BPOL2014-108378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA.92253
Application Number: BPOL2014-1083
Property Address: 79100 CASA VIDA CIRCIR
APN: 602170022
IJP/'�1{AW VOICE (760) 777-7125
D FAX (760)777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/17/2014
Owner:
AL SAWIN
Application Description: POOL SPA BBQ AND FIRE PIT
Property'Zoning:
Application Valuation: $30,000.00
Applicant:
TESERRA
PO BOX 1280
COACHELLA, CA 92236
LICENSED. CONTRACTOR'S DECLARATION
I hereby affirm under penalty -of perjury that I am licensed underprovisions of Chapter
9 (commencing with Section 7000yof Division 3 of the Business and Professions Code,
and my License�is in full force and Leffect:
License Class: C-8, C27, C30, C29: C53 License No.: 656128
Date: 0 7 Contractor: �FS 7R e q
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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
signedstatement 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 she1s exempt therefrom andthe
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)..
U I, as ownerof the property, or my employees with wages as their sole
compensation; will do the work, andthe 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 whodoes the work
himselfor herself through, his ocher 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 wlth.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 thisreason
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 Name:
Lender's
79100 CASA VIDA
LA QUINTA, CA 92253
Contractor:
TESERRA
PO BOX .1180
COACHELLA, CA 92236
(760)39&9222
Lic. No.: 656128
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WORKER'S COMPENSATION DECLARATION
I hereby afflrm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, asprovided'for by Section 3700 of the Labor Code, for the performance
of the work for which this permit'ls issued.
/h 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: 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 3700 of the Labor Code, l.shall forthwith
comply with those provisions.
Date: Z47 /-7 Applicant: 4Ali-ef I Jett
WARNING: FAILURE.TO.SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND,SHALLSUBJECT 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"SECTION3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'SFEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT:Applicatiomis hereby made to the Building Official for a permit subject to
the conditions and�restrictlons,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 isiperformed 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 omissionreiated 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 applicationand state that the above; information is correct:
I agree to comply with all city and county ordinances and state laws relating to building
construction,.and hereby authorize representatives of this city to enter'upon the above-
mentioned property for inspection purposes.
Date: lid% Signature=(Applicant or Agent) /f/ll//fes ��`LM/RGZ
FINANICIAL ••
ON
DESCRIPTION ACCOUNT
QTY AMOUNT PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306
0 $2.00 $0.00
PAID BY ETH OD'.
RECEIPT 9 CHECK.# CLTD BY
Total 'Paid for BUILDINGSTANDARDS ADMINISTRATION iBSA $2.00 $0.00
" DESCRIPTION
LAZCOUNT' .
QTY"T
,AMOUNT
PAID
PAID DATE,
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #.-
CHECK.#
CLTD BY
DESCRIPTION:
ACCOUNT
QTY
AMOUNT
PAID.
PAID DATE
DEVICES, FIRST 20 PC
101.0000-42600
01
$24:17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK'#
CLTD BY
Total.Paid forELECTRICAL: $48.34 $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,
i4MO.UNTPAID:
� 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
SWIMMING POOL/SPA
101-0000-42404
0
$183.29
$0.00
PAID By"
METHOD
RECEIPT'#:
CHECK?#-
CLTD'BY
DESCRIPTION:
ACCOUNT-,
QTY'
AMOUNT, .
PAID
PAID DATE.
SWIMMING POOL/SPA PC
101-0000-42600
0
$98.62
$0.00
PAID BY ;: _ ..
METHOD-
RECEIPT#•
CHECKT#
CLTD BY
Total Paid for POOL / SPA $279.91 $0.00
TOTALS:00
City of La Qulnta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
��,� N
!.a Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:/DD Cy?r�+
VIDx� G,eCZ p-.
Owner's Name: SSW 1 fJ
A. P. Number.
Address: �J too SCLC
Legal Description:
City, ST, Zip: b t)l/ N7/t- Coet- gZZS'3
Contractor.% �SE2leI
Telephone:
Address: 9'0 017 1qy ( SY
Project Description: '� p 01-
City, ST„zips �eK GLf�
CjZZ3lo
7�z.Ve p�-T iQ &M
Telephone: z
MINirOv /�
State Lic. # : C—G 2
City-Lic. #.
fca,- -iC—,Wtf
Arch., Engr., Designer
Address:
?ov
City., ST, Zip:
p �� tl
Telephone:
State Lic. C
Construction Type: Occup
Project type (circle one) eW Add'n Alter Repair Demo
Name of Contact Person:
lPM� y K
Sq. Ft.: /6 Z,5
# Stories:
# Units:
Telephone #:of Contact Person: -?d, 6
2r0 - f
Estimated Value of Project: 30 r c3c3 v
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Recd
TRACIMG
PERMIT FEES
Plan Sets
Plan..Chech submitted
Item
Amount
Structural Cates.
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°! Review, ready for correction:fissue
Electrical
Subcontaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
INHOUSE.-
Reylew, ready for correcdonsJissue.
Developer Impact Fee
Planning Approval
Called Contact Person •
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Schodl.Fees
Total Permit Fees
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` PA ro P~l AC FOIE X 11�TION P1A S ()NLY
POOL 3PtFF MAJH U"AW SUCTION MINIMUM Y APART
ANTI -COVERS ter ASME I ANSI APPROVED
SPA SPLIT MAIN GRAIN 5UCTICNJ MINIMUM V OART —
ANTI_COVERS 1ff A£4IE 1 ANSI APPROVED
SPA AT Ir MTH 1111 DAM SHALL
1'.a' S11 6 !
[ILL
i NI'l 23'- 15L3.
Ei
INSTALLATION OF POOL SYSTFUS AND EQUIPMENT WML1 COMPLY VOTH
SECTION 114 - MANDATOI#Y 4�EQUIRF-MEffEi
EXIT ALARMS TO BE INSTALLED ON ALL DOORS WITH DIRECT AOCESS
TO THE POOL
PDOL HEATERS I PUMP EQUIPMENT SKALL BE iNSTALLER PER MANU FACTUREf rG
RECDAIMENDATIONS AND IN ACCORDANCE WTH LOCAL REOULAT1ON5
AU 0ECNUN0 F,,jRpANSION MINTS FOR REPRES€NTAJON ONLY,
FIELD LAVOLM WILL VARY
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