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
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SYSTEMS
ATTACHMENTS 1
r
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sysreMs