BPOL2019-006778-495 CALLE TAMPICO Ct 0 4
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LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTME
BUILDING PERMIT
Permit Type/Subtype: POOL/PRIVATE
Application Number: BPOL2019-0067
Property Address: 79175 LATIGO CIR
APN: 604263020
Application Description DAVIS / POOL AND SPA AT REAR YARD
Property Zoning:
Application Valuation: $20,000.00
Applicant:
JOHN HARDWICK/TESERRA
P 0 BOX 1280
COACHELLA, CA 92236
-----------------------------------------------------------
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 CZ9 ,C53 C27, 012 License No.: 656128 oft) e,work for which this permit is issued.
ll IIAC-1
r p, --� / l,.r I have and will maintain workers' compensation insurance, as required by
Date: e- AC I � I Contractor: r � SPF l� er Sectioh3�1fl0 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:
Ca�ip E MARK INSURANCE COMPANY Policy Number: CST5014959
Wm
fy that in the performance of the work for which this permit is issued, I
lifiallany person in any manner so as to become subject to the workers'
co nsation laws of California, and agree that, if I should become subject to the
w ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
K —
Date. Applican
WARNI G: FAILURE TO SECURE WORKERS' COMA ON COVERAGE 15 UNLAWFUL,
AND SHALLSUBJECTAN EMPLOYER TO CRIMI;IIS ENALTIES AND CIVIL FINES UPTO
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.
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.).
(1 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 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:
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 menti ed foperty for Inspection purposes.
L}
Date: 1_ Signature (Applicant or e
VOICE (760) 777-7125
FAX (760) 777-7011
NT
INSPECTIONS (760) 777-7153
Date: 4/8/2019
Owner:
BRETT DAVIS
p
79175 LATIGO CIR
C_nn
LA QUINTA, CA 92253
t?o
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Contractor:
M A oo
TESERRA
—3 c tv
P0BOX 1280
0
M c Q
COACHELLA, CA 92236
(760)389-9222
Llc. No.: 656128
—+
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.).
(1 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 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:
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 menti ed foperty for Inspection purposes.
L}
Date: 1_ Signature (Applicant or e
Application Number:
BPOL2019-0067
Property Address:
79175 LATIGO CIR
APN:
604263020
Application Description:
DAVIS / POOL AND SPA AT REAR YARD
Property Zoning:
Application Valuation:
$20,000.00
Applicant:
JOHN HARDWICK/TESERRA
P 0 BOX 1280
COACHELLA, CA 92236
Owner:
BRETT DAVIS
79175 LATIGO CIR
LA QUINTA, CA 92253
Contractor:
TESERRA
P O BOX 1280
COACHELLA, CA 92236
(760)389-9222
Llc. No.: 656128
Date: 4/8/2019
Detall: POOL AND SPA AT REAR YARD [DOUGLAS FERREL ENGINEERING.] NEW EQUIPMENT MUST BE LOCATED IN AN APPROVED LOCATION EITHER WITHIN
THE REAR YARD SETBACK OR T MINIMUM FROM THE SIDE P/L--FIELD VERIFY. THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCL05URE. ALARMS AND
BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. SPECIAL INSPECTION REPORT REQUIRED AT PRE PLASTER. 2016 CALIFORNIA BUILDING
CODE
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
RECORDS MANAGEMENT FEE
101-0000-20306
0
$1.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
AMOUNT t
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
101-0000-42404
0
$200.12
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA PC
101-0000-42600
0
$108.87
Total Paid for POOL / SPA: $308.99
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT t
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
ta Q�dara
_
PERMIT # P*Jf
OC67
CAI IYORNIA -
PLAN ATION:
Project Address: 7q—(7Lj /,jt-;Qr) C&Rj r Project Description:
APN #: NES i,ci S
Applicant Name:[
Address:
City, ST, Zip:
Telephone: 760
Email: ;jo �.s�a�z �• Valuation of Project $
� � E
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
# l
Submittal
Required Received
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
......
[Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
i
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License