BRES2016-0032i
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BRES2016-0032
80479 CHAMPIONS WY
775220021
SIGNATURE / GAS LINE AND ELECTRICAL FOR BBQ
$800.00
01
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
RREF II CWC LAQ LLC
5927 PRIESTLY DR STE 110
CARLSBAD, CA 92008
Date: 2/9/2016
Applicant: Contractor:
TESERRA TESERRA rev o_
P O BOX 1280 P O BOX 1280 a �'
COACHELLA, CA 92236 COACHELLA, CA 92236
(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 Class: C-8. C10, C29, C53, C27, D12 License No.: 656128
Date: / Contractor: "ie eat
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
compehsation, 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.).
(1 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 Name:
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'
comp nsation, as provided for by Section 3700 of the Labor Code, for the performance
owe w r 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.
Date: .k—'7 , / & Applicant:
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 ent upon the
above-mentioned property for inspection purposes.
Date: a — I —.I h Signature (Applicant or Agent)
FO • mATI.b
$",'.;GyEY,i; ..'I K"SS : .y`; s`"` x< x'^:,i-.n E -,pis xr, w,t c'�a,"Y":3''r:i..ri,? h mss' w ., „frpa v ;'kT•„ x.e - :9':>.
DESCRI?TION��A000UNT401 DATE
a p £ < � y¢QfY7 ��AMOUNT_PAIDA3TtPAID
BSAS SB1473 FEE
101-0000-20306 05 '$1 ' $0.00
ti �, t 4 ",.. = SYd•S'__, xy.S. .� r¢. y.`<i '^@ �j _�,ih�-� , m.
_PAID,BY',
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g RECEIT
,;.E 3i=
kCLTDBY,
MvW1100115,�
�METHO,D<��<` ra #� ..r _. pHECK4#.�
kLTN
Total Paid for -BUILDING STAN DARDS'ADM IN ISTRATION BSA: $1.00 $0.00
_'; fiR x:44 ''�..f '<—f. .i--^..C":t,�'4'•fi
.� 3-n .'..g'z,g.M
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QT{YAMOUNT
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PAID DATE
nDESCRIPTION-e�
bACCQUNT
^
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$0.00
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METIODRECEIPT#C+IECK#
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z DESCRIPTION;:.
ACCOUNT*
�AM�OUNT
ADD T
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Ra
a .. �a
,gTY�mmg
...PAID.-
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DEVICES-, FIRST 20 PC
101-0000-42600
0.
'$24.17
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x:z°k¢,
<mmmW- z.,
METHOD
{Y
#"e<?�
_—r -fin r
#
a
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YRECEIPT
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Total Paid for ELECTRICAL: $48.34 $0.00
1F�duiL.'_ ., g i<31
DESCRIPTION �,, �F
:t.£h'i� o.kiC l'..£.f
ACCOUNT
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t �.: i2 at:. 4!
.S£.'B:KR.i
DATE=
.:
=
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�AMOU,NT
sP,A1Di4;PAID
PERMIT ISSUANCE
101-0000=42404
0
. $91.85
$0.00"
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METHOD��
> € 6 a;
RECEIPTS#M'�a�CHECK#QTD`BY
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Total Paid for PERMIT.ISSUANCE: ' $91.85 $0.00
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DESCRIPTION����ACCOUNT
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t, <. r,
,� .;4 t:,;3;�
'PAID
GAS SYSTEM,.1=4 OUTLETS
101-0000-42401
0
$12.09
$0.00
PAiD BY z
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get, .X".i�.�5p, w£{ '� - F"` ;
, a ;
RECEIPT #��.,
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AMOUNT
.(.s`3iS.T�
0
PAID DATE:
x uDESGRIPTION ; #
t� p ACCDUNT# „^ y
.
� t v x
PAID;. k
GAS SYSTEM, 1 -4 -OUTLETS PC
101-0000-42600
0
$24.17
$0.00
TH$ -PfY b � ..�„�
PAID
.,y1.- { ;�`, ' .:....:exY.k` ji, +� ,.
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RECE�T
AF .3 F. .'�,.5 $F.?Y
BY
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. <METFIOD IiMM
#4 �xCHECKCLTD
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Total Paid for PLUMBING FEES: $36.26 $0.00
i 3h ., .x
rDE5CRIPTION' �•
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w'
'QTY
4 R S :%
AMOUNT
- $ 4
PAID
���
' a
QC�<��,��
. ..ACCOUNT .:
q�
PAIDDATE
SMI - RESIDENTIAL
101-0000-20308
.0
• . $0.50
$0.00'
-.. „<��
PAIDW " � F
f� _5*�
�CHECK #
p�
Total Paid for STRONG MOTION INSTRUMENTATION SMI:' .$0.50 $0.00
"ICIT••
Permit Details PERMIT NUMBER
City of La Quinta BRES201�6-0032 `*
�"� Ilt`
Description: SIGNATURE / GAS LINE AND ELECTRICAL FOR BBQ
Type: BUILDING, RESIDENTIAL
Subtype: REMODEL Status: UNDER REVIEW
Applied: 2/9/2016 SKH
Approved:
Parcel No: 775220021 Site Address: 80479 CHAMPIONS WY LA QUINTA,CA 92253
Subdivision:
Block: Lot: 79
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
PHONE
Details: • GAS LINE AND ELECTRICAL FOR BBQ. 2013 CALIFORNIA BUILDING CODE.
EMAIL
ADDITIONAL SITES
CHRONOLOGY
CONTACTS
NAME TYPE
NAME
ADDRESSI
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: Tuesday, February 09, 2016 2:38:20 PM 1 of 2 Cr
SYS7Eti1S
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, 14
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: $177.95 00
INSPECTIONS
ATTACHMENTS
Printed: Tuesday, February 09, 2016 2:38:20 PM 2 of 2 ,
S YS7f MS
l;lil #
Colty ®f La Quinta
Building U Safety Division
INHOUSE-- ''" Review, ready for corrections/issue Developer Impact Fee
P.Q. Box 1504, 78-495 Calle Tampico
Permit #
La Quinta, CA 92253 - (760) 777-7012
Planning Approval Called Contact Person A.II.P.P.
Building Permit Application and `racking Sleet
Project Address: _
Owner's Name:Ll VM 6MOLY D
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: ��� a4
Telephone:
Address: g(�— U ;
��` Project Description: AA 111-
City, ST, Zip:= Z
Cl4' ZZ�� J
Telephone:
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
f
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:'Project
type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: # Stories: # Units: 4
Telephone # of Contact Person:
Estimated Value of Project:r
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd
Recd TRACEING • PERIVIIIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Cafes.'
Reviewed, ready for corrections Plan Check Deposit
Truss Cafes.
Called ContactPerson :.. Plan Check Balance
]Energy Calcs,
Plans picked. up Construction
Flood plain plan.
Plans resubmitted Mechanical
Grading plan .
20 Review, ready for correctionsrssue Electrical
Subcontactor )List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval. Plans resubmitted Grading
INHOUSE-- ''" Review, ready for corrections/issue Developer Impact Fee
Planning Approval Called Contact Person A.II.P.P.
Pub. Wks. Appr Date of permit issue
School Fees
Total Permit Fees