BPOL2014-1014J A,
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
BPOL2014-1014
Property Address:
78895 VIA CARMEL
APN:
646430026
Application Description:
POOL/SPA, BBQ
Property Zoning:
Application Valuation:
$30,000.00
Applicant:
TESERRA
PO BOX 1280
COACHELLA, CA 92236
D . �ititli�Cl/ VOICE (760) 777-7125
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/28/2014
Owner:
CHARLES & NA ICY COLLINGE•
78-895 VIA CAF MEL
LA QUINTA, CA 92253
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. C27, C10, C29, C53 License No.: 656128
`Datei
2' / Contractor. %C=f
L
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 i
basis for the alleged exemption. Any violation.of Section 7031.5 by any applicant for
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.).
(_ 11, 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. Q. �
Lender's Name:
Lender's
Contractor:
TESERRA
PO BOX 1280
COACHELLA, CA92236
(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 certificat=_ 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.
Dater // / Applicant: /!'zol fFf
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 N SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOW-EDGEMENT
IMPORTANT: Application is hereby made to the 3uilding 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 isssance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and statethat 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: — N Signature (Applicant or r gent): Av "Olf-& M qM,(�,Cz
t. .
FINANCIAL • i•
1K3 DESCRIPTIONx r4 ACCOUNT�4 QTY WPAID PAID'DATE.
?AMOUNTS'
BSAS SB1473 FEE 101-0000-20306
0 $2.00
$2.00 7/28/14
SPAIDBY4 �s' METHOD` z
s= °RECEIPT #�'�y` xya�CHECK
#'{SCUD BY
TESERRA CHECK
R534
123895 AOR
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $2.00 $2.00
DESCRIPTION DESCRIPTIONr& a
ACCOUNT�w
QTY'
AMOUNT `:
PAID DATE`
c.
i�
DEVICES, FIRST 20
101-0000 42403"
0
$23.83
$23.83
7/28/14
k
PAID4BY�¢METHOD
"�
CHECK #
CLTD BYE
�."..:RECEIPT#
"
,`a`„
.' _ I+,t
tx
TESERRA
CHECK
R534
123895
AOR
n� `DESCRIPTIONS
€+ a n
QTY
AMOUNT
�4
PAIDPAID�DATEi'
,>.":"�...ACCOUNT
a: .":
aha
DEVICES, FIRST 20 PC
101-0000-42600
0
$23.83
$23.83
7/28/14
PAID: BY s �4$`
n� METHODS
£rRECEIP.T #
CHECK #` F
CLiD BY''
. Y' d •'' s
-E- -3 rv...d. l"< :i' -fa.,
w- .}. .rtfi' xf£.
.--f•. .dFe:. a
A
TESERRA
CHECK
R534
123895
AOR
Total Paid for ELECTRICAL: $47.66 $47.66
ION',�,,..'��°"
€-�4`xA000UNT _ r
�QTY�,
``*tz AMOUNT ;;x
' P D
AI
P AT
AID D E
,x.r 14,
�
SWIMMING POOL/SPA
101-0000-42404
0
$178.75
$178.75
7/28/14
PAID BY-'- 4`� £
i y.� METHOD" s`"
:RECEIPT # °
CHECK #'CLTD3BY
`
�<*
+"
TESERRA
CHECK
R534
123895
AOR
4 DESCRIPTION
ACCOUNT' =
QTY
AMOUNT, S`7�
PAID rte'
PAID: DATE'
r 'fr.
4 E a,
§
SWIMMING POOL/SPA PC
101-0000-42600
0
$97.24
$97.24
7/28/14
{`PAID BY _.
z zMETHOD"; a :',
t„RECEIPT#
`� CHECK#
x}CLTD BY gv.
s;"'"
TESERRA
CHECK
R534
123895
AOR
Total Paid for POOL / SPA: $275.99 $275.99
• i
i
s
4
Floodplain plan
Bin #
Permit #P.O.
04
Qty of La Quinta
Building &r Safety Division
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:
Legal Description:
Contractor:—FF5e:
City; ST, Zip:
Telephone:
Address: Project Description: TC)DL- <
City, ST, Zip:
Telephone: -76 0 -1 z--z -2
Subcontactor List
State Lic.
Arch., Engr., Designer,
City Lic. #..
Address:
City., ST, Zip:
Grant Deed
Telephone:
State Lic. #:
Name of Contact Person:
K, Construction Type: Occupancy:
Ad4'n
......... . ....... Project type (circle one):G) Alter Repair Demo
Sq. Ft.: 113 L) 1# Stories: ts:
Telephone #,of Contact Person:
Estimated Value of Project: .30,0-00
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
Req1d
Rcc1d TRACKING PERMIT FEES
Plan Sets
3rd Review, ready for corrections/issue
Plan Check- submitted
I'll Item
Amount
Planning Approval
Structural CaIcs.
Called Contact Person,
A.I.P.P.
Reviewed, ready for corrections
t Plan Check Deposit
Pub. Wks. Appr
Truss-Caics.
Called Contact Person-
Plan Che:k Balance
Title 24 CaIcs.
Plans picked up
Construction
Floodplain 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.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3rd Review, ready for corrections/issue
Develope:- Impact Fee
Planning Approval
Called Contact Person,
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees