The URL can be used to link to this page

BRES2016-0041ft1 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&�t 4 4 Q9&& COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT 1111111 1111111111111 04 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 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 C C-8 _C10 C53 C27 D12 License No.: 656128 Date. 2 tl 7 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 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. 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 o�ionroo which this permit is issued. ve and will maintain workers' compensation insurance, as required by Sf 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: _ 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 o e Labor Code, I shall forthwith comply with those provisions. Date: 2 177"^1 !VisApplicant: 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, DAMAGESAS 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: Q— t 7 t G Signature (Applicant or Agent) Date: 2/17/2016 Application Number: BRES2016-0041 Owner: Property Address: 80465 CHAMPIONS WY RREF II CWC LAQ LLC APN: 775220021 5927 PRIESTLY DR STE 110 Application Description: SIGNATURE / GAS LINE AND ELECTRIC FOR BBQ CARLSBAD, CA 92008 Property Zoning: Application Valuation: $800.00 - Applicant: Contractor: I 1� TESERRA TESERRA P O BOX 1280 P 0 BOX 1280 �'," L'J COACHELLA, CA 92236 COACHELLA, CA 92236 1=— (760)389-9222 LIC. 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 C C-8 _C10 C53 C27 D12 License No.: 656128 Date. 2 tl 7 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 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. 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 o�ionroo which this permit is issued. ve and will maintain workers' compensation insurance, as required by Sf 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: _ 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 o e Labor Code, I shall forthwith comply with those provisions. Date: 2 177"^1 !VisApplicant: 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, DAMAGESAS 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: Q— t 7 t G Signature (Applicant or Agent) -'-M, Wu 'b'ESCRI" F im-ggg mg ACCOUNTVic" 4 4,* )UNT `fEffi DESCRIPTION tpA� QTX '-PAID!` PA DDATE 'NMAWN' 4, ".--v p NINIt BSAS SB1473 FEE', 101-0000-20366 0, $1.00 $0.00 qq Eka Y R '- 13 �.RECElr HCHECK-WIAH" 0- litiT t�B x --iffim I '�: 4 -111.1, 0�F. i"M Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.0.0 '7" rtxY mn gkgw up"'.qb-UN-q&-- I S, .�T Roll T. AN. 64OUNT'Iv�;?-` DEVICES, FIRST 20 101-0006-42403 -0 $24.17 L E RMETTH NO k E t R`A' f I p -4t 44N�' 0 -1-11WHAC COU 4�14 we. R M LIN, F 'A k POPAIM LW m, -OE �WIMDATE- DEVICES, FIRST 20 PC 101-060042600 0 $0.00 BY Hill dt "W 'N n, ACL DxBY 1 -111: -., R. -RANR -R M Total.Paid for,ELECTRICA,L: $48.34 $0.00 DESCRIPTION 4-H,R'AU4 M4'm ACCOUNT W, V"AMOU PAID #Z ZWr...WM I �,* t PERMIT ISSUANCE 101-0000-42404 0 $91.85 !":A Q D N "MEN �'vrti,l' 'Total Paid for PERMIT ISSUANCE: $91.85 $0.00 g , -qg bESCk 6 N4.m 4, 'tit A-7 A MOUNMI A H X- W. 0�"jTwzr a K r k NATiK, �.a "AIN 1, a WgM pR GAS SYSTEM, 14 OUTLETS 101-0600-42401 0 .$12.09 .$0.00 'METHOD`0��—M�,.KR Q E 'g Or -P&4. TV,`� AMOUNTt'W�Q,'-�e` -!W;t 11.11NPMAIW5 4 16DATE T R GAS SYSTEM, 1-4 OUTLETS PC 401-0000-42600 0, $24.17 -'.$0.00 ,AP MW mk VCT jA'APAID v4 BYRECEIPT %, Total Paid for PLUMBING FEES:_ $36.26 $0.00 R PT ON, R 11.1Z I I W11 P Al b`#,"N-il'1�5A*! -JOAIIWDATE�', yF MWN r -p'z.t4'4W- 1*m .2- M SMI - RESIDENTIAL 101-0000720308 0 $6.50 $0.00 .�CLTD ML gtx' MM DAJRi'�w MCHECK: # BYE 5;1, Total Paid for STRONG MOTION ,INSTRUMENTATION SMI:. $0.50 $0.00 Description: SIGNATURE / GAS LINE AND ELECTRIC FOR BBQ Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: UNDER REVIEW Applied: 2/17/2016 SKH Approved: Parcel No: 775220021 Site Address: 80465 CHAMPIONS WY LA QUINTA,CA 92253' Subdivision: Block: Lot: 80 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $800.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0. FAX Details: ELECTRICAL AND GAS FOR BBQ. EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER SPECIFICATION. 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 RREF II CWC LAQ LLC 5927 PRIESTLY DR STE 110 CARLSBAD CA 92008 Printed: Wednesday, February 17, 2016 12:04:51 PM 1 of 2 SYSTEMS, DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY 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 for ELECTRICAL: $48.34 $0.00 PERMIT ISSUANCE 101-0000=42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.09 $0.00 GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $24.17 $0.00 Total Paid for PLUMBING FEES:. $36.26 $0.00 SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.00 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00 TOTALS:• 00 INSPECTIONS Printed: Wednesday, February 17, 2016 12:04:51 PM 2 of 2 SYSTEMS Bin # Citgo of La Quinta Building at Safety Division P.O. Box 1504, 78-495 Calle Tampico � �� La Quinta, CA 92253 - (760) 777-7012 !ding Permit Application and Tracking Sheet Permit # �� 2� ( Project Address:Owner's Name: l' ^ A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: T�.s� Address: g(a — ( 00 A V&- -5-t; Telephone: Project Description: City, ST, Zip: 606C44ELL bi CA- ZZ3 "J Telephone: ��i r7ZZZf121.ta State Lie. # : City Lie. #: Arch., Engr., Designer: " Address: City, ST, Zip: Telephone: State Lie. V Construction .Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. FL: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING . 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 Cates. Plans nicked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan V 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:- 3' 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