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BRES2017-012078-495 CALLE TAMPICO . LA QUINTA, CALIFORNIA 92253 Application Number: BRES2017-0120 Property Address: 53497 ROSS AVE APN: 767680055 Application Description: PIERCEY / 5,620SF Property Zoning: Application Valuation: $499,303.10 Applicant: DISCOVERY BUILDERS CALIFORNIA INC DBA DB 14605 N 73RD STREET SCOTTSDALE, AZ 85260 `&h 4 4v a w VOICE (760) 777-7125 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 7/28/2017 DOwner: J/VBVf 2nPIERCEY RESIDENCE INfAS-fiC&SMIA/L3 , LA QUINTA, CA 92253 CITY OF LP, OLIATA COMMUNITY DEVELOPMENT DEPARTMENT Contractor: DISCOVERY BUILDERS CALIFORNIA INC DBA DB 14605 N 73RD STREET SCOTTSDALE, AZ 85260 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: /BB License No.: 915336 Date:t vV v -Contractor. 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).: (_)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 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 contractors) 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 Name: Lender's Address: (480)624-5200 Llc. No.: 915336 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: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA Policy Number: YJUB282D7797 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 provisions. DateZ �� 5�A pp _Iicant: 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: `2% ` Signature -(Applicant or Agent). ` d Applicant: Contractor: DISCOVERY BUILDERS CALIFORNIA INC DBA DB DISCOVERY BUILDERS CALIFORNIA INC DBA DB 14605 N 73RD STREET 14605 N 73RD STREET SCOTTSDALE, AZ 85260 SCOTTSDALE; AZ 85260 (480)624-5200 Llc. No.: 915336 Detail: 5,620 SF DWELLING - MADISON CLUB LOT33. MAIN HOUSE: 4,479 SF, GUEST HOUSE: 1,141 SF. [VB/RES-3/CLASS A-FR/13D] THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2016 CALIFORNIA BUILDING CODES. Date: 7/28/2017 Application Number: BRES2017-0120 Owner: Property Address: 53497 ROSS AVE PIERCEY RESIDENCE APN: 767680055 Application Description: PIERCEY / 5,620SF DWELLING/VB/RES-3/CLASS A-FR/13D LA QUINTA, CA 92253 Property Zoning: Application Valuation: $499,303.10 Applicant: Contractor: DISCOVERY BUILDERS CALIFORNIA INC DBA DB DISCOVERY BUILDERS CALIFORNIA INC DBA DB 14605 N 73RD STREET 14605 N 73RD STREET SCOTTSDALE, AZ 85260 SCOTTSDALE; AZ 85260 (480)624-5200 Llc. No.: 915336 Detail: 5,620 SF DWELLING - MADISON CLUB LOT33. MAIN HOUSE: 4,479 SF, GUEST HOUSE: 1,141 SF. [VB/RES-3/CLASS A-FR/13D] THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2016 CALIFORNIA BUILDING CODES. DESCRIPTION ACCOUNT CITY AMOUNT ART IN PUBLIC PLACES - RESIDENTIAL 270-0000-43201 0 $748.26 Total Paid for ART IN PUBLIC PLACES - AIPP: $748.26 DESCRIPTION ACCOUNT CITY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $20.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $20.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - CIVIC CENTER 252-0000-43200 0 $942.00 DESCRIPTION ACCOUNT CITY 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 CITY AMOUNT DIF - LIBRARIES 253-0000-43200 0 $344.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - PARK MAINTENANCE 256-0000-43200 0 •$40.00 DESCRIPTION ACCOUNT . CITY AMOUNT DIF - PARKS/REC 251-0000-43200 0 $2,048.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 DESCRIPTION ACCOUNT CITY AMOUNT TEMP POWER SERVICE 101-0000-42403 0 $25.33 DESCRIPTION . ACCOUNT CITY AMOUNT TEMP POWER SERVICE PC 101-0000-42600 0 $17.73 Total Paid for ELECTRICAL: $43.06 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $77.52 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, EA ADDITION 1,O00SF, PC 101-0000-42600 0 $31.92 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $152.00 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, FIRST 1,O00SF, PC 101-0000-42600 0 $50.16 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $311.60 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL PRECISE GRADING -CUSTOM HOME LOT>7KSF 101-0000-42408 0 $38.00 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL'PRECISI'. GRADING - CUSTOM HOME LOT>7KSF PCI 101-0000-42600 0 1 $190.00 I' Total Paid for GRADING: $228.00 DESCRIPTION ACCOUNT CITY AMOUNT CONDENSER/COMPRESSOR •101-0000-42402 •0 $190.00 DESCRIPTION ACCOUNT CITY AMOUNT CONDENSER/COMPRESSOR PC 101-0000-42600 0 $126.65 DESCRIPTION ACCOUNT CITY AMOUNT EXHAUST HOOD 101-0000-42402 0 $12.67 DESCRIPTION ACCOUNT CITY AMOUNT EXHAUST HOOD PC 101-0000-42600 0 $5.07 DESCRIPTION ACCOUNT CITY AMOUNT FURNACE 101-0000.42402 0 $190.00 DESCRIPTION ACCOUNT CITY AMOUNT FURNACE PC 101-0000-42600 0 $126.65 DESCRIPTION ACCOUNT CITY AMOUNT VENT FAN 101-0000-42402 0 $126.70 DESCRIPTION ACCOUNT CITY AMOUNT VENT FAN PC 101-0000-42600 0 $50.70 Total Paid.for MECHANICAL: $828.44 DESCRIPTION ACCOUNT CITY AMOUNT NEW CONSTRUCTION PERMIT 101-0000-42400 0 1 $786.52 I. Total Paid for NEW CONSTRUCTION PERMIT: $786.52 DESCRIPTION ACCOUNT CITY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $1,200.00 DESCRIPTION ACCOUNT CITY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $476.75 Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,676.75 DESCRIPTION ACCOUNT CITY AMOUNT BACKFLOW DEVICE 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT CITY AMOUNT BACKFLOW DEVICE PC 101-0000-42600 0 $5.07 DESCRIPTION ACCOUNT CITY AMOUNT BUILDING SEWER 101-0000-42401 0 $25.33 DESCRIPTION ACCOUNT CITY AMOUNT BUILDING SEWER PC 101-0000-42600 0 $17.73 DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $342.09 DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $342.09 DESCRIPTION ACCOUNT CITY AMOUNT GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $38.00 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 5+ OUTLETS PC 101-0000-42600 0 $25.33 DESCRIPTION- ACCOUNT QTY AMOUNT ROOF DRAIN 101-0000=42401 0 $291.41 DESCRIPTION ACCOUNT QTY AMOUNT ROOF DRAIN PC 101-0000-42600 0 $291.41 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $25.34 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 $15.20 DESCRIPTION ACCOUNT QTY 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: $1,4S7.01 DESCRIPTION ACCOUNTQTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $64.91 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $64.91 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 1• Total Paid for TECHNOLOGY ENHANCEMENT FEE: 55.00 DESCRIPTION ACCOUNT QTY AMOUNT SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 Total Paid for TUMF - RESIDENTIAL: r $1,837.44. �rr�S Zon - c L 61- 33 A Fiidre 53-qq1 idress 7 .caner Malling Address City Contractor TO.VK m Address i6o 9 SS' City Ld, & Classif. U.I Aer Zip r /IA + [_ 1 I �►tJ !aC&4 ��fr� r ar7 ;�J P.O. BOX 1504 APPLICATION ONLY 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 r '•roar BUILDING: TYPE CONST. V OCC. GRP. Re 5I CA erT r &J A.P. Number _767- 6,,S _] — 00 3% 1 Tel. � Cas+i�ec'►n''� � IhC. S2 Tel. S-3 760-393-5*2 City Lic. # Designer KM A Areb l-TLa T Address "Tel. 721SS t�o:,�Ter t�aT STA 760-776-10G49 City Zip State 'PckI I7_e-seer '0 Lic.# (--24%47 LICENSED 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 GATE 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 Pmfesslans Code: Any city or county which requires apermit to construct after, fmprrn Q. demolish, or repair any5"cture; pdorto its issuance also requires the appiiCarrtfor such ppeermit m file a s mid slalemeni Nlaf he is licensed pursuant In the provislons of the Conlrac- v.. Ltcansa Law, Clwpiar R (commarrcing with Section:7000) of Division 3 of the Business and tlessians Cade, or hhat he is exempt therefrom, and rho basis for the alleged exontptiora. Any }letfon of Saclfon 703f.5 by any applicant fora permit subjects the applicant to a civil penally of ,ot more than five hundred dollars (S500). ❑I, as owner of the property, or my employees with wages as their sole win pensatio n, wifi do the work, and the structure is not intended or offered for sale. (Sac. 7044. 9usfness and Profes- sions Code: The Contractor's License Law does nor 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). ❑ I, 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 properly who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to tho Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason 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 shati ba deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency forthe 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 9xpiration if work thereunder is suspended for 180 days. I certify that I have read thIr application and state that the above information is correct. �grea to comply with all city and county ordinances and state laws relating to building —�anstruction, and hereby authorize reprasenlafives of this city to enter the above -mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip WHITE = BUILDING DEPARTMENT Legal Description -� Project Description cu_S_Tn m Ce r Sq. Ft. No. No. Dw. Size 7 S Stories Units New ill Add ❑ Alter ❑ Repair ❑ Demolition ❑ MB-�n C4w%% Td0. 9 4 -7 +.+CST '%1' ea.. 1 111i I To To.1, 1 It I%\A S62o C�o�tc.gG S,�acQ.c12 r 10 a y DuT �asr �i V iY�G� 61q To To. I -15`i 7 Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL CONTACT INFORMATION NAME: PHONE: 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: YELLOW = APPLICANT PINK = FINANCE fubw0 C-( 61vtSail. Cowl Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (76b) 398-5909 — Fax (760) 398-1224 Project Name: Mr. and Mrs. 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) Madison Club Owner's Name: Discovery Builders California, Inc. / T-Star 111 Project Address: 53-497 Ross Avenue, La Quinta, CA 92253 Project Description: Single Family Dwelling Unit APN: 767680055 Type of Development: Residential Tract #: xx Commercial Total Square Feet of Building Area: 5,620 SQ. FT. Date: July 18, 2017 Phone No. 760-393-5286 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 to sign on behalf of the owner/developer. Dated: - 1 el-l/ 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 Gov. Code Project 17620 65995 Approval Number of Sq.Ft. 2,282.96 Amount per Sq.Ft. 3.48 Amount Collected $7,944.70 Building Permit Application Completed: Yes/No By: Elsa F. Esqueda, Director of Facilities and Maintenance Certificate issued by: Leticia Torres, Facilities Analyst Agreement Existing Not Subject to Fee Prior to 1/1/87 Requirement Note: CERTIFICATE OF PREPAID S UARE FOOTAGE This Certificate Sq.Ft. 5,620.00 Previous Sq.Ft. balance 3,337.04 Square Footage After Credit 2,282.96 NOTICE OF 90 DAY PERIOD FOR PROTEST OF_FEES ANC STAXtMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, req at 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. 11/2010 EsGil Corporation In (Partnership with Government for Building Safety DATE: 7/ 18/2017 ❑ APPLICANT JURIS. JURISDICTION: LA QUINTA ❑ PLAN REVIEWER ❑ FILE PLAN CHECK NO.: BRES2017-0120 SET: II PROJECT ADDRESS: 53-497 ROSS AVENUE PROJECT NAME: SFD — STRUCTURAL ONLY — FOR PIERCEY ® 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 contacted: A Telephone #: Date contacted: (by:— ) Email: Mail Telephone Fax In Person REMARKS: By: Bert Domingo Enclosures, EsGil Corporation ❑ GA ❑ EJ ❑ MB ❑ PC 7/12/2017 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576 -T4ht 4 4 a" Design and Development Department - Building Division 78-495 Calle Tampico, La Quinta, CA 92253 (760) 777-7125 Fax: (760) 777-7011 Website: www.la-quinta.org IC Date:. --�" -30 20; Application Number. Fro 'E O Cs ;?/ - al2 D Project Street Address: -5f'65 V.Q Applicant: ❑ Architect or W Contractor of Project (Please check appropriate box) Policy Conditions: 1. Limited to Custom residential pre -fabricated wood trussed roof projects on a case by case basis; 2. This form will be completed and submitted to the Building Division for approval prior to the Second submittal, ** The approved form will be submitted as part of the second submittal package; 3. Deferred Truss Submittal will consist of two sets wet stamped Truss Calculations, Roof Layout and Engineer of Record's Acceptance stamp or letter; 4. Review timeframe is 10 working days; 5. Service Fee of plan review and processing based on actual hourly cost of plans examiner, structural consultant, permit technician (payment required at the time of pickup of approved truss calculations; 6. The deferred truss submittal review and approval will be required prior to a foundation / footing inspection (no exceptions). 7. The approved "JOB" Copy of Truss Calculations is required to be onsite at the time of Print name: 1l1 e7 0 I�Wll17tE- Signature: fffzWW By singing this form, the app] ican t6Vnmyledges and agrees to all conditions and requirements. If Approved(; �j ""r" mte: T 1, **Not�_So Permit Techalcian: I3c7. Not Accept wiOlQui Approval of Form 78-495 Calle Tampico I La Quinta I California 92253 1 760.777.7000 1 www-1 n- Quint "9 �'. V ED JUL 10 2017 CITY OF LA QUINTA PLANNING DEPAPTMENT' 019 Z rim r- Building Permit Number. -. Project Description: SFR Exempt: O (Materials may contain hazardous wastes and s are not subject to recycling provisions) OF r Construction Debris Management Plan Plan Submittal Job Stte Add rass Owner's N Number-, Street, or PO City, State, Postal C Owner's Phone Nun Owner's E-Mail Add Project Manager's Name Project Manager's Phone Number Project Manager's E-mail Address Builder / Contm Number, Street or PO City, State, Postal C Project Square Footage City Approval By Date of City Approval Materials To Be Discarded: Product Trash Asphalt Brick/Block Cardboard Commingled Concrete Drywall Donated / Reuse* *Describe Items 5/5=17 53-497 Ross Ave (Lot 33A) William Plercey c% 53985 Humboldt Blvd La Quanta, CA. 92253 Tammy Jenkins 780-393-5286 flenitinsvidiscrDverybulldg_gUc corn Discovery Builders Califomia Inc. 53985 Humboldt Blvd Le Quints, CA. 92253 5,620 square feet -� t� Renado Gouidlock-DI C/Burrt$c Waste Tons Not recyclable Recyclabie Recyclable Recyclable 27.00 Recyclable 3.00 Recyclable 0.00 Recyclable Totals: Recycle Trash 4B.7L 24.3 RECE&IrE4i JUN 0 2017 PL4NA �a DE AUINry RTMEN/ Product Tons Masonry (broken) 0.00 Plaster 6.75 Scrap Metal 0.00 Tile (floor) 0.62 Tile (roof) 0.78 Wood 1 8.50 Landscape Debris 1 0.00 Projected Diversion: B'�.80°fin I understand tt Is the property owners responsibility to submit copies of weight tickets or receipts to the District Environmental Coordinator as these hauls occur. i hereby certify that completion, Implementatlon and adherence of the Debris Management Plan (DMP) for the above named project shall guarantee that at least 66% of the jobsite waste is diverted from Iandfllllng. 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 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 owner(s) 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 bi-monthly reports. If self -hauling, all refuse material from this project site must be taken to an approved recycler or transfer Recyclable Owner 1 Developer Project Manager 1 Superintendent Date EASYTOUCH 11 STANDARD KEYPAD 7iser inter faces KSxxxx-xxxx Modular one to five button options Backlighting automatically adjusts based on time of day, easily see which scenes are active based on backlit button color or intensity Custom color pallette option to match or mix finishes for trims, buttons and faceplates I product oz-o 'itV description EasyTouch II is a modular keypad with contemporary aesthetics and functionality that complements each project design. Available in one through five -button configurations, EasyTouch II's custom color pallete allows designers to match or mix finishes for trims, buttons, and faceplates. Buttons feature full - range RGB backlighting with a built-in diffuser. The backlight color indicates the status of the programmed button by providing the user with the option to personalize the color for on, off, or other status feedback. And, due to Vantage's use of laser engraving, only the lettering on each button will be illuminated, maintaining the aesthetic appeal of the keypad. RECEIVED Two-step painting process ensures consistent color definition and reflectivity Laser -engraved buttons are available with LED backlighting in any color Hidden infrared receiver allows you to easily select new lighting or music scenes from a remote control 0 operation EasyTouch II Keypads are designed and programmed through Design Center software (2.3 or higher). Installation is very simple, requiring a proprietary 2-wire Vantage Station Bus pigtail connection. The EasyTouch II keypad can be mounted into standard 1-4 gang electrical boxes, PROJECT LOCATION/TYPE JUL 10 2017 CITY OF LA QUINTA PLANNING DEPARTMENT Ir VAN TAG E" specifications 4.125" x 2.30" x 0.9" 105mm x 58mm x 23mm necificatic Models KSxxxx-xxxx Weight 1,8 oz (51g) Ability to gang with conventional switches Yes (see NEC code book for proper installation of Class 2 and line voltage connections) Addressing Self -addressing through software IR receiver Yes, Built-in/standard Ambient light sensor Yes, Built-in/standard Ambient operating temperature 32-95°F (0-35°C) Ambient operating humidity 5-95% non -condensing Button LED RGB, full color Button configurations 1 - 5 Buttons Color options Arctic White (AW), Vantage Ivory (VI), Black (BK), Original Bronze (OB) and Titanium (TI) Maximum number of gangs Up to 4 gangs Sound Yes (variable pitch) Status LED Microprocessor status LED blink pattern Surge suppression Yes UL, CUL, and CE listed Yes Auxiliary connections 2 Outdoor use (1 or 2 Gangs Only) With approved weatherproof cover (Part# WPC-1 or WPC-2) Power for external devices 15mA (aa) 12V DC Ouxiliary wiring connection 2 wire 600V pigtail (included) Station Bus connection 2 conductor, 16 AWG stranded, non -shield, <30 pF/Foot - Station Bus should be separated a minimum of 12" from other parallel communication and/or high voltage runs Station wiring configuration Daisychain/star/branch Station Equivalent 24V 3 buttons count as 0.6 Watts, S buttons count as a72 Watts Station Equivalent 36V 3 buttons count as 0.9 Watts, 5 buttons count as 1.08 Watts System Compatibility 1/VANTAG E'_ 1� station bus wiring with low -voltage keypads (VC each STATION BUS RUN 1 (Back to Main Terminal board "Station Bus 1") KITCHEN BATHROOM BEDROOM DEN • SPEC: 2C, 16AWG/1.31mm 2 twisted, non -shielded, <30pF per foot. Separate a minimum of 12"/30.5cm from other parallel communication and/or height voltage runs • Max. Wire Length Station Bus: 2,000ft/609m of cabling max on each Station Bus. No station more than 1,000ft/305m from Controller • 36V: Each Station Bus run has a 60W power supply. Up to 60 stations each bus or until the 60W supply has been used • 24V: 35W max power supply to BOTH Station Bus runs. Up to 50 stations each bus or until the shared 35W supply is used • Wire Configuration for Station Bus: Daisy chain, branch, star • All Station Bus runs terminating at keypad should be connected red -red and black -black. The keypad is non -polarized so Station Bus pigtail leads can be connected either way IFVANTAGE- 0 Standard Finish Options Custom Finish Options (extended lead time) Metal Faceplates I Trim Line II '=•••• Sol""ne ••' ME MENEM Ii Align Arctic Vantage Oil -Rubbed Vantage Black Chrome Brass Clear Custom White Ivory Bronze Almond Painted I Anodized Polished I Satin Polished I Satin Anodized Paint ■ ■ Plastic Faceplates '•TrimLine II ••••' NE N Arctic Vantage Original Black Titanium Brown Custom Custom White Ivory Bronze Paint Paint Plastic Faceplates I Arctic Vantage Brown Vantage Black Custom White Ivory Almond Paint Trims -. T: t .....� .Arctic Vantage Original Black Titanium Oil -Rubbed Brown Vantage Black Chrome Brass Custom White Ivory Bronze Bronze Almond Anodized Paint Buttons EasyTouch II BEEN 0 Arctic Vantage Original Black Titanium Custom White Ivory Bronze Paint Buttons /SquareTouch FineTouch••••/ ■ ■ � ■ ■ ■ Arctic Vantage Brown Vantage Black Silver Gold Custom White Ivory Almond Paint 1F V A N T A G E" 09E Sladden Engineering 45090 Golf Center Parkway, Suite F, Indio, CA 92201 (760) 863-0713 Fax (760) 863-0847 6782 Stanton Avenue, Suite C, Buena Park, CA 90621 (714) 523-0952 Fax (714) 523-1369 450 Egan Avenue, Beaumont, CA 92223 (951) 845-7743 Fax (951) 845-8863 800 E. Florida Avenue, Hemet, CA. 92543 (951) 766-8777 Fax (951) 766-8778 May 3, 2017 Par Development 42-240 Green Way, Suite C Palm Desert, California 9221 Subject: Geotechnical li3pi26-5 Zol 7- Ol 20 CITY OF LA QUINTA BUILDING & SAFETY DEPT APPROVED FOR CONSTRUCTION DATE Project: Proposed Custom Residence �.0rp l Ce .. 53-497 Ross Avenue f The Madison Club — Lot 33A La Quinta, California Project No. 544-14057 17-05-186 REIIVIE7 JUN Of 7017 CITY OF LA ,-,UINTA PLANNING DEPARTMENT Ref: Geotechnical Investigation Report prepared by Sladden Engineering dated January 28, 2005; Project No. 544-4810, Report No. 05-01-101 Report of Testing and Observation During Rough Grading prepared by Sladden Engineering dated March 2, 2006; Project No. 522-4810; Report No. 06-02-120 As requested, we have reviewed the above referenced reports as they relate to the design and construction of the proposed custom residence to be to be constructed on Lot 16 at 53-497 Ross Avenue within the Madison Club development in the City of La Quinta, California. It is our understanding that the proposed residential structure will be of relatively lightweight wood - frame construction and will be supported by conventional shallow spread footings and concrete slabs on grade. The subject lot was previously graded during the rough grading of the Madison Club project site. The rough grading included over -excavation and recompaction of the native surface soil along with the placement of engineered fill material to construct the building pads. The site grading is summarized in the referenced report of Testing and Observation During Rough Grading along with the compaction test results. Because the lot has been previously rough graded, the remedial grading required at this time should be minimal provided that the building area falls within the previously assumed building envelope. The building areas should be cleared of surface vegetation, scarified and moisture conditioned prior to precise grading. The exposed surface should be compacted to a minimum of 90 percent relative compaction prior to fill placement. The previously removed soil and any fill material should be placed in thin lifts at near optimum moisture content and compacted to at least 90 percent relative compaction. Kt� Sladden Engineering May 3, 2017 -2- Project No. 544-14057 17-05-186 The referenced reports include recommendations pertaining to the design and construction of residential structure foundations. The previous reports also address the potential for liquefaction, subsidence and differential settlement. Based upon our review of the referenced reports, it is our opinion that the structural values included in these reports remain applicable for the design and construction of the proposed residential structure foundations. The allowable bearing pressures recommended in the referenced Geotechnical Investigation report remain applicable. Conventional shallow spread footings should be bottomed into properly compacted fill material a minimum of 12 inches below lowest adjacent grade. Continuous footings should be at least 12 inches wide and isolated pad footings should be at least 2 feet wide. Continuous footings and isolated pad footings should be designed utilizing allowable bearing pressures of 1500 psf and 2000 psf, respectively. Allowable increases of 300 psf for each additional 1 foot of width and 300 psf for each additional 6 inches of depth may be utilized, if desired. The maximum allowable bearing pressure should be 3000 psf. The recommended allowable bearing pressures may be increased by one-third for wind and seismic loading. Lateral forces may be resisted by friction along the base of the foundations and passive resistance along the sides of the footings. A friction coefficient of 0.48 times the normal dead load forces is recommended for use in design. Passive resistance may be estimated using an equivalent fluid weight of 300 pcf. If used in combination with the passive resistance, the frictional resistance should be reduced by one third to 0.33 times the normal dead load forces. The bearing soil is generally non -expansive and falls within the "very low" expansion category in accordance with the 2016 (CBC) classification criteria. Sladden has reviewed the 2016 California Building Code (CBC) and summarized the current seismic design parameters for the proposed structure. The seismic design category for a structure may be determined in accordance with Section 1613 of the 2016 CBC or ASCE7. According to the 2016 CBC, Site Class D may be used to estimate design seismic loading for the proposed structures. The 2016 CBC Seismic Design Parameters are summarized below. Risk Category (Table 1604.5): I/II/I1I Site Class (Table 1613.3.2): D Ss (Figure 1613.3.1): 1.510g Sl (Figure 1613.3.1): 0.709g Fa (Table 1613.3.3(1)):1.0 Fv (Table 1613.5.3(2)):1.5 Sms (Equation 16-37 {Fa X Ss)): 1.510g Sml (Equation 16-38 {Fv X Si)): 1.064g SDS (Equation 16-39 12/3 X Sms)): 1.007g SD1 (Equation 16-40 12/3 X Smi}): 0.709g Seismic Design Category: D Sladden Engineering r1T May 3, 2017 -3- Project No. 544-14057 17-05-186 In addition, we have sampled the surface soil on the subject lot to determine the soluble sulfate content as it relates to selecting appropriate concrete mix designs. The testing indicated soluble sulfate content of 5500 ppm (0.550 percent) that corresponds with the "severe" exposure category in accordance with ACI 318-08, Table 3. Based upon this, the use of sulfate resistant concrete mixes will be required. Structural concrete in contact with the soil should have a minimum compressive strength of 4000 psi and a maximum water -cement ratio of 0.45. We appreciate the opportunity to provide service to you on this project. If you have any questions regarding this letter or the referenced reports, please contact the undersigned. Respectfully submitted, SLADDEN ENGINEERING Brett L. Anderson_ Principal Engineer SER/clb Copies: 4/Addressee BRETf L. RSON j CD No. C45389i Exp. 9/30/18 T CIVIL ENGINEERING ff 9F Cf.\ Sladden Engineering Myl-I NO -1 - Please verify that soils reports contain all of the above information. In addition, to assure continuity between the investigationlreporting stage and the execution stage, please use the following checklist to verify that the conclusions and recommendations in the report cover all the required elements. Only then can we be assured that the construction documents address all of the site soil conditions. La Quinta Geotechnical Report Checklist Does the "Conclusions and Recommendations" section of the report address each of the following criteria? "Address" means: (a) the criterion is considered significant and mitigation measure($) noted, -or; (b) the criterion is considered insignificant and explicitly so stated. .Ygs - No Criterion J ❑ Foundation criteria based upon bearing capacity of natural or compacted soil. ❑ Foundation criteria to mitigate the effects of expansive soils. ❑ Foundation criteria based upon bearing capacity of natural or compacted soil. A❑ Foundation criteria to mitigate the effects of liquefaction. ❑ Foundation criteria to mitigate the effects of seismically induced differential settlement. ❑ Foundation criteria to mitigate the effects of long-term differential settlement ❑ Foundation criteria to mitigate the effects of varying soil strength_ 1 ❑ Foundation criteria to mitigate expected total and differential settlement. Any "No" answers to theabovechecklist should be noted as specific required corrections. Sladden Engineering 45090 Golf Center Parkway, Suite F, Indio, CA 92201 (760) 863-0713 Fax (760) 863-0847 6782 Stanton Avenue, Suite C, Buena Park, CA 9062I (714) 523-0952 Fax (714) 523-1369 450 Egan Avenue, Beaumont, CA 92223 (951) 845-7743 Fax (951) 845-8863 800 E. Florida Avenue, Hemet, CA. 92543 (95I) 766-8777 Fax (951) 766-8778 July 6, 2017 Project No. 544-14057 17-07-292 IQ3A Architects �0' 7 r 017 O 72-185 Painters Path, Suite A _ Palm Desert, California 92260 n Ty n F iA Q a i d N I A Subject: Project: Ref: Foundation Plan Review Proposed Custom Residence 53-497 Ross Avenue The Madison Club - Lot 33A BUILDING & SAFETY DEFT. APPROVED FOR CONSTRUCTION ❑ATE �17-BY J La Quinta, California .OFF-7ce Geotechnical Investigation Report prepared by Sladden Engineering dated January 28, 2005; Project No. 544-4810, Report No. 05-01-101 Report of Testing and Observation During Rough Grading prepared by Sladden Engineering dated March 2, 2006; Project No. 522-4810; Report No. 06-02-120 Geotechnical Update prepared by Sladden Engineering dated May 3, 2017; Project No. 544-14057, Report No. 17-05-186 As requested, we have reviewed the Foundation Plans prepared by Young Engineering for the proposed custom residence to be constructed at 53-497 Ross Avenue within the Madison CIub development (identified as Lot 33A) in the City of La Quinta, California. Based on our review, it is our opinion that the recommendations provided in the above referenced Geotechnical reports have been properly incorporated into these plans. We appreciate the opportunity to provide service to you on this project. If you have any questions regarding this letter or the referenced reports, please contact the undersigned. Respectfully submitted, SLADDEN ENGINEERING Brett L. Anderson -"-�i --,,u Principal Engineer �' 8RErT ANDERB F Z ui No. IV G? SER/gvm P.0 IL s/30 9 N� AIGI EERING � (,rem® 'gy p CALIF JUL 1 0 2017 Copies: 4/Addressee CITY OF LA QUINTA PLANNING, nFPAPTNAFN1 Sladden Engineering .944:-� sZZ)n--61Z`l0 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. j Date: 6/,79 / Developer:�� Tract No.: D�10' Tract Name: Lot No.(s): Address(s): S-5,74-70 2o!55 /4vt Phone Number: ( ) �-3 547— - The following are the requirements for Public Works Clearance to authorize issuance of a building permit from the Building & Safety Department: i�CUSTOM HOMES- PROVIDE ITEMS #4 #3, #4, 45 & #7 BELOW ❑ TRACT HOMES: PROVIDE ITEMS #1; #2, #3 & #5 BELOW ❑ COMMERCIAL BUILDINGS/OTHER: PROVIDE ITEMS #1, #2, #3, 45 & #7 BELOW ❑ WALLS, SIGNS, OTHER: PROVIDE ITEM 06 BELOW 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. 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 PM10 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 zo.ne developments will require an approved flood plain development plan. 6. Attach supporting documentation for wall plan, monument sign, grease trap or special facility installations. 7. 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: http://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 by City staff. a(77 Recommended by: Date: /2 / Public Works Distribution: ( L--J' Green Sheet to Building & Safety ( ) Green Sheet to Planning Department Declined for approval for reason(s) as follow(s), please correct and resubmit: TAChecklists - Forms & Applications\Forms & Applications\GREEN SHEET cover & PM10 less than 1 Acre Revised 10-02-12.doc City of La Quinta - PM 10 Fugitive Dust Control Project Information Construction Phase PM 10 Agreement (< 1 acre/lot or Infill Project) Project Information Project Contractor:; Project Phase (check one) Construction ❑ Demolition Project Name: -�' 2 Project Tract/Lot Numbers: 4d V d 71JJ 1 Project Street Address: �'7 Total Acres in Active Construction (< 1 a r. per Lot): , "1�vI r 7 Anticipated Start Date: r �� r 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. rda / Jl y(� Name: Title: Company Name: Mailing Address: City, State, ZIP Code: Primary Phone #: qv SY Fax #: 24 Hour Emergency Phone#: `_ !� l � 0 Zr/ �Z V Cell Phone #: Z y2. Email Address: AtPM 10 Certificate#: t-:�V L it l 00 3 0 2-Lo The above stated property owner (or authorized representativey: ❖ 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. 4• 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; " Shall authorize representatives of City/County to enter the property -for inspection and/or abatement purposes; Shall hold harmless the City/County and its representatives from liability for any actions related to this dust control plan or any City/County initiated abatement activities. Signature of Pro &V Owner or Authorized Representative Date City of La Quinta - PM 10 Fugitive Dust Control Plan (< 1 acre per Lot or Inf ill Project) This Fugitive Dust Control Plan shall take into account applicable SCAQMD Regulations Rule 403, 403.1, 401, 402, 201, 203 and Portable Equipment Registration Program (PERP). WATERING: Continuous watering is required to prevent dust and must occur a minimum of four (4) times daily. Water shall be applied from an adequate sized metered water source to dry soils to prevent: ■ Visible dust emissions >20% opacity_ ■ Visible dust emissions that travel > 100 feet from the source (within site) • Visible dust emissions that cross any property line ❖ EDUCATION: The responsible dust control Individual and key personnel shall attend SCAQMD PM10 class and obtain PM10 certificate number prior to construction activity (training information may be obtained by contacting SCAQMD at (909) 396-2183). _CONSTRUCTION & DEMOLITION ACTIVITIES: A copy, of this approved Fugitive Dust Plan must be kept on site. At least one short-term stabilization method must be used during off hours. At least one long-term stabilization measure must be used within ten (10) days of ceasing activity. WEATHER MONITORING: Wind predictions shall be monitored. ❖ SIGNAGE: Approved signs shall be installed at a highly visible location. Please refer to the Coachella Valley Fugitive Dust Control Plan Handbook for Construction Signage Guidelines. TRAFFIC: Construction traffic shall not be allowed on the pad, unless absolutely necessary. If vehicles operate on pad, pad shall be kept firm and moist through hose watering and sprinklers; and a maximum traffic speed of 15mph will be enforced. Fugitive Dust shall be prevented by fencing off site to prevent unauthorized traffic on pad. PARKING: Parking is not allowed on pad. All vehicles must park on street at designated areas only. ❖ TRACK OUT: Provide 24 hour street cleaning and track out system as approved by City Public Works inspectors. No dirt on public or private roads. Track out shall be cleaned up within one (1) hour of incident and at the conclusion of each workday. ❖ DIRT PILES: Dirt piles shall be limited to 50 cubic yards and built per California Building Code grading requirements. Piles shall be kept moist or covered with tarp material. Larger dirt piles will require stockpile or grading permit. FENCING: Provide PM10 fencing at perimeter of public roads and where applicable. Wood slat fencing can be installed at rear of property and return 20 feet on either side if HOA restrictions apply. Block walls can replace PM10 fencing during the construction phase. s EQUIPMENT: Extra hoses and sprinklers shall be maintained on site. s EXCAVATION MEASURES: All areas to be excavated or graded shall be pre -watered. Water shall also be applied during excavation or grading operations. DUMP TRUCKS: Open top dump trucks shall be wet down, moist and covered with a tarp prior to leaving site. •: INACTIVE SITE: Within 10 days of ceasing of activities, re -vegetate or permanently stabilize as required. RECORD KEEPING: Fugitive Dust Control Plan records (i.e. self inspection records, records of use of chemical suppressants, etc.) shall be maintained for 3 years by- the Property Owner (or Authorized Representative). Property Owner shall notify the City, and SCAQMD within 10.days of completion of project. Water nuality Mananament Plan (WQMP) Exemption Form - Whitewater River Region 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? / 1� 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 gasojine 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 Company Phone Email rjil(•d��Q� 7� �. f�� Project Information Project Name 5 Type (SFH, Multi -Family, Commercial, Etc.) Location or Street Address Nearest Cross Streets Municipality/County/Zip Code La Quinta Tract Number(s) and/or Assessor Parcel Number(s) ,q 3- A i//' V Other Location Information Watershed Whitewater River Source Control BMP Information _ Size of Project Area (nearest 0.1 acre) 7 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 �0 ordinance or policy? Name of the Entity that will implement, operate, and '� I' _r 11A l � maintain the Source Control C Contact Name "6 6 r ` C/i/1 Street or Mailing Address j AO l/ City /, A ;o Zip Code G Z j 0 Phone 0 b �57 Check Item Source Control BMP Requirements - All Projects Require Non -Structural BMP Source Control To be Performed 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 Vehicle Washing Ongoing Street Sweeping at Private Streets and Private Parking Lots Check Item Source Control BMP Requirements — Small Sloped Lots, Small Commercial, < 10 Unit To be Subdivisions, < 5,000 Square Ft. Parking Lots, Etc. Provided 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 Acknowled 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. 137-2008-0001 and the State Water Resources Control Board's Order No. 99-08-DWQ. Signature: 7�p 4V_111 — I ► + Print Name: Title: ILI YI J Date: I / lei 1-7 Phone: Applicant Certification I certify that I have read this form in its entirety and understand the City's submittal and review process and the requirements for this form. I understand and agree that if during the processing of the form, it is determined the information contains errors or omissions, clarification and/or supplemental information may be required and the preparation of such information may be considered, in the Community Development Director's judgment, an unreasonable delay and will result in a suspension of processing time limits in accordance with the California Code of Regulations, Title 14, Section 15109. Signature: I Print Name: &7,/ L ' `C Title: [ e k �hfr i/GfA r I�� Date: Phone: { l �-/ 40— G ( 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 is the subject matter of this application and I am authorizing and hereby do consent to the filling of this application and acknowledge that the final approval by the City of La Quinta, if any, may result in restriction, limitations and construction obligations being imposed on this real property. Signa Print Title: Date: Phone:) 7,� l� 7 �J