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BRES2019-0178���� 78-495 CALLE TAMPICO VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/17/2019 Permit Type/Subtype: BUILDING RESIDENTIAL/DWELLING - SINGLE FAMILY DETACHED Owner: Application Number: BRES2019-0178 LOUIS D. & GLORIA RUSSELL Property Address: 57330 PENINSULA LN 57330 PENINSULA LANE APN: 762150040 LA QUINTA, CA 92253 Application Description: RUSSELL / 8,900SF DWELLING Property Zoning: Application Valuation: $654,220.00 Applicant: Contractor: MICHAEL HANES - WEST COAST BUILDERS EARTHWORK & LA WEST COAST BUILDERS EARTHWORK & LANDSCAP 78005 WILDCAT DRIVE #104 n n 78005 WILDCAT DRIVE #104 PALM DESERT, CA 92211 z/----�, u PALM DESERT, CA 92211 SEP 17 2019 (760)345-3800 Llc. No.: 368452 CITY Chi LA QUINTA -----------------__�_ -------IMStG1V&MEIUNENTGCM71%rc6,ii--------------------------------- 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 r2J ess and Professions Code, and my License is in full force and effect. License Class: C27 A C12. B License No.: 3 Date: 4 �1t —) l 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).: (_) 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 N Lender's WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ 1 We and wlll maintain a certificate of consent to self -insure for workers' compens as provided for by Section 3700 of the Labor Code, for the performance of he 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: STATLCOMeEN5ATION INSURANCE EUND Policy Number: 9038341 I certify that in the performance of the work for which thi ermit is issued, I shall not employ any person in any manner so as to be c a Subje o the workers' compensation laws of California, and agree that, if I o d c subject to the workers' compensation provisions of Section 37pi f t L ode, I shall forthwith comply with those provisions. Date: ( ^ I T L 12_Applicant: 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 -equest and for whose benefit work is performed under or pursuant to any permit issued es a result of this application, the owner, and the applicant, each agrees to, and shall Jefend, 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 'ollowing issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not :ommenced within 180 days from date of issuance of such permit, or cessation of work or 180 days will subject permit to cancellation. certify that I have read this application and state that the above infor ion is r ect. agree to comply with all city and county ordinances and state laws a ng t ding :onstruction, and hereby authorize representatives of this city to t upo above- nentioned property for inspection purposes. )ate: Y 1 Z l 9 Signature (Applicant or Agent Date: 9/17/2019 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: BRES2019-0178 57330 PENINSULA LN 762150040 RUSSELL / 8,900SF DWELLING $654,220.00 Applicant: MICHAEL HANES - WEST COAST BUILDERS EARTHWORK & LANDSCAP 78005 WILDCAT DRIVE #104 PALM DESERT, CA 92211 Owner: LOUIS D. & GLORIA RUSSELL 57330 PENINSULA LANE LA QUINTA, CA 92253 Contractor: WEST COAST BUILDERS EARTHWORK & LANDSCAP 78005 WILDCAT DRIVE #104 PALM DESERT, CA 92211 (760)345-3800 Llc. No.: 368452 Detail: 8,900SF DWELLING - LOT 6 [VB/RES-3/CLASS A-FR/13D] THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2016 CALIFORNIA BUILDING CODES. FINANCIAL INFORMATION DESCRIPTION ACCOUNT CITY AMOUNT ART IN PUBLIC PLACES - RESIDENTIAL 270-0000-43201 0 $1,135.55 Total Paid for ART IN PUBLIC PLACES - AIPP: $1,135.55 DESCRIPTION ACCOUNT CITY AMOUNT 101-0000-42600 ($350.00) DESCRIPTION ACCOUNT CITY AMOUNT 101-0000-42600 ($250.00) DESCRIPTION ACCOUNT CITY AMOUNT 101-0000-42600 ($120.00) DESCRIPTION ACCOUNT CITY AMOUNT HOURLY CHARGE - INTERWEST PLANS EXAMINER 101-0000-42600 3.5 $350.00 DESCRIPTION ACCOUNT CITY AMOUNT HOURLY CHARGE - INTERWEST PLANS EXAMINER 101-0000-42600 1.2 $120.00 DESCRIPTION ACCOUNT CITY AMOUNT HOURLY CHARGE - INTERWEST STRUCTURAL PLAN REVIEW 101-0000-42600 2 $250.00 Total Paid for BLDG CITY STAFF - PER HOUR: $0.00 DESCRIPTION ACCOUNT CITY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $27.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $27.00 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 CITY 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 $26.68 DESCRIPTION ACCOUNT CITY AMOUNT TEMP POWER SERVICE PC 101-0000-42600 1 0 $18.68 Total Paid for ELECTRICAL: $45.36 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $122.49 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF, PC 101-0000-42600 0 $50.40 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $160.10 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $52.83 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $385.82 DESCRIPTION ACCOUNT CITY AMOUNT CONDENSER/COMPRESSOR 101-0000-42402 0 $200.10 DESCRIPTION ACCOUNT CITY AMOUNT CONDENSER/COMPRESSOR PC 101-0000-42600 0 $133.40 DESCRIPTION ACCOUNT CITY AMOUNT EXHAUST HOOD 101-0000-42402 0 $26.68 DESCRIPTION ACCOUNT CITY AMOUNT EXHAUST HOOD PC 101-0000-42600 0 $10.68 DESCRIPTION ACCOUNT CITY AMOUNT FURNACE 101-0000-42402 0 $200.10 DESCRIPTION ACCOUNT CITY AMOUNT FURNACE PC 101-0000-42600 0 $133.40 DESCRIPTION ACCOUNT CITY AMOUNT VENT FAN 101-0000-42402 0 $173.42 DESCRIPTION ACCOUNT CITY AMOUNT VENT FAN PC 101-0000-42600 0 $69.42 Total Paid for MECHANICAL: $947.20 DESCRIPTION ACCOUNT CITY AMOUNT MULTI -SPECIES RESIDENTIAL 0-8 UNITS - 2019 UPDATE 101-0000-20310 1 0 d $1,331.00 Total Paid for MULTI -SPECIES RESIDENTIAL: $1,331.00 DESCRIPTION ACCOUNT CITY AMOUNT NEW CONSTRUCTION PERMIT 101-0000-42400 0 $924.09 Total Paid for NEW CONSTRUCTION PERMIT: $924.09 DESCRIPTION ACCOUNT CITY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $2,006.93 Total Paid for NEW CONSTRUCTION PLAN CHECK: $2,006.93 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 $13.34 DESCRIPTION ACCOUNT CITY AMOUNT BACKFLOW DEVICE PC 101-0000-42600 0 $5.34 DESCRIPTION ACCOUNT CITY AMOUNT BUILDING SEWER 101-0000-42401 0 $26.68 DESCRIPTION ACCOUNT CITY AMOUNT BUILDING SEWER PC 101-0000-42600 0 $18.68 DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $426.88 DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $426.88 DESCRIPTION ACCOUNT CITY AMOUNT GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $40.02 DESCRIPTION ACCOUNT CITY AMOUNT GAS SYSTEM, 5+ OUTLETS PC 101-0000-42600 0 $26.68 DESCRIPTION ACCOUNT CITY AMOUNT ROOF DRAIN 101-0000-42401 0 $53.36 DESCRIPTION ACCOUNT CITY AMOUNT ROOF DRAIN PC 101-0000-42600 0 $53.36 DESCRIPTION ACCOUNT CITY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $26.68 DESCRIPTION ACCOUNT CITY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 $16.00 DESCRIPTION ACCOUNT CITY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $13.34 DESCRIPTION ACCOUNT CITY AMOUNT WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $13.34 Total Paid for PLUMBING FEES: $1,160.58 DESCRIPTION ACCOUNT CITY AMOUNT 101-0000-42600 ($21.00) DESCRIPTION ACCOUNT CITY AMOUNT RECORDS MANAGEMENT FEE - MAJOR 101-0000-42416 0 $21.00 Tntmi Pain fnr Ri:rnRnc MAIUArCMCIUT CCC - RAAWND. do nn DESCRIPTION ACCOUNT CITY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $85.05 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $85.05 DESCRIPTION ACCOUNT CITY AMOUNT 101-0000-42600 ($5.00) DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 DESCRIPTION Total Paid for TECHNOLOGY ENHANCEMENT FEE: $0.00 ACCOUNT I CITY I AMOUNT 101-0000-42600 ($454.00) DESCRIPTION ACCOUNT CITY AMOUNT SINGLE FAMILY DETACHED 2018 UPDATE 224-0000-20320 0 $454.00 DESCRIPTION ACCOUNT CITY AMOUNT SINGLE FAMILY DETACHED 2018 UPDATE 224-0000-20320 0 $1,856.00 Total Paid for TUMF - RESIDENTIAL: $1,856.00 TOTALS: tev0"fra - - GENA of,b, DESERT - PERMIT it-J06 .D (� C) I �f"� DTIT \ i , 1 PLAN LOCATION: V IV �j ' Project Address: 59-330 P�AjiA-�svzAzA,,�J6 Project Description: Pool, Remodel, Add% Elect, Plumb, Mech APN #: 96;L- 50 -O !o IW /I�Ey..> �J _ i S ►(� gL60a--/so-005 Applicant Name: .C� )4k"L<-S Address: 960-5 (�/1 '� ?Q� ve City, ST, Zip: P��,� C4 9 2Z� Telephon 6,9 - 3 3 69 Email: �k I �� Valuation of Project S��r .000, ^� Contractor Name: �..r It,Ti?� New SFD Construction: Address: �.� i - ��� Conditioned Space 2 SF City, St, Zip �DPLM G� L.2 / Garage �, / 00 SF Telephone• 176a JIY5 _38� Patio/Porch olSC7 SF Email: I en 1.JCJW , l,f,.S Fire Sprinklers. SF State Lic:jgySa City Bus Lic: Arch/Eng Name: Construction Type: V Jj Occupancy: R,3 Address: Grading: U City, St, Zip Telephone: Bedrooms: Stories: # Units: !' Email: State Lic: City Bus Lic: Property Owner's Name: /s )aU5-S6LL New Commercial / Tenant Improvements: Address: "p Total Building SF City, ST, Zip Qt)1� = ,p, Gn, Construction Type: Occupancy: Telephone- 9/ T 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: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: I COMMAND, AMOUNT: DATE: RECEIPT: CHECK#: INITIALS CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: West Coast Builders Owner's Name: Louis D & Gloria Russell RELer. Project Address: 57-330 Peninsula Lane, LaQuinta 1-7 2019 Project Description: Single Family Dwelling APN: 762-150-040 Type of Development: Date: September 17, 2019 Phone No. 760-345-3800 CrfY OF LA QUINTA Tract #: DESIGN AND DEVELOPMENT DEPARW's: Residential xx Commercial Total Square Feet of Building Area: 7,000 ss . ft. 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: Seltember 17, 2019 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 7000 $3.79 $26530.00 Project Agreement Existing Not Subject to Fee Approval Prior to 1/1/87 Requirement Building Permit Application Completed: Yes/No By: Larry Moen, Director Facilities Dev. & Planning Note: 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. Administrative Spec. Signature: 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. 11/2010 f / r COMMUNITY DEVELOPMENT DEPARTMENT 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 (760) 777-7012 FAX (760) 777-7011 CERTIFICATION OF BUILDING AREA STREET ADDRESS OF JOB: 57-330 PENINSULA LN APN: 762-150-040 DESCRIPTION OF WORK: NEW SINGLE FAMILY DWELLING SQUARE FOOTAGE: 7,000 S.F. OWNER'S NAME: LOUIS D. & GLORIA RUSSELL For questions regarding this letter, please call: City of La Quinta Permit Center CITY OF LA 0 0 I NTA (760) 777-7012 BUILDING DIVISION REVIEWEL,' �:0I3 Coachella Valley Unified School District CODE 83-733 Avenue 55 &AM LIANCE P O Box 847 DATA By 'F Thermal, CA 92274 (760) 398-5909 Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 Please note: This letter verifies conditioned square footage. Please can your School District to verify school fees, requirement for cashier's check or money order and hours of operation. r;. . Plan Submittal Job Site Owner's N Number, Street, or PO City, State, Postal C Owner's Phone Nun Owner's E-Mail Add Project Manager's Project Managers Phone N Project Manager's E-mail A Building Permit Number: . Project Description: SFR Exempt: O (Materials may contain hazardous wastes and are not subject to recycling provisions) Construction Debris Management Plan 6/27/2019 (revised) 57330 Penninsula Ln Louis Russell Nathan VanMalsen 760-578-3888 na ta.�?wr�ui Iders.�o m Builder / Conlractorl West Coast Builders Number, Street or PO Box1 78005 Wildcat Dr #104 City, State, Postal Code I Palm Desert, CA. 92211 Project Square Approx. 9,375sf RECEIVED SEP 17 2019 CITY OF !A QUIHTA DESIGN AND DEVELOPMENT DpARTMENT OA. 0 City Approval By Renadv Qouldlock-DECfBurrtec Waste Date of City Approval _0110 Materials To Be Discarded., Product Trash Asphalt Brick/Block Cardboard Commingled Concrete Drywall Donated / Reuse* *Describe Items Tons 37.00 Not recyclable 0.00 Recyclable 0.00 Recyclable 2.2_5 Recyclabte 0.00 Recyclable 42.00 Recyclable 4.75 Recyclable 0.00 Recyclable Product Tons Masonry (broken) 0.00 Plaster 11.00 Scrap Metal 0.00 Tile (floor) 1.00 Tile (roof) 1.25 Wood 15.00 Landscape Debris D.00 Totals: Recycle Trash Projected f]iversiarr: 77.31 F 37.0 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 oft properly owner(s) and shall remain their property throughout the construction and/or demolition project. A con1ra9WAerVFAg as agent of the owner may obtain a DMP for the owner. However, the DMP is still issued' thenaof the p erty owner(s) and the owner retains legal responsibility for ensuring that the provisions of the DMPareTh roperty owners) and general contractor shall be kept informed of the diversion progress through bi-monthl-hauling, all refuse material from this project site must be taken to an approved recycler or transfer Owner eve[oper! Project Manager / Superiniendant Date Construction Debris Management Plan Summary of Requirements As of January 1, 2017, The Green Building Standards Code (CALGreen) requires that the construction of most new structures in the State of California comply with sections 4.408 and 5.408 of the code in accordance with Assembly Bill 939 requiring that no more than 35% of jobsite waste be disposed of as trash at local land fill sites and transfer stations. Exceptions may be made for certain projects under certain conditions. The City of La Quinta is committed to the highest level of environmental respect, to conserving our precious natural resources and setting an example to provide for a better world for generations to come. Recycling helps keep reusable resources out of landfills and will also reduce disposal costs. IMPORTANT: Burrtec Waste & Recycling Services is the City's franchise hauler. If you choose to self -haul any recyclables or trash, you must provide copies of all weight tickets and/or receipts from the transfer station, landfill, or recycler as the job progresses. Clean-up companies and other haulers are not permitted to haul waste or recyclables from the City of La Quinta. Self -haul weight tickets should be submitted to: Renado Gouldlock, District Environmental Coordinator - rgouldlock@burrtecdesert.com, or faxed to (760) 340-0417, or mailed to: 41575 Eclectic Street, Palm Desert, CA. 92260. A pp r-0 Ira-- (.e*e - - r PGA WE ST. FAIRWAYS ASSOCIATION NOTICE OF RESULTS OF ARCHITECTURAL APPEAL TO THE BOARD July 29, 2019 Louis & Gloria RussellRECEIVED SEP 17 2019 RE: 57330/57340 Peninsula Lane — Architectural Appeal to the Board of Direct CITY OF LA QUINTA WSIGN AND DEVELOPMENT DEPARTMENT Dear Mr. and Mrs. Russell, The Board of Directors of the PGA WEST Fairways Association met on Tuesday, July 23, 2019 to review your appeal of the Architectural Review Committee's decision to deny your application to construct a new residence on two (2) lots within the Peninsula Park Homeowners Association (PPHOA). As noted in the previous letter dated July 3, 2019 the Architectural Review Committee felt that the privacy walls and vehicle gates as proposed would create a compound look and feel to this property with obstructed views of the home which does not currently exist within the PPHOA. The Board did not disagree with this opinion. After due consideration, and review of the information from the PPHOA, the Board determined to approve your application as submitted with the strong recommendation that you reconsider the current design of the privacy wall and vehicle gates. In the spirit of achieving the desired harmony with the adjacent and surrounding homes, the Board recommends that you consider making adjustments to the design that contains visibility or sight lines to the home (i.e. wrought iron gates and/or wall openings) The Board sincerely appreciates your proposed improvements to the Peninsula Park neighborhood and looks forward to the completion of your residence. If you have any questions, please contact Kari Martin at 760-895-6345 or by email at K;iri.Marlin�rt`in�ana;.7erner�ttrusl.con�. Sincerely, By Direction of the Board of Directors PGA WEST jE�S pT FIalr ys Association as►ie Gertz, CCAMTCA General Manager TheManagement Trt Division cc: Lot File Architectural Committee Peninsula Park ALDRC Post Office Box 1690 • La Quinta, California 92247 • Phone (760) 776-5100 • Fax (760) 776-51 11 • ww%%%pga%vestfair%vays.com OF Associa" Desert Resort Management PENINSULA PARK June 25„ 2019 Mr. & Mrs. Louis Russell 4PP 1- a vaj- L,e��f�e� RECEIVED SEP 17 2019 Via email: DESIGN AND DEVELOPMENT DEPARTMENT RE: Architectural Review Dear Mr. & Mrs. Russell: The Construction Drawing review has been completed, there are no exceptions noted. We are however, still awaiting approval from The Fairways. At this time, the following items will be required: ■ A Construction Compliance Deposit in the amount of $12,500 payable to Peninsula Park ■ A copy of the building permit • Two (2) copies of the Temporary Construction Facilities Plan Please refer to the Construction Process in the Architectural Guidelines, beginning on page 48 to be sure the process is followed, and construction goes as planned. A copy of this letter is being sent to your architect for the corrections that need to be made so that construction can commence. Sincerely, Rosie Galla, CCAM-HR®, PCAM® Community Association Manager P.O. Box 14387 Palm Desert, CA 92255 176o.346.ii6i ' www.drminternet.com Delivering unsurpassed management and lifestyle services to communities worldwide. www.associaonline.com 8&-rsa.v I9-oI-7S CITY OF LA QUINTA - PUBLIC WORKS DEPARTMENT GREEN SHEET PUBLIC WORKS CLEARANCE FOR RELEASE OF BUILDING PERMIT Form updated & effective 9125/2009 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: /I Developer: RJbLlL�&!�S Tract No.: Tract Name: P&j WP�j� Lot No. is): Address(s): t4s u-1,oL L&Ae, Phone Number: (Ia) Sq,r-- � The following are the requirements for Public Works Clearance to authorize issuance of a building permit from the Building & Safety Department: 111 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. 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. 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. QAttach 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. 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: t!ttp://www.la-guinta.org/PlanCileck/m search.asr)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 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 st ff. !J Recommended by: Date: 1 !I 1 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: TAChecklists - Forms & Applications\Forms & Applications\GREEN SHEET cover & PM10 less than 1 Acre Revised 10-02-12.doe City of La Quinta - PM 10 Fugitive Dust Control Project Information Construction Phase PM10 A reement (<1 acre/lot or Infill Project) Project Information Project Phase (check one) Construction Demolition Total Acres in Active Construction (< 1 acre per Lot): „ S? PM 10 Contact Information ect Contractor: I Project Name: C� Project Tract/Lot Numbers: j Z,Z P, Project Street Address: 5 Lct,Qu.inizt. Anticipated Start Date: B_/_L5' /fq_ Anticipated Completion Date: 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 Na- d, Yale Y I` IaAse,� Title: W 1 SD r any Name: Address City, State, ZIP Code: Primary Phone #: _ Fax #: 24 Hour Emergency Phone#: W t6f- C©a67+ 96,4a (d ars 7$C,OS' W;1 d w4 Dr i ✓Q- 61-t,; ec 10� P0Jr , Des"O'rf, Ca4- Qzzll `7 6D -- 34S--390 a `760 -3gS-4�00 -740 5-7 9- 3y88 Cell Phone #: I -76057S 30e6 Email Address: nafe_� WGbmw Id errs•Gam PM 10 Certificate #: GV 16 v `-606 - ` I — & fo The above stated property owner or authorized representative) - 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; " ❖ 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. Signatu o Property Owner or Authorizedl Representative Date W&5 c 6u-I ldu�s City of La Quinta - PM10 Fugitive Dust Control Plan (< 1 acre per Lot or Infill 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). •3 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. EQUIPMENT: Extra hoses and sprinklers shall be maintained on site. 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 Quality Management Plan (WQMP) Exemption Form - Whitewater River Region Documentation of Project Not Reqorinq a WQMP but RequiringRLquiring 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 Praiert) Entitlement or construction of new single-family hillside residence(s) that create 10,000 square feet, or more, of impervious area where the. re -development natural slope is 25% or greater? 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 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? V Applicant Information Name and Title Company ld.ff ,�V- Phone D - 0 - Email l P-AD r Ltd"M' Project Information Project Name Type (SFH, Multi -Family, Commercial, Etc.) �( ( 2�is,l� 2nCe— - J Location or Street Address n II Nearest Cross StreetsVivi!�-a- .� �$ r%1 n9GC���L i�NC�1Qi Municipality/County/Zip Code La Quinta Tract Number(s) and/or Assessor Parcel Number(s) 2 ZZ Z'� •• `E" Other Location Information Watershed Source Control Size of Project Area (nearest 0.1 acre) Whitewater River BMP Information 07 . $� n (IG W e Coast- g wi l d 2,Vs 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 Contact Name Street or Mailing Address ,.. / /_ Q.h Vox, /^n _ ASS` 7 � r l I i v� ' F-� City Fed re, Zip Code q ZI-�' Phone o — s Check Item To Pe rm ed o 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 V 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 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 Acknowledgement 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. Print Narne: Date:1I Phone: W %j12, ant 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. Print Name:yn-OR4 •. 514111 • Phone: (Z 0)-34ft;--,�ND10 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. Signature: Print Name: L gols7)�"2qgg2-/� Title: lJ 6d Ai ZTO Date: —7 / 0/1 (? Phone: (7:�) 3 56 Q.3 4.5 Xv*a�M131 LUlF.LS7C0RS7 BUILDERS INC TO: CITY OF LA QUINTA RE: BRES2019-0178 As the owner of 57-330 Peninsula Lane in La Quinta, CA 92253, I hereby authorize West Coast Builders to coordinate building permit submittal documents with the City of La Quinta and to pull the building permit. Signature: LZl 1 Dater r Printed Name: Louis Russell 7BOE35 Wildcat Drive, Suste # 104 ^ Palm Desert, CA 92211 • Orti-e 7B0. 345.3800 • Fax 760.345 •4700 RECEIVE i Design and Development Department - Building Division 78-495 Calle Tampico, La Quinta, CA 92253 11 H: (760) 777-7125 Fax: (760) 777-7011 Website: www.lo-quinto.org JUL 0 3 2019 MY OF LA gUIiVDEFERRED TRUSS SUBMITTAL FORM T DESIGN AN UPM f Application Number: 2017-01?n Project Street Address: S %` 30 106,V1.<V5UZ_4 &AAJ6 Applicant: eArchitect or ❑ 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 inspection. Print name: Signature: By singing this requirements. CIP the applicant acknowledges and agrees to all conditions and F- V�� s Approved By: _ �C _ _ Title:���MINIM, Date: 19 "Note to Permit Technician: ❑o Not Accept submittal without Approval of Form. 78-495 Calle Tampico I La Quinta I California 92253 1 760.777.7000 1 www.La-Quinta.org Z'r'T n�nella Valley Water District Desert, Domestic Water System Flow Analysis J U L 0 5 1 Im Deert CA 92211 L'RvVEST Domestic Water System Flow Analysis (Hydraulic Model) CONSULTING GROUP Requested By: WEST COAST BUILDERS, INC. Date: 6/24/19 Address: 78005 WILDCAT DRIVE #104 APN: 762150040 Req. Fire Flow: gpm at 20psi for hours. PALM DESERT, CA 92211 MICHAEL HANES Project Name: Contact Name: RUSSELL RESIDENCE FSAME Phone: 760.899.3368 Email: mike@wcbuilders.com Cell: Domestic Water System FIRE FLOW ANALYSIS -HYDRANT CLOSEST TO 57330 PENINSULA, LOT 6, PGA WEST, LA QUINTA, Flow Analysis Location: GEO 6-7-21-4, PZ 19-10087 Model Information CVWD • •Model Requested • Flow Analysis Description Test 1 Test 2 Test 3 Test 4 Flow Domestic -16 system flow 82.58 available without 76.84 exceeding Elevation (Ft): Steady State, Dynamic (psi): Residual Pressure (psi): Fire Flow Tested (gpm): 1,700 N/A CVWD's Combined Total: N/A criteria. t_ Tested Model Junction: J2276 Duration: 2 hours Demand Conditions: Peak Day Demand (PDD) Reservoir No./Level (s): Reservoir 6726127.42' Pumps Operating No's: Pumps On Pressure Zone and HGL: Lake Cahuilla (145') Model: Working 5-9-19-CVWD_.DomesticWater 012616 Comments: The domestic water system is capable of providing 1,700 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 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 CVWD's design criteria on the domestic water network. 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 fire system, meters, service lines, backflow assemblies and other appurtenances were not considered in this analysis, which may alter actual flows or pressures. Due to continuous changes in the system, CVWD only considers this system flow analysis valid for six months from date of modelling/analysis. These system flow analysis comments are for plan check purposes only. The ultimate design responsibility resides with the Engineer -of -Record for this Project. Fshould you have any questions or need additional information, please contact me at (760) 398-2661, ext. 2397. Completed By:� l� Date RECEIVED Page 1 of 1 CITY OF LA QUINTA DESIGN AND DEVELOPMENT DEPARTMENT ENG DS-016 (8/31/15) S 6 - 7 - 21 - 1 A '\ • P • WOMMON ilia ral, I alai 13 - - ��T_ff7�l�ICR�I©©R�w�IM�ff®®�l��l�ll- � E�sS.�i L � 1 _ 4 M11w."_ OR SRI MEN Mi 034 ,. 1111111M � - _ - AAA➢A94A OEM 6 - ] - Z9 - 1 0 100 200 400 600 800 DIVISION: 10 00 00—SPECIALTIES SECTION: 10 3100—MANUFACTURED FIREPLACES REPORT HOLDER: EARTHCORE INDUSTRIES, LLC EVALUATION SUBJECT: RECEIVED JUL 0 5 2019 INTERWEST CONSULTING GROUP ISOKERN STANDARD MODELS 36-INCH, 42-INCH AND 46-INCH FIREPLACE AND DM CHIMNEY SYSTEMS; ISOKERN MAGNUM FIREPLACE SERIES MODELS 28, 36, 42, 48, 60 AND 72; ISOKERN FIREPLACE WITH FIRE-LITE APPLICATION; MODELS VF-36, VF-42, AND VF-46 UNVENTED GAS APPLIANCE ENCLOSURES; AND MODELS IBV-36 AND IBV-46 VENTED GAS APPLIANCE ENCLOSURES icc [cc 1CC RECEIVED JUL U 3 2019 PMG LISTEr+J CITY OF LA QUINTA DESIGN AND DEVELOPMENT DEPARTMENT "2014 Recipient of Prestigious Western States Seismic Policy Council (WSSPQ Award in Excellence" INIENNAIIONAL A Subsidiary of COOFCOUNCN• ICC-ES Evaluation Reports are not to be construed as representing aesthetics or any other attributes not specifically addressed, nor are they to be construed as an endorsement of the subject of the report or a recommendation for its use. There is no warranty by ICC Evaluation Service, LLC, express or implied, as to any finding or other matter in this report, or as to any product covered by the report. Copyright ° 2018 ICC Evaluation Service, LLC. All rights reserved. 4 I'0/1EC 17065 P'a','l Coif-1— Body n'000 $,A ICC-ES Evaluation Report ESR-2316 Reissued October 2018 This report is subject to renewal October 2019. www.icc-es.or 1 (800) 423-6587 1 (562) 699-0543 A Subsidiary of the International Code Council° DIVISION: 10 00 00—SPECIALTIES Section: 10 31 00—Manufactured Fireplaces REPORT HOLDER: EARTHCORE INDUSTRIES, LLC EVALUATION SUBJECT: ISOKERN STANDARD MODELS 36-INCH, 42-INCH AND 46-INCH FIREPLACE AND DM CHIMNEY SYSTEMS; ISOKERN MAGNUM FIREPLACE SERIES MODELS 28, 36, 42, 48, 60 AND 72; ISOKERN FIREPLACE WITH FIRE-LITE APPLICATION; MODELS VF-36, VF-42, AND VF-46 UNVENTED GAS APPLIANCE ENCLOSURES; AND MODELS IBV-36, AND IBV-46 VENTED GAS APPLIANCE ENCLOSURES 1.0 EVALUATION SCOPE Compliance with the following codes: ■ 2012, 2009 and 2006 International Building Codee (IBC) ■ 2012, 2009 and 2006 International Residential Code® (IRC) ■ 2012, 2009 and 2006 International Mechanical Codee (IMC) ■ 2012, 2009 and 2006 International Fuel Gas Code® (IFGC) Properties evaluated: ■ Fire resistance ■ Seismic resistance 2.0 USES The Isokern fireplaces are wood -burning or gas -burning fireplaces that are constructed in the field using prefabricated cementitious blocks. 3.0 DESCRIPTION 3.1 Solid -fuel -burning Fireplaces: Isokern Standard Models 36-Inch, 42-Inch, and 46-Inch with DM Chimney; and Magnum Fireplace Series Models 28, 36, 42, 48, 60 and 72 with DM54 Chimney: Isokern fireplaces and DM54 chimney systems are modular refractory units designed for field assembly. The units consist of interlocking precast parts that are fitted together in the field using a premixed mortar called Earthcore mortar, supplied with the units, to form a solid - fuel -burning fireplace and chimney system. The refractory parts are manufactured using a proprietary mixture of volcanic pumice aggregate and aluminate cement. The firebox, smoke dome and chimney outer casing are manufactured with medium -density material, and the flue liner with high -density material. High -temperature refractory firebricks, a minimum of 11/8 inches (28.6 mm) thick, are provided to line the interior of the firebox. The firebox is available in sizes noted in Table 2. See Figures through 5 for further details. 3.2 Fire-Lite Systems: 3.2.1 General: The Fire-Lite systems consist of Standard Models 36-inch, 42-inch, and 46-inch fireplaces and Magnum Series Models 28-inch, 36-inch, 42-inch 48-inch, 60-inch and 72-inch fireplaces, described in Section 3.1, and a factory -built chimney. All conditions of fireplace manufacture and installation noted in Section 3.1 apply, except as noted in Section 3.2.2. 3.2.2 Factory -built Chimney: A listed and labeled factory -built chimney is used with the fireplaces, subject to the following requirements: 1. The factory -built chimney is listed by an approved agency for compliance with the requirements of UL 103 for continuous use at 1000°F (537°C) and intermittent use at 1700°F (927°C). 2. The factory -built chimney is for use only with an open combustion chamber and must be marked "Residential Type and Building Heating Appliance Chimney." 3. The chimney is either solid -pack insulated, a combination of insulation and air space, or noninsulated, completely thermal siphoning, double - wall air-cooled. 4. Listed chimney liners conforming to the 1700°F (927°C) requirements of UL 1777, ULC S635, or ULC S640 may be used. 5. Chimneys and chimney liners must be installed and terminated in accordance with the manufacturer's installation instructions and under the terms of the manufacturer's listing for use with open-faced, masonry fireplaces. 6. A minimum 2-inch (51 mm) clearance to combustible construction and 3-inch (76 mm) clearance to insulation is maintained. As an alternative, a listed and labeled Security Chimneys International (Lennox) FTF-13 factory -built chimney may be used with the fireplaces, subject to the following requirements: 1. The factory -built chimney must be installed and terminated in accordance with the report holder's ICC-ES Evaluation Reports are not to be construed as representing aesthetics or any other attributes not specifically addressed, nor are they to be construed as an endorsement of the subject of the report or a recommendation_for its use, There is no warranty by ]CC Evalualion Service, LLC express or implied, as to any,finding or other matter in this report, or as to any product covered by the report, rtvx na k cmEauxa� Copyright © 2018 ICC Evaluation Service, LLC. All rights reserved. Page 1 of 9 , ESR-2316 Most Widely Accepted and Trusted Page 2 of 9 installation instructions and under the terms of the report holder's listing for the fireplaces. A minimum 2-inch (51 mm) clearance to combustible construction and insulation is maintained. 3.3 Models VF-36, VF-42, and VF-46 Unvented Gas Appliance Firebox Enclosures: The enclosures consist of materials similar to those used for the Isokern solid -fuel -burning fireplaces. The enclosures are recognized as complying with ANSI Z21.91 and are for use with unvented decorative gas logs listed and labeled as complying with ANSI Z21.11.2, and having a maximum heat input of 40,000 Btu/h (11 700 W). The gas logs must be factory -equipped with a listed oxygen - depletion safety shutoff system (ODS) and must comply with 2012 and 2009 IFGC Section 621.6 and 2006 IFGC Section 620.6 (2012, 2009 and 2006 IRC Section G2445.6). The enclosure must only be installed within a room that has a primary source of heat, and use of the units is prohibited in locations defined in IRC Section G2406.2 and IFGC Sections 303.3 and 621.4. Combustion air must be provided in accordance with IRC Section M1702 and IFGC Section 621.5. The room in which the units are installed must have a free -air volume equal to or greater than 50 cubic feet per 1000 Btu/h (4.8 m3/kW) of the aggregate input rating of all appliances within the room. The base, sides, rear and top of the firebox consist of preformed refractory components that interlock together to form the enclosure. Assembly of the firebox is as described in Section 4.3 of this report, except that a 1/2-inch-wide (12.7 mm) mortar joint is used; and 1 o/e-inch-thick (28.6 mm) (minimum) refractory firebrick, conforming to ASTM C1261, is used to line the hearth, side walls and back wall. The unit must be anchored in accordance with IRC Section M1307.2 and IFGC Section 301.12. The firebox is illustrated and dimensions are noted in Figure 2. The firebox may be installed on combustible construction when installed as described in Section 4.3, and at zero clearance to combustible construction on sides, back and top. Minimum clearances are 15'/, inches (394 mm) to side walls, 42 inches (1067 mm) to ceilings and 12 inches (305 mm) to combustible mantles. 3.4 Models I13V-36, and IBV-46 Vented Gas Fireplaces: 3.4.1 General: Vented gas -fired fireplace models IBV-36 and IBV-46, with dimensions and weights as described in Figure 5, comply with ANSI Z21.50 and are for connection to listed Type B gas vents as described in Section 3.4.2. 3.4.2 Gas Vent: The gas vent system consists of a nominally 10-inch-diameter (254 mm), Type B gas vent complying with Chapter 8 of the IMC and Chapter 5 of the IFGC and Chapter 24 of the IRC. 3.5 Factory -built Chimney: The firebox units, described in this report, may be used in conjunction with factory -built chimneys listed and labeled as complying with UL103, and must be used with one in Seismic Design Categories C, D, E, and F. The factory - built chimneys must comply with Type HT requirements of UL 103 and be marked "Type HT" and "Residential Type and Building Heating Appliances." As an alternative, a listed and labeled Security Chimneys International (Lennox) FTF-13 factory -built chimney may be used with the fireplaces. The chimneys are limited to a maximum height of 80 feet (24380 mm) and a minimum height of 14 feet (4270 mm); except that where offsets are used, the minimum height is 17 feet (5180 mm). The maximum number of offsets is two. 3.6 Grout and Mortar: Grout used in construction of the fireplace unit is Quickcrete Concrete Mix #1001, 4000 psi concrete mix or equivalent. Mortar used with the fireplace unit is Earthcore mortar. 4.0 DESIGN AND INSTALLATION 4.1 General: The fireplaces must be installed in accordance with this report, the manufacturer's instructions and the applicable code. A copy of the manufacturer's published instructions must be available at the jobsite at all times during installation. The fireplaces are not recognized for use with doors. 4.2 Design: Installation is limited to Seismic Design Categories A and B, except that when installation is in accordance with Section 4.3 of this report, the fireplaces may be installed in Seismic Design Categories C, D, E and F, provided the seismic design factors are limited to the values noted in Table 1. The seismic design must be in accordance with Sections 15.3.2 (1) and 13.3, 13.4, 13.5 and 13.6 of ASCE 7. Fireplace systems used in Seismic Design Categories C, D, E, and F are limited to those incorporating listed and labeled factory -built chimneys. Structural design calculations and construction plans prepared by a licensed design professional are required to determine the requirements for the fireplace foundation and anchorage of the fireplace to the foundation. When installation is on wood floor construction, the licensed design professional must determine the requirements for support and anchorage for the combined gravity and seismic loading. The applicability of the seismic design parameters in Table 1, for Seismic Design Categories C, D, E and F, must be verified with due consideration of the flexibility of anchorage and supports. In addition, the calculated long-term deflection of the wood members supporting the fireplace must not exceed the values shown in IBC Table 1604.3 for floor members. Under the IRC, an engineered design must be provided in accordance with IRC Section R301.1.3. 4.3 Installation: 4.3.1 General: A noncombustible foundation, adequate to support all required loads, is necessary and must be approved by the building inspector. Fire-Lite Series and Models IBV-36 and IBV-46 Vented Gas fireplaces and Models VF-36, VF-42 and VF-46 may be installed on combustible systems. For combustible supporting systems, installation of a 3-inch-thick (76 mm) Earthcore base plate is required before placement of the firebox hearth components. The Fire-Lite system firebox is assembled following the manufacturer's published instructions. For Seismic Design Categories C, D, E and F, anchorage of the fireplace unit to the foundation or supporting floor must be designed as described in Section 4.2. Units are assembled on the foundation by installing the base plate, firebox wall sections, damper assembly and smoke dome. Earthcore Mortar is mixed with water until smooth and without dry spots, and is then poured into the supplied Earthcore application bag and applied to one adjoining component face of each joint. A 1/2-inch-wide (12.7 mm) line of mortar is applied 1/2 inch (12.7 mm) from all edges of the face with two longitudinal lines between. Mortar must be exposed at the joints when components are joined, and the excess must be smoothed out. The firebox hearth, side walls and back wall are then lined with approved refractory ESR-2316 I Most Widely Accepted and Trusted Page 3 of 9 bricks a minimum of 11/8 inches (28.6 mm) thick, except for the Magnum Models 60 and 72, which require minimum 4-inch-thick (101.6 mm) approved refractory bricks, complying with ASTM C27 or ASTM C1261, at the side walls using a refractory mortar, complying with ASTM C199, recommended by Earthcore Industries, LLC. 4.3.2 Clearances: Minimum clearance from the fireplace opening to side walls is 26 inches (660 mm). Sheathing and trim must be kept at least 8 inches (203 mm) from the opening. Combustible mantles must be at least 14 inches (356 mm) above the opening. A noncombustible hearth extension is necessary and must extend a minimum of 20 inches (508 mm) in front and 12 inches (305 mm) beyond each side of the fireplace opening. For the Magnum Series Models 60 and 72, minimum clearance from the fireplace opening to side walls is 48 inches (305 mm). Sheathing and trim must be kept at least 9 inches (228 mm) from the opening. Combustible mantles must be at least 38 inches (965 mm) above the opening. A noncombustible hearth extension is necessary and must extend a minimum of 33 inches (838 mm) in front of and 12 inches (305 mm) beyond each side of the fireplace opening. 4.3.3 DM54 Chimney Systems: The DM54 chimney system must be supported from the top plate of the smoke dome. The chimney is assembled starting with a 6-inch- high (152 mm) liner that offsets the joints in the octagonal inner Earthcore liner from those in the square outer chimney casing. The mortar mix is applied in all joints as previously described. The outer chimney blocks have provisions for installation of reinforcing bars. Chimneys may include offsets with a maximum horizontal distance of 6 feet (1829 mm) which is 24 offset blocks in sequence. The offset blocks are supplied by Earthcore Industries, LLC. The fourth and sixth offset blocks and every third block thereafter must be supported by a concrete block support wall. Where required by the code official, details of the support wall construction must be provided. The portion of the chimney exposed to the exterior must be covered with weather protection material such as exterior plaster or brick veneer, in accordance with the applicable code. Terminations must comply with IBC Section 2113.9 and IRC Section R1003.9. Where required by the code official, an approved spark arrester complying with 2012 IBC Section 2113.9.2 or 2009 and 2006 IBC Section 2113.9.1 must be used. Under the 2012 IBC and IRC, a chimney cap must be installed in accordance with IBC Section 2113.9.1 and IRC Section R1003.9.1. For installations with vertical chimneys, the fireplace and chimney may be installed with zero clearance to combustibles, except that the Magnum series units require a minimum 11/2-inch (38 mm) clearance on the sides and back of the firebox and smoke chamber. When offset blocks are used, the system must be installed with minimum 11/-inch (38 mm) clearance on the sides and back of the firebox and smoke chamber, and with zero clearance on the top; the chimney is installed at zero clearance to combustibles. Except as noted in this section for clearances to combustibles, chimney fireblocking must be in accordance with IBC Section 2113.20 and IRC Section R1003.19. 4.3.4 Gas Vent Installation: Gas vents are installed through a 10-inch-diameter (254 mm) hole cut into the top plate of the fireplace enclosure, centered from each edge. The Isokern Anchor Plate/Downdraft Diverter component is placed over the hole using either a bed of Earthcore mortar, or an approved ceramic blanket gasket. The Anchor Plate/Downdraft Diverter hood component is then secured to the top plate using masonry screws. The Type B gas vent must be connected to the Anchor 4.3.5 Plate/Downdraft Diverter component and installed in accordance with the vent manufacturer's instructions. 4.3.6 Unvented Gas Appliance Firebox Enclosures: Models VF-36, VF-42 and VF-46 unvented gas appliance firebox enclosures must be installed in accordance with IFGC Section 621, IRC Section G2445 and the manufacturer's published installation instructions. 4.3.7 Vented Gas Fireplaces: Models IBV-36 and IBV-46 vented gas fireplaces must be installed in accordance with IFGC Section 604, IRC Section G2434 and the manufacturer's published installation instructions. 5.0 CONDITION OF USE The Isokern fireplaces and chimney systems described in this report comply with, or are suitable alternatives to what is specified in, those codes listed in Section 1.0 of this report, subject to the following conditions: 5.1 The fireplaces must be installed in accordance with this report, the manufacturer's published installation instructions and the applicable code. In the event of a conflict between this report and the manufacturer's instructions, this report governs. 5.2 Structural design and calculations from a registered design professional must be provided to the code official to justify the supporting structure for all applicable loads, including gravity, wind and earthquake loading, and applicable load combinations per IBC Section 1605. 5.3 An analysis shall be provided to the code official establishing that the seismic conditions for the installation site do not exceed the specified seismic limitations. 5.4 The fireplaces must not be installed with doors 5.5 Compliance with the fireplace air leakage provisions Found in 2012 Infemational Energy Conservation Code''' (IECC) Section R402.4.2 and Table R402.4.1.1; 2012 IRC Section N1102.4.2 and Table N1102.4.1.1; 2009 IECC Section 402.4.3; and 2009 IRC Section N1102.4.3, are outside the scope of this report. 5.6 The wood -fired fireplaces and unvented gas -fired units are manufactured in Chesapeake, Virginia, under a quality control program with inspections by ICC-ES. The IBV vented gas -fired fireplaces are manufactured in Chesapeake, Virginia, under a quality control program with inspections by ICC-ES. 6.0 EVIDENCE SUBMITTED Data in accordance with the ICC-ES Acceptance Criteria for Field -constructed Fireplace Systems Using Prefabricated Blocks (AC375), dated February 2012. 7.0 IDENTIFICATION 7.1 The components of the fireplace and chimney are supplied to the jobsite on shrink-wrapped pallets bearing a label with the Earthcore Industries, LLC, name and address; the product name; the address of the manufacturing plant and the evaluation report number (ESR-2316). A permanent label must be attached to the fireplace and to the vented or unvented enclosure, bearing the Earthcore Industries, LLC, name; the product name; the manufacturing location; the date of manufacture and the serial ESR-2316 I Most Widely Accepted and Trusted number; the clearances to combustibles; other information required by UL 127; (for wood -fired fireplaces and unvented gas appliance firebox enclosure models VF-36, VF-42 and VF-46; or PFS Corporation for vented gas fireplace models IBV-36 and IBV-46); and the evaluation report number (ESR-2316). Page 4 of 9 7.2 The report holder's contact information is the following: EARTHCORE INDUSTRIES, LLC 6899 PHILLIPS INDUSTRIAL BOULEVARD JACKSONVILLE, FLORIDA 32256 (904) 363-3417 www.isokern.net TABLE 1—SEISMIC DESIGN FACTORS FOR SEISMIC DESIGN CATEGORIES C, D, E AND F FACTOR VALUE Amplification Factor, ap 1.0 Component response modification factor, Rp 3.0 Z/h factor, where Z is the height in structure of point of attachment with respect to the base; and h is the average roof height of structure with respect to the base 0.65 Spectral response acceleration parameter, Sos 2.0 Weight, Wp (Ibs) See Figure 1 Fundamental period of fireplace unit, T. 0.35 For SI: 1 foot = 305 mm; I lb = 4.45 N. TABLE 2—ISOKERN FIREPLACE DIMENSIONS MODEL OVERALL SIZE (inches) FIREBOX OPENING SIZE (inches), Width x Height HEARTH EXTENSION SIZE (inches), Width x Depth CHIMNEY MINIMUM SIZE (inches), I.D. INSTALLED HEIGHT, FIREPLACE AND CHIMNEY DM SYSTEM (feet) Width Depth Height , Minimum Maximum 36-Inch 43 25'/4 63'/4 37 x 32 58 x 20 123/4 18 80 42-Inch 49 251/4 63'/4 42 x 32 64 x 20 123/4 123/a 18 y 80 46-Inch 53 25'/4 63% 47 x 32 68 x 20 18 80 IBV36 43 25'/4 71 37 x 32 58 x 20 10 15 46 IBV42 49 251/4 79 42 x 32 64 x 20 10 15 46 IBV46 53 25'/4 71 47 x 32 68 x 20 10 15 46 VF - 36 43 251/4 38 36 x 311/2 N/A N/A N/A N/A VF - 42 49 251/4 38 43 x 311/2 N/A N/A N/A N/A VF - 46 53 251/4 38 47 x 311/2 N/A N/A N/A N/A Mag - 28 351/2 28 60'/4 31 x 28'/2 571/2 x 20 12 18 80 Mag - 36 43 28 693/4 381/2 x 38 60'/2 x 20 123/4 18 80 Mag - 42 48'/2 28 693/4 441/2 x 38 61/2 x 20 123/a 18 80 Mag - 48 53 28 693/a 481/2 x 38 70'/2 x 20 123/4 18 80 Mag - 60 731/2 28 853/4 69'/2 x 38 91 x 33 123/4 18 80 Mag - 72 851/2 28 853/a 811/4 x 38 101'/4x 33 123/4 18 80 For SI: 1 foot = 305 mm; 11b = 4.45 N. ESR-2316 I Most Widely Accepted and Trusted Page 5 of 9 rB �. J w vow o� G A RwVww RMww MODEL A 8 C' D E F G I J MINIMUM FRAMING 1 WEIGHT 36 43' 2S1/4' 631/4' 31112' 36l/8' 271/4' 33' 20114' S' (46'W)x(6S'H)x(263/4'D) 120SIbs 42 49' 2S 1/4' 631/4' 31 112' 431/8' 331/4' 33' 201/4' S' (S2'Mx(6S'H)x(263/4'D) 132SIbs 46 53' 2S 1/4' 631/4' 31 1/2' 47l/8' 371/4' 43' 201/4' S' (S6'W)x(6S1ft(263/4'D) 14SOIbs 'For Fire-Lite Units — Add 4 inches to C and to minimum framing height H. Top Plate - Medium Part No. Model Qty M77 36 1 M77 42 1 Top Plate - Large Part No. Model Qty M81 46 1 2S 1/4' .4 3/4' FIGURE 1—STANDARD SERIES DIMENSIONS .4 3/4' ESR-2316 I Most Widely Accepted and Trusted 6 of 9 j N TO u' S" Side View Front View Plan View Model A B C MINIMUM FRAMING WEIGHT 36' 43" 361/8' 271/4' 43Wx371/2'Hx251/4`D 7151bs 42' 49" 43 1/8' 33 1/4' 49"W x 371/2"H x 25 1/4"D 8201bs 46" 53" 471/8" 37 1/4" 53'W x 37 1/2'H x25 1/4'D 8801bs w See -Thru Models 13 Mode! See -Thru Models 13 Mode! A B C 36' 43" 37' 53' 42' 49' 43' 59, 46' 53" 47' 63' r 1 I A C Ali FIGURE 2—UNVENTED GAS -FIRED SERIES DIMENSIONS ESR-2316 I Most Widely Accepted and Trusted 7 of 9 SIDE VIEW TOP PUN VIEW o _ m A FRONT VIEW PUN SECTION A A mom •A• v 'C' 1 v r f •G LMMAAIFPAMNG 3 V90a 3r. 35 V7 3r 60 W 3I w )r 19W 22 fw- 3rW,6I VZH,?A I2'D IO/Ob 36 ap 3r asYr •V 3638 VIf V 4M x ?IN x 29 1/70 13Mba 4: 4v 26' 03W •I• MV: 33VC V S:Wi7INx29= I MMb 46' L St 3r 69 30r 41' 4617' 37 W ar SM 17IN 1291/2D 1600 b 1For Fire-Lite Units — Add 4 inches to C and to minimum framing height H. PART NO U77 K77 McPUCE dIUHM SZE. 31M I 42'W I TOP PLATE, SIAILL PART No Io1 FIIEPUCE OUAHRTY SIZE 06 W FIGURE 3—MAGNUM 28, 36, 42 AND 48 SERIES DIMENSIONS 4434' ESR-2316 I Most Widely Accepted and Trusted Page 8 of 9 .� H L G � O c T D L J � B L Right Section A Front Elevation Top Plan View TK 1 -- L T B I_ E i Plan Section Model A B c D E F G H I J K M N O 60" 73 1/2' 28" 85 3/4' 41" 69" 57 1/4' 55 12' 25'/4" 4 3/4" 5' 8' 14 1/4' 11' 55 12" 72' 85 1/2' 28' 85 3/4 ' 41" 81 1/4" 69 39" 65112' 25'/: 4 3/4" 5' 8' 14 1/4' 11' 65 12' Minimum Framing Weight 76 1/2' W x 871/2' H x 29'/� 2500 lbs. 8812"W x 87 12" H x 29'/� 2900 lbs. Pan Fireplace QuanW.. No.: Sloe: M77 60'W 2 M77 72'W 2 TOP PLATE FIGURE 4—MAGNUM 60 AND 72 SERIES DIMENSIONS ESR-2316 I Most Widely Accepted and Trusted 9 of 9 D f I � I Side View Front View Plan View Model A B C D E F G H I Minimum Framing Weight -46- 43" 25'/4" 71 1 /4" 31 112' 36 1/8" 1 27 1 /4" 21'.h" 201/4" 5" 43"W x 71 1 /4" H x 26 3/4"D 1500 lbs. 46' 53" 251/4 71 1 /4" 31 112" 47 1 /8" 37 1 /4" 32" 201/4" 5" 53"W x 71 1 /4" H x 26 31 /4" D 1700 lbs. 'To achieve height dimension "D" in table above, a 100" (8.3') minimum flue height with 10"I.D. B-Vent is required 36" 43" 1 251/, 81 3/4" 1 '42" 1 36 1 /8" 1 27 1 /4" 1 21 Y�" 1 201/4" 5 1 43"W x 81 3/4" H x 26 3/4" D 1650 lbs. 46" 53" 25-,1 1 813/4" 1 '42" 1 471/8' 1 371/4" 1 32" 1 20Y4" 5" 1 53-Wx813/4'Hx263/4"D 1850lbs. 'To achieve height dimension "D'in table above, a 9' minimum flue height with 10"I.D. B-Vent is required 36' 43" 251/4" 921/4"" '52112" 361/8" 271/4' 21'/a" 43"Wx921/4"Hx263/4'D 1800lbs. 46' S3" 251,/4 92 1 /4" ' 52 1 /2" 47 1 /8" 37 1 /4" 32- d5" 5" 53' W x 92 1 /4" H x 26 3/4" D 2000 lbs. 'To achieve height dimension "D" in table above, a 12' minimum flue height with 10" I.D. B-Vent is required FIGURE 5—VENTED IBV SERIES DIMENSIONS