BRES2016-0031r .✓ t
78-495 CALLE TAMPICO C� 0 U �KtiMCl/
LA QUINTA,' CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BRES2016-0031
Property Address: 80450 PLATINUM WY
A011: 775220021
Application Description: SIGNATURE / GAS LINE AND ELECTRICAL FOR BBQ
Property Zoning:
Application Valuation: $800.00
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: a4 _ y— 16 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).:
(1 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
1 11111111111111111111
.80
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
(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�to r which this permit is issued.
ave 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 f the Labor Code, I shall forthwith
comply with those provisions.
Date�C% ` % Applicant
0
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. -
Dater) —1 0 Signature (Applicant or Agent)
Date:
2/9/2016
Owner:
RREF -II CWC LAQ LLC
5927 PRIESTLY DR STE 110
CARLSBAD, CA 92008
c
2
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C7:7
Contractor:
p
CLQ
TESERRA
a
N
P 0 BOX 1280
rn
COACHELLA, CA 92236
(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�to r which this permit is issued.
ave 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 f the Labor Code, I shall forthwith
comply with those provisions.
Date�C% ` % Applicant
0
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. -
Dater) —1 0 Signature (Applicant or Agent)
:�.,,�T .. V = ~y�"y
T?�s",W
AMOUNT
DESCRIP�TIONt"ACCOUNT QTYPAIDf €PAID DATEt
s, 3
BSAS SB1473 FEE 101-0000-20306>0
$1:00 $0.00
> $'.�3S�r,,,m. Lam'. - y,1 Red- F'::' 3�>�'^i„^�±t 3 3 3
PAID BY>!
!:'.N{ Vh .. -�Eg.z .T..?r.,..,r N -?^'k ,Tt'>'b"¢
CHECK # CLTU BY
,A q.`.vr. x T�METNOD{RECEIPT#dam
- i.;
r
vs
Total Paid,for BUILDING STANDARDS ADMINISTRATION BSA: °: $1.00
:DESCRIPTIONS
.ACCOUNT''
TY:
kAMOUNI`'P,i41D�
iA
P,AIDDATE
V
3P'yr-..e.'V':.i«Fx:
.DEVICES, FIRST 20
101-0000742403.
0
$24:17.
$0.00 '.
PAID BY
Y§' " ,-i�g,y,>�
f�i'. f S+s'£ 'SviuJ
:Mll, :,yS �E, ... _'y-'' ,,.a.:W .:,£.i q - .
°�'?c. -3m C
RECEIP,Ta#
�a'
�...ehy
CHECK #
$v",y E
CW BY
x,. s
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e e, : METHOD x
-a .. .. ��X-
ss ,
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R3:: "Rrrx«.
DESCRI?TIONii``t
, {v.F,Ir .:ih.
>"- . Rep
JW�'..... A 'i.",� ,wv rs�""ge'
"- 'Iv�t{ j'y:`4-.?b`e >r4 E r
k .ffi.Yii .�dieES
DATE
`
=. d UNT ..QN,
-sAMOUNT ....,
PAtDS�
PAID
DEVICES, FIRST 20 PC
101-0000-42600
0 $24.17:.,-,,
$0.00
''CC
X k S vw4 ` . M
PAID BY
354,' WY,y rYitr:•.. .�;,ea, �
•. ., 3v`s 'y .a' .7 ivn `o.... €`rtt +"d
METFIOD
v. F.- e, x '.:. �• � ,e& -
K - ?3
{ •59 e'aJ*`� , 3 OK-mg
# �
vY. e+ i
mi' ,a :,!' i t , , i — ��3y°'J�
�� CHECK #�
}' .`vv�
L��,I "Sv?•.S'. ` oRr ,%
CLTDlBI%
N
�,x ,�
�An..?r... s'�`: zvAz :Fr, `9 !T b ,�i,. tt� Y.e .r.
� ` ;RECEIPT �� �
...-�i. %. `E. k: bf8,;t S`3:4i5?k+, t.':J.: ,sb,'�.k
k,.?'nc�d* 2r
�'.
Total Paid for ELECTRICAL: $48:34 $0.00
.::^-v a"`i,.;
DESCRIP.TIONr�
;;�� a'":kx'rws,t, <�3�,'. . >-:
.' �"'`a,.
'„"-?t"*px.:r'C"�n-zv.r-
'�t
,Y r,.:,`+ _
PAID DATE;
EA000UNT F€t
,.J,-. X?v ar�r,3 �lYt i e.:?5`
QTY.t.^AMOUNT��
.,v3a�t:Fsw'�K
:;,n ,-S%, ve` b.:-.-rcPk+..-.*1€
�y�PAIO
i"'.vs•r x FK' -.. siC¢ ..I .:k
S-3.. :...:
-PERMIT ISSUANCE
.101-0000-42404
0
$91.85
$0.00
METH
RECEI
y
Y
rffi DBY
� "i
Total Paid;for PERMIT ISSUANCE: $91.85 . ' ' $0.00
.. .y,{ -P::._ " �^;na
i
fir. !,' _,i E•3+E,;3i
ACCOUNT
.fir Zx,
QTY
:. ': ?. zgx »,s,§54K�`>
AMOUNT
,' >-"=s�°k, .3}i lie> 4
& PA103
w. 'C . red
PAID`DATEx
iDESCR101ON, a?,
�.k°.9E,.,.
�'k',;ss.`z�.'z3
�,:,'i'
GAS SYSTEM, 1-4.OUTL'ETS
101-0000-42401
0
$12.09
$0.00
„ £'.fI
i PAID BY
�METHOD�RECEIPT#8
v YY✓ -a £.ab 4;E.�'. �,
�r CHECK #
,,4'R..:.v5 'l'E'?-Y*.,3.•.,
BYY
s
,S�'.
#...-
4 irk ;a3�ak'�''��-
>nGr�itF,. a"a:if:.�z: .:'
�CLTD RN
...:t'd`.•a.. Sts, 7, .phi
`:
DESCRIPTION}ACCOUN.
ME �uRv�-
QTM�`
AMOUNT_�PAID,h
PAID DATE
-fiw ,�..:-...4x. �.
GAS SYSTEM, 1-4 OUTLETS PC
101=0000-02600
0
$24:17
$0:00
..i %F. r_-.>.rhy R •( �. ,'�``� .^_ . �,q°i.C�
Y� Y•�'vE: °i Vii" �^i£.['YY
'L*. Y 3•
#
CLTD�BYM
.METHOD
>. ,RECEIPT;#�szCHEGK
Total Paid for, PLUMBINGFEES:. $36.26 $0.00
%.
DESCRIPTION£.Pa
`, Aif,
11 �ACCO,UNT y `QTYAMOUNT�PAIDY
ffiz
DATEi
€ A
,PAID
SMI - RESIDENTIAL
101=0000-20308
0
$0.50-.>
$0.00 .
i.cr :. bj'lk%t�l..P`ss+a'.a.
N.11 ^JPAID BY
$>,. Ks"p"i: y-}i&.
d M ETHOD
-�..i`Kf",.�"' y+.,'SE4::::.5' i•f:'•.�`
RECEIPT #
i-3:=s3,ty}.L. '3aa :iF'dE ry `3•
$ CHECK #
{ y, .u,,.,,, (,v {::
CLTD BY
v
+- -'�'
Total Paid for STRONG MOTION INSTRUMENTATION SMI:. $0.50 $0.00
• 00
Description: SIGNATURE/ GAS LINE AND ELECTRICAL FOR BBQ
ADDITIONAL
Type: BUILDING, RESIDENTIAL
Subtype: REMODEL Status: UNDER REVIEW
Applied: 2/9/2016 SKH
Approved:
Parcel No: 775220021 Site Address: 80450 PLATINUM WY LA QUINTA,CA 92253
Subdivision: PM 20426
Block:. Lot: 36
Issued:
Lot Sq Ft: 0
Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $800.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
CITY
Details: GAS LINE AND ELECTRICAL FOR BBQ. 2013 CALIFORNIA BUILDING CODE.
ZIP
Printed: Tuesday, February 09, 2016 2:45:52 PM 1 of 2 (CR
SYSTr•IAS
ADDITIONAL
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
TESERRA
P 0 BOX 1280
COACHELLA
CA
92236
(760)918-2839
(760)918-
6749
CONTRACTOR
TESERRA
P 0 BOX 1280
COACHELLA
CA
92236
(760)918-2839
(760)918-
6749
OWNER
RREF II CWC LAQ LLC
5927 PRIESTLY DR STE
CARLSBAD
CA
92008
(760)918-2839
(760)918-
LBELLOSO@CALIFORNI
110
1
6749
AWESTCOMMUNITIES.
COM
Printed: Tuesday, February 09, 2016 2:45:52 PM 1 of 2 (CR
SYSTr•IAS
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION.
$1.00 $0.00
BSA:
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
GASSYSTEM, 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
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
$0.00
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.S0 $0.00
TOTALS:i
INSPECTIONS
BOND INFORMATION
Printed: Tuesday, February 09, 2016 2:45:52 PM 2 of 2 N? _
SYSTEh1S
5
Btn ,#
Permit #
r WN
Yu-
Project Address: _
City. of La Quint
Building a Safety ®iVision
P.®. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit .Application and Tracking Sheet
Owner's Name: ,YLI
A. P. Number:
Address:
Legal Description:
Contractor:�-
City, ST, Zip:
Telephone:
Address: &,-120 � Project Description:
City, ST, Zip: _
ZZ3 •
Telephone:
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #: •
Construction Type: Occupancy:
Project type (cirole one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft:
# Stories:
# Units:
Telephone # of Contact Person:
# Submittal Req'd
Plan Sets
Estimated Value of Project: �—
APPLICANT: DO NOT WRITE BELOW THIS LINE
Recd TRACEJVG . PERMIT FEES
Plan Check submitted . Item Amount
Structural Calcs.
Reviewed, ready for corrections Plan :Check Deposit
Truss Calcs..
Called Contact Person Plan Check Balance
Dnergy Calcs....
Plans picked up Construction:
Flood plainplan
Plans resubmitted : Mechanical °..
Grading plan ' :.: ..
.-2Review, ready for correttions/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-.-
''" 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