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BRES2016-0159- art 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/10/2016 Application Number: BRES2016-0159 Owner: Property Address: 78959 BRECKENRIDGE DR GARY DEBIASI F APN: 770320044 Property Zoning: U0 -2 w Application Valuation: $2,000.00 t� N P U:2 Applicant: Contractor: � v w TESERRA TESERRA U P 0 BOX 1280 P 0 BOX 1280 —s COACHELLA, CA 92236 COACHELLA, CA 92236 U (760)389-9222 Llc. No.: 656128 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 eCClass: /C--8 C10, C29 C53 C27 DD1�2 License No.: 656128 D te:(O - { l/ - �F� Contra" or: 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 wort( himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. �. B.&P.C. for this reason Date: .,Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Lender's Address: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issu rkers' compensation insurance carrier and policy number are: Carri Policy Number:_ VI certify that in the performance of the work for which this permit is issued, I shallnot 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 370 'the Labor Code, I shall forthwith comply with those provisions. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE If -UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. 1)at1A" 6 Signatua Applicant or Agent): DESCRIPTION FINANCIAL INFORMATION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT# CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 101-0000-42403 0 $24.17 $0.00. RAID BY. :.. METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT : QTY AMOUNT- PAID: PAID DATE DEVICES, FIRST 20 PC 101-0000-02600 0 $24.17 $0.00 PAID BY METHOD RECEIPT.# CHECK # CLTD BY Total Paid for ELECTRICAL: .$48.34 $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 for PERMIT ISSUANCE: $91.85 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD - RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $36.26 $0.00 DESCRIPTION ACCOUNT. QTY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00 TOTALS:00 Description: DEBIASI RESIDENCE INSTALL BBQ & PRE -FAB FIREPLACE Typc: BUILDING, RESIDENTIAL Subtype: REMODEL Status: APPROVED Applied: 6/10/2016 AZA Approved: 6/10/2016 AZA Parcel No: 770320044 Site Address: 78959 BRECKENRIDGE DR LA QUINTA,CA 92253 Subdivision: TR 25389-3 Block: Lot: 44 Issued: Lot Scl Ft: 0 Building Scl Ft: 01 Zoning: Finaled: Valuation: $2,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 92236 Details: INSTALL BBQ WITH 130 FT OF 11/2 INCH GAS LINE AND FOUR (4) ELECTRICAL OUTLETS. 2013 CALIFORINIA BUILDING CODES. Printed: Friday, June 10, 2016 1:35:57 PM 1 of 2 srsrcMs CHRONOLOGY CONDITIONS NAME"TYPE...:... . .._..,. ...... 4 bRES51 CONTACTS CITY STATE _ _... ZIP PHONE FAX EMAIL APPLICANT' TESERRA P O BOX 1280 COACHELLA _ CA 92236 CONTRACTOR TESERRA P O BOX 1280 COACHELLA CA 92236 OWNER GARY DEBIASI 3231 VERONA CT CONCORD CA 92253 Printed: Friday, June 10, 2016 1:35:57 PM 1 of 2 srsrcMs DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY DEVICES, FIRST 20 101-0000-42403 0 $24.17 $0.00 NOTES DATE DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 Total Paid for ELECTRICAL:. $48.34 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.09 $0.00 GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $24.17 $0.00 Total Paid for PLUMBING FEES: $36.26 $0.00 SMI - RESIDENTIAL 101-0000-20308 1 0 $0.50 $0.00 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00 INSPEC�'Y`�IONS PARENT PROJEC'TS 'I l f ; RETURNED STATUS REMARKS REVIEW TYPE REVIEWER SENT DATE DUE DATE NOTES DATE 11=1 N Q0 All OMill AeTT�ACHMENTS Printed: Friday, June 10, 2016 1:35:57 PM 2 of 2 ' �L! i�l SYS 7rlviS Ci'ti ®f La Quinta Building U Safety Division ri ,�r�� P.O. Box 1504, 78-495 Calle Tampico reDO La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet PP g Permi #t. (�/�l Project Address: Owner's Name: 0 A. P. Number: Address: tJ— Legal Description: Contractor: -7:�--<c ai4 Address: oo q V; City, ST, Zip:la 3 Telephone: Project Description: Awl . a City, ST, Zip: 6P = L Cf4'7z-z3 elp; • ec 1 Telephone: City Lic. #: State Lic. # : Arch., Engr., Designer: lJl! Address: City, ST, Zip: l:! ` Telephone: State Lic. #: Name of Contact Person: �r Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: , 212 - 7145 Estimated Value of Project: 4j ✓. APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Caics. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval • Plans resubmitted Grading IN HOUSE: ''" Review, ready for correctionsrssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees