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BPOL2016-008578-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: TESERRA P 0 BOX 1280 COACHELLA, CA 92236 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BPOL2016-0085 53576 VIA STRADA 777200016 NEIL/ POOL, SPA, FIREPIT AT $45,000.00 OFLA VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 aOwner: WALTER NEIL 44800 VILLAGE COURT M RD INDIAN WELLS, CA 92210 Contractor: TESERRA P 0 BOX 1280 COACHELLA, CA 92236 (760)389-9222 Llc. No.: 656128 Date: 6/10/2016 © ~ w Date: 3 G Contractor: Section 3700 of the Labor Code, for the performance of the work for which this permit 4 Q©tom. 0 I hereby affirm under penalty of perjury that I am exempt from the Contractor's State C3 w CrJ i R rl O `u Q Lo signed statement that he or she is licensed pursuant to the provisions of the comply with those provisions. Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division C) LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the following declarations: 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, I have and will maintain a certificate of consent to self -insure for workers' and my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance License Class: C-8. C10, C29, C53, C27, D12 License No.: 656128 of the work for which this permit is issued. 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 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: t'O %3 Signature (Applicant or Agent): /!/i0/✓E� ��/f1 / FEZ I have and will maintain workers' compensation insurance, as required by Date: 3 G Contractor: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and polity number are: OWNER -BUILDER DECLARATION Carrier:- Policy Number: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State I certify that in the performance of the work for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree that, if I should become subject to the any structure, prior to its issuance, also requires the applicant for the permit to file a workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith signed statement that he or she is licensed pursuant to the provisions of the comply with those provisions. 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 �A Flo Date: to /3 Applicant: 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO (_) I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF compensation, will do the work, and the structure is not in or offered for sale. COMPENSATION,' DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to within one year of completion, the owner -builder will have the burden of proving that the conditions and restrictions set forth on this application. he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose (_) I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued as a result of this application , the owner, and the applicant, each agrees to, and State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or the Contractors' State License Law.). following issuance of this permit. (� I am exempt under Sec. . B.&P.C. for this reason 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. 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 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: t'O %3 Signature (Applicant or Agent): /!/i0/✓E� ��/f1 / FEZ • •• • x�fx SF " tt wAMOUNT DESCRIPTON, -' I ACCOUNT'' L QTYr �p PAID PAID DATE _'5... - ,✓> �7, <d'., a r<d_<6:'A'47.,a . ,c 3_ a „5.. -..J1,-.,.Y.'�.f _—.�...s# .; ,Y't-... BSAS SB1473 FEE 101-0000-20306 0 $2.00 '$0.00 -a� E•P -✓ 1 ✓r S. 4 K 3'e moi. TYy4 �-'Y°<'4 i A .. ST, ,x•vr ,'NX ;�..':cR i-Ce,�e4. .%�y °x DRi r "'M�_ PAID 6Y METHOD, b... { f:F':S #✓i4 +1R`b;, %� : ik: yxX +Y �e tai I "RECEIPT ' ' +r. j, , ��~ � E a .. -,, ,...<:_e, a ..1._..nx .._.,.,-4. w..?'- ., ,:.. ... ✓.{ _.' .. �_ ., .a{ yiS r � .:.w.e_� _..... t # `F� CHECK # CLTD BY '.z`'.s_n..G.T Total Paid for BUILDING STANDARDS ADMINISTRATION,BSA": $2.00 $0.00 :per DESCRIPTION g NT xU> AMOUNT '°. s` l '.. ..,. .•3_ ".,u Y"i ,.",. _� il ,- 3. .M,�A000r '-.tti °3.,xxe Y .. ..a r'." d f QTY# 'S x : y� ? PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.09 $0:00 ^ z l5 PAID BY � � 4 -�� h W . � ..kf sIZ :. :v. . '. .«us< <.E&.<. ✓ „sy<.. ...� � METI O�� s g ; :,r. ` fni,.�' . ,*' RECEIPT # n .CHECKb#� CLTD BY r �'I� .#�i €�`J.h. @ �.,.; ' y{ x �. Y i'.`. :. ., S '.''t 4.,v,.✓::. '1. 4ti xt.` .� - Y � ,. 7e,'c., ...:; . , g,a,#. k,. <r-, a .a ^s.... ..,'z, 2w ..n_s�R.,.a•w .. ACCOUNT"I", �.te.#,....,x .., ..-_t=a.; Via. <#„,: ='QTYAMOUNTS z' , sa -r zxy, <. Vie. .v`*, �? PAID . ` .€:. < r.,:+ro,�c X45 PAID DATE' .,F; u:. 'GAS SYSTEM, 1-4 OUTLETS PC_ 101-0000-42600 0 $24.17 $0.00 {` �4 2 @ AD ' - S a PAID BY- 2y” r;$y .ys? 4Y 4C2`i•�, ['1[:.P ie f.2 k^'!'Xi b d �k'^ -� ���,�s N.. �° I• ..i D"a .*,{'Y.dLs.oy ..s X VN €1 3 n'n' .2i'Y 4 yvvi`es +?'..kY..3• {) I �:tYY: `K a METHOD aeXrF�4,''.<1 mss., r,.s�i3r. rRECEIPT # r n,4 ,.iw >v „?4. ,A�:?-s ,. 3'.v�T CHECK# �-0:4, �'i• CLTD BY Total Paid for PLUMBING FEES: $36.26 $0.00. DESCRIPTION >� s ACCUUNT QTtY , .::� AMOUNTS n l r R PAID PAID DATE SWIMMING POOL/SPA 101-0000-42404 0. $181.29 $0.00 BYEas ax, ix,.: 5 �ttr r` e.a'.V..,f'sr±sws ,g ti b_:tRECEIPT # ".� CHECK # ,, CLTD BY tY" ACCOUNTy $s QTY AMOUNT' ° ` "6710AID DATE .DESCRIPTIONi fPAID SWIMMING POOL/SPA PC 101-0000-42600 0 $98.62 $0.00 i E :, t : `' ''—r 5 PAID BYt S.+.a * ih 5 gr y v.� 8 METHOD a1 Y .s: {. .,.. 3 RECEIPT,# .' CHECK # �� dee # CLTD BY y x,.w.P _ :.�._,s n� q s x rix e DESCRIPTI{ONS,?�ACCOUNT;�, r .�� Rig us ,.. € r a tri �� v <.. :"�'C1TY AM',OUNT ,� {PAID F. ,PAIDDATE' _< WATER FEATURE '101-0000-42404 0 $181.29 $0.00. Z,t, PAI By. i^ga-.. METHOD � RECEI?T # t CHECK # CLTDf BY ,.;�. .'>.�� ' y n . • � .,n � ;.� X .x x?`ffi', DESCRIPTIOIV ref..t a AMOUNT PAID, b PAID DATES ,. ? a .... ,A000UNT # <.. ,... QTI(x ,` u _. ; r t .. WATER FEATURE PC 101-0000-42600 0 $98.62 $0.00 `'vF:. k PAID BYE..N. k.$; 4i C�, r`„, s.s r 1u�{-"`a;. 4 S WNW .. .-Ra..>'.c'?x .T.# t x X"k`r..:3'i,�„ eri , : ._ METHOf) ,;:. f .:-i. :.. _: _,xa,% •:,,.i,:-:.R>a.s. yF. r�<!u ;k x>x FRECEIPT # r +°s, t ,'i' : �; ( i.Rr Y«x 3E1S... -..fKF.;xe Yr.�. 