BCOM2015-0006-78-495 CALL-E -TAMP ICO
LA QUINTA, CALIFORNIA 92253
T,dy'4 11 40mi&
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BCOM2015-0006
Property Address:
79795 HIGHWAY 111
APN:
600440010
Application Description:
COSTCO DISPOSAL OF COOLING TOWER BLOW DOWN WATER
Property Zoning:
Application Valuation:
$157,100.00
Applicant:
INTEGRATED WATER SERVICE INC
PO BOX 10273
PLEASANTON, CA 94588
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: License No.: _
Date:A—tV ^ f% � Contractor•
k4f-;�o J70C
S64GIf CGS
OWNER -BUILDER DECLARATION Z.�C
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
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 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 Address
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/26/2015
Owner:
COSTCO WHOLESALE CORP
999 LAKE DR
ISSAQUAH, WA 92253
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Contractor:
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INTEGRATED WATER SERVIC
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PO BOX 10273
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PLEASANTON, CA 94588
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(925)895-3895
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LIc. No.:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the labor Code, for the performance
of t w r or which this permit is issued..
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:_ Policy Number: _
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 of the Labor Co , I shall forthwith
comply with those provisions.
Date: —��/j 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
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application ,.the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold.harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this ci Q enter upon tre above -
mentioned property for inspection purposes. 1 ^ 7,__1 . J
Date: -Gb — 0/ Signature (Applicant or Agent)
' DESCRIPTION,
INFORMATION
ACCOUNT •
QTY' c . AMOUNT
PAID =
PAID DATE,
ART IN PUBLIC PLACES - COMMERCIAL
REMOD
270-0000-43201
0
$285.50
$0.00
PAID BY .
METHOD
RECEIPT #
CHECK #
CLTD BY,
Total Paid forART IN PUBLIC PLACES - AIPP: $285.50 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$7.00
$0.00
PAID BY
METHOD
RECEIPT # .•. r
CHECK #
CLTD BY.
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $7.00 $0.00
DESCRIPTION '
ACCOUNT:' _
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY -. -
. METHOD � ,
' ' RECEIPT # ` `
CHECK # '"`"
""CLTD BY
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
DESCRIPTION
ACCOUNTy . r
CITY
° AMOUNT
PAID
PAID DATE
FIXTURE/TRAP
101-0000-42401
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT # r t j.
CHECK #
CLTD BY.
DESCRIPTION .�.
ACCOUNT'
QTY
AMOUNT ; '
PAID
PAID DATE
FIXTURE/TRAP PC
101-0000-42600
0
$12.09
$0.00
PAID BY, ` . ,
METHOD r ":
RECEIPT # -
CHECK #
CLTD BY
DESCRIPTION "-
ACCOUNT.
QTY
AMOLINT
PAID_
PAID. DATE
SEPTIC SYSTEM
101-0000-42401
0
$60.45
$0.00
PAID BY
METHOD
RECEIPT #
CHECK # =
CLTD BY'
' DESCRIPTION
,, ACCOUNT
QTY,
AMOUNT z
PAID
PAID DATE
SEPTIC SYSTEM PC
101-0000-42600
0
$24.15
$0.00
PAID BY'
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $108.78 $0.00
TOTALS: $493.13 00
Description: COSTCO DISPOSAL OF COOLING TOWER BLOW DOWN WATER
Type: BUILDING, COMMERCIAL Subtype: REMODEL Status: APPROVED
Applied: 1/15/2015 MFA
Approved: 4/30/2015 JFU
Parcel No: 600440010 Site Address: 79795 HIGHWAY Ill LA QUINTA,CA 92253
Subdivision: PM 33960 Block: Lot: 1
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $157,100.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: DISPOSAL OF COOLING TOWER BLOW DOWN DISCHARGE. (5) SEEPAGE PITS W/ 1 1/2" DISCHARGE PIPING FROM CHILLER
EQUIPMENT. PER WATER QUALITY ORDER NO. 2003-0003-DWQ AND 2013 CALIFORNIA BUILDING CODES.
ADD171PINIAL
CHRONOLOGY TYPE,' STAFF NAME ACTION DATE - COMPLETION DATE
NOTES
SEE ATTACHED EMAIL. APPLICANT HAS RECEIVED NECESSARY
INFORMATION FROM THE CITY OF LA QUINTA TO ACQUIRE
E-MAIL
JAKE FUSON
2/17/2015
2/17/2015
HIS REQUIRED APPROVAL FROM THE COLORADO RIVER BASIN
WATER QUALITY CONTROL BOARD. OFFICIAL APPROVAL STILL
OUTSTANDING.
NOTIFIED PETER BALAS W/ INTEGRATED WATER SYSTEMS
E-MAIL
JAKE FUSON
4/30/2015
4/30/2015
THAT ALL APPROVALS HAD BEEN OBTAINED, PLANS HAD BEEN
APPROVED AND THE PERMIT WAS READY TO ISSUE.
REVIEWS FROM PLANNING & PUBLIC WORKS PICKED UP
NOTE
KAY HENSEL
1/26/2015
1/26/2015
FROM BUCKET ROOMAND RETURNED TO FOLDER. PLANS
RETURNED TO C5D
PLAN CHECK SUBMITTAL
MARY FASANO
1/15/2015
1/15/2015
ALSO ROUTED A SET OF PLANS TO ED WIMMER PER AJ
RECEIVED
Printed: Friday, June 26; 2015 8:48:33 AM 1 of 3
SYSTEMS
SPOKE WITH PETER BALAS W/ INTEGRATED WATER SYSTEMS
NOTIFYING HIM HIS APPROVAL APPLICATION TO THE
TELEPHONE CALL
JAKE FUSON.
2/10/2015
2/10/2015
COLORADO RIVER BASIN WATER QUALITY CONTROL BOARD.
WAS INCOMPLETE, AND REQUIRED FOR APPROVAL.
CONbITIONS
NAME TYPE
IMP
- NAME
ADDRESSI.
CITY
STATE
ZIP' PHONE FAX - , _ EMAIL
APPLICANT
INTEGRATED WATER SERVICE INC
PO BOX 10273
PLEASANTON
CA
94588
CONTRACTOR
INTEGRATED WATER SERVICE INC
PO BOX 10273
PLEASANTON
CA
94588
OWNER
COSTCO WHOLESALE CORP
999 LAKE DR
ISSAQUAH
WA
92253
FINANCIAL
INFORMATION
.:
DESCRIPTION :: ACCOUNT QTY. 'AMOUNT
PAID
CLTD
PAID DATE RECEIPT # , CHECK # ; METHOD PAID BY' . ' _
BY
ART IN PUBLIC PLACES -
270-0000-43201 0 $285.50
$0.00
COMMERCIAL REMOD
Total Paid forART IN PUBLIC PLACES - AIPP: $285.50 $0.00
BSAS SB1473 FEE
101-0000-20306
0
$7.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$7.00 $0.00
BSA:
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
FIXTURE/TRAP
101-0000-42401
0
$12.09
$0.00
FIXTURE/TRAP PC
101-0000-42600
0
$12.09
$0.00
SEPTIC SYSTEM
101-0000-42401
0
$60.45
$0.00
SEPTIC SYSTEM PC
101-0000-42600
0
$24.15
$0.00
Total Paid for PLUMBING FEES: $108.78 $0.00
TOTALS:0•
Printed: Friday, June 26, 2015 8:48:33 AM 2 of 3
SYSTEMS
INSPECTIONS
PARENT PROJECTS
REVIEWS
RETURNED STATUS REMARKS
REVIEW TYPE REVIEWER
SENT DATE
DUE DATE NOTES
DATE
BRYAN
1/15/2015
1/22/2015
1/22/201S
READY FOR APPROVAL
PUBLIC WORKS
Public Works has no comments
MCKINNEY
NON-STRUCTURAL
JAKE FUSON
1/15/2015
1/22/2015
2/2/201S
PENDING DOCUMENTS
APPROVABLE PENDING COLORADO RIVER BASIN
WATER QUALITY CONTROL BOARD APPROVAL.
ACTION IS EXEMPT FROM CEQA UNDER 15301(a) -+
MINOR ALTERATIONS TO EXISTING MECHANICAL
EQUIPMENT
PLANNING
WALLY NESBIT
1/15/2015
1/22/2015
1/22/2015
NOT REQUIRED
CEQA EXEMPT
EMAILED PETER BALAS 2/17 THAT PERMIT IS A NO
PROJECT FOR CEQA PURPOSES (MINISTERIAL
PERMIT, CEQA GUIDELINES 15278), AND
THEREFORE EXEMPT FROM CEQA
CITY ENGINEER -
TIM
1/22/2015
1/22/2015
1/22/2015
COMPLETE
REVIEW
JONASSON
NON-STRUCTURAL
JAKE FUSON
4/30/2015
5/14/2015
4/30/2015
APPROVED
BOND INFORMATION
- Type .....
Attachme nt T e CREATED- k OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED
BCOM2015-0009 -
BCOM2015-0009 -
• DOC
2/19/201S
JAKE FUSON
EMAIL
EMAIL
0
CORRESPONDENCE FOR
CORRESPONDENCE FOR
CEQA EXEMPT
CEQA EXEMPT.pdf
AT R QUALITYORDER
WATER QUALITY ORDER
WATER QUALITY ORDER
DOC
4/30/2015
JAKE FUSON
NO. 2003-0003-
0
DWQ.pdf
Printed: Friday, June 26, 2015 8:48:33 AM 3 of 3
wsysrrnns
Bin. #
C
CI ty Of, %d Quin td
Building 8t Safety Division
P.O. Box 1504,78-495 Calle Tampico '
La.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
B omuts, D b
Project Address: .—
141 1 �� �' '
Owner's Name:. r✓O W )d �O /1? 0/1
A. P. Number.
a ..
Address:low 4& '
Legal Description:
City, ST, Zip: s' a w g?02
Contractor.
,e trill Q°S` a
Telephone: 2•5- 3 8S
Address:
:7
013
Project Description: r '
(I�
City, ST, Zip: eC�
�r �, p
C� i / S
• Os� 0) t
Telephone: 72L
0
State Lic. #:
Arch., r., Design
rn
City Lic. #:
P,
'
(
Address: �J IfILDAIG Jv••3"�.
/� C--
City., ST, Zip:
Telephone:
>%z
K; £sr.;. .,;�;
k t _
Construction Type:. ` Occupancy: r WU'1 &,
State Lic. #:fit?
Project type (circle one): New Add'n ter 'Repair Demo
Name of Contact Person:
alf
4.Sq.
Ft.: # Stories:
# Unit$:
Telephone # of Contact Person:
Estimated Value of Project: 57,Q®
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°d Review, ready for correctionsfiissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I. .
H.O.A. Approval
Plans resubmitted
Grading
N uOUSE:-
'^' Review; ready for corrections/issue
Developer Impact Fee
Planning Approval
4
Called Contact Person
A.Y.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees