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BPOL2015-014278-495 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 BPOL2015-0142 59295 SEVILLE 764700006 FLORESSI RESIDENCE POOL $38,000.00 c&tvl 4 64� QUM& COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT 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 License No.: 656128 Cate: —7/-7 5 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 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, 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/2/2015 Owner: FLORESSI 59295 SEVILLE LA QUINTA, CA 92253 Contractor: TESERRA P 0 BOX 1280 COACHELLA, CA 92236 (760)340-9000 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. ,,pp Date: —2 Applicant: ,-"0 /S Ef R -EZ 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 he authorize representatives of this city to enter upon the above- mentioned property for inspection purposes. Date: Signature (Applicant or Agent)�u0/r0- DESCRIPTION FINANCIAL INFORMATION 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 forELECTRICAL: $48.34 $0.00 DESCRIPTION ACCOUNT, QTYAMOUNT 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 Description: FLORESSI RESIDENCE POOL Type: POOL Subtype: Status: APPROVED Applied: 7/2/2015 EVA Approved: 7/2/2015 EVA Parcel No: 764700006 Site Address: 59295 SEVILLE LA QUINTA,CA 92253 Subdivision: TR 31681-3 Block: Lot: 171 Issued: Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $38,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: POOL, SPA, FIRE PIT, AND BBQ WITH [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. 2013 CALIFORNIA BUILDING CODE. Applied to Approved Printed: Thursday, July 02, 2015 8:14:28 AM 1 of 2 C sys7rnns CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT TESERRA P 0 BOX 1280 COACHELLA CA 92236 CONTRACTOR TESERRA P 0 BOX 1280 COACHELLA CA 92236 OWNER FLORESSI 59295 SEVILLE LA QUINTA CA 92253 Printed: Thursday, July 02, 2015 8:14:28 AM 1 of 2 C sys7rnns INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES FINAL" BLD 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 forELECTRICAL: $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 DATE DATE RESULT REMARKS NOTES FINAL" BLD REVIEWS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES DATE ATTACHMENTS Printed: Thursday, July 02, 2015 8:14:28 AM 2 of 2 w� S YSTF. 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