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BPOL2015-0198Applicant: Contractor: TESERRA TESERRA 78-495 CALLE TAMPICO P 0 BOX 1280 T Twit D VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 - (760)389-9222 FAX FAX (760) 777-7011 Llc. No.: 656128 COMMUNITY DEVELOPMENT DEPARTMENT (760) 777-7153 BUILDING PERMIT Date: 9/15/2015 Application Number: BPOL2015-0198 Owner: Property Address: 59505 SEVILLE T D DESERT DEV APN: 764710004 81570 CARBONERAS \ Application Description: WROBBEL / POOL, SPA, FIRE PIT AND BBQ LA QUINTA, CA 0 Property Zoning: Application Valuation: $30,000.00 Applicant: Contractor: TESERRA TESERRA P 0 BOX 1280 P 0 BOX 1280 COACHELLA, CA 92236 COACHELLA, CA 92236 (760)389-9222 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 Dater / / G / Contractor:�P—)4 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 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 contractors) 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: 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. ,,W4 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: �% lv Applicant: Ia.vr 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 roperty for inspection purposes. / ,p Date GI �6 / � Signature (Applicant or Agent):/% &,6/ - /C n f yeFZ 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 # {LTD BY Total Paid forPOOL / SPA: $279.91 $0.00 TOTALS:i0 Description: WROBBEL / POOL, SPA, FIRE PIT AND BBQ Type: POOL Subtype: Status: APPROVED Applied: 9/11/2015 AOR Approved: 9/14/2015 KKI Parcel No: 764710004 Site Address: 59505 SEVILLE LA QUINTA,CA CA Subdivision: TR 31681-3 Block: Lot: 178 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $30,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: POOL, SPA, FIRE PIT, AND BBQ. 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. FINANCIAL INFORMATION Printed: Tuesday, September 15, 2015 9:21:04 AM 1 of 2 C. S YSTr: tits ADDITIONAL CHRONOLOGY TYPE STAFF NAME CHRONOLOGY ACTION DATE COMPLETION DATE NOTES NOTE STEPHANIE KHATAMI 9/14/2015 returned 9/14 /15 to stephanie CONDITIONS •NAME TYPE ' " NAME"' ADDRESS1 CONTACTS 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 T D DESERT DEV. 81570 CARBONERAS LA QUINTA CA 0 FINANCIAL INFORMATION Printed: Tuesday, September 15, 2015 9:21:04 AM 1 of 2 C. S YSTr: tits DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD 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 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 forPLUMBING 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:00 INSPECTIONS ATTACHMENTS Printed: Tuesday, September 15, 2015 9:21:04 AM 2 of 2 SYSTEMS Bin # Otj/ d La Quinta Building 8t Safety Division Pennit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 %w1viS. D11i Building Permit Application and TracMng Sheet ProjcctAddtrss: Owner's Name: A. P. Number. Address: Legal Description: City, ST, Zip: Z m d 2 2 Y:? Contractor S E ,214 Telephone: Address. ' !jG D A -V6 s ProjectDesc ription: D L i Cit', ST, Zip: �LL�a 2 -2 3% Telephone:J,U 2Z State Lia # : 6 S(o . 2kCity Lia #� Arch.Enl;x, Desigmer Address: City, SP, tip: Telephone: State Lia #: Construction Type: Occupancy: Project We (circle one): NewAdd'n Alter Repair Demo Name of Contact Person: S M1E Z Sq. Ft: /") # Stories: # Units Tetephonq #,of Contact Person: p 250 • Estimated Value of Project; 30 Oil d APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd ' Reed 'IRAC MG PERMCP FEES Plan Sets Plan Check submitted -t 11 j' Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Tress Calcs. Called Contact Person Plan Check Balance ----------------- Title 24 Cale& Plans picked up boush ction Flood plain plan Plans resubmitted Mechanical Grading plan 2", Review, ready for corrections/issue Ejectiieal Subeoatactor List Called Contact Person Plumbing. Grant Deed Plans picked up SM.L H.O.A: Approval Pians resubmitted ::Grading IN ROUSE:- 'a Reylew, ready for eorreedonsfissue Developer Lnpact Fee Planning Approval Called Contact Person • A,Iy p, Pub. Wks. Appr Date of permit issue Schodl Few Total Permit Fees