5 CHECK# h93sYd�:Iw`xS`,•Rei�t.,:c y CLTD BYE :: xr-"^Y �:@%3�_1£.fl,Pv:.:''vE Total Paid for POOL / SPA: $559.82 $0.00 Description: NEIL / POOL, SPA, FIREPIT AT REAR YARD+WF AT COURT YARD Type: POOL Subtype: Status: APPROVED Applied: 6/8/2016 MFA Approved: 6/10/2016 MFA Parcel No: 777200016 Site Address: 53576 VIA STRADA LA QUINTA,CA 92253 Subdivision: TR 29894-2 Block: Lot: 264 Issued: Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $45,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 CHRONOLOGY TYPE Details: POOL, SPA AND FIRE PIT AT REAR YARD WITH WATER FEATURE AT COURT YARD [DOUGLAS FERRELL ENGINEERING] THIS PERMIT DOES. NOT INCLUDE EQUIPMENT ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE. Printed: Friday, June 10, 2016 12:59:47 PM 1 of 3 r SYSTEMS ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES PHONED APPLICANT THE PLANS ARE APPROVED BUT THEIR TELEPHONE CALL AJ ORTEGA 6/9/2016 6/9/2016 CITY LICENSE IS REQUIRED TO BE RENEWED PRIOR TO ISSUANCE CONDITIONS CONDITION DATE DATE DATE CONTACT STATUS REMARKS NOTES TYPE ADDED REQUIRED SATISFIED READY TO ISSUE AJ ORTEGA 6/9/2016 6/10/2016 COMPLETE CITY BUSINESS LICENSE RENEWAL REQUIRED FOR CHECKLIST CONTRACTOR OF RECORD 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 Printed: Friday, June 10, 2016 12:59:47 PM 1 of 3 r SYSTEMS FINANCIAL • •• DESCRIPTION - ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $2.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $2,00 $0.00 BSA: GAS.SYSTEM, 1-4 101-0000-42401 0 $12.09 $0.00 OUTLETS GAS SYSTEM, 1-4 101-0000-42600 0 $24.17 $0.00 OUTLETS PC' Total Paid for PLUMBING FEES: $36.26 $0.00 SWIMMING POOL/SPA 101-0000-42404 0 $181.29 $0.00 SWIMMING POOL/SPA 101-0000-42600 0 $98.62 $0.00 PC. WATER FEATURE 101-0000-42404 0 $181.29 $0.00 WATER FEATURE PC 101-0000-42600 0 $98.62 $0.00 Total Paid for POOL / SPA: $559.82 $0.00 TOTALS:0: $0.00 Printed: Ftiday, June 10, 2016 12:59:47 PM 2 of 3 Or , SYSTEMS 1ST BLDG ,NS (1 I CLAYTON I 6/8/2016 I 6/9/2016 I 6/9/2016 I APPROVED Printed: Friday, June 10, 2016 12:59:47 PM 3 of 3 CRWSYSTFtitS Qir Permit , r Poi --o/ Project Address: 53 5-76 A. P. Number: Citi" of La Quinta Building a Safety Division P.O.. Box 1504, 78-495 Calle Tampico La Quinta, CA. 9225: - (760) 777"-7012 BUli9ding Permit ,Application and Tracldng Sheet ��f� Owner's Name: E/� Address: City, ST, Zip: La 40G Arr,4 1 922 Contractor: �� i'2�el '`d Review, ready for corrections/issue TeIephone: Developer Impact Fee Address: CO A VE Planning Approval Project Description: p 00 LSPA City, ST, Zip: �-UrC/4- Z Z TeIephone: PZZZ • E ��► r State Lic. # : 5 Arch., Engr., Designer: City Lic. #: CITY OF LA QUINTA BUILDING & SA ETTDEPT. Address: APPREYVE EOB COM City, ST, Zip: Telephone: State Lic. #: Name of Contact Person:D / f f f 1g1M/,et 2— Construction Ty : u Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: Q # Stories: # Units: Telephone # of Contact Person: %0) 2, S D /9 y % Estimated Value of Project: UDO APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Coles. Reviewed, ready for corrections Plan Check Deposit Truss Caics. Called Contact Person Plan Check Balance Energy Calcs. ]Plans picked up Construction Flood plain plan (Plans resubmitted Mechanical Grading plan 2"d Review, ready for correctionsrissue Electrical Subcontactor hist Called Contact Person Plumbing Grant Deed Plans picked up SMI '. IN HOUSE:- '`d 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 imum- 'IaU�yl IFlIV LOTIV 1 LN, �r��ai%<; iiiaii70 L!1 f-f-ma in -I _ firlf��i IfC11� A\ M] 0