BRES2017-0187�W) `Y,
78-495 CALLE TAMPICO Tw�t D 4 QuiRro VOICE (760) 777-7125
'
LA (1UINTA; CALIFORNIA 92253 DESIGN &DEVELOPMENT DEPARTMENT FAX (760) 777-7011
FAX
(760) 777-7153 '
BUILDING PERMIT
Date: 8/8/2017
Application Number: BRES2017-0187 Owner:
Property Address: 81785 FOUR SEASONS LAA�QUINTA HOUSING 1, LLC
APN: .767860010 PL
a7285 LAS RAMS' -AS, SUITE 230
Application Description: MONTERRA / TM 32742/ PLAN 3 / MISSION VIEJO, CA 92691
Property Zoning: AUG U 8 2017
Application Valuation: $220,058.90
CITY OP IA 00KA
Applicant` DESIGN AND DEVEI-oPMENT DEPARTKU8.6rtractor:
WOODBRIDGE PACIFIC GROUP LLC WOODBRIDGE PACIFIC GROUP LLC
27271 LAS RAMBLAS SUITE #100 27271 LAS RAMS. -AS SUITE #100
MISSION VIEJO; CA 92691 MISSION VIEJO, CA 92691
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: B License No.: 963887
Date: 6 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, 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 Name:
Lender's Address:
(949)348-8162
Llc. No.: 963887
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one o: the following declarations:
I have and will maintain a certificat � of consent to'self-insure for workers'
compensation, as provided for by Section 370D of the Labor Code, for theperformance
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 perfornance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: GRANITE STATE INSURANCE COMPAN- Policy Number: WC065256310
I certify that in the performance of :he 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 1 should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall orthwith
complywith
ose provisions.
Date: 6Z 7 Applicant:
WARNING: FAILURE TO SECURE WORKERS' COv1PENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMIKAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,00D). 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'ssuance 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 purpses.
ZX
Date:d/ 7 Signature (Applicant or Agent )•
C
Date: 8/8/2017
Application Number: BRES2017-0187
Owner:
Property Address: • 81785 FOUR SEASONS
LA QUINTA HOUSING 1, LLC
AP.N: 767860010
27285 LAS RAMBLAS, SUITE 230
Application Description: MONTERRA / TM 32742 / PLAN 3 / LOT 10
MISSION VIEJO, CA 92691
Property.Zoning:
Application Valuation: $220;058.90
Applicant:
Contractor:
WOODBRIDGE PACIFIC GROUP LLC
WOODBRIDGE PACIFIC GROUP LLC
27271 LAS RAMBLAS SUITE #100
27271 LAS RAMELAS SUITE #100
MISSION VIEJO, CA 92691
MISSION VIEJO, CA 92691
(949)348-8162
------------------------------------------------------------------------------------------------
LIc. No.: 963887
Detail: 3,370.SF DWELLING - PLAN 3 LOT 10 [VB/RES-3/CLASS-A/13D] THIS PERMIT DC)ES NOT INCLUDE POOL, SPA, BLOCK WALLS, BBQ OR WATER FEATURE.
PER 2016 CALIFORNIA BUILDING CODES
C
'w
INFORMATIONFINANCIAL
DESCRIPTION
ACCOUNT QTY AMOUNT
ART IN PUBLIC PLACES - RESIDENTIAL
270-0000-43201 0 $50.14
Total Paid for ART IN PUBLIC PLACES - AIPP: $50.14
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE.
101-0000-20306
0
$9.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $9.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - CIVIC CENTER
252-0000-43200
0
$942.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - COMMUNITY CENTERS
254-0000-43200
0
$129.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - FIRE PROTECTION
257-0000-43200
0
$433.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - LIBRARIES
253-0000-43200
0
$344.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - PARK MAINTENANCE
256-0000-43200
0
$40.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - PARKS/REC
251-0000-43200
0
$2,048.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - STREET MAINTENANCE
255-0000-43200
0
$116.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - TRANSPORTATION
250-0000-43200 _
0
$2,842.00
Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TEMP POWER SERVICE
101-0000-42403
0
$25.33
Total Paid for ELECTRICAL: $25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, EA ADDITION 1,000SF
101-0000-42403
0
$51.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, FIRST 1,000SF
101-0000-42403
0
$152.00
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $203.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL PRECISE GRADING - TRACT HOME
101-0000-42408
0
$139.84
Total Paid for GRADING: $139.84
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402.
0
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
EXHAUST HOOD
101-0000-42402
0
$12.67
DESCRIPTION
ACCOUNT
QTY
—AMOUNT.
FURNACE
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN
101-0000-42402
0
$88.69
Total Paid for MECHANICAL: $253.36
DESCRIPTION
ACCOUNT
QTY
AMOUNT
MULTI STRUCTURE PLAN CHECK -'EACH
101-0000-42600
0
$50.67
Total Paid for MULTI STRUCTURE PLAN CHECK - EACH: $50.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
MULTI SPECIES RESIDENTIAL 0-8 UNITS - 2017 UPDATE
101-0000-20310
0
$1,245.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
MULTI -SPECIES RESIDENTIAL >14 UNITS - 2017 UPDATE
101-0000-20310
0
$17.00
Total Paid for MULTI -SPECIES RESIDENTIAL: $1,262.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NEW CONSTRUCTION PERMIT
101-0000-42400
0
$621.91
Total Paid for NEW CONSTRUCTION PERMIT: $621.91
DESCRIPTION
ACCOUNT
QTY
AMOUNT '
BACKFLOW DEVICE
101-0000-42401
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BUILDING SEWER
101-0000-42401
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTUREITRAP
101-0000-42401
0
$266.07
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 5+ OUTLETS
101-0000-42401
0
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT
101-0000-42401
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
$12.67
Total Paid for PLUMBING FEES: $367.41
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$28.61
Total Paid for STRONG MOTION INSTRUMENTATION SMI: • $28.61
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMEVT FEE: $5.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT.
SINGLE FAMILY DETACHED
224-0000-20320
0
$1,837.44
Total Paid for TUMF - RESIDENTIAL: $1,837.44