BRES2016-008178-495 CALLE TAMPICO T
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
11
DESIGN &
B
BRES2016-01081
79873 VIA SAN MATEO
776220012
BEAZER HOMES / FLORESTA / SALES OFFICE
$25,000.00
Applicant:
BEAZER HOMES HOLDINGS CORP
1600 E IMPERIAL HWY STE'200
BREA, CA - -
. v '
VOICE (760) 777-7125
FAX (760) 777-7011
M,ENT-DEPARTMENT INSPECTIONS (760) 777-7153
G PERMIT
Date: 9/13/2016
SEI' [Clo _Owner:
r— — BEAZER HOMES HOLDINGS CORP
CITYOFLAtQUi,`)TA 1_600 E IMPERIAL HWY STE 200
L":iYDG:'cLC"4EfTCEP.iT:E'BREA, CA '
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that lam 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: B License No.: 818129
/ i
CDate: '/J. (O c -'contractor:
OWNER -BUILDER DECLARATION
1 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
Contralctor'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. . B.&P.C. for this reason
Date:
Owner:
Contractor:
BEAZER HOMES HOLDINGS CORP
1731 E ROSEVILLE PKWY #140
ROSEVILLE, CA 95661
(916)773-3888
Llc. No.: 818129
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.
I 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: LIBERTY INSURANCE CORPORATION Policy Number: WA765DO04147
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 0 of the Labor C11 1 shall forthwith
comply with those provisions.
Date: Applicant:, �`�.
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 st to laws relating t building
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this cit o enter upon th
above-mentioned property for inspection purposes. t
Lender's Name:
Date: Signature (Applicant or Agent): i
Lender's Address:
Date: 9/13/2016
Application Number: BRES2016-0081 Owner:
Property Address: 79873 VIA SAN MATEO BEAZER HOMES HOLDINGS CORP
APN: 776220012 1600 E IMPERIAL HWY STE 206
Application Description: BEAZER HOMES / FLORESTA / SALES OFFICE BREA, CA
Property Zoning:
Application Valuation: $25,000.00
Applicant: Contractor:
'BEAZER HOMES HOLDINGS CORP BEAZER HOMES HOLDINGS CORP
1600 E IMPERIAL HWY STE 200 1731 E ROSEVILLE PKWY #140
BREA, CA ROSEVILLE, CA 95661
(916)773-3888
Llc. No.: 818129
------------------------------;--------------------------------------------------------------
', GARAGE TO TEMPORARY SALES OFFICE IN MODE!, HOME COMPLEX. MUP2016-0005. 2013 CODES
NOTE: SALES OFFICE TO BE RETURNED BACK TO GARAGE WHEN HOME IS SOLD.
I
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
QTY
AMOUNT
HOURLY CHARGE - BLDG CITY STAFF
101-0000-42600
0.5 •
$72.50
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HOURLY CHARGE - CITY BUILDING STAFF
101-0000-42600
0.75
$108.75
Total Paid for BLDG CITY STAFF - PER HOUR: $181.25
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
RESIDENTIAL, FIRST 1,000SF
101-0000-42403
0
$145.03
• 0 .,, . DESCR.IPTLON
.c�CGOE �_...>......
.QTY
AMOUNT ....
RESIDENTIAL, FIRST 1,0005F, PC
101-0000-42600
0
$47.86
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $192.89
DESCRIPTION
ACCOUNT
QTY
AMOUNT
OTHER MECHANICAL EQUIPMENT
101-0000-42402
0
$36.26
DESCRIPTION
ACCOUNT
QTY
AMOUNT
OTHER MECHANICAL EQUIPMENT PC
101-0000-42600
0
$36.26
Total Paid for MECHANICAL: $72.52
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$21.75
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$17.40
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 100 SF
101-0000-42400
0
$49.31
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$134.88
Total Paid for REMODEL: $223.34
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$3.25
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $3.25
Beazer_
-Homes
September 8, 2016
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92253
Atten: City Staff -All Departments
RE: Beazer Homes Project-Floresta (formerly Watermark) -Tract 36762
To Whom It May Concern:
Please allow this letter to serve as authorization for MSA Consulting, Inc. to pick up plans/permits, submit for plans/
permits, sign for plans/permits, or act in any other capacity as an authorized agent on behalf of Beazer Homes on the
above referenced project. MSA Consulting, Inc, is the project engineer on the above referenced project, as well.
MSA Consulting is located at 34200 Bob Hope Drive, Rancho Mirage, CA 92270.
If you have any questions, please feel free to contact: Beazer Homes -Kim Molina at 714.782.4271.
Thank you,
Kim Molina
Director of Planning
Beazer Homes
cc: Paul Sepulveda, MSA
Diana Diaz, MSA
. at atoarrpubhueola.Naes io tmprabp ue110elgy,&wa raww-tthe mpe lomau Chaff p" W*nd eatiaear
m rimeal WtiMrcatron,and are rd"mxW 1a LWle AAT WAtunir a caters( rOts Al cloomlana bre a oWm.Dto etan"n�vatrorrseno prk"&11he"fe"lwnaMspod1Zo1i*M are MneWd cmrn4
'be orooatyal Orn Hames. CmWl t -I Nmt Nmne Coosdofa*IAn S.492014&am Names -W1 A4 G4U41G (OAS SJOnoy my ebav!Aam ae the OKV.1Wn.-U out-, tl—L All p121p ate
Leek A License 'License Detail Page 1 o:
Contractor's License Detail for License # 818129
IISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this
/formation, you should be aware of the following limitations.
CSLB complaint disclosure is restricted bylaw (B&P 7124.6) If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on lh
link or button to obtain complaint and/or legal action information.
Per B&P 7071.17 , only construction related civil judgments reported to the CSLB are disclosed.
Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration.
Due to workload, there may be relevant Information that has not yet been entered onto the Board's license database.
Business Information
BEAZER HOMES HOLDINGS CORP
1731 E ROSEVILLE PKWY #140
ROSEVILLE, CA 95661
Business Phone Number:(916) 773-3888
Entity Corporation
Issue Date 03/18/2003
Expire Date 03/31/2017
License Status
This license.is current and active.
All information below should be reviewed.
Classifications
B - GENERAL BUILDING CONTRACTOR
Bonding Information
Contractor's Bond
This license filed a Contractor's Bond with ARCH INSURANCE COMPANY.
Bond Number: SU5016776
Bond Amount: $15,000
Effective Date: 01/01/2016.
Contractor's Bond History
Bond of Qualifying Individual
This license filed Bond of Qualifying Individual number SU1134570 for JOHNATHON PATRICK ERES in the amount of $12,500
with ARCH INSURANCE COMPANY.
Effective Date: 09/14/2015
Workers' Compensation
This license has workers compensation insurance with the LIBERTY INSURANCE CORPORATION
Policy Number:WA7650004147
Effective Date: 04/01/2013'
Expire Date: 04/01/2017
Workers' Compensation History
Other
Personnel listed on this license (current or disassociated) are listed on other licenses.
ps://www2.cslb.ca.gov/onlineservices/CheckLicenseIIILicenseDetail.aspx?LicNum=818129 7/1/20