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BRES2016-0345
78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BRES2016-0345 Property Address: 52880 EISENHOWER DR APN: 773331008 Application Description: MARVIN / SINGLE FAMILY Property Zoning: Application Valuation: $122,678.70 Applicant: SOUTH WEST CONCEPTS, INC. 78115 CALLE ESTADO, SUITE 105 LA QUINTA, CA 92253 c&ut 4 XP Q" DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT APR d 7 2017 v______ -- CITY0FLA 1JINTA COMML' LAITY DEVELOPMENT DEPARThIENT 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 Professions Code, and my License is in full force and effect. License Class: B License No.: 771883 �jj ('Date: 7 I /� Contractor: 1/ by 1. 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 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).: (_J 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 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.). (_J 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 prgperty who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_J I 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. 3097, Civ. Q. Lender's Name: Lender's Addre: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/7/2017' Owner: WELLS MARVIN Contractor: MARVIN INVESTMENTS INC 78100 MAIN STREET #203 LA QUINTA, CA 92253 (650)492-1762 Llc. No.: 771883 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 �Ncpk 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 and policy number are: Carrier: SECURITY NATIONAL INSURANCE COMPANY Policy Number: SWC1114236 _ 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, l shall forthwith comply with those provisions. Date: 7 < z i Applicant: Lnl WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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. 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 the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above- mentioned property for inspection purposes. Date: Signature (Applicant or Agent): ) i Date: 4/7/2017 Application Number: BRES2016-0345 Owner: Property Address: 52880 EISENHOWER DR WELLS MARVIN APN: 773331008 78100 MAIN ST 203 Application Description: MARVIN / SINGLE FAMILY LA QUINTA, CA 92253 Property Zoning: Application Valuation: $122,678.70 Applicant: Contractor: SOUTH WEST CONCEPTS, INC. MARVIN INVESTMENTS INC 78115 CALLE ESTADO, SUITE 105 78100 MAIN STREET #203 LA QUINTA, CA 92253 LA QUINTA, CA 92253 (650)492-1762 -------------------------------------------------------------------------------------------- Llc. No.: 771883 Detail: NEW 1759 SQ. FT. SFD WITH DECK, THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALL, DRIVEWAY APPROACH, WATER FEATURE, BBQ, OR FIRE PIT. HOME IS FIRE SPRINKLED PER 2013 CRC CODES. i 7 , DESCRIPTION ACCOUNT I QTY I AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $5.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $5.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - CIVIC CENTER 252-0000-43200 0 $942.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 - DESCRIPTION ACCOUNT QTY AMOUNT DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - LIBRARIES 253-0000-43200 0 $344:00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - PARKS/REC 251-0000-43200 0 $2,048.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - STREET MAINTENANCE 255-0000-43200 0 .$116.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF -TRANSPORTATION 250-0000-43200 0 $2,842.00 Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 DESCRIPTION ACCOUNT QTY AMOUNT TEMP POWER SERVICE 101-0000-42403 0 $25.33 ` DESCRIPTION ACCOUNT QTY AMOUNT TEMP POWER SERVICE PC 101-0000-42600 0 $17.73 Total Paid for ELECTRICAL: $43.06 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $25.84 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF, PC 101-0000-42600 0 $10.64 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $152.00 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $50.16 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $238.64 DESCRIPTION ACCOUNT QTY AMOUNT ' RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT <=7KSF 101-0000-42408 0 $38.00 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT <=7KSF PC 101-0000-42600 0 $38.00 Total Paid for GRADING: $76.00 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR 101-0000-42402 0 $76.00 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR PC 101-0000-42600 0 $50.66 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD 101-0000-42402 0 $25.34 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD PC 101-0000-42600 0 $10.14 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE 101-0000-42402 0 $76.00 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE PC 101-0000-42600 0 '$50.66 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN 101-0000-42402 0 $38.01 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN PC 101-0000-42600 0 $15.21 Total Paid for MECHANICAL: $342.02 DESCRIPTION ACCOUNT QTY AMOUNT MULTI -SPECIES RESIDENTIAL 8.1-14. UNITS - 2016 UPDATE 101-0000-20310 0 $508.00 Total Paid for MULTI -SPECIES RESIDENTIAL: $508.00 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PERMIT 101-0000-42400 0 $543.32 Total Paid for NEW CONSTRUCTION DERMIT: $543.32 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $1,000.00 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $63.08 Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,063.08 DESCRIPTION ACCOUNT QTY AMOUNT BACKFLOW DEVICE 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT BACKFLOW DEVICE PC 101-0000-42600 0 $5.07 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER 101-0000-42401 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER PC 101-0000-42600 0 $17.73 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $126.70 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $126.70 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $38.00 - DESCRIPTION ACCOUNT QTY AMOUNT y GAS SYSTEM, 5+ OUTLETS PC 101-0000-42600 0 $25.33 DESCRIPTION ACCOUNT CITY AMOUNT ' ROOF DRAIN 101-0000-42401 0 $63.35 DESCRIPTION ACCOUNT. CITY AMOUNT ROOF DRAIN PC 101-0000-42600 0 $63.35 DESCRIPTION ACCOUNT CITY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT CITY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 $7.60 DESCRIPTION ACCOUNT CITY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.67 Total Paid for PLUMBING FEES: $549.84 DESCRIPTION ACCOUNT CITY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $15.95 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $15.95 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 DESCRIPTION ACCOUNT CITY AMOUNT SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 Total Paid for TUMF - RESIDENTIAL: $1,837.44 Building Address v owner, l� `^ , a ( V1 Mailing/ ( j�V' Address 7`� ((�v �/ fit tA Z6 3 Ity Lr Contractor 0 ,,,.i vi er Address City State Lic. & Classif. IfluT 014 a" P.O. BOX 1504 `�� 11�✓Pr` 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 - BUILDING: TYPE CONST. �w OCC. GRP.� A.P. Number -7-Z3 —. '3S / — UQ APPLICATION ONLY zip le I Legal Description Project Description S �l 1Q r d1I ' l `i ✓` `_ Lic. # Arch., Engr., / Designer � vU " i'1 W � '� C" eel)) c, '06 1 Lic # LICENSE13 CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contrac- tor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that he 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). ❑ 1, 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 Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such 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 did not build or improve for the purpose of sale). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKER'S COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation 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 Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above -mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip Sq. Ft. 17 <� No. No. Dw. Size Stories Units New �'� Add ❑ Alter ❑ Repair ❑ Demolition ❑ 06 C_) Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. ��` Z-•^^"'"� Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL CONTACT INFORMATION NAME: PHONE: 15 7 0 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE Bin # City of La Quinta Building 8t Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: ea= i f G IF \S>" krM+VVL p IL L.9 Owner's Name: A. P. Number: Address: S2. S w Legal Description: City, ST, Zip: Contractor: Telephone: :: f.::i :::4 ^.:vim• Address: Project Description:s�Y�� City, ST, Zip: Telephone: - - State Lie. # : City Lic. #: Arch-, Engr., Designer SouTilwersft �wv�r �Nl... Address: -� \1i Cv Gtrsv o 4TtlZt5 City, ST, Zip: k,a, .0r4c.4 53 Telephone: 1 OAl dl State Lie- #: :::hrr` h�hr%; { :- ,' "'• -y' GF'.> tY.•t >.'��;;;•,;f{ �f�! s�;'�R;�-;i. Construction Type: Occu an Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: STtyV0* W ja o Sq. FL: # Stories: # Units: Telephone # of Contact Person: 1 p. S` p" Estimated Value of Project: 0, 00 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req°d Rec'd TRACKING PERMIT FEES Plan Sets Plan Ckeck submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.1. H.O.A. Approval Plans resubmitted Grading IN HOUSE: '"d Review, ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees PLAN LOCALION B ddress: 529s$� frr�SGNNowfiCL 1.A Q u t�i Project Description: Pool, Remodel, Add't, Elect, Plumb, 1\4ech APN #: ,A.& VlMrWR LOCAT20N d,ONNz) poky 7cantN'ame: tq�ctd,n> tt1�L-s'7YH fS ' S t-i 1A s: ` -r; Zip: r e4 01- ^gel'ephone: nail: Valuation of Project $ Odhtractor Name: Ow� gUiZ�. New SFD Construction: 9 ddress: 5'2-ft U eyi sG,viH 6v&Tx_ Piz - Conditioned Space SF ( rly, St, Zip Lh- Garage SF elephone: Patio/Porch SF SE1n•afl: Fire Sprinklers SF Sale Lic: • NtCify Bus Lic: r !-ch/Eng Name: 5;0„r-J4Wr-S1- e_owcptvrS1 /Aug • Construction Type: Occupancy: AViess: 78 NS c"i_v r-,rA0© 5 rt log- Grading: @Eiw'-'St, Zip ts� Qvi6v7�F « �t 22 Te phone: 7aa, r,6¢ ,470 7 Bedrooms: Stories: #Units: t� ", C x'2-e r� infrail: sp y,#LA/ C/) Sw�otvcr-PI'5,ca�►-�-. W - e Lic: `City Bus Lic: Property Owner's Name: ut�F2v��U �� 1iGS(�Y+E�7$ . New Commercial / Tenant Improvements: ,address: 5� rg�0 gasEw/�-owbti Total Building SF gty;'ST, Zip yA• Pvgv noe,+- Construction Type: Occupancy: Telephone: I 'inai l: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 CERTIFICATE OF COMPLIANCEsc Desert Sands Unified School District 47950 Dune Palms Road <Zyyo Vi BERMUDA DUNES r RA MIRAGE Date: 4/7/2017 La Quinta, CA 92253 Y INOIAN WELLS COACHERI LLA -0Y LA OUINTA 7� No.: 17-00543-1 (760)771-8515 0 IN..O Y Owner: Marvin Wells Email: Address: 52-880 Eisenhower Dr. Jurisdiction: La Quinta City: La Quinta Tract #: Type: Single Family Residential Lot # Street No. Street Name Sq. Feet APN Permit No. 52-880 Eisenhower Dr. 1759 773-331-008 R E C'; E" IVE D APR 0 7 2017' CITY OF Lei QUINTA COMMUNITY DEVELOPMENT Comments: At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking eating, or sanitation) or replacement mobile homes. It has been determined that the above -named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fess imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $3.48 X 1759 S.F. or $6,121.32 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in the proposed project may now be issued. Fees Paid By: O/C OneWest Bank Bank Name/Recipient of Certificate By Kathleen Felci Interim Superintendent Fee Collected Exempted by: 6 Check No.: Telephone: 650% 492-1762 Funding: Residential Certificate Fees Due: $6,121.32 Original Payment(s) Rec'd: $0.00 New Payment Rec'd: $6,121.32 Over/Under: $0.00 NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90-day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District(`s) behalf, whichever is earlier. Notice to Building Department: THIS DOCUMENT VALID ONLY IF IMPRINTED WITH EMBOSSED SEAL. Building Permit Number. Project Description: SFR Exempt: ❑ (Materials may contain hazardous wastes and are not subject to recycling provisions) Construction Debris Management Plan Plan Submittal Job Site Owner's Name Number, Street, or PO Box City, State, Postal Code Owner's Phone Number owner's E-Mail Address Project Manager's Name Project Manager's Phone Number Project Manager's E-mail Address Builder / Contrf Number, Street or PO City, State, Postal C Project Square 4/5/2017 52880 Eisenhower Dr Wells Marvin 78100 Main St #203 La Quints, CA. 92253 650-492-1762 wellsmarvinAgmail.com Wells Marvin 650-492-1762 wellemarvin0amall.com Marvin Investments Inc. 78100 Main St #203 La Quanta, CA. 92253 1,759 square feet Clty Approval By Renedo Goukilock-DEC/Burrtec Waste Date of City Approval 04/05 h 7 To Be Discarde Product Trash Asphalt Brick/Block Cardboard Commingled Concrete Drywall Donated / Reuse* *Describe Items Tons _Z,76J Not recyclable 0.00 Recyclable R E VE D APR 0 7 2017 CITY OF LA QUINTA COMMUNITY DEVELOPMENT Product Masonry (broken) Piaster Scrap Metal Tile (floor) Tile (roof) Wood Landscape Debris Tons Totals: Recycle Trash Projected Diversion: 14.4 1 7.81 t36.07% I understand it is the property owner's responsibility to submit copies of weight tickets or receipts to the District Environmental Coordinator as these hauls occur. I hereby certify that completion, implementation and adherence of the Debris Management Plan (DMP) for the above named project shall guarantee that at least 65% of the jobsite waste is — - - diverted from-Iandfi111ng. T•he-remalning material -will be recycled or reused. I will -divert, for-recycling•orm-use, remaining materials generated from the first day of the project through the completion of the project In accordance with this plan. This DMP Is issued in the name of the property owner(s) and shall remain their property throughout the construction and/or demolition project A contractor serving as agent of the owner may obtain a DMP for the owner. However, the DMP Is still issued In the name of the property owners) and the owner retains legal responsibility for ensuring that the provisions of the DMP are adhered to. The property owner(s) and general contractor shall be kept informed of the diversion progress through bl-monthly reports. If self hauling, all refuse material from this project site must be taken to an approved recycier or transfer 2iJ)1. �IC-T1(7 Owner / Developer / Project Manager / Superintendent Date