BPOL2019-007978-495 CALLE TAMPICO D� VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
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 Clas�tf �0• C29• C53. X77 D1�� License No.: 656128
Date: Contractor: 1
OWNER -BUILDER DECLARATION
I hereby affirm under penal tyof periury 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 Far 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 appllcant for a
permit subjects the appl)cant 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, wlII do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Cade: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself a herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the budding or improvement Is sold
within one year of completl on, the owner -builder wilt 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 projectswit h a tontractor(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 Name:
Lender's Add
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
oft n r for which this permit is issued.
WI have and will mairrtain 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:j�ENCHMARK I�URANCE COMPANY — T Policy Number:014
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 if I should becomesut) ect to the
workers' compensation provisions of ion 7 of the bor C I all fort ith
comply wit se provisions.
Date: Appl' ant.
WARNING: FAILURE TO SECURE W R RS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOY R CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOL ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS OVIDED 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 appiIca nI, each agrees to, and
shall defend, Indemnify and hold harmless the Clty of La Quinta, Its officers, agents, and
employees for arty act or omisslon 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 ordinal
construction, and hereby authorize representativ
above -men "o 7ed property For inspection purpos
Date: Signature (Applicant or
ate: 4/11/2019
Permit Type/Subtype:
Application Number:
POOL/PRIVATE
BPOL2019-0079
Owner:
PRESIDIO FD CITRUS, LLC
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Property Address:
50758 CEREZA
APN:
776340008
50732 CEREZA
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Application Description:
PRESIDIO FD CITRUS, LLC / POOL AND SPA AT COURTYARD
LA QUINTA, CA 92253
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Property Zoning:
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Application Valuation:
$20,000.00
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Applicant:
Contractor:
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m rTESERRA
TESERRA-JOHN HARDWICK
P O BOX 1280
COACHELLA, CA 92236
P 0 BOX 1280
COACHELLA, CA 92236
M
(760)389-9222
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 Clas�tf �0• C29• C53. X77 D1�� License No.: 656128
Date: Contractor: 1
OWNER -BUILDER DECLARATION
I hereby affirm under penal tyof periury 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 Far 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 appllcant for a
permit subjects the appl)cant 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, wlII do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Cade: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself a herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the budding or improvement Is sold
within one year of completl on, the owner -builder wilt 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 projectswit h a tontractor(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 Name:
Lender's Add
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
oft n r for which this permit is issued.
WI have and will mairrtain 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:j�ENCHMARK I�URANCE COMPANY — T Policy Number:014
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 if I should becomesut) ect to the
workers' compensation provisions of ion 7 of the bor C I all fort ith
comply wit se provisions.
Date: Appl' ant.
WARNING: FAILURE TO SECURE W R RS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOY R CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOL ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS OVIDED 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 appiIca nI, each agrees to, and
shall defend, Indemnify and hold harmless the Clty of La Quinta, Its officers, agents, and
employees for arty act or omisslon 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 ordinal
construction, and hereby authorize representativ
above -men "o 7ed property For inspection purpos
Date: Signature (Applicant or
Application Number:
BPOL2019-0079
Property Address:
50758 CEREZA
APN:
776340008
Application Description
PRESIDIO FD CITRUS, LLC / POOL AND SPA AT COURTYARD
Property Zoning:
Application Valuation:
$20,000.00
Applicant:
TESERRA-JOHN HARDWICK
P 0 BOX 1280
COACHELLA, CA 92236
Owner:
PRESIDIO FD CITRUS, LLC
50732 CEREZA
LA QUINTA, CA 92253
Contractor:
TESERRA
P 0 BOX 1280
COACHELLA, CA 92236
(760)389-9222
Llc. No.: 656128
Date: 4/11/2019
---------------------------------------------------------------------------------------------
Detail: POOL AND SPA AT COURTYARD [DOUGLAS R. FERRELL ENGINEERING]. POOL EQUIPMENT LOCATED AT REAR YARD. THIS PERMIT DOES NOT INCLUDE
EQUIPMENT ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2016 CALIFORNIA BUILDING CODE.
DESCRIPTION
ACCOUNT QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT QTY
AMOUNT
SWIMMING POOL/SPA
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
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611 0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00
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