BRES2018-0255VOICE (760) 777-7125
78-495 CALLE TAMPICO D LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/27/2018
Permit Type/Subtype: BUILDING RESIDENTIAL/DWELLING - SINGLE FAMILY DETACHED Owner:
Application Number: BRES2018-0255 JASON J. WALLACE, TRUSTEE
Property Address: 81303 COLUMBUS WY 400 DOHENY RD
APN: 767690002 BEVERYLY HILLS, CA 90210
Application Description: WALLACE / 9,258SF SINGLE FAMILY DWELLING
Property Zoning:
Application Valuation: $794,989.50
Applicant: Contractor:
n
RUBEN FERNANDEZ/ KHA ARCHITECTS D Z � BRADSHAW CONSTRUCTION INC
78-185 PAINTERS PATH WAY, SUITE A 81335 THUNDER GULCH WAY
PALM DESERT, CA 92260 2 7 2018 LA QUINTA, CA 92253
CITY OF LA QUINTA (760)347-4246
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 848057
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
{commencing with Section 70001 of Division 3 of the Business and Professions Code, and
my License is in full force and effect.
License Class: B License No.: 2548057,
Date: / - 2 / Zf Contractor:
d
OWNER -BUILD 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
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
oft rk fo, which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
5 u n 3700 of the Labor Code, forthe performance of the workfor which this permit is
Issued. My workers' compensation insurance carrier and policy number are.
Carrier: C UALTY COMPANY Policy Number:
BNUWC0143135
_ 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.
Date: `l — Z `7—%Applicant: -
WARNING: FAILURE TO SECURE WORKERS' COMSATION 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 ofthis permit.
2. Any permit issued as a result of this application becomes null and void if work is not
commenced within 180 daysfrom 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: ! Z r — Signature (Applicant or Agent): u 7
,f
Date: 9/27/2018
Application Number:
BRES2018-0255
Property Address:
81303 COLUMBUS WY
APN:
767690002
Application Description:
WALLACE / 9,258SF SINGLE FAMILY DWELLING
Property Zoning:
Application Valuation:
$794,989.50
Applicant:
RUBEN FERNANDEZ/ KHA ARCHITECTS
78-185 PAINTERS PATH WAY, SUITE A
PALM DESERT, CA 92260
Owner:
JASON J. WALLACE, TRUSTEE
400 DOHENY RD
BEVERYLY HILLS, CA 90210
Contractor:
BRADSHAW CONSTRUCTION INC
81335 THUNDER GULCH WAY
LA QUINTA, CA 92253
(760)347-4246
Llc. No.: 848057
Detail: 9,258SF DWELLING - [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 $1,487.47
Total Paid for ART IN PUBLIC PLACES - AIPP: $1,487.47
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$32.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $32.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DIF - CIVIC CENTER
252-0000-43200
0
$796.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DIF - COMMUNITY CENTER
254-0000-43200
0
$129.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DIF - FIRE PROTECTION
257-0000-43200
0
$366.00
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 ATTACHED: $6,681.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TEMP POWER SERVICE
101-0000-42403
0
$26.01
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TEMP POWER SERVICE PC
101-0000-42600
0
$18.20
Total Paid for ELECTRICAL: $44.21
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, EA ADDITION 1,000SF
101-0000-42403
0
$132.60
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, EA ADDITION 1,000SF, PC
101-0000-42600
0
$54.60
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, FIRST 1,000SF
101-0000-42403
0
$156.04
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, FIRST 1,000SF, PC
101-0000-42600
0
$51.49
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $394.73
