BPOL2015-022778-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
49
Q�i U VOICE (760) 777-7125
FAX (760) 777-7011COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/15/2015
Application Number:
BPOL2015-0227
Owner:
Property Address:
80451 CHAMPIONS WY
PINGREE
APN:
775220021
80451 CHAMPIONS WAY
Application Description:
PINGREE / POOL AND SPA ONLY
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$14,500.00
Applicant:
TESERRA
P 0 BOX 1280
COACHELLA, CA 92236
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
Date: — Contractor:TTC
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.).
(_J 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 Name:
Lender's Address:
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
o
f for which this permit is issued.
ve and will maintain workers' compensation insurance, as required by
00 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/ C/'� i Applicant:���__/''%re�
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:ISignature (Applicant or Agent):
f
'�''•, x - ��ti%�"f�� 4 JQ �
^flESCRIPTION y ACCOUNT" :QTY AMOUNT y PAID " PAID DATE,
CCOU
; s �,�' � ° _ � u
BSAS SB1473 FEE 101-0000-20306' .0 $1.00 $0.00
PAIO BY METIiOD RECEI # WECC
CK# LTD f3Y
>..a...
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00.
"r DESCRIPTION k
`°;ACCOUNT
�
Y TY
Q
MOUNT
5..�
PAID,
MAID DATE',
.,.. , , � .. x
;v a y
� s' �
.
SWIMMING.POOL/SPA
101-0000-42404
0
$181.29
$0.00
�c P,A{ID BY
r
> METHOD ` :
�
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C C #
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ri ACCOUNT
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P,AIP-
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SWIMMING POOL/SPA PC
101-0000-42600
0
$98.62
$0.00
-
RE C'EIP,T #
CHECK #
CLTD
`PAID BYE„
:2METWOD
"
�„
BY
Total Paid for POOL / SPA: $279.91 $0.00
Y
Description: PINGREE / POOL AND SPA ONLY
Type: POOL Subtype: Status: UNDER REVIEW
Applied: 10/15/2015 SKH
Approved:
Parcel No: 775220021 Site Address: 80451 CHAMPIONS WY LA QUINTA,CA 92253
Subdivision: Block: Lot: 81
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $14,500.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
TESERRA
Details: POOL AND SPA ONLY. EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER SPECIFICATIONS. ALARMS AND
BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE.
CHRONOLOGY
CONDITIONS
NAME TYPE
NAME
ADDRESSI
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
PINGREE
80451 CHAMPIONS
WAY
LA QUINTA
CA
92253
Printed: Thursday, October 15, 2015 10:21:20 AM 1 of 2
SYSTEMS
INSPECTIONS
Printed: Thursday, October 15, 2015 10:21:20 AM 2 of 2 Orpw-lYSTEMS
CLTDy
—B -
DESCRIPTION
A
ACCOUNT
CITY
AMOUNT
PAID
PAID
RECEIPT
CHECK ECK #
METHOD
PAID BY
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
INSPECTIONS
Printed: Thursday, October 15, 2015 10:21:20 AM 2 of 2 Orpw-lYSTEMS
B;ta #
Permit #
Project Address: <Rt?. 131
City ®f La Quinta
Building U Safety Division
P.®.. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Wracking Sheet
Owner's Name: e Lo.
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:�
Address: 00 A V ;
-5-6
Telephone: "
h
Project Description:
�^ '
City, ST, Zip: 6 - = c
Cid' 7-236,
1
S i Jt �1�4 S
Telephone:
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:'
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
�.
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
{ Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I. .
H.O.A. Approval.
_
Plans resubmitted.Gr-ading
-
IN ROUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Sebool Fees
t—t—
Tota{ Permit Fees