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BPLB2016-003678-495 CALLE TAMPICO 4 LA QUINTA, CALIFORNIA 92253. COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING PERMIT Application Number: _ Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: TESERRA P 0 BOX 1280 COACHELLA, CA 92236 BPLB2016-0036 80445 PLATINUM WY 775220021 SIGNATUIRE / FABER/ GAS LINE FOR FIRE PIT $800.00 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: CC -n-8. C10, C29, C53, C27, D12 License No.: 656128 as7 Date: , --? —' G Contractor: e* -6-r Yh 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 ) 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: 1 04 VOICE .(760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: FABER ' 80445 PLATINUM WY LA QUINTA, CA 92253 Contractor: TESERRA P 0 BOX 1280 COACHELLA, CA 92236 (760)389-9222 Llc. No.: 656128 Dater 3/2/2016 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 a % Xr which this permit is issued. �xave 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 l should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: — — Applicant: { t./ 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. -x 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 r upon the above-mentioned property for inspection purposes. Date: Signature (Applicant or Agent) Description: SIGNATUIRE / FABER / GAS LINE FOR FIRE PIT ADDITIONAL Type: PLUMBING Subtype: Status: UNDER REVIEW Applied: 3/2/2016 SKH Approved: Parcel No: 775220021 Site Address: 80445 PLATINUM WY LA QUINTA,CA 92253 Subdivision: Block: Lot: 31 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 ZIP PHONE FAX Details: PLUMBING - 116LF OF GAS LINE FOR FIRE PIT. 2013 CALIFORNIA BUILDING CODES. APPLICANT Printed: Wednesday, March 02, 2016 10:34:24 AM 1 of 2 srsrenns ADDITIONAL CHRONOLOGY CONDITIONS NAME TYPE NAME ADDRESS1' 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 FABER 80445 PLATINUM WY LA QUINTA CA 92253 Printed: Wednesday, March 02, 2016 10:34:24 AM 1 of 2 srsrenns DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 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 TOTALS:06 PARENT PROJECTS BOND INFORMATION Printed: Wednesday, March 02, 2016 10:34:24 AM 2 of 2 #?SYSTEh1S DESCRIPTION FINANCIAL •• ACCOUNT • QTY AMOUNT- PAID PAID -DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: . $1.00 '. $0.00 DESCRIPTION ` ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY, Total Paid for PERMIT ISSUANCE: $91.85 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $36.26 $0.00 TOTALS:00 Bin'# CK I -y of La Qu'nta Building U Safety Division P.O. Box 1504, 78-x•95 Calle Tampico La Quinta, CA, 92253 - (750) 777-7012 Bullding Permit Application and Tracking Sheet Owner's Name: Permit # Project Address: A. P. Number:` Address: e Legal Description: City, ST, Zip: Contractor: / 2S� a_ Telephone: - Address: g(-- (� Ay ; Project Description: City, ST, Zip: Co c- CA- ZZ3 (> 6.1 fu' Telephone: State Lie. # : Arch., Engr., Designer: City Lie. #: Address: City, ST, Zip: Telephone: State Lic. Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair 0 Sq. Ft.: # Stories: # Units: Demo Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WROTE BELOW THUS LUNE #1 Submittal Req'd ]Plan Sets ]Reed TRACNIING PERMIT FEES Plan Check submitted Item Amount Structural Coles. Reviewed, ready for corrections Plan Check Deposit Taws Calcs. Called Contact Person Plan Check Balance F,nergy Calcs. ]Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. ki.O.A. AQproval. Plans resubmitted_J_____ ^__. —_.-GKading----- -- ---•__ ........... . IN ROUSE:- 3`d Review, ready for correctionstissue (Developer IImpact Fee Planning Approval Called Contact Person A.II.P.P. Pub. Wks. Appr gate of permit issue School Fees Total Permit Fees