BPOL2015-0014Applicant: Contractor:
TESERRA JAN 14 2015 TESERRA
PO BOX 1280 PO BOX 1280
COACHELLA, CA 92236 CITY OFIA()UINTA COACHELLA, CA 92236
COMMUNITY DEVELOPMENT DEPARTMENT
(760)398-9222
{ Llc. No.: 656128
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that l 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, C30, C29, C53 License No.: 656128
`Date: N S Contractor:
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 requ res 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 Divisio
of the Business and Professions Code) or tha: 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).:
(_)1, 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-bu Ider 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.).
(_J 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'
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 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.
�Aate: Applicant: /I 4�/�1.rFl �! lh OZO-Z
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.
pate: / N Signature (Applicant or Agent):,il/f0/lE 1 &e"z
VOICE (760) 777-7125
78-495 .CALLE TAMPICO
D
FAX (760) 777-7011
LA gUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760).777-7153
BUILDING PERMIT
Date: 1/14/2015
Application Number:
BPOL2015-CO14
Owner:
Property Address:
81695 MACBETH ST
IOTA GRIFFIN
APN:
767800066 •
4675 MACARTHUR CT N0.1550
Application Description:
POOL SPA B3QAND FIRE PIT
NEWPORT BEACH, CA 0
Property Zoning:
Application Valuation:
$35,000.00
n n n
Applicant: Contractor:
TESERRA JAN 14 2015 TESERRA
PO BOX 1280 PO BOX 1280
COACHELLA, CA 92236 CITY OFIA()UINTA COACHELLA, CA 92236
COMMUNITY DEVELOPMENT DEPARTMENT
(760)398-9222
{ Llc. No.: 656128
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that l 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, C30, C29, C53 License No.: 656128
`Date: N S Contractor:
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 requ res 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 Divisio
of the Business and Professions Code) or tha: 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).:
(_)1, 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-bu Ider 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.).
(_J 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'
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 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.
�Aate: Applicant: /I 4�/�1.rFl �! lh OZO-Z
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.
pate: / N Signature (Applicant or Agent):,il/f0/lE 1 &e"z
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
QTY
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
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
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
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 forPOOL / SPA: $279.91 $0.00
TOTALS:0i
Description: POOL SPA BBQ AND FIRE PIT
Type: POOL Subtype: Status: APPROVED
Applied: 1/12/2015 MFA
Approved: 1/13/2015 JFU
Parcel No: 767800066 Site Address: 81695 MACBETH ST LA QUINTA,CA 92253
Subdivision: TR 32879 Block: Lot: 141
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
MARY FASANO
Details: POOL, SPA, FIRE PIT, AND BBQ WITH 4 FOOT HIGH EQUIPMENT WALL [2 INCH GAS PIPING/#8 AWG IN 1 INCH CONDUIT ELECTRICAL]
THIS PERMIT DOES NOT INCLUDE ELECTRICAL AT BBQ. EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER
SPECIFICATIONS. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2010 CALIFORNIA BUILDING
CODE.
FINANCIAL INFORMATION
Printed: Wednesday, January 14, 2015 10:36:12 AM 1 of 3
B?WSYS7EMS
ADDITIONAL
CHRONOLOGY TYPE
STAFF NAME
CHRONOLOGY
ACTION DATE
COMPLETION DATE NOTES
PUBLIC COUNTER VISIT
MARY FASANO
1/12/2015
1/12/2015
TELEPHONE CALL
JAKE FUSON
1/13/2015
1/13/2015
NOTIFIED MOISES W/ TESERRA PLANS WERE APPROVED AND
PERMIT READY TO ISSUE.
CONDITIONS
'NAME TYPE
NAME ' ' ".
ADDRESS1
CONTACTS
CITY
STATE
ZIP PHONE FAX
EMAIL
APPLICANT
TESERRA
PO BOX 1280
COACHELLA
CA
92236
CONTRACTOR
TESERRA
PO BOX 1280
COACHELLA
CA
92236
OWNER
IOTA GRIFFIN
4675 MACARTHUR CT
NO 1550
NEWPORT
BEACH
CA
0
FINANCIAL INFORMATION
Printed: Wednesday, January 14, 2015 10:36:12 AM 1 of 3
B?WSYS7EMS
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES
DATE DATE
FINAL*" T
PARENT PROJECTS
BOND INFORMATION
Printed: Wednesday, January 14, 2015 10:36:12 AM 2 of 3
CRWrsrenas
CLTD
DESCRIPTION
ACCOUNT
QTYAMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$0.00
Total Paid for BUILDING 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:• •0
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES
DATE DATE
FINAL*" T
PARENT PROJECTS
BOND INFORMATION
Printed: Wednesday, January 14, 2015 10:36:12 AM 2 of 3
CRWrsrenas
ATTACHMENTS
Printed: Wednesday, January 14, 2015 10:36:12 AM 3 of 3 CRWrsrEMS
,
Bin # i
1
gPo�2 ol5 - obl'� i
4
,
Bin # i
gPo�2 ol5 - obl'� i
.0ty ®f La uin to
-Building- &r Safety Division
Permit #
P.O. Box 1504, 78-495 Calle Tampico
i
La Quinta, CA 92253 - (760) 777-7012
Building Permit Applicati®n and Tracking Sheet
Project Address: �+ .� i
C 7" S Owner's Name: STR�S
A. P. Number:
Address:q 1cj s114A C 61EE-ST-
Legal Description:
City, ST, Zip:
Contractor:,::;:�;<.
Telephone: +
c
Address: �(� �Q (� fes! Es S
Project Description:
City, ST, Zip: Cpot LcorI'
C 14 ZZ36
Telephone: -76d 3 ��' . 2 2 Z 1-.:- �.�..•,�':.s++;�,<:.;�w �.:5 ,��•,:;:�? ";'+:;4
State Lie. #
City Lie. #;
Arch., Engr., Designer.
Address:
City., ST, Zip: ,
Telephone: I
nz "}: k r; rev,'•;>yfi yt
<'f�•, :; 7?3"xa'>
:y:.L�:"�iL];; ,•;.#:<,...•.�.•<: w�L:
Construction Type: Occupancy:
State Lie. #: j
}'''`i'uS ?'ry ?'s
?i•%'i'•k• rYnh i....b•:J.t✓.x{.S", 1.��.; w4"K:.
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: -h
0 E
Sq. Ft.
# Units:
Telephone #,of Contact Person: L
Estimated Value of Project: � 3 S, UOU
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd 1!
Rec'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
i
Reviewed, ready forte l S.f uE
l
f 3
Plan Check Deposit
Truss Cates.
!
Called Contact Person
1
Plan Check Balance
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A: Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd Review, ready for correctionsrissue
Developer Impact Fee
Planning Approval
{
Called Contact Person.
A.I.P.P.
Pub. Wks. Appr
;
Date of permit issue
School Fees
l
1
Total Permit Fees