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT >7KSF
101-0000-42408
0
$39.01
DESCRIPTION
ACCOUNT
CITY
1 AMOUNT
RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT>7KSF PC
101-0000-42600
0
$195.05
Total Paid for GRADING: $234.06
DESCRIPTION
ACCOUNT
CITY
AMOUNT
AIR HANDLER
101-0000-42402
0
$39.01
DESCRIPTION
ACCOUNT
CITY
AMOUNT
AIR HANDLER PC
101-0000-42600
0
$13.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402
0
$351.09
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$234.09
DESCRIPTION
ACCOUNT
CITY
AMOUNT
EXHAUST HOOD
101-0000-42402
0
$26.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
EXHAUST HOOD PC
101-0000-42600
0
$10.40
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FURNACE
101-0000-42402
0
$312.08
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FURNACE PC
101-0000-42600
0
$208.08
DESCRIPTION
ACCOUNT
CITY
AMOUNT
VENT FAN
101-0000-42402
0
$156.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
VENT FAN PC
101-0000-42600
0
$62.40
Total Paid for MECHANICAL: $1,412.15
DESCRIPTION
ACCOUNT
CITY
AMOUNT
NEW CONSTRUCTION PERMIT
101-0000-42400
0
$960.57
Total Paid for NEW CONSTRUCTION PERMIT: $960.57
DESCRIPTION
ACCOUNT
CITY
AMOUNT
NEW CONSTRUCTION PLAN CHECK
101-0000-42600
0
$2,095.25
Total Paid for NEW CONSTRUCTION PLAN CHECK: $2,095.25
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PLAN CHECK DEPOSIT- RESIDENTIAL
101-0000-42600
1
$1,200.00
Total Paid for PLAN CHECK DEPOSIT - RESIDENTIAL: $1,200.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BACKFLOW DEVICE
101-0000-42401
0
$13.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BACKFLOW DEVICE PC
101-0000-42600
0
$5.20
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BUILDING SEWER
101-0000-42401
0
$26.01
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BUILDING SEWER PC
101-0000-42600
0
$18.20
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$507.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$507.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
GAS SYSTEM, 5+ OUTLETS
101-0000-42401
0
$39.01
DESCRIPTION
ACCOUNT
CITY
AMOUNT
GAS SYSTEM, 5+ OUTLETS PC
101-0000-42600
0
$26.01
DESCRIPTION
ACCOUNT
CITY
AMOUNT
ROOF DRAIN
101-0000-42401
0
$208.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
ROOF DRAIN PC
101-0000-42600
0
$208.00
Total Paid for PLUMBING FEES: $1,557.43
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE - MAJOR
101-0000-42416
0
$20.00
Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $20.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.10
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$103.25
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $103.35
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
101-0000-42600
($1,200.00)
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SINGLE FAMILY DETACHED
224-0000-20320
0
$637.44
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SINGLE FAMILY DETACHED
224-0000-20320
0
$1,200.00
Total Paid for TUMF - RESIDENTIAL: $637.44
TOTALS:.4
c& Qa4tra
— I:EiM nJ rbr F)I-SERT —
Project Address: 81-303 Columbus Way
APN #: 767690002
Applicant Name: Ruben Fernandez -KHA Architects
Address:
72-185 Painters Path STE A
City, ST, Zip:
Palm Desert, CA 92260
Telephone:
760-776-4068
Email:
ruben@kristihanson.com
Contractor Name: Client still need to select
Address:
City, St, Zip
Telephone:
Email.
State Lic: City Bus Lic:
Arch/Eng Name:
Kristi Hanson - KHA Architects
Address:
72-185 Painters Path
City, St, Zip
Palm Desert, CA 92260
Telephone:
760-7 76-4068
Email:
kristi@kristihanson.com
State Lic: CA
City Bus Lic: C-24847
Property Owner's Name: Mr. & Mrs Wallace
Address:
City, ST, Zip
Telephone:
Email:
PERMIT # 8kf-5 ) (:7\ 5?
