BPOL2016-009478-495 CACLE TAMPICO C� 0 D VO'IC 7FiU)�
LA QUINTA, CALIFORNIA 92253 6. 1760r
COMMUNITY DEVELOPMENT DEPARTMENTINSPECTIONS (76L
BUILDING PERMIT o
Application Number:
BPOL2016-0094 `
Owner:
n o tN
Property Address:
80464 PLATINUM WYSCHRAM
o 5; o
APN:
775220021
80464 PLATINUM WAY
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9
Application Description:
SCHRAM / POOL
LA QUINTA, CA 92253
y
Property Zoning:
z�
Application Valuation:
$20,000.00
Applicant:
Contractor:
TESERRA
TESERRA
P 0 BOX 1280
P 0 BOX 1280
COACHELLA, CA 92236
COACHELLA, CA 92236
(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 Class: C-8. C10, C29, C53, C27, D12 License No.: 656128
Date: Contractof:
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:
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'
compe ation, as provided for by Section 3700 of the Labor Code, for the performance
o e wo 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 3700 of t e Labor Code, I shall forthwith
comply with those provisions. /7
Date: V " 6 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 city to enter upon the
above-mentioned property for inspection purposes. , � /I
Date: —..n,-J,/Signature (Applicant or Agent)
DESCRIPTION
FINANCIAL
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
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.86
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$60.91
$0.00
PAID BY
, METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for FENCE OR FREESTANDING WALL: $108.77 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
$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 #
CHECK #
CLTD BY
Total Paid for POOL / SPA: $279.91 $0.00
TOTALS:00
Description: SCHRAM / POOL
ADDITIONAL
Type: POOL
Subtype: Status: APPROVED -CONDITIONS
Applied: 6/24/2016 RSE
Approved: 6/27/2016 DCL
Parcel No: 775220021 Site Address: 80464 PLATINUM WY LA QUINTA,CA 92253
Subdivision: PM 20426
Block: Lot: 35
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $20,000.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
RAMSES SEVILLA
Details: POOL AT REAR YARD [DOUGLASS FERRALL ENGINEERING] AND 1OLF AC SCREEN CITY STANDARD DETAIL. ALARMS AND BARRIERS
REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE.
6/24/2016
I`
__j j Applied to Approved
Printed: Tuesd'ay, June 28, 2016 8:35:05 AM 1 of 2 C
SYS7Eti1S
ADDITIONAL
CHRONOLOGY
CHRONOLOGY TYPE
STAFF NAME
ACTION DATE
COMPLETION DATE
NOTES
PLAN CHECK SUBMITTAL
RECEIVED
RAMSES SEVILLA
6/24/2016
6/24/2016
�.:
>•
TELEPHONE CALL
DUANE CLAYTON
6/27/2016
6/27/2016
PHONED FERNANDO GONZALEZ AND INFORMED HIM PLANS
WERE APPROVED W/CONDITION(REQUIRE SET OF
ENGINEERING PLANS).
CONDITIONS
NAME TYPE
NAME
ADDRESSl'
CONTACTS
CITY
STATE
ZIP PHONE FAX EMAIL
APPLICANT
TESERRA
P 0 BOX 1280
COACHELLA
CA
92236
CONTRACTOR
TESERRA
P 0 BOX 1280
COACHELLA
CA
92236
OWNER
SCHRAM
80464 PLATINUM WAY
LA QUINTA
CA
92253
Printed: Tuesd'ay, June 28, 2016 8:35:05 AM 1 of 2 C
SYS7Eti1S
FINANCIAL
••
•
CCT[
DESCRIPTION ACCOUNT QTY AMOUNT
PAID
PAID DATE RECEIPT # CHECrt # METHOD PAID BY
'BY
BSAS SB1473 FEE 101-0000-20306 0 $1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1:00 $0.00
BSA:
WALL/FENCE - FIRST
101-0000-42404
0
$47.86
$0.00
100 LF
WALL/FENCE - FIRST
101-0000-42600
0
$60.91
$0.00
100 LF PC
Total Paid for FENCE OR FREESTANDING WALL: $108.77 $0.00
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
$0.00
SWIMMING POOL/SPA
101-0000-42600
0
$98.62
$0.00
PC
Total Paid for POOL / SPA: $279.91 $0.00
TOTALS:00
REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES
DATE
1ST BLDG NS (1 DUANE APPROVED- PLANS APPROVED BUT AN ADDITIONAL COPY OF
DAY) CLAYTON 6/24/2016 6/27/2016 6/27/2016 CONDITIONS POOL ENGINEERING IS REQUIRED.
Printed: Tuesday, June 28, 2016 8:35:05 AM 2 of 2 J ...
SYS T(: h1S
E ,
Bili # City ®f La Quinta
Building 8E Safety Division
Permit # P-®. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
building Permit Application and Tracking Sheet
Project Address: Owner's Name:
A. P. Number:
Address:
Legal' Description:
Contractor: Tom. P_k4
City, ST, Zip: Ja
Telephone:
Project Description:Idudi4
YN
Address: g,— 100
City, ST, Zip: - _
7ZZ3
Telephone:
U
State Lic. # :
Arch., Engr., Designer:
City Lic. #:
C C
r
AnJr
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
�d ld r—a LIS _C_#Units:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft:
#Stories:
Telephone # of Contact Person: Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Recd TRACMG PERMIT FEES
Plan Sets Plan Check submitted Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss C. ales.
Person
PlanCheck Balance
]Energy Calcs.
rCalled'Contact
picked up
Construction
Flood plain plan
resubmitted
Mechanical
Grading plan
rd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
_
H_O.A. Approval!
IN HOUSE:
_
_
Plans resubmitted
_
_Grading
Jrd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.Y.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees