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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 C C M z c-) L nn z Contractor: m O o INTEGRATED WATER SERVIC lfq G7 PO BOX 10273 4 z ru PLEASANTON, CA 94588 n A rn (925)895-3895 z C 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