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BELC2015-010478-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BELC2015-0104 T4'�t 4 XP Q" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Property Address: 78390 CAMEO DUNES PL PL APN: 643181016 Application Description: LABAYOG / ELECTRIC TO SPA Property Zoning: Application Valuation: $12,000.00 Applicant: TESERRA P 0 BOX 1280 NOV L��S COACHELLA, CA 92236 =.__ • I IT utvt(JPC7EN rDEPF,9WENT 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. C30, C29, C53, C27, 012 License No.: 656128 Date: —I ( 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).: ( ) 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 ) 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: 53 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/19/2015 Owner: LAWRENCE•& MELISSA LABAYOG 78390 CAMEO DUNES PL La Quinta, Ca 92253 Contractor: TESERRA P 0 BOX 1280 COACHELLA, CA 92236 (760)389-9222 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. ave 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: Applicant: r If % 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 property for inspection purposes. Date: �? Signature (Applicant or Agent) DESCRIPTION FINANCIAL ' -ACCOUNT 7 QTY AMOUNTPAID . PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 11/19/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY TESERRA CHECK R10987 132203 SGU Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00. $1.00 DESCRIPTION ACCOUNT - QTY. .:.:: AMOUNT PAID PAID DATE DEVICES, FIRST 20 101-0000-42403 0 $24.17 $24.17 11/19/15 PAID -BY METHOD 'RECEIPT# CHECK# CLTD BY TESERRA CHECK R10987 132203 SGU DESCRIPTION ACCOUNT QTY'.. AMOUNT PAID PAID DATE DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $24.17 11/19/15 PAID BY' METHOD RECEIPT # CHECK # CLTD BY TESERRA CHECK R10987 132203 SGU Total Paid for ELECTRICAL: $48.34 $48.34 DESCRIPTION ACCOUNT QTY °AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 11/19/15 PAID BY METHOD RECEIPT # CHECK # . CLTD BY TESERRA CHECK R10987 132203 SGU Total Paid for PERMIT ISSUANCE: $91.85 $91.85 Description: LABAYOG / ELECTRIC TO SPA Type: ELECTRICAL Subtype: Status: APPROVED Applied: 11/19/2015 SGU Approved: 11/19/2015 SGU Parcel No: 643181016 Site Address: 78390 CAMEO DUNES PL PL LA QUINTA,CA 92253 Subdivision: TR 2043 Block: Lot: 14 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $12,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0' Details: INSTALLING ELECTRIC TO SPAIN BACKYARD WITH ASME COVER. 2013 CALIFORNIA BUILDING CODE CONDITIONS Printed: Thursday, November 19, 2015 10:02:23 AM 1 of 2 C?� SYSTEMS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT TESERRA P 0 BOX 1280 COACHELLA CA 92236 CONTRACTOR TESERRA P O BOX 1280 COACHELLA CA 92236 OWNER LAWRENCE & MELISSA LABAYOG 78390 CAMEO DUNES PL La Quinta Ca 92253 Printed: Thursday, November 19, 2015 10:02:23 AM 1 of 2 C?� SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY DEVICES, FIRST 20 101-0000-42403 0 $24.17 $24.17 11/19/15 R10987 132203 CHECK TESERRA SGU DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $24.17 11/19/15 R10987 132203 CHECK TESERRA SGU Total Paid for ELECTRICAL: $48.34 $48.34 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 11/19/15 R10987 132203 CHECK TESERRA SGU Total Paid for PERMIT ISSUANCE: $91.85 $141.19 $91.85 $141.19 INSPECTIONS PARENTTOTALS: PROJECTS REVIEWS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED DATE STATUS REMARKS NOTES 1ST BLDG NS (1 WK) JIM JOHNSON 11/19/2015 11/19/2015 11/19/2015 APPROVED BOND INFORMATION Printed: Thursday, November 19, 2015 10:02:23 AM 2 of 2 Lf lJ SYSTEMS Bin # City of La Quin to f Building 8i Safety Division U 1 USI 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 `j3 6 Building Permit Application and Tracking Sheet Permitfl LC' ZU `� Project Address: r� 1-- Owner's Narrie: L A. P. Number: Address: Legal Description: City, ST, Zip: G0. Qv Contractor: c Telephone: Address: irk J Project Description: l a City, ST, Zip: oc,G k r7 TeleP h0 ne: � 3 6 I 0 ? v ti 0 State Lic. # 2 City Lie. #.: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: e:Occupancy: Constr ucti n Type: e: State Lu New Add'n Alter Repairair Demo Project (circle one)::N Name of Contact Person: c.tJ� —E"y � Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: ^%�� - �' Estimated Value of Project: 0-J O APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Req'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales, Called Contact Person Plan Check Balance Title 24 Cales. Plans 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.M.I. I-I.O.A. Approval Plans resubmitted Grading IN HOUSE:- 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