PLAN LOCATION:
Project Description: Pool, Remodel, Add't, Elect. Plumb, Mech
New two story single family custom residence
Type V-B construction with built-up roof and stone/stucco
Valuation of Project $ 4 2fi0 000
New SFD Construction:
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
Mechanical & Storage
Construction Type: VB
Grading:
Bedrooms: 7 I Stories: 2
9,258 SF
1,259 SF
1,452 SF
SF
206 SF
Occupancy: Residential
# Units:
New Commercial / Tenant Improvements:
Total Building SF
Construction Type: Occupancy:
p y:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
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:
LEVEL ONE AMOUNT
DATE:
AMOUNT
LEVEL TWO AMOUNT:
COMM/IND" AMOUNT:
RECEIPT: I CHECK #:.:�t4
CERTIFICATE OF COMPLIANCE
Project Name: Wallace Madison Club (California Education Code 17620)
Owner's Name: Jason J. Wallace Trustee
Project Address: 81-303 Columbus Way, LaQuinta
Project Description: SFD
APN: 767-690-002-9
Tract #:
Type of Development: Residential XX
Commercial
Total Square Feet of Building Area:
Certification of Applicant/owners: The person signing certifies that
penalty of perjury and further represents that he/she is authorized to sib
Dated: Se tember 27 2018
Signature:
9258 sq. ft.
C1Ty
��Abit+!;,tlt, ry L, �3ct3c��A
-��• Gila
Date: September 27, 2018
Phone No.
Lot #Is:
Industrial
!F above information is correct and makes this statement under
on behalf of the owner/developer.
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
9258
$3.48
$32 8712 4
Building Permit Application Completed: Yes/N
Project Agreement Existing
g
Prior to 1I11$7 Not Subject to Fee
Requirement
0
By: Andy Jenkins, Interim Dir, Facilities Dev. & Planning
Note:
Pursuant to Ala 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:
NOTICE 'OF 90 DAY PERIOD F
section 6602t] n the Government Code asserted by Assemhty flit! 3t]81, effeetive January 1, 1997, requires that this f]istricl root
OR PROTEST OF FEES AND STATEMENT OF FEES
Project appellant, at the time of pslyment of school fees, nuligalinn payment or other exactions {"Fens"}, of the 9tthda
Tees and (2} the amount of the fees. Therefore, in accordance with section 66920 of the Government code and other a Period to law,
ttdvisc you that the 9l]-day protest period in regard !o such Fees or the validity the commences with the p de [f] a written notice to the
requirements as described in section 66020 of the [:nvernment code. Addiliu>7afly, the amount of the w y of III to proles! the i ticesholl a !bete
time or in whole or in part prior to issuance of a CeWificate of Occupancy. As in the lot;Per, tht 9Q days star lhzs Notice shall serve to
Payment of ths as he e fees or performance of any other
10 three
is valid For thinly [30] days Crom the date of issuance. Extensiuu ►vi]i be granted pier for goad talusst as determined hrein set +frth, whether payable a! this
to three {a] Such extensions may he granted, Y is on the date hereof This Certificate of
Y the School District, and up
11/2010
��'
Building Permit Number: ----
Project Description: IISFR - --
Jy
�`
Exempt: Elr,
(Materials may contain hazardous wastes and
OF
Construction Debris Managerrnent�Plan recycling Provisions)
Plan Submittal Date
8/10/2018
,lob Site Address
81303 Columbus Way
Owner's Name
Number, Street, or PO Box
Jason Wallace
Owners E-Mail Address
Project Managers Name
Project Managers Phone Number
Project Managers E-mail Address
Daniel Sutton
760-469-6402
don markbradshawconstructicn.com
RECEIVED
S F P 0 5 2018
Builder/Contractor
Number, Street or PO Box
City, State, Postal Code
Bradshaw Construction Inc.
81335 Thunder Gulch Way
La Quinta, CA, 92253
CITY OF LA 004,1114
COMMUNITY DEVE,L09MEMT
Project Square Footage
Approx. 9,920 sq ft
City Approval By
Renado Gouldlock-DEC/Bunlec Waste'
Date of City Approval
C49 f i0
Materials To Be ❑iscarded-
Product
Tons
Trash
41.00 Not recyclable
Asphalt
Brick/Block
0.00 Recyclable
Product
Masonry (broken)
Tons
Cardboard
0.00 Recyclable
0.00 Recyclable
Plaster
0.00 RecyclabiE
11.75 Recyclable
Commingled
0.00 Recyclable
Scrap Metal
0.00 Recyclable
Concrete
44.00 Recyclable
Tile (floor)
1.00 Recyclable
Drywall
Donated / Reuse*
5.00 Recyclable
Tile (roof)
Wood
1.40 Recyclable
0.00 Recyclable
Landscape Debris
16.00 Recyclable
*Describe Items
---------
0,00 Recyclable
Totals:—
Rec is
79.2
Trash
41.t3
Projected Diversion:
65.88%
I understand it is the property owner's responsibility to submit copies of weight tickets Or receipts to the 0lstrict
Environmental ent Plan
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 [east 65°/0 of the jobsite waste is
diverted from I rated fro 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 pain. This
D M P is issued in the name of the property owner(s) and shall remain their property throughout the construction and/or
demOhtaon project_ A contractor serving as agent of the owner may abtain a D M P for the owner, However, the D M P is still
issued in the name of the property owners) and the owner retains Iegal responsibility for ensuring that the provisions of the
❑MP are adhered to. The property Own ar(s) and general contractor shall be kept informed of the diversion progress through
bi-monthly raports. If self -hauling, all refuse material from this project site must be taken to an approved recycaer or transfer
Owner 1 [7eveloper 1 Project Manager J 5uperintendant
Date
10A
EsGil
DATE: 09/ 13/2018 A SAFEbullt`Company
JURISDICTION: La Quinta
PLAN CHECK #.: BRES2018-0255 SET: II
PROJECT ADDRESS: 81303 Columbus Way
PROJECT NAME: SFD for Wallace
❑ APPLICANT
UlRIS.
® 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
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 staff did not advise the applicant that the plan check has been completed.
❑ EsGil staff did advise the applicant that the plan check has been completed.
Person contacted: -
`--(t3: )
Fax I son
Date contacted
Mail Telephone
❑ REMARKS:
By: Ryan Murphy (for A.D.)
EsGil
09/06/2018
Telephone #--
Email:
Enclosures:
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
W Cl- (I c- C (�--
7 TT N'
J^ Y
i.�csign and Development Department - Building Div----
7.8-495 Calle Tampico, La Quinta, CA 92253
111: 7760) 777-7125 Fax: (760) 777-7011 Website: wwwJa-quinta.org
DET
Date: U _ q u.. IVED
Application Number: 12 f S5 — d ZS S— AUG 15 20.18
Project Street Address: 3Q kk CITY OF LAQUINTA
�, I U"A COMMUNITY DEVELOPMENT
Applicant: ❑ Architect or ❑ Contractor of Project (Please check appropriate box)
Policy Conditions:
l . 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 4vill 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, l he approved "JOB" Copy of Truss C
inspection
alculations is required to be onsite at the time of
Print nartic: ;Q0 1110,11,
Signature:
By singing this form, the `applicant�ad
requirements.
ledges and agrees to all conditions and
r
Approved By:
Title: �[ ]trte:��
**lV to to Permit Technician; i7t keel
78-495 Calle Tampico I La
P Quinta I California 92253 I 760.777.7000 I www _
Q1d�a2S?!"g
,�r��
a
Domestic Water System Flow Analysis
Domestic Water System Flow Analysis (Hydraulic Model)
Requested By: JD MECHANICAL, INC.
Address: + 82579 FLEMING WAY, SUITE D
f INDIO, CA 92201
Contact Name: JOHN DOVER
Phone: 760-775-6004
Coachella Valley Water District
75515 Hovley Lane East
Palm Desert, CA 92211
Date: 8/13/18
APN: 767690002
Req. Fire Flow: gpm at 20psi for hours.
Project Name: WALLACE RESIDENCE
— Email: I kathy@jdmechanical.co —
Cell:
Domestic Water System FIRE FLOW ANALYSIS OF HYDRANT CLOSEST TO 81303 COLUMBUS WAY, MADISON CLUB, ysis Location: 6-7-10-2, PZ 18-91
Flow Anal69 GEO
Model Information
Flow Analysis Description
Test 1 Test 2 Test 3 Test 4
Requested
•
Elevation (Ft):
0
Flow
Domestic
Steady State, Dynamic (psi);
76.41
system flow
Residual Pressure (Psi)
68.46
None
available
Fire Flow Tested (gpm):
2,750
without
Combined Total:
I I/A
exceeding
CVWD's
Tested Model Junction:
11886
N/A
criteria.
Duration:
2 hours
Demand Conditions:
Peak Day Demand (PDD)
Reservoir No./Level (s);
6726/26.85'
Pumps Operating No's:
Pumps On
--_—
Pressure Zone and HGL:
Lake Cahuilla (145')-
- Model:
Columbus FF CVWD MHRes-D
—
omesticWater 012616 --- — —
Comments: 1 The domestic water system Is capable of providing 2,750 gpm for 2 hours that satisfies CVWD's minimum
pressure, velocity, and/or head loss criteria. This flow can be achieved by using multiple fire hydrants. This 1
simulated system flow analysis may not include all facilities that may be required for this development/project.
Please check with Development Services for further information on all required facilities. The theoretical flow to
drop the residual pressure to 20 psi is greater than 5,000 gpm. Please note the theoretical flow exceeds CVow t
design criteria on the domestic water network.
MM
I These results are based on hydraulic modelling and not a guarantee that CVWD's domestic water system will have the capacity to
supply water to the project at the flows or pressures indicated. It is important to note that the capacity of the on -site fires stem
meters, service lines, backflow assemblies and other appurtenances were not considered in this analysis, which may alter actual I
flows or pressures. Due to continuous changes in the system, CVWD only considers this system flow analysis valid for six month
from date of modelling/analysis. These system flow analysis comments are for plan check purposes only. The ula de
timat months
responsibility resides with the Engineer -of -Record for this Project. f
sign
I
Should you have any questions or need additional information, please contact me at (760) 398-2661, ext. 2397.
HEr
SEP 05 2018
Completed By: ]
- CITYOF 14A'.,s_;a� Date: �.� �� d1lNTMUNITY 0 ' . i '� r ' e
Page 1 of 1
ENG DS-016
(8/31/15)
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RECEIVED
CITY OF LA QUINTA - PUBLIC WORKS DEPARTMENT GREEN SHEETS
PUBLIC WORKS CLEARANCE FOR RELEASE OF BUILDIN)C Pk�MV TM
Form updated & effective 9/2S/; 009 a
1.111Mi aneet apPrOvals are forwarded to the Building & Sa Ay De artment directs b Ii FV\�I? TA
submit the Green Sheet (Public Works Clearance) Packet to the Public Works De hJ , � � NOT
below are complete. Incomplete applications or applications which cannot be processed will be returned to applicant.listed
Date: 08 108 12 Developer: Bradshaw Construction
Tract No,: 33076 Tract Name: Madison Club
Address(s): 81303 Columbus Way
Lot No.(s): 10
Phone Number: ( 760 ) 275-6891
The following are the requirements for Public Works Clearance to authorize issuance of a building permit from the
Building & Safety Department.
❖ 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 -- #fi BELOW
1. Attach Pad Elevation Certificates in compliance with the approved design elevation for building pad (maximum
alfowable deviation of +/- 0.1 foot). Pad Elevation Certi#cates must be current (within 6 months of current date)
If a precise grading plan creates the pad for approval, please withhold greed sheet submittal until a Pad Elevation
Certificate can be provided.
2. Attach geotechnioal 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.
3. Attach recorded final map or title informationlgrant 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 -
5. 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
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 WOMP exemption form.
Approved maps/plans may be viewed at the following link: t�tt Ilwww.la- uinla or /PtanChecklm search.as x
I have reviewed and confirmed the requirements listed above as presented and find the improvements to be sufficiently
complete for construction of the proposed buitdings/structures/walls/signs on the subject lot(s). Pursuant to my findings -
the above project may be released for building permit issuance.
TL:
-- .7w"Iv111 GV111pleteu Dy ully suit, Recommended by: i Date: + �3
1 rffl f
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 & ApplicationslGREEN SHEET cover & PM10 loss than 1 Acre Revised 9-25-09 doc
FM
City of La Quints - PMID Fugitive Dust Controi Project InfarimAe "
Construction Phase PM10 Ag regiment 1<4 acrei#,,t % lriflli Prt ' ct
j Pro e i'iniarrrxatilvn F
#rri! show C?rtstructio-nProject phase e- 'Wallace ResidenCe
[check one]
/Lot Numbers: 33476 lot 1 U
Construction
D molition t Aadress-. 81303 Columbus Way
Iota± Acres in ActiueConstruction (c l'acre perLot): ,67 tart Date: Q� 100 1dAnticlpated Completion Date: 518. 1't}13 0.1 B
15M70 t~ontact Please mote; t7ust.cantrol i repaired 24 Hours a day, 7�'days "a vv$ek, regardless of .
Inf�rrnalivrf construction status. Person lisled below is responsible for dust cvntrpt.during.busir?9ss 8t�d
r►0�i•b1a5144[1r3.
N�rrre: ,.lttnathari ltj� Afstina
5 Y_
Tide: upat isor
-_ — -- } ;
wpm err Name: am shy Conatr�Cme a qq A
8 f 335 Thunder GutCh Way
.".... M, lira d rg�t:s:
Ci_tStata'JP Grade: La Quints, Gp 82253
P 760-3.47.4246 7..i. .
- Primp: #tvria #:
Fax # 760-347-6497
Phone# ,760a46M986
hnOne # 764-275-68.9.7 41,I.
keil - ---�-- 7.
:.tS• �r.:
Addr+�sa: � Y@rnarkbradshawconstruction.ca i11 :'f µ1.5
PM90 Cortinwe #:.' CV1702-004253,4320
Th[� above s ted" ire . . ... . .r.� .•; �x.M1,;.. .
•-�--'---�-�v-oY1!nl�.!LL�!' aufho � d r r �I:�i;���i��-��.:..
Shall aoi' as hisfher+knowledgernent of dust: oah'irvl requiremfts a erhd their enforceability; pursuant -to SCA.QMD
Rules 403, 4f}3"7; 4�,�,31. At3 , 201 03 and.Pi=RP;
4-Shall canstltute an i�treement td comply with all project conditions. as
•9 identified in the approves dust control Acknawledgea that dust etantrol is required twenty4o.ur j74j hours a day, seven (7) clays ;a We* ..thrQughaut the
Period of, project performance, regardless of project,i tus;
•s Shall ensum that each aril every contractor, subcontretto'e;end all otter Persons associated-Wlth }he pro;e�# shall
be in conti 6uous cdmpiiance with all. requirernents of the approved dust Control plari; . .
v Shah take all necessary precautions to minimize dust
control plan -are necessary; y even if additional measr+ss bByons those lis1ed in the dust.
�:• Shali,autnt3rize representatives of C WCOunty to enter,lhe property for inspsaian andlpr abatement {�urpase5;
4• Shall bold harmless'the CityJCpurtty d • representatives hpm liability for any actions related to this dust cgntrci
pi +�'or any CitylGt ntyihitia to nt ativities, f
,NATUE-E . L
Signature .."....rope, art ".Or: Aucnanzeo re r¢e
P Date
f' �Glotl hglr • P7rtrie 8 FippYEa *ftifvma.at AypI"kt r[e1rR.Er: 1 SHLE7 ecverA PM10 aes rryrt i !ue Ravn�d &2a-0B doG
ok
. - _ •'!�Oijl-•� C•110P
�4�,y'1i.'�r 4 �i„�ii� 'W-0..F... +* ••::y�.y� _
Water Quality Mana ement Plan WQMP Exemption Form - Whitewater River Re ion Documentation of Pro ect Not Reguir_ ing a WQMP but Re Requiring Site Deli n 13MPs 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 Answarpei "Nn" T., n__:___,
N. E&
Entitlement or construction of new single-family hillside residence(s) that create 10,000 square feet, or Yes . No
more, of 1rnpRrvious area where 11:1 re-develo ment natural sic a is 25% or reater? ❑
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 ❑ ll ✓ i
Classification SIC codes 5013, 7532, 7533, 7534, 7537, 7538, and 7539]? L� !!
Entitlement or construction of new retail gasoline outlets disturbin reater than 5,000 square�feet? Entitlement orconstructionofnewrestaurants) (or potential restaurant shell space) disturbiner n
than 5, 000 square feet?
Entitlement or construction of new home subdivisions with 10 or more housin units?
Entitlement or construction of new parking lot(s) of 5,000 square feet or more, or with 25 or more
parking spaces, and tentiall ex osed to Urban Runoff?
Applicant Information
Name and Title Kelly Bradshaw
Company
Bradshaw Construction
Phone
760-347-4246
Email
kelly@markbradshawconstruction.com
Project Information
Project Name
Wallace Residence
(SPH, Multi -Family, Commercial, Etc.)
SFH
Location or Street Address
81303 Columbus Way
Nearest Cross Streets Ave 54 & Madison
Municipality/County/Zip Code�7�97-690-002-6
Tract Number(s) and/or Assessor Parcel Number(s)
Other Location Information
Watershed I Whitewater River
Source Control BMP Information
Size of Project Area (nearest 0. 1 acre) .67
Project Area managed with Site Design or Low
Impact Development (LiD) BMPs (nearest 0,1 acre) 67
Is the project subject to onsite retention by City
ordinance or policy? no
Name of the Entity that will implement, operate, and
maintain the Source Control BMPs Bradshaw Construction
Contact Name Kelly Bradshaw
Street or Mailing Address
81335 Thunder Gulch Way
City
I La Quinta
Zip Code
92253
Phone
760-347-4246
T 1Checklisls - Forms & Applicalions\Fomis & ApplicationMISREEN SHEET cover & PM10 less than 1 Acre Revised 9-25-09 doc
Check Item
To be
Performed
W1
Check Item
To be
Provided
LES
10
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
EducationlTraining for Property Owner, Operators, Occupants, or Employees
Activity Restrictions — Prohibition of Debris Blowing/Sweeping/Washing into StreettStorm Drain, Closed
Trash Lids, Restriction of Vehicle Washing
Ongoing Street Sweeping at Private Streets and Private Parking Lots
-----------------------
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 &Main#enance) 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 Ac
I he 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:
Print Name. Jonw�'Wn
Title: Supervisor
Date: 08 108 12018
Phone: (76 275-6891
T 1Checklists - Forms & ApplicationsWorms & ApplicationslGREEN SHEET cover & PM10 less than 1 Acre Revised 9-25-09 doc
l Ortffy' tllat itAve Md Alis forri'1 ill it,$ entirety ai]d
Undlerstafid efts Ciry`s submfttel en-d review process and the
r�itttuFtn�sr�t:s fOr this fixrm, I Understand and egree•th.at 1.
during Th.a procbssint} of the forn), it is detefrmir}ed. the
informa0011 Orite"ns errors or dmissiorFs, Glariflcstjc,l and/or
quPplementel infc?FM OP May be required End the
prsparatirrn of sucirt inforrrmatlon'may be considered, in the
Community € Vafopment Muctor's judgment, an
unfeasonabie cfdla!r sncl will result in a suspensJon of
iuoceasing Tinte limits in accdrdaboe with the Calffot nia Co6.ig
of Reg 11lations, Titta 14, Section 15109-
.
cooft
certif'� and&r.the penalty, a#':the laWa of the stetaf.ot
C:a"Ornia that I an; the.Prdpert.y owner. of:.tha property tfiaY
is the SYNCCr matter: of:tf,la' 0PPli(:4tinn and I amsurhar�xirlg
di)d hereby do consent to Ina fIIIin9. pY tfti$ ap�tlotion aid'-
ackrrowtvtfge that the fines .approval by t1je ell o'il:e it a
if r,nyr l ay reault.in restrictiah, Ffnitatians and Cofttr"tr63 t
obliggrions bejq il-npossd on this real property.
fPrint fFE mu. �rtrl"" +' •n L��1 �r'r �.
760 34 424.6.
Phone:......7,.. _..... _...
51GNATURE
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