BPOL2016-002278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&t1t:4 4v Qumz
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BPOL2016-0022
Property Address:
81155 GIACOMO WAY
DPN:
767780005
Application Description:
KLAEB / POOL SPA BBQ FIRE PIT
Property Zoning:
Application Valuation:
$28,000.00
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: 116 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.).
(_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 contracto:(s) 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
11111111111111111111
31
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760)•777-7153
Date: 3/10/2016
Owner:
IOTA GRIFFIN
4675 MACARTHUR CT NO 1550
NEWPORT BEACH, CA 0
FuA51h1(",,'G1-ZQ1JNTA
Contractor:0 2016
TESERRA
P OBOX 1COACHELLA, CA.,_...__�..
(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.
,,*jtT _ 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: 3 16 116 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 ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and.the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date: �� Signature (Applicant or Agent):,/uiorl,(Cr
an' R' '9 ,✓' .M1l:$..3v' ,�S<, . - a > *vii: R ,y
��EsDESCRIPTION "QTY ; QgAMOUNT PAIDPAID'DATE
_.. AC000NTry:` r��
BSAS SB1473 FEE 101-0000-20305` •. :,
0 :$2.00: $2.00 3/10/16
a ° METHODSmNrwl
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RECEIR?�#�.1 CHECK #ry CTD BY
, x
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TESERRA_'CHECK'-','
R13768 ` 133914 RSE
Total Paid for BUILDING STANDARDS 'ADM INISTRATION BSA.: "$2'.00: ` $2:00:
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QTLY AMOU�NT���
PAID
PAID,DATE
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DEVICES, FIRST 20
101-0000-42403
0 : $24.17,
" .$24.17
3/10/16
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RECEIPT # '
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DEVICES, FIRST 20 PC:
101=0000-42600:
0
: $24.17•
$24.17
3/10/16
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ar
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CHECK
'R13768
133914`
RSE
< Total Paid for ELECTRICAL:: $48.34 :. :$48'.34L''_
I.M.
DESCRIP�TION��-
Y`"aSE �:.�*�`:Y�':
ACCUUN7�t
R?'A�g
Rte,?�F•
PAID iPAIDDATE
�j<Fy�
:: :y
4N
.AMOUNT
�aoor;.:
'GAS SYSTEM,4-4 OUTLETS.
101-0000-42401,
0'
$12.09
$12.09 ',
.3/10/16
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PAID'BY:'¢
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CHECK._
1113768
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......
.GAS SYSTEM; 1-4.OUTLETS PC "
161-0000-42600
0
$24.17
$24.17
3/10/16
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IMP`PAID METHODRECEIP�T
MENcxa.
CHECKS#��;
�CLTD BY
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TESERRA
CHECK
R13768
133914"
RSE
'Total Paid for'PLUMBINGr FEESi': $36.26 $36.26 '
.. {., f DlA4<',,,.<._ `$b d k 1�
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ACCOUNT
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AMOUNT��PAID
kq�°n, .E 5?` d:3 l
_'cFy.-"tS+�'-'`ET'
PAID DATE
.f.< #" �DESCRIPTION`�:
fi
SWIMMING POOL'/SPA_ '
101-0000-42404 r.
0 :'
$181.29.
$181.29
`3/30/,16
METHOD
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CHECK ,.
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P ID DATE
:a�'r$ n.. £�>!i w nn• x,:"w 2:: i..: yxy. 1F:".. .i.�iirta,�, '.f'r. %.,:.'.'.
.:�«:f,..� ..%-Yt`. Ea'xi..,z''`,:a Ec�`1:... .,, _.
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PAID 3
k.. "x:.w:.s .,,',s:. ..�xc..g
SWIMMING POOL/SPA PC
10.1.0000-42600 .:
0 -: ', $98.62
$98.62
3/10/16
�5
g -�, 4S,I"' `.�kj.S.Y%_ y SeNt .. ..".:
r f PAID BYq�METHOD
n-3 C' _4 `K<{"Y'... $'N.C' �, ,?
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TESERRA.`
CHECK
1113768
'13P14:RSE.
Total Paid for POOL'/ SPA: , $279.91. $279:91
0
N.
Permit Details PERMIT NUMBER
City of la Quinta BPOU2016 0022• yr,�
Description: KLAEB / POOL SPA BBQ FIRE PIT
Type: POOL Subtype: Status: APPROVED
Applied: 3/3/2016 RSE
Approved: 3/4/2016 BHA
Parcel No: 767780005 Site Address: 81155 GIACOMO WAY LA QUINTA,CA 92253
Subdivision: TR 32879 Block: Lot: 53
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $28,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: POOL, SPA, FIRE PIT, 400,000 BTU POOL HEATER AND BBQ.2 INCH GAS PIPING, #8 AWG IN 1 INCH CONDUIT ELECTRICAL] THIS
PERMIT DOES NOT INCLUDE ELECTRICAL AT BBQ. EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER
SPECIFICATIONS. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING
CODES.
CHRONOLOGY TYPE
STAFF NAME
ACTION *DATE
CHRONOLOGY
COMPLETION DATE NOTES
TELEPHONE CALL
BURT HANADA
3/4/2016
3/4/2016
NOTIFIED MOISES THAT PERMIT IS APPROVED AND READY TO
ISSUE. $366.51 FEE.
CONDITIONS
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
IOTA GRIFFIN
4675 MACARTHUR CT
NO 1550
NEWPORT
BEACH
CA
0
FINANCIAL INFORMATION
Printed: Thursday, March 10, 2016 10:17:09 AM 1 of 2 CRsrsrrees
DESCRIPTION
ACCOUNT.
CITY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID $Y
CLTD
BY
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$2.00
3/10/16
R13768
133914
CHECK
TESERRA
'RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION $2,00 $2.00
BSA:
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$24.17
3/10/16
R13768
133914
CHECK
TESERRA
RSE
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$24.17
3/10/16
R13768
133914
CHECK
TESERRA
RSE
Total Paid for ELECTRICAL:. $48.34 $48.34
GAS SYSTEM, 1-4
101-0000-42401
0
$12.09
$12.09
3/10/16
R13768
133914
CHECK
TESERRA
RSE
OUTLETS
GAS SYSTEM, 1-4
101-0000-42600
0
$24.17
$24.17
3/10/16
R13768
133914
CHECK
TESERRA
RSE
OUTLETS PC
Total Paid for PLUMBING FEES: $36.26 $36.26
SWIMMING POOL/SPA"
101-0000-42404
0
$181.29
$181.29
3/10/16
R13768
133914
CHECK
TESERRA
RSE
SWIMMING POOL/SPA
101-0000-42600
0
$98.62.
$98.62
3/10/16
R13768
133914
CHECK
TESERRA
RSE
PC
Total Paid for POOL / SPA: $279.91 $279.91
TOTALS:
BOND INFORMATION
Printed: Thursday, March 10, 2016 10:17:09 AM 2 of 2
SYSTEMS
u"' ff Gray of La QuInta
Building & Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
I�jQ OC,ZQ� 16 Building Permit Application and Tracking Sheet
Project Address:
Owner's Name:
1—,A C 13 9//5-5-
A. P. Number: ore 0
Address:
Legal Description:
City, ST, Zip: LA Ca, ZZ S3
Contractor: (r s � �l4
Telephone:
P
�:`�; N rte'++4 •i
Address: too
Project Description: uOL— SPK}
City, ST, Zip: .'6 W1 L IJ`i-
23 G
/Z
g la
State Lic. # : S �o I. 2
City Lic. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lic. #:s,�,'�.£Ly;.#_
�`'JaY > �• >;;���?' ,� '
Construction Type: Occupancy:
Project type (circle oneNe Add'n Alter Repair Demo
Name of Contact Person: / rFJ
0Z^Z t 1A6-2
Sq. Ft.: b C1 3
# Stories:
# Units:
Telephone #,of Contact Person: %6 0
2 s o l9y
Estimated Value of Project. 2 , 0a C
# Submittal Req'd Recd
APPLICANT: DO NOT WRITE BELOW THIS LINE
'TRACMG PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss•Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.OA: Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for correctlourissue
Developer Impact Fee
Planning Approval
Called Contact Person
-
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Scho61 Fees
Total Permit Fees
f