BPOL2016-0126ti
]]. O�i .VOICE (760) 777-7125
78 495 CALLE TAMPICO C` D
LA QUINTA, CALIFORNIA 92253 ., DESIGN & DEVELOPMENT DEPARTMENT FAX (760) 777-7011
FAX
(760) 777-7153
BUILDING PERMIT
Date: 8/29/2016
Application Number: . BPOL2016-0126 Owner:
Property Address: 50576 CEREZA CITRUS EL DORADO,LLC
APN: 776340015 1157 N.RED GUM ST
Application Description: CITRUS EL DORADO, LLC / POOL SPA AND EQUIPMENT WALL ANAHEIM, CA 92806
Property Zoning:
Application Valuation: $22,000.00
Applicant: Contractor: =_-
TESERRA TESERRA 1
P O BOX 1280 P O BOX 1280 AUG 3 0 2016
COACHELLA, CA 92236' COACHELLA, CA 9236
' G1 �pil.ACll;lPfi
(760)389-9222 MI;WI!,Ni `�FMeP1i-fit'
Llc. 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, CSO, C29, C53, C27, D12 License No.: 656128
/
�Date: d p 3d !O Contractor�E✓!Fg
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.).
(� 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. . BiP.C. for this reason
Date:
Owner:
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.
,01& 1 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: STARSTONE NATIONAL INSURANCE COMPANY Policy Number:
710160317
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: 3U �� Applicant %`t/L// Z
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.
CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct.
I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws relating to building
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Lender's Name:
-5;f/56
p 36 / Sig
nature(Applicant or Agent)
Lender's Address:
i
Date: 8/29/2016
Application Number:.
BPOL2016-0126
Owner:
Property Address:
50576 CEREZA
CITRUS EL DORADO,LLC
APN:
776340015
1157 N RED GUM ST
Application Description:
CITRUS.EL DORADO, LLC / POOL SPA AND EQUIPMENT WALL
ANAHEIM, CA 92806
Property Zoning: .
Application Valuation:
$22,000.00•
Applicant:
Contractor:
TESERRA
TESERRA
P 0 BOX 1280
P 0 BOX 1280
COACHELLA, CA 92236
COACHELLA, CA 92236
(760)389-9222
---------------------------------------------------------------------------------------------
Llc. No.: 656128
Detail: POOL SPA AND WATER FEATURE WITH POOL EQUIPMENT ENCLOSURE AND FUTURE GAS LINE FOR BBQ PER 2013 CBC. POOL DECK SHALL DRAIN PER
APPROVED GRADING PLAN.
i
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.86
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/FENCE -FIRST 100 LF PC
101-0000-42600
0
$60.91
Total Paid for FENCE OR FREESTANDING WALL: $108.77
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SWIMMING POOL/SPA PC
101-0000-42600
0
$98.62
DESCRIPTION
ACCOUNT.
CITY
AMOUNT
WATER FEATURE
101-0000-42404
0
$181.29
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WATER FEATURE PC
101-0000-42600
0
$98.62
Total Paid for POOL / SPA: $559.82
Bin #; Qty ®9 LaQuinta
' Building SL Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
(jQ���bl7�o Building Permit Application and Tracking Sheet
Project Address: S0 5-76- CFRt Z `Owner's Name: !r
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
P :
Contractor: ESS`-°(Z*c
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Telephone: r'•.sA<s.::
Address: ](� I0Q Prvt L
Project Description: �Q (� Spp, (- u e
City, ST, Zip: Cv�ct`tELI_►� s- Cl 2236
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It
Telephone: -7&6
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State Lie. # : 6 S;_6 12— e
City Lie. #;
Arch., Engr., Designer.
Address:
City., ST, Zip:
• .,JQyJ>L =v'• �,yi.+p�:i ii^'+,uy..•{.ir..nf.;
Telephone:f, • »: �xx�, ;y r.
tis :�<fq{ foy,r
State Lie. #:y
Construction Type: Occupancy:
project type (circle one : New dd'n Alter Repair Demo
Name of Contact Person: ��p �S r- �9,t�— Z
Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person: -7 6 d Z (j 11 Li(
Estimated Value of Project: 22 o vrD.
APPLICANT: DO NOT WRITE. BELOW THIS LINE
N Submittal Req'd Recd TRACIGNG PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°d Review, ready for corrections/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:
:
s'a Reyiew, ready for corrections/issue
Dcveloper Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees