BPOL2014-102178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BPOL2014-1021
Property Address: 53452 VIA PALACIO
APN: 777220021
Application Description: POOL/SPA, BBQ FIREPIT
Property Zoning: �
Application Valuation: $30,000.00 If•1
Applicant:
TESERRA
PO BOX 1280
COACHELLA, CA 92236
u
C& 0 D VOICE (760) 777-7125
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/28/2014
Owner:
CLARK & SOLIS DEV
51220 AVD CARRANZA
_ LA QU I NTA, CA 0
JUL 2 g 2014 W
OITY OF Q,uiPITA
UNITY DEVELOPMENT DEPAATM
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 {commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C-8. C27. C10. C29. C53 License No.: 656128
Date:—? Z� ` 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 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
Contractor:
TESERRA
PO BOX 1280
COACHELLA, CA 92236
(760)398-9222
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 polity number are:
Carrier: Polity 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. r P
Da Z f / / / Applicant:,�,10%fC l k6ge doff -Z
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 propert for inspection purposes.
jute: I Signature (Applicant or Agent)
1 1 • • 1
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Total Paid for ELECTRICAL: $47.66 $47.66
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7/28/14
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Total Paid forPLUMBYI'NG FEES: $35.75 $35.75
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101-0000-42404
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Total Paid for POOL / SPA: $275.99 $275.99
l3rn #
Permit #1vZ
O. Cpl^
City ®f La Quin to
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:
Owner's Name:
A. P. Number:
Address: 93 LIrZ �pLlq{ 1 6
Legal Description:
City, ST, Zip: LA av I r,,74N Cjo, 612Z5-3
Contractor: S C"
Telephone:
.
Address: OV
A �L-,
Project Description: 'POOL— 75Q
City, ST, Zip:
gZZ3�1
Izc 'p
TelephIT-
one: 0
do 3�l
Z22
'.;;.::,.:.:;.:•.;;::.;:;::>:•::;,:,.;:,.;;.,.;:.,.
�<>�
State Lic. # : & 9-6 1.2-9
City Lie. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
le one:
P
Construction n T yp . Occupancy:
State Lic_ #:
Ie ne N w Addn Alter Repair Demo
Name of Contact Person:
SSS �-�
Sq. Ft.: 6 y el
# Stories:
# Units:
Telephone #,of Contact Person: 76-0) 2s--6- /Iliz
Estimated Value of Project: 3 O C)
# Submittal
APPLICANT: DO NOT WRITE BELOW THIS LINE
Req'd Rec'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
+Plan
Amount
Structural Cates.
Reviewed, ready for corrections
Check Deposit
Truss Calcs.
Called Contact Person-
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2od Review, ready for correctio /issueZ
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
3d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person,
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
i...r,... �! a:�:�:��:�� ♦ SIT NI-■ �►
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+
_ 4 � a�� • � 7i. i. .Ili%
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:own No-saam
NOW
ilg.- y Srf4.ii���7Ilk
,`♦��,���`�
r
joisma
ilo
RI'aso. U66fm nw, Lot
Ali'
PRE- VC1.5m
n.,uununnun.ununn•u.,�
122 Pm, • N W. rnu.nuuu.nuruu�nnuc .nn:.u.���i II��
....-,A��1IJ��\�1�-�,��I��iA**�It�s��1��1���%�.��.:��I �t��.����•�•�. -
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13
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