BPOL2016-007378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
TESERRA
P 0 BOX 1280
COACHELLA, CA 92236
c&ht 4 XP Quiaro
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BPOL2016-0073
81257 MERV GRIFFIN WY
767780009
LENNAR / POOL, SPA, BBQ AND FIRE PIT AT REAR YARD
$28,000.00
Owner:
IOTA GRIFFIN
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
4675 MACARTHUR CT NO 1550
NEWPORT BEACH, CA 0
Contractor:
TESERRA
(1fjAY 2 J � �. P O BOX 1280
COACHELLA, CA 92236
CITYOFLA QUINTA (760)389-9222
COMMUNITY DEVELOPMENT DEPARTMENT 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 s Z 3In contract r. —%ETA i�lL�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, 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
Lender's Address:
Date: 5/20/2016 .
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.
/�l 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.
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 actor 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.
,, .. l 3 1G ----------- r ✓�,
FINANCIAL . ,
DESCRIPTION ACCOUNT CITY AMOUNT . PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306
0 $2.00 $0.00
PAID BY METHOD
RECEIPT # CHECK # CLTD BY
Total Paid for BUILDING 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.OUT LETS
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:0•
Description: LENNAR / POOL, SPA, BBQ AND FIRE PIT AT REAR YARD
Type: POOL Subtype: Status: APPROVED
Applied: 5/18/2016 RSE
Approved: 5/20/2016 AOR
Parcel No: 767780009 Site Address: 81257 MERV GRIFFIN WY LA QUINTA,CA 92253
Subdivision: TR 32879 Block: Lot: 57
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $28,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
TESERRA
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.
j Applied to Approved
CHRONOLOGY
CONDITIONS
NAME"'TYPE
NANI'E
46DRESS1
CONTACTS
CITY STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
TESERRA
P 0 BOX 1280
COACHELLA CA
92236
BY
BSAS 581473 FEE 101-0000-20306 0
$2.00
CONTRACTOR
TESERRA
P O BOX 1280
COACHELLA CA
92236
$2,00
$0.00
OWNER
IOTA GRIFFIN
4675 MACARTHUR CT
NO 1550
NEWPORT CA
BEACH
0
Printed: Friday, May 20, 2016 11:36:42 AM 1 of 2
SYST(MS
FINANCIAL
INFORMATION
CL
DESCRIPTION ACCOUNT QTY
AMOUNT
PAID
PAID DATE RECEIPT # CHECK #t METHOD PAID BY
BY
BSAS 581473 FEE 101-0000-20306 0
$2.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$2,00
$0.00
BSA:
Printed: Friday, May 20, 2016 11:36:42 AM 1 of 2
SYST(MS
Printed: Friday, May 20, 2016 11:36:42 AM 2 of 2 R
SYS7EiNS
CLTD
DESCRIPTION
ACCOUNT
QTY.
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
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 -$0.00
Printed: Friday, May 20, 2016 11:36:42 AM 2 of 2 R
SYS7EiNS
Bin # .
Qty of La u►nta
Building &r Safety Division
Per 't# P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
b° OV Building Permit Application and Tracking Sheet
Project Address:
A. P. Number:
Address: Z.�7 E�2✓ /2/FF/N W%}
Legal Description:
E/Z
City, ST, Zip: /—A- j/& -7-;n 6W 92 ZS -3
Telephone: f�;•,;,<:��.�,.::,>..�;:
RISE :
Address: d0 .qv is 8-9
Project Description: ,0 p
City, ST, Zip: CDp Ctleu 6%— Z 23 6
Telephone: 6 D 39
State Lic. # : S /p Z
City Lic. #,
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
P
State Lic. #:
,,• �s,.>�>:.t�sa;,;s
s • ::# f,,,. qz°.
Construction Type: Occupancy:
Project type (circle on New)Add'n Alter Repair Demo
Name of Contact Person: Vly I
� M 2t"Z
Sq. Ft-: 6,0d
# Stories:
# Units:
Teltphone #,of Contact Person: 6 o
2S0 1,74/
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Recd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Pians picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.MX
H.O.A. Approval
-------------
Plans resubmitted
Grading
IN ROUSE:-
3 Review, ready for correctioastissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees