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BRES2017-0213'k 1 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: TOMAS JAKWAY P.O.BOX 1565 PALM SPRINGS, CA 92263 Tr�&lwQw;.rw DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT BUILDING RESIDENTIAL/DVA BRES2017-0213 52577 MER IWETHER 767690028 WAGNER / 9,390SF DWELLI $822,886.20 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.: 848057 11Date. —tractor:. 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).: (_) 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.). (_) 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 property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). . (_) 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. C.). Lender's Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/4/2017 Owner: WAG TRUST 52577 MERIWETHER WY LA QUINTA, CA 92253 Contractor: BRADSHAW CONSTRUCTION INC 46-248 ROUDEL LANE LA QUINTA, CA 92253 (760)347-4246 Llc. No.: 848057 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 and policy number are: Carrier:. STATE COMPENSATION INSURANCE FUND Policy Number: 9043902 I certify that in the performance of the for which this permit is issued, I . shall not employ any person in any manner so as to come subject to the workers' compensation laws of California, and agree that, if ould become subject to the workers' compensation provisions of Section 370 the Labor Code, I shall forthwith comply with those provisions. > Date: A�t: 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 n ormation is correct. I agree to comply with all city and county ordinances and state s relating to building construction, and hereby authorize representatives of this city nter upon the above-mentioned property for inspection purposes. Oates - 1 Signature.(Applicant.or_Agent): 1 i Date: 12/4/2017 Application Number: BRES2017-0213 Owner: Property Address: 52577 MERIWETHER WAG TRUST APN: 767690028 52577 MERIWET4ER WY .Application Description: WAGNER / 9,390SF DWELL]NG/VB/,RES-3/CLASS A-FR/13D LA QUINTA, CA 92253 Property Zoning: Application Valuation: $822,886.20 Applicant: Contractor.1 TOMASJAKWAY BRADSHAW CONiTRUCTION INC P.O.BOX 1565 46-248 ROUDEL LANE PALM SPRINGS, CA 92263 LA QUINTA; CA 92253 (760)347-4246 --------------------------------------------------------------------------------------------------- Llc. No.: 848057 Detail: 9,424SF SINGLE FAMILY.DWELLING [VB/RES-3/CLASS A-FR/13D) THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2016 CALIFORNIA BUILDING CODES. 1 i 1 l FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT ART IN PUBLIC PLACES - RESIDENTIAL 270-0000-43201 0 $1,557.21 Total Paid for ART IN PUBLIC PLACES - AIPP: $1,557.21 DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $33.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $33.00 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 $132.60 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF, PC 101-0000-42600 0 $54.60 DESCRIPTION' ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $156.04 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $51.49 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $394.73 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 $190.00 Total Paid for GRADING: $228.00 DESCRIPTION ACCOUNT QTY AMOUNT AIR HANDLER 101-0000-42402 0 $380.00 DESCRIPTION ACCOUNT QTY AMOUNT AIR HANDLER PC 101-0000-42600 0 $126.70 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR 101-0000-42402 0 $380.00 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR PC 101-0000-42600 0 $253.30 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD 101-0000-42402 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD PC 101-0000-42600 0 $5.07 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN 101-0000-42402 0 $101.36 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN PC 101-0000-42600 0 $40.56 Total Paid for MECHANICAL: $1,299.66 DESCRIPTION ACCOUNT QTY AMOUNT MULTI SPECIES RESIDENTIAL 0-8 UNITS - 2017 UPDATE 101-0000-20310 0 $1,245.00 Total Paid for MULTI -SPECIES RESIDENTIAL: $1,245.00 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PERMIT 101-0000-42400 0 $977.09 Total Paid for NEW CONSTRUCTION PERMIT: $977.09 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $1,200.00 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK - 101-0000-42600 0 $933.05 Total Paid for NEW CONSTRUCTION PLAN CHECK: $2,133.05 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 $608.16 DESCRIPTION ACCOUNT QTY AMOUNT . FIXTURE/TRAP PC 101-0000-42600 0 $608.16 SMI - RESIDENTIAL DESCRIPTION ACCOUNT QTY AMOUNT $5.00 GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $39.01 ACCOUNT DESCRIPTION ACCOUNT CITY AMOUNT 224-0000-20320 GAS SYSTEM, 5+ OUTLETS PC 101-0000-42600 0 $26.01 DESCRIPTION ACCOUNT CITY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $25.34 DESCRIPTION ACCOUNT CITY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 $15.20 DESCRIPTION ACCOUNT CITY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT CITY AMOUNT WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.67 Total Paid for PLUMBING FEES: $1,408.02 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $106.98.' Total•Paid for STRONG MOTION INSTRUMENTATION SMI: $106.98 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 DESCRIPTION ACCOUNT QTY AMOUNT SINGLE FAMILY DETACHED 224-0000-20320 0 . ' $1;837.44 Total Paid for TUMF - RESIDENTIAL: $1,837.44 r Bin# ST" City of La Quinta Building & Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit# Project Address:e> -5 O-ne 's ame: A.P. Numb . Address:, �� v Legal Description: Ci�ty,_ST, Zip: r r At Contracto% Telephoner Address: Project DescripYon'7 City, ST, Zip: l4 n IA(Telephone: State Lic. #: City Lic #: Arch, EngT., Designer: H 5 0 Address: City, ip: T ne: �a+ �3 iJ��/ , Construction Type: • L- Proj. Type New Add'n Occupancy; .- - Alter . Repair Demo State Lic. #: Name of Contact` 1/ SgFt...! 2 � � #Stories] # Units: Telephone of Contact:; � a�. Estimated a71ue of Project:, APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check Submitted Item Amount Structural Calcs Reviewed, ready for corrections Plan Check Deposit: Truss Cales Called Contact Person Plan Check Balance: Title 24 Calcs Plans Picked Up Construction: Flood Plain Plan Plans Resubmitted Mechanical: Grading Plan 2nd Rev, Ready for corrections / Electrical: Subcontractor List Called Contact Person Plumbing: Grant Deed Plans Picked Up S.M.I. HOA Approval Plans Resubmitted Grading IN-HOUSE 3rd Rev, Ready for corrections / Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Apps Date of pe i School Fees AUG 18 20 7 'a Total Permit Fees COMMUNITY DEVELOPMENT Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 This Box For District Use Only DEVELOPER FEES PAID AREA, AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMM/IND. AMOUNT: DATE: RECEIPT: CHECK #: INITIALS CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: �%Iadis� o� Owner's Name: Project Address: Mark Wagner 52-577 Meriwether Way, LaQuinta Project Description: Single Family Dwelling APN: 767-690-028 Tract #: Type of Development: Residential XX Commercial Total Square Feet of Building Area: 9,424 sq. ft. Date: November 20, 2017 Phone No. 760-347-4246 Lot #'s: Industrial Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized too sign on behalf of the owner/developer. Dated: November 20, 2017 Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code 17620 Number of Sq.Ft. Amount per Sq.Ft. Amount Collected Gov. Code 65995 9424 $3.48 $32795.52 Project Agreement Existing Not Subject to Fee Approval Prior to 1/1/87 Requirement Building Permit Application Completed: Yes/No By: Andy Jenkins, Director of Facilities and Maintenance _No Pursuant to AB 181 any room additions or enclosures of 500 sq. ft. or less are exempt from developer fees. Any mobile homes being relocated within the same school district's jurisdiction are exempt from developer fees. Certificate issued by: Laurie Howard, Secretary Signature: �`�"G✓'�tJ� NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90-day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90-day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. MV:c/mydocs/dei,Cces/certificate of coinphi ncc fr01111 updated 3-2007 11/2010 THE. MADISON CLUB OWNERS' ASSOCIATION November 30,2017 RECEIVED Mr. and Mrs,..Mark Wagner 1609 Milano Villa Ave. Henderson, NV 89057 D F C 01 2017 RE: Lot 36B at 52577 Meriwether way CITY OF LA QUINTA Construction Documents #2 COMMUNITY DEVELOPMENT Dear Mr. and Mrs. Wagner. This correspondence shall serve as notification from The Madison Club Design :Review Committee (DRC) that your revised construction document submittal was reviewed at the November 20; 2017 meeting. The committee has .issued. a conditional approval to start construction. Revised plans which. address the following. concerns must 'be submitted. no: later than December 7�` for the review, at the December le meeting. Work in the field will be temporarily halted if revised plans are not submitted by 4 30 p.m: on December 7'. 2017. 1. The yard wall details.were not .keyed in on any of the plan sheets as required. As a reminder, the. property line wall footings should not extend over the property line. 2. There: was no information provided for the material or detailing.of the yard gates or the horizontal steel fencing and gate at ground level (shown on the elevations). 3. It appears that most of the roof edge, parapet, details,. etc. are provided; however, there, were no details keyed in on the elevations or plan sheets. 4. Please provide the materials, colors and .finishes for all exterior elements on-. the elevations — consistent with the approved color board. 5:. Please. clarify the detailing and .material call -outs for the pizza oven_ The details provided indicate a domed oven with a•sheet metal stack; however; the plans appear to show the pizza oven built-in with the walls extending to the ceiling: Please indicate. if there is a,simple vent on. the, roof that will be screened and if the oven/walls will be stucco. 6. .Lot. K grading and landscape plans do not match as to the location of the existing fan Palms. It appears .that two existing palms will be buried as much as 5` - this is possible with W. fil fera palms as long. as the irrigation is modified correctly. 7. The `grading at the; steps (which lead to.'the pool level) does not appear to word as shown: (ex...1001 vs 1000.57 and 7" drop at upper patio to the finish grade). The correction of this detail may result in 2:1 slopes which are strongly discouraged. The committee recommends the addition of wing walls or retaining walls to solve: the visual and maintenance issues. 8. The driveway -boulders do, not appear to be necessary for retention except in. a; small area. The committee suggests utilizing the boulders only as needed for retention. 9.: The pool equipment should be located a minimum of five -feet from the property line. It also appears .that the scale of the equipment may need to be enlarged to be certain there is ample room and proper screening provided. 10. Please provide details that indicate how the exposed wall of the pool wl be finished. 11. The committee suggests pulling. back the side yard property wall to the, Transition Area and creating a stepping detailto reduce any impact the adjacent neighbor. 12. The Lot: K Planting plan indicates Tecoma and Callistemon will: remain; however, it: also indicates the area is being raised 5' :so the replacement of plants and irrigation must be clarified. 53035 MERIWETTIEH WAY, r A,Qunrrn, CA 92253 TEL 76o 39 -:4564 FAX 76639 -4591 13. The baditflow prevention device must be screened ' from public view upon completion of the landscape. It is currently located at the street edge (next to the water meter) which may not be acceptable. .14. The irrigation plan is unclear as to who is responsible for irrigation in the streetscape area. The plan indicates, all,new irrigation - even in areas where there is existing plant material- Please clarify and work with the Raymond Garcia, and. Pete: Moyer to be certain that AU changes to the existing, plantmaterial and irrigation are approved by the HOA. 15. A landscape lighting plan is. required for review and approval. 16. Eric Puls, has approved the proposed, changes to, the golf course property per his field meeting with Mark Bradshaw. 17. Where the Association owns and/or maintains property adjaceht,tQ. Lot 36B that will be 'Modified, an as -built plan will be required at completion of the project. The %as -built should detail the maintenance and irrigation responsibility for all landscape areas that are outside of the property boundaries as agreed by the Owner and the Association - Please, contact. Brook Marshall. at 760-219-8057 or by email at. DRCFa,pititator@gmaii.com with any questions or to schedule your Pre -Construction Meeting once a Building Permit has .been obtained- As a reminder, no activity or temporary construction materials (fencing, signage,:trash can, etc.)- should be brought on site prior to the Pre -Construction Meeting. being held.. Sincerely, JIL4DISONCL-.UBDESIGNREVMWCOMMITTEE By: Title: Date: 0 /1.-1 cc. Mark Bradshaw Tom Jakway AmeAninW Efir, Puts DRC,File Pursaw to CaL Civil GW my r4edion by fix.DRC may be appealed to the Board ofDpwonfor Ow Assomnom If you wi* to pursue an appeal please contact &eAzm-mfton'sprqp" manager so dWym may bep& on the ncdmwMgagrndz I I $145 Zo (7— CITY OF LA QUINTA - PUBLIC WORKS DEPARTMENT GREEN SHEET PUBLIC WORKS —CLEARANCE FOR RELEASE OF BUILDING PERMIT Form updated & effective 9/25/2009 Green Sheet approvals are forwarded to the Building & Safety Department directly by Public Works. Please DO NOT submit the Green Sheet (Public Works Clearance) Packet to the Public Works Department until ALL requirements listed below are complete. Incomplete applications or applications which cannot be processed will be returned to applicant. Date:/_L_/1,FDeveloper:,cA��,t,1 Tract No.: �%�%�'tract Name: l_x."C3 Lot No.(s): �P Address(s): 2 S'%1 ta Li9-r W Phone Number: (—) 2-IS--[o�� The -following are the requirements for Public Works Clearance to authorize issuance of a building permit from the Building & Safety Department: L4_ CUSTOM HOMES: PROVIDE ITEMS #2, #3, #4, #5 & #7 BELOW ❑ TRACT HOMES: PROVIDE ITEMS #1, #2, #3 & #5 BELOW ❑ COMMERCIAL BUILDINGS/OTHER:.PROVIDE ITEMS #1, #2, #3, #5 & #7 BELOW ❑ WALLS, SIGNS, OTHER: PROVIDE ITEM #6 BELOW 1. Attach Pad Elevation Certificates in compliance with the approved design elevation for building pad (maximum allowable deviation of +/- 0.1 foot). Pad Elevation Certificates must be current (within 6 months of current date). If a precise -grading plan creates the pad for approval, please withhold green sheet submittal until a Pad Elevation Certificate can be provided. 2� Attach geotechnical certification of grading plan compliance including compaction reports from a licensed Soils Engineer. Recently rough graded residential developments which ;have a previously approved geotechnical certification are exempt from this requirement. Attach recorded final map or title information/grant deed showing proposed building locations are legal lots. 4 Complete the attached <1 acre per lot or infill project Fugitive Dust Control project information form, PM10 plan & agreement or provide alternative & valid City'approved `PM 10 plan set reference number or hard copy plan. PM10 plans for commercial & residential developments (beyond 1 lot) are submitted separately with grading plans & are subject to additional requirements. A current PM10 certification number is required. Attach a copy of the rough or precise grading plan to the Public Works Department showing building location(s) for pad elevation verification. AO flood zone developments will,require an approved flood plain development plan. 6. Attach supporting documentation for wall plan, monument sign, grease trap or special facility installations. ©I Complete and sign the attached water quality management plan (WQMP) exemption form, if applicable. PW approved building construction projects require either. a WQMP or a completed WQMP exemption form. Approved maps/plans may be viewed at the following link: htto://www.la-guinta.org/PlanCheck/m search.aspx I have reviewed and confirmed the requirements listed above as presented and find the improvements to be sufficiently complete for construction of the proposed buildings/structures/walls/signs on the subject lot(s). Pursuant to my findings, the above project may be released for building permit issuance. This section completed City staff. Recommended by: Date/&LLI Public Works Distribution: ( ) Green Sheet to Building & Safety ( ) Green Sheet to Planning Department Declined for approval for reason(s) as follow(s), please correct and resubmit: T:\Checklists - Forms & Applications\Forms & Applications\GREEN SHEET cover & PM10 less than 1 Acre Revised 10-02-12.doc i 5 City of La Quinta - PM 10 Fugitive Dust Control Project Information Construction PhacP PM1f1 Anrnnrr.nr.t /,- 9 ­-/1 ... 1 Z'11 Project Information Project Contractor: Project Phase (check one) E!��Construction ❑ Demolition Project Name: �— Project Tract/Lot Numbers: Project Street Address: Total Acres in Active Construction (< 1 acre per Lot): Anticipated Start Date: Anticipated Completion Date: PM10 Contact Information Please note: Dust control is required 24 hours a day, 7 days a week, regardless of construction status. Person listed below is responsible for dust control during business and non -business hours. Name: l Title: Company Name: jijc e f 4eL Mailing Address: . Q . City, State, ZIP Code: [,..,A- �t/�tt� l%,/'► �'(,'[S Primary Phone #: 77 (O - g(o . ri'O Fax #: 24 Hour Emergency Phone#: Cell Phone #: Co v - `L-7 .S_- Email Address: E iA W-4<CN�� Or'� i C 6 �•` PM 10 Certificate #: TI_ « 01 ■- D O3 3 0 9 jr waa V—Puliy VVVIIGI 1U1 aUU1U11LUU 1UP1t;5Uf1La lVe): Shall act as .his/her acknowledgement. of dust control requirements and their enforceability, pursuant to SCAQMD Rules 403, 403.1, 401, 402, 201, 203 and PERP; ❖ Shall constitute an Agreement to comply with all project conditions as identified in the approved dust control plan. ❖ Acknowledges that dust control is required twenty-four (24) hours a day, seven (7) days a week, throughout the period of project performance, regardless of project size or status; ❖ Shall ensure that each and every contractor, subcontractor and all other persons associated with the project shall be in continuous compliance with all requirements of the approved dust control plan; Shall take all necessary precautions to minimize dust, even if additional measures beyond those listed in the dust control plan are necessary; s Shall authorize representatives of City/County- to enter the property for inspection and/or abatement purposes; Shall hol I harmless the ity/County and its representatives from liability for any actions related,to this dust control pl :Tfz /County init' ted abatement activities. —> Water Qualitv Management Plan (WQMP) Exemption Form - Whitewater River Reaion Documentation of Project Not Requiring a WQMP but Requiring Site Design BMPs. and Source Control BMPs by Entitlement Conditions of Approval or Permit Conditions —.WQMP Required for the Listed Change of Land Uses. or for Changes of Pollutant Stream (All Questions Below Must be Answered "No" To Exempt Project) Yes No Entitlement or construction of new single-family hillside residence(s) that create 10,000 square feet, or more, of impervious area where the pre -development natural slope is 25% or greater? ti'-- Entitlement or construction of new single-family hillside residence(s) that create 10,000 square feet, or more, of impervious area where the pre -development natural slope is 10% or greater where erosive soil conditions are known? Entitlement or construction of new commercial and industrial development(s) of 100,000 square feet or more? Entitlement or -construction of new automotive repair shop (s).including body, upholstery, paint, exhaust, tire, transmission, engine or other automotive specialty repair. [Standard Industrial Classification (SIC) codes 5013, 7532, 7533, 7534, 7537, 7538, and 75391? Entitlement or construction of new retail gasoline outlet(s) disturbing greater than 5,000 square feet? Entitlement or construction of new restaurant(s) (or potential restaurant shell space) disturbing greater than 5,000 square feet? Entitlement or construction of new home subdivision(s) with 10 or more housing units? ✓, Entitlement or construction of new parking lot(s) of 5,000 square feet or more, or with 25 or more parking spaces, and potentially exposed to Urban Runoff? Applicant Information Name and Title MA4At- -6g"_R i1A J Company *{f.*,03 LALA Codv ST*A.AC_'6CsJ4 Phone --) 6,a— 2-7 S- %?at ( Email AA^.R,k &WtAJ(c-'C/L403&LAUCcsav 3Ti�xtr4Onc. Cgvti Project Information Project Name Type (SFH, Multi -Family, Commercial, Etc.) (1_L(L QI1014�C'-41r- Location or Street Address Nearest Cross Streets Municipality/County/Zip Code La Quinta Tract Number(s) and/or Assessor Parcel Number(s) p (o .Z %{ —7 61 _ (A p Other Location Information Watershed Whitewater River Source Control BMP Information Size of Project Area (nearest 0.1 acre) Project Area managed with Site Design or Low Impact Development (LID) BMPs (nearest 0.1 acre) Is the project subject to onsite retention by City ordinance or policy? Name of the Entity that will implement, operate, and maintain the Source Control BMPs -TA*4) 9 UAL.) 6%tlk-4` i`IL�►•t.ea►k42,q Contact Name V,A4-v b i 44 $LLA L Street or Mailing Address City L" r Zip Code Q1 'L2:5 M Check Item To be Performed Source Control BMP Requirements - All Projects Require Non -Structural BMP Source Control Non -Structural BMP (See Appendix H, Section 4.5.2.1) ✓' Ongoing Irrigation System and Landscape Maintenance �- Ongoing Litter Control </ Ongoing Drainage System Inspection & Maintenance ✓ Education/Training for Property Owner, Operators, Occupants, or Employees Activity Restrictions — Prohibition of Debris Blowing/Sweeping/Washing into Street/Storm Drain, Closed Trash Lids, Restriction of Vebicle Washing ✓ Ongoing Street Sweeping at Private Streets and Private Parking Lots Check Item To be Provided Source Control BMP Requirements — Small Sloped Lots, Small Commercial, < 10 Unit Subdivisions, < 5,000 Square Ft. Parking Lots, Etc. Structural BMP (See Appendix H, Section 4.5.2.2) Storm Drain Inlet Stenciling and Signage Landscape and Irrigation System Design to Minimize Erosion & Nuisance Runoff Protection of Slopes and Channels to Minimize Erosion Multi -Family Project Use of Community Car Wash Racks Wash Water Controls for Food Preparation Areas to Use Sanitary Sewer Fueling Area (Design & Maintenance) Including PCC Surface, Canopy & Spill Prevention Air/Water Supply Area Drainage (Design & Maintenance) Including Spill Area Containment Trash Storage Areas (Design ,& Maintenance) Including Attached Lids, Storm Water Controls Loading Docks (Design &'Maintenance) Including Storm Water Controls, Dry & Frequent Cleaning Procedures Maintenance Bays (Design & Maintenance) Including Indoor Location & Storm Water Containment Vehicle and Equipment Wash Areas (Design.& Maintenance) Including Canopy & Containment Outdoor Material Storage Areas (Design &' Maintenance) Including Canopy & Containment Outdoor Work Areas or Processing Areas (Design & Maintenance) Including Canopy & Containment CC&R's, Maintenance Agreements or Other mechanisms will be used to ensure the ongoing operation, maintenance, funding, transfer and implementation of the project -specific WQMP requirements. Legal description and plat stamped by Registered Surveyor to be attached to the applicable CC&R or Maintenance Agreement for recordation at Riverside County. (Optional Requirement to be reviewed on a Project by Project basis) BMP Acknowl The applicant shall comply with listed BMPs and applicable provisions of the City's NPDES stormwater discharge permit, LQMC Sections 8.70.010 et seq: (Stormwater Management and Discharge Controls), and 13.24.170 (Clean Air/Clean Water); Riverside County Ordinance No.. 457; the California Regional Water Quality Control Board — Colorado River. Basin Region Board Order No. R7-2008-0001 and the State Water Resources Control Board's Order No. 99-08-DWQ.. . Signature: r Print Name: Title: Date: 16 / .( /_c?