 ^/A (A1�ST S �r � Pr Z V�R LArl-b-FILL
ADDRESS 3(0 2-j F WMj) nvu E ADDRESS ��- o S' A2- u 5A . 4-ver4Q F
CITY L'IN W00jb I STATE CA I zip 12,c,, CITY wf%T CO'0V A STATE CA ZIP y)74
Asbestos surveys are required prior to Demolition and Renovation
Forms,instructions,and thG We 1403 can be obtained from AQMD web Site httpdtwww.agmd.gov Page i of 2 Form REV 20MO627
SCAQMD NOTIFICATION OF DEMOLITION OR ASBESTOS REMOVAL
MAIL FORM AND FEE TO SUM,ASBESTOS NOTIFTCATKM.FLE!$0111.LOS ANGELES CA 900744641
WASTE TRANSPORTER t2 E G T I WASTE STORAGE SIRE La P„ land
ADDRESS p, p, ggX g ADDRESS.)-
CRY SAn 8,enawdr; a STATE CA IIP 1 i CI1Y � �(' STATE ant ZIP
CONTROLS: DESCRIBE WORK PRACTICES AND CONTROLS TO BE USED AT THE RENOVATION AND DEMOLITION SITE. Prooedure d 1,2,3,40k 00w.
For mbeslos removals drde late canbir4m of Rule 14M pmoWtm used Procedure 4 and S subuallo ns for AQMD prior approval.
ASBESTOS DETECTION PROCEDURE: CIRCLE THE kOCEOUkS AND AALYTICAL METHODS USED TO DETERMINE ASBESTOS IN THE BUILDING:
Sarver,Bulk Samp ft Mvecfim,(!g)PCM,TEM,Assumed as Asbestos-PACid.Desalt Otlter.
FOR DEMOLITIONS GIVE THE COMPANY NAME AND DATES OF THE ASBESTOS REMOVAL:
FOR ORDERED DEMOLITION SEND A COPY OF THE ORDER AND GIVE THE AGENCY NAME 3 PHONE S A L P-C-f-b j
AUTHORrM PERSON: TITLE y
DATE OF ORDER: OF LAKEC-LSWOF-ej DATE ORDERED TO BEGfN: S W.415av AS.sa4
FOR EMERGENCY ASBESTOS REMOVAL GNE THE NAME AND PHONE NUMMCit OF THE PEItSON DECLARMGIAUT14ORONG THE EMERGENCY,DATE NO HOUR OF
EMERGENCY AND DESCRME THE SWOEK UNEVWTED EVENT:
/VIA-
EXIAM HOW THE EV8v1't XXILD CAUSE t UPE OONDfTIONS,EGUNMENT DAMAGE OR UNREASONABLE FINANCIAL BURDEN:
CONT91GENCY PL.Alt DESCRIBE ACTIONS TO RE FOLLOWED IF INFECTED ASBESTOS E FOUND DURING DEMOLITION OR ASBESTOS MATERIAL BECOME
DISTURBED CRlJMIM PULVERM OR P 31M TO POWDER. 141P
TRAIJ M C@tTMATION:l cer0fy that an Wmi&W trained in the provisions of regA ifim AOMD Rule 1403 and NFSHAP wM be on she during the removal and
•evidence that the r qjW Vvh tng has bow acocrroWwl by rids person wO be able for during rro ,W bustrresa han ..
1 etc<,— T �Lmz-..o oIN $O QWr4M
Company Name Print name of owrr kpen for Skr �' The of ownerkpmalor Ode
VWORMAT=CERT1FICATXXI:I aw y go the above kftn rim Is aareet
The d mwkpvgw Dale
Nuff atlorts tan not be aaoepted wboul the mq twl fee(AQMD Rule 301). Asbestos removals of less Nan 100 square feet are exempt from r4dcWm and fees.
Please make clerics payab a to'SCAQMD'. Fees are per rtatf>catiort,not refundable,and vary aoeordng to the project ft. Fees are as follows:
DE110UTtON OR ASBESTOS REMOVAL PROCEDURE 4 OR 5 PLAN I
121
FROM 100 TO 1,000 SOIARE FEET S 29M SPECIAL HANDLING FEE S
FROM II W TO 5.000 SQUARE FEET S 9D 24 REVISON OF NOTIFICATION $11.94
FROM 5A01 TO 10p00 SOUARE FEET $211.22 RETURNED CHECK CHARGE $29.28
MORE THAN 10A00 SOUARE FEET S33121 CANCELLATION OF NOTIFICATION sob
DEMOLITION OF LESS THAN 100 SO FT $29.52 ASBESTOS REMOVAL AT owner- $20.52
ATTENTt & K*q a copy of your noblkaUon. State law requires that you pmvW a cM of the demoAUon rtWo=don to B A ft and Sdety before laerrertoe of a
dertrdiort pem IL Forques♦am call 9093W2M5. For your convenfmw please mall the form artd be and do not hand carry to AOMD.
0 L FORM AND FEE TO:SCAQW,ASBESTOS NOTWICATIONS,FILE R W",LOS ANGELES CA 90074.5641 Page 2 d 2
TELEPHONE (909)39ti. M FAX (909)39b 4M Form REV 20030827
FORMS,INSTRUCTIONS,AND THE RULE 1403 CAN BE OBTAINED FROM AQMD WEB SITE AT W TP://W W W.AOMD.GOV
SCAQW b bossed at 21865 E.Coptey Drive,Diamond Bat,CA 91765.4182 (909)396-2000