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BPOL2015-014178-495 CALLE TAMPICO�' LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: TESERRA PO BOX 1280 COACHELLA, CA 92236 BPOL2015-0141 81720 MACBETH ST 767800057 GRIFFIN RANCH / LENNAR / POOL S c&uY °& 4 Q" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT $35,000.00 LICENSED CONTRACTOR'S DECLARATION I heieby 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,,:53 License No.: 656128 1 -_ _ Drate: � 7 S Contractor: / ESEi_1?—& 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, after, 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).: 1 ( ) 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 Na Lender's Add VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/30/2015 Owner: IOTA GRIFFIN 4675 MACARTHUR CT NO 1550 NEWPORT BEACH, CA 0 Contractor: TESERRA PO BOX 1280 COACHELLA, CA 92236 '(760)398-9.222 Llc. No.: 656128 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. Date: 1 Applicant: zywfc--f /�f7ti1/I2EZ 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: / 1 s Signature (Applicant or Agent):lsA44/10EZ 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 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 for POOL / SPA: $279.91 $0.00 TOTALS:00 Bin # Ut®f uIa . n Bulidtng 8r Safety Dhdsion P.O. Box 1504, 78-495 Catte Tampico " permit # Ca Quinta, CA 92253 - (760) 777-7012 o L X15 d l 4'1.: 'Building Permit Application and Wracking Sheet Project Add[ . O Owner's Name: L.EAj pjp, p, - A. P. Number. Address: 72- 0 Legal Description:City, ST, Zap: z? ZS 3 Telephone: Contractor. Address: Neat Description: /OOt, S �3 City.ST.Zip, Go 22 6 P/7— Telephone: , % f 922 2 State Lia # - (v S6 i d City Lia #1 Arch., Engr•., Designer Address: , City, ST, ,Tap: Telephone: State Lia #: Construction Type: Occupancy: Project type (circle one) New Add'n Alba Repan Demo Name of Contact P"n:' /O/4l f /2 Sq. Ft.:. y '� 7 # Stories: #Units Telephone #,of Contact Fuson: %( 4 2,� �9 Estimated Value of Project APPUCANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRAC9<CIIVG PERMIT FM Pfau Sets Plan Check submitted item Amount Strutt" Calfs. Reviewed, ready for corrections Plan Check Deposit Truss•G`alcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up boustrac8an ' Flood plain plan Plans resubmlftd Mechanical Gradlug plan 2`' Review, ready for correctionsflssue ElEctiical Subcoutactur List Called Contact Person Plumbing. Grant Deed Plans piclad up SMy . 'Grading H.O.A: Approval Pians resubmitted IN HOUSE-.- ''' Wcw, ready for correetions/issim Developer Impact Fee Planning Approval Called Contact Person- AIZX. Pub. Wks. APer Date of vermit Issue Schodl Fees Total Permit Fees i Description: GRIFFIN RANCH / LENNAR / POOL SPA BBQ AND FIRE PIT Type: POOL Subtype: Status: APPROVED Applied: 6/29/2015 SKH Approved: 6/30/2015 KKI Parcel No: 767800057 Site Address: 81720 MACBETH ST LA QUINTA,CA 92253 Subdivision: TR 32879 Block: Lot: 132 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 STAFF NAME Details: POOL, SPA, FIRE PIT, AND BBQ EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER SPECIFICATIONS. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION.'2013 CALIFORNIA BUILDING CODE. Printed: Tuesday, June 30, 2015 4:31:46 PM 1 of 3 J ,r„ SYSTEMS ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES NOTE MARY FASANO 6/30/2015 CONDITIONS NAME TYPE NAME ADDRESSI 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 Printed: Tuesday, June 30, 2015 4:31:46 PM 1 of 3 J ,r„ SYSTEMS PARENT PROJECTS Printed: Tuesday, June 30, 2015 4:31:46 PM 2 of CN?ffff SYSTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # [METHOD PAID BY BY 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: $366.51 00 PARENT PROJECTS Printed: Tuesday, June 30, 2015 4:31:46 PM 2 of CN?ffff SYSTEMS ATTACHMENTS 1 r Printed: Tuesday, June 30, 2015 4:31:46 PM 3 of 3 J sysreMs