- 0 Applicant Certification certify that I have read this form in its entirety and. understand the City's submittal and review process and the Signature: requirements for this form. I understand and agree that if during the processing of the form, it is determined the l Print Name: RUA information contains errors or omissions, clarification and/or supplemental information may be required and the Title: L%, preparation of such information may be considered, in the Community Development Director's judgment, an Date: 110 /—L/—L-I— unreasonable delay and will result in a suspension of processing time limits in accordance with the California Code ,- Phone: 12top) of Regulations, Title 14, Section 15109. Owner Certification I certify under the penalty of the laws of the.State of California that I am the property owner of the property that Signature: is the subject matter of this application and I am authorizing and hereby do consent to the filling of this application and Print Name: 00, I acknowledge that the final approval by the City of La Quinta,,k��� if any, may result in restriction, limitations and construction Title: obligations being imposed on this real property. Date: 16 /L/A-1-+ Phone: (-Ho ) :5Zce -- -14'%2-: 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 Datel 10/30/2017 Job Site Address 52577 Medwether Way (Lot 38) Owner's Name Number, Street, or PO Box City, State, Postal Code Owner's Phone Number Owner's E-Mail Address Mark & Debra Wagner Project Manager's Name I David Miller/Bradshaw Const Project Manager's Phone Number 760-347-4246 Project Manager's E-mail Address david(cDmarkbradshawconstruction.com Builder / Contractor Bradshaw Const Number, Street or PO Box 81335 Thunder Gulch Way City, State, Postal Code La Quinta, CA. 92253 Project Square Footage Approx. 8,300 sq feet CityApproval By R. Gouldlock-DEC/Burrtec Wast Date of City Approval 1013oh ? RECEIVED Nov 0"8 2017 CITY OF LA QUINTA COMMUNITY DEVELOPMENT Materials To Be Discarded: Product Tons Trash 35.00 Not recyclable Product Tons Asphalt 0.00 Recyclable Masonry (broken) 0.00 Recyclable Brick/Block 0.00 Recyclable Plaster 10.00 Recyclable Cardboard 0.00 Recyclable Scrap Metal 0.00 Recyclable Commingled 0.00 Recyclable Tile (floor) 0.90 Recyclable Concrete 37.00 Recyclable Tile (roof) 1.20 Recyclable Drywall 4.25 Recyclable Wood 13.00 Recyclable Donated / Reuse* 0.00 Recyclable Landscape Debris 0.00 Recyclable *Describe Items Totals: Recycle Trash 66.4 35.0 Projected Diversion: 55.47% 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 landfilling. The remaining material will be recycled or reused. I will divert, for recycling or re -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 ntractor serving as agent of the owner may obtain a DMP for the owner. However, the DMP is still issued in the nam of the property owner(s) and the owner retains legal responsibility for ensuring that the provisions of the DMP are adher o. T e property owners) and general contractor shall be kept informed of the diversion progress through bi-monthly re s. If fio-hauling, all refuse material from this project site must be taken to an approved recycler or transfer Date GIVia�.ac.. /I EsGil Corporation In (Partnership with ('Government for Building Safety DATE: November 2, 2017 ❑ APPLICANT �RIS. JURISDICTION: La Quinta ❑ PLAN REVIEWER ❑ FILE PLAN CHECK NO.: BRES2017-0213 SET: II PROJECT ADDRESS: 52577 Meriwether Way i' PROJECT NAME: Wagner Residence ® The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. ❑ The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. ❑ The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. ❑ The check list transmitted herewith is for your information. The plans are being held at EsGil Corporation until corrected plans are submitted for recheck. ❑ The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. ❑ The applicant's copy of the check list has been sent to: ® EsGil Corporation staff did not advise the applicant that the plan check has been completed. ❑ EsGil Corporation staff did advise the applicant that the plan check has been completed. Person contact Telephone #: Date contacted: ) Email: Mail Telephone Fax n erson ® REMARKS: STRUCTURAL CHECK ONLY. By: Abe Doliente Enclosures: Old plans. EsGil Corporation ❑ GA ❑ EJ ❑ MB ❑ PC 10/26/17 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576