BPOL2015-0001i
ANIM
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 9L'253
r
J
TA'r44Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
LICENSED CON'RACTOR'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. C27, C10, C29, C53 License No.: 656128
Date: /I � �S Contractor:
OWNER -BL ILDER 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, alsc requires the applicant for the permit to file a
signed statement that he or she is licersed pursuant to the provisions of the
Contractor's State License Law (Chapte. 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 Volation 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 m� 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 Ccde: 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 owrer-builder will have the burden of proving that
he or she did not build or improve for Oe purpose of sale.).
(_) I, as owner of the property, am 6clusively 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 pro ects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
( ) I am exempt under Sec. . 3.&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 :his permit is issued (Sec. 3097, Civ. Q.
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.
/Y►�i 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 provisicns of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions. /�rf
Date: Applicant:-OzolrGJ A��.Ix L
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.
Date: Signature (Applicant or Agent): 4e1/etZ
�•
Date:
1/8/2015
Application Number:
BPOL2015-0001
Owner:
Property Address:
81680 MACBETH ST
LENNAR HOMES OF CALIF INC
APN:
767800059
980 MONTECITO DR STE 302
Application Description:
POOL SPA BBQ & FIREPIT AT REAR YARD
CORONA, CA 0
Property Zoning:
Application Valuation:
$35,000.00
Lr)
a
Applicant:
Contractor: 00
X
TESERRA
PO BOX 1280
TESERRA C.
PO BOX 1280
o
COACHELLA, CA 92236
Z
COACHELLA, CA 92236 Q
��
(760)398-9222
I
Llc. No.: 656128
LICENSED CON'RACTOR'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. C27, C10, C29, C53 License No.: 656128
Date: /I � �S Contractor:
OWNER -BL ILDER 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, alsc requires the applicant for the permit to file a
signed statement that he or she is licersed pursuant to the provisions of the
Contractor's State License Law (Chapte. 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 Volation 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 m� 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 Ccde: 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 owrer-builder will have the burden of proving that
he or she did not build or improve for Oe purpose of sale.).
(_) I, as owner of the property, am 6clusively 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 pro ects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
( ) I am exempt under Sec. . 3.&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 :his permit is issued (Sec. 3097, Civ. Q.
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.
/Y►�i 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 provisicns of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions. /�rf
Date: Applicant:-OzolrGJ A��.Ix L
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.
Date: Signature (Applicant or Agent): 4e1/etZ
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306 0
$2.00 $0.00
PAID BY METHOD RECEIPT # CHECK # CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $2.00 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
DEVICES, FIRST 20;
101-0000-42403
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for ELECTRICAL: $48.34 $0.00
DESCRIPTION
ACCOUNT
CITY
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
CITY
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
CITY
AMOUNT
PAID
PAID DATE
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
CITY
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:• ••
N 2•,- S '4 ap '}
+e j
OF
x
Description: POOL SPA BBQ & FIREPIT AT REAR YARD
Type: POOL Subtype: Status: APPROVED
Applied: 1/7/2015 PJU
Approved: 1/8/20151FU
Parcel No: 767800059 Site Address: 81680 MACBETH ST LA QUINTA,CA 92253
Subdivision: TR 32879 Block: lot: 134
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $35,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: POOL, SPA, BBQ AND FIRE PIT AT REAR YARD'[DOUGLAS FERRELL ENGINEERING] THIS PERMIT DOES NOT INCLUDE EQUIPMENT
ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE.
;y„�
� ,�� t_%$41.5
,�-fir
a,
Process
! J Applied to Approved
..•ems 7bt > -=•c sr-1,�ir „r+: a. +C '
w�7 �a4x=r ,fi CONDITIONS •�`. V -�
A
.r- -
Printed: Thursday, January 08, 2015 3:07:47 PM 1 of 3
- OLi 1J LJ SYSTEMS
INSPECTIONS
FINANCIAL
1 •
DESCRIPTION
ACCOUNT QTY
AMOUNT
PAID
PAID DATE RECEIPT# CHECK# METHOD PAID BY CLTD
BY
BSAS SB1473 FEE
101-0000-20306 0
$2.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$2.00
$0.00
BSA:
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$0.00
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$0.00
Total Paid for ELECTRICAL:
$48.34
$0.00
GAS SYSTEM, 1-4
101-0000-42401
0
$12.09
$0.00
OUTLETS
GAS SYSTEM, 1-4
101-0000-42600
0
$24.17
$0.00
OUTLETS PC
Total Paid for PLUMBING FEES:
$36.26
$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
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
FINAL"
Printed: Thursday, January 08, 2015 3:07:47 PM 2 of 3
N?WSYSTEMS
BOND INFORMATION
Printed: Thursday, January 08, 2015 3:07:47 PM 3 of 3 C��
SYSTEMS
Qin # , City of La Quinta
Building &r Safety Division
Permit # D1 P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:it'a& 7-f � ST Owner's Name:
A. P. Number:
Address: Q ��
Legal Description: City, ST, Zip: 14+
Contractor
' �5�,��-� Telephone:{::>t'`s:`�<.;:�h::�.;.;:;•,>>:.:>;;;<;::;.;l:::
Address: 9FZIP Slt Project Description: PUp' ~
City, ST, Zip: p�}Cff�LLl4- C 9Z23t'o
E
Telephone:
�4 •fJ}iiir:}{ ��f�:j4,Y:.':>:?: J ji:? F� nv}j:{i+ri�'-'
Plan Sets
State Lie. # : to Z,
City Lie.
.
f
Arch., Engr., Designer:
Item
Address:
City., ST, Zip: '
Telephone:
:: >r:>;•:, :::< :>:>;» '?
fry..S�.{:�.f�iv>}:j?.l'/:.i:.i-.?:v:;:<v: �}?;J.>.i�•
::%:;•:;4;:;.;;;r:;:.<:<- .::;.:.::,:.:
.......:................
Construction Type: Occupancy:
State Lie. # •
Project type (circle bne)• Ne Add, n Alter Repair Demo
' r
Name of Contact Person: /J/J�/r`( �,,1 �. , .n..
cn Ft • CGG
i! Ct r e
u Y
Telephone #,of Contact Person: 6 2 SU _
Estimated Value of Project: 3 S UDD
APPLICANT: DO NOT WRITE BELOW THIS LINE
N Submittal Req'd Recd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for 15SVE.
1 g
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Floodplain plan
I
Plans resubmitted
Mechanical
Grading plan
i
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
rN HOUSE:-
i
3' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A,I,P,P•
Pub. Wks. Appr
{
Date of permit issue
School Fees
Total Permit Fees