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BPOL2015-0079Applicant: APR ? 7 2015 Quo 4 VOICE (760) 777-7125 78-495 CALLE TAMPICO TESERRA fC1 0 D CITYOFLAOUINTA LCO;MUNITVDEVELOpMENTDEPARTMENT LA QUINTA, CALIFORNIA 92253 COACHELLA, CA 92236 FAX (760) 777-7011 COACHELLA, CA 92236 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 4/27/2015 Application Number: BPOL2015-0079 Owner: Property Address: 56175 PLATINUM WAY RREF II CWC LAQ LLC APN: 775370016 5927 PRIESTLY DR STE 110 Application Description: SIGNATURE WATER FEATURE ELECTRIC LINE CARLSBAD, CA 92008 Property Zoning: Application Valuation: $1,500.00 Applicant: APR ? 7 2015 Contractor: TESERRA L/ U TESERRA PO Box 1280 CITYOFLAOUINTA LCO;MUNITVDEVELOpMENTDEPARTMENT Po Box 1280 COACHELLA, CA 92236 COACHELLA, CA 92236 (760)398-9222 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 Class: C-8. C10, C29. C53 .License_ N 656128 Date:- Contractor: v" 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 Name: Lender's Address: I 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 oe wyork �for which this permit is issued. bL,r'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, I shall forthwith comply with those provisions. Date: JV 7-1 - 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. 1 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 en pon the above• mentioned property for inspection purposes. /1 �7 y ( Date: `� / -tSignature (Applicant or Agent FINANCIAL INFORMATION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY _ =a. -n .. METHOD..— RECEIPT#, CHECK # CLTD BY"' Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER FEATURE ONLY 101-0000-42404 0 $181.29 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER FEATURE ONLY PC 101-0000-42600 0 $98.62 $0.00 - PAID BY. METHOD RECEIPT # CHECK # CLTD BY `, Total Paid for POOL / SPA: $279.91 $0.00 Description: SIGNATURE WATER FEATURE ELECTRIC LINE Type: POOL Subtype: Status: APPROVED Applied: 4/22/2015 PJU Approved: 4/23/2015 MFA Parcel No: 775370016 Site Address: 56175 PLATINUM WAYLA QUINTA,CA 92253 Subdivision: TR 29421 Block: Lot: 2 Issued: Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $1,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 CITY Details: WATER FEATURE 169 LF ELECTRIC LINE. THIS PERMIT DOES NOT INCLUDE POOL, SPA, FIRE PIT OR BBQ. 2013 CALIFORNIA BUILDING CODE. PHONE FAX ,, j Applied to Approved Printed: Monday, April 27, 2015 10:30:14 AM 1 of 2 CN? s • • •• CHRONOLOGY - • CONDITIONS CONTACTS' NAME TYPE - NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL . APPLICANT TESERRA PO BOX 1280 COACHELLA CA 92236 (760)918-6768 CONTRACTOR TESERRA PO BOX 1280 COACHELLA CA 92236 (760)918-6768 OWNER RREF II CWC LAQ LLC 5927 PRIESTLY DR STE 110 CARLSBAD CA 92008 (760)918-6768 Printed: Monday, April 27, 2015 10:30:14 AM 1 of 2 CN? s DESCRIPTION ACCOUNT M QTY _ AMOUNT PAID PAID DATE RECEIPT# CHECK# METHOD PAID BY CLTD BY WATER FEATURE ONLY 101-0000-42404 0 $181.29 $0.00 WATER FEATURE ONLY 101-0000-42600 0 $98.62 $0.00 PC Total Paid for POOL/ SPA: $279.91 $0.00 Printed: Monday, April 27, 2015 10:30:14 AM 2 of 2 cg?wl hili # Permit Project Address: A. P. Number: Legal Description: Contractor: -�� Address: A City, ST, Zip: Telephone: cP Z L State Lic. # Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Telephone # of Contact Person: # Submittal Rey Plan Sets Structural Calcs. Truss Calcs. Energy Calcs. Flood plain plan Grading plan Subcontactor List I Grant Deed H.O.A. Approval. IN HOUSE:- Planning OUSE:Planning Approval Pub. Wks. Agpr School Fees 1 City ®f La Quinta Building u Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Owner's Name: e Address: _ 1 VA City, ST, Zip:,/,a 1.1,1 Telephone: Project jDescription: Lic. #: Total Permit Fees Construction Type: Occupancy: Project type (circle one):(New Add'n Alter Repair Demo t ( Sq. Ft: # Stories: # Units: 760) Estimated Value of Project: -- APPLICANT: DO NOT WRITE BELOW THIS LINE Recd TRACKING . PERMIT FEES Plan Check submitted Z em Amount Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted Mechanical 2"d Review, ready for correctionsrissue Electrical Called Contact Person Plumbing Plans picked up S.M.I. Plans resubmitted Grading 'rd Review, ready for corrections/issue Developer Impact Fee Called Contact Person A.I.P.P. Date of permit issue Total Permit Fees