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BRES2015-0372Applicant: Contractor: WOODBRIDGE PACIFIC GROUP LLC WOODBRIDGE PACFIC GROUP LLC 27285 LAS RAMBLAS SUITE #230 27285 LAS RAMBLAS SUITE #230 MISSION VIEJO, CA 92691 MISSION VIEJO, CA 92691 (949)348-8162 Llc. No.: 963887 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 `ate: �O Contractor OWNER -BUILDER DECLARA N 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 of 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 1 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 Addre! WORKER'S COMPENSATIQV DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate cf consent to self -insure for workers' compensation, as provided for by Section 3700 cf the Labor Code, for the performance o�f�#pr�/ k for which this permit is issued. g have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perform; nce of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: _ Policy Number: I certify that in the performance of th � 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: , 4�7 Applicant WARNING: FAILURE TO SECURE WORKERS' COMPENSA N 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 IU SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWEEDGEMENT IMPORTANT: Application is hereby made to the Cuilding Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this applica>Gon is made, each person at whose request and for whose benefit work is performec 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 Ci -y 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 issjance 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-mentione d property for inspection purposes. Date: A r Signature (Applicant orAgent): 4 4 VOICE (760) 777-7125 78-495 CALLE TAMPICO D 1 FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/23/2015 Application Number: BRES2015-0372 Owner: Property Address: 55102 SUMMER LYNN CT MONTERRA PROP APN: 767860031 55075 MONROE ST Application Description: MONTERRA / TM32742 / LOT 31 / PHASE 1 / PLAN 4A LA QUINTA, CA 0 Property Zoning: Application Valuation: $235,785.30 Applicant: Contractor: WOODBRIDGE PACIFIC GROUP LLC WOODBRIDGE PACFIC GROUP LLC 27285 LAS RAMBLAS SUITE #230 27285 LAS RAMBLAS SUITE #230 MISSION VIEJO, CA 92691 MISSION VIEJO, CA 92691 (949)348-8162 Llc. No.: 963887 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 `ate: �O Contractor OWNER -BUILDER DECLARA N 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 of 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 1 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 Addre! WORKER'S COMPENSATIQV DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate cf consent to self -insure for workers' compensation, as provided for by Section 3700 cf the Labor Code, for the performance o�f�#pr�/ k for which this permit is issued. g have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perform; nce of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: _ Policy Number: I certify that in the performance of th � 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: , 4�7 Applicant WARNING: FAILURE TO SECURE WORKERS' COMPENSA N 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 IU SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWEEDGEMENT IMPORTANT: Application is hereby made to the Cuilding Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this applica>Gon is made, each person at whose request and for whose benefit work is performec 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 Ci -y 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 issjance 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-mentione d property for inspection purposes. Date: A r Signature (Applicant orAgent): FINANCIAL INFORMATION DESCRIPTION `' ' ACCOUNT QTY AMOUNT PAID 'PAID DATE' ART IN PUBLIC PLACES - RESIDENTIAL 270-0000-43201 0 $89.46 $0.00 PAID BY METHOD RECEIPT # CHECK # -: CLTD.BY Total Paid for ART IN PUBLIC PLACES - AIPP: $89.46 $0.00 DESCRIPTION ACCOUNT. QTY AMOUNT'. 'PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $10.00 $0.00 PAID BY., METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $10.00 $0.00 DESCRIPTION : ACCOUNT _ QTY AMOUNT PAID - PAID DATE: DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $0.00 PAID BY METHOD RECEIPT # - CHECK # CLTD BY DESCRIPTION • ACCOUNT QTY AMOUNT a PAID'.- '. PAID DATE DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 $0.00 PAID BY. METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 $0.00 , PAID BY ' ' METHOD RECEIPT # CHECK # CLTD BY' DESCRIPTION ACCOUNT QTY _ A;" AMOUNT = PAID '� ° , PAID DATE DIF - LIBRARIES 253-0000-43200 0 $344.00 $0.00 PAID BY METHOD RECEIPT # _ ' CHECK # CLTD BY DESCRIPTION ACCOUNT QTY` ,. AMOUNT PAID PAID DATE DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION, ';; ACCOUNT QTY AMOUNTIR PAID PAID DATE DIF - PARKS/REC 251-0000-43200 0 $2,048.00 $0.00 'PAID BY METHOD RECEIPT,# ,. , CHECK #' . CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 $0.00 PAID BY• y METHOD RECEIPT # _ _. "CHECK # 'CLTD BY , DESCRIPTION 'ACCOUNTQTY AMOUNT , _ PAID PAID DATE DIF -TRANSPORTATION 250-0000-43200 0 $2,842.00 $0.00 L�71 A) rt PAID'BY^; �• METHOD RECEIPT # CHECK # CLTD BY _; Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 $0.00 DESCRIPTION ACCOUNT QTY ". ' AMOUNT = PAID PAID DATE: TEMP POWER SERVICE 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK #" CLTD BY Total Paid for ELECTRICAL: $24.17 $0.00 DESCRIPTION . ACCOUNT QTY . AMOUNT PAID PAID DATE RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $49.32 $0.00 PAID BY METHOD ,RECEIPT # CHECK # CLTD.BY , DESCRIPTIONACCOUNT QTY AMOUNT = PAID PAID DATE RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $145.03 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL - NEW CONSTRUCTION: $194.35 $0.00 - . DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL PRECISE GRADING -TRACT HOME 101-0000-42408 0 $133.43 $0.00 PAID BY, METHOD RECEIPT # CHECK # CLTD BY Total Paid for GRADING: $133.43 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE CONDENSER/COMPRESSOR 101-0000-42402 0 $108.78 $0.00 PAID BY METHOD RECEIPT # 'CHECK # CLTD BY" DESCRIPTION ACCOUNT QTY AMOUNT = PAID PAID DATE EXHAUST HOOD 101-0000-42402 0 $12.09 $0.00 PAID BY - METHOD RECEIPT # - ` CHECK # - CLTD BY.; DESCRIPTION ` - - ACCOUNT QTY AMOUNT = PAID PAID DATE FURNACE 101-0000-42402 0 $108.78 $0.00 PAID BY ,'. METHOD RECEIPT # . „ CHECK #• CLTD BY ' DESCRIPTION "_ ACCOUNT QTY. AMOUNT ' PAID •` PAID DATE VENT FAN 101-0000-42402 0 $84.63 $0.00 r PAID BY METHOD. =` RECEIPT-# CHECK#, • ,, "'CLTD'•BY Total Paid for MECHANICAL: $314.28 $0.00 DESCRIPTION -"ACCOUNT _ `QTY AMOUNT- - PAID PAID DATE MULTI STRUCTURE PLAN CHECK - EACH 101-0000-42600 0 $48.34 $0.00 PAID BY - '.� METHOD RECEIPT # CHECK # CLTD BY Total Paid for MULTI STRUCTURE PLAN CHECK - EACH: $48.34 $0.00 " DESCRIPTION ACCOUNT": QTY AMOUNT PAID, PAID DATE' MULTI -SPECIES RESIDENTIAL 0-8 UNITS - 2015 UPDATE 101-0000-20310 0 $1,301.00 $0.00 ` PAID BY4METHOD RECEIPT # CHECK # CLTD BY Total Paid for MULTI -SPECIES RESIDENTIAL: $1,301.00 $0.00 DESCRIPTION ACCOUNT QTY . AMOUNT = PAID 'PAID DATE NEW CONSTRUCTION PERMIT 101-0000-42400 0 $601.73 $0.00 PAID BY, :METHOD. RECEIPT # - _ . CHECK # CLTD BY Total Paid for NEW CONSTRUCTION PERMIT: $601.73 $0.00 "DESCRIPTION ACCOUNT. QTY AMOUNT •",� PAID ,_ PAID DATE BACKFLOW DEVICE 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # `. CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT- r PAID PAID DATE BUILDING SEWER 101-0000-42401 0 $12.09 $0.00 + PAID BY. METHOD RECEIPT #' CHECK # CLTD BY DESCRIPTION .- .-ACCOUNT QTY- .. AMOUNT = PAID' PAID DATE FIXTURE/TRAP 101-0000-42401 0 $253.89 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY .DESCRIPTION .. ACCOUNT QTY AMOUNT _ ' PAID-_ • 'PAID DATE: GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $36.26 $0.00 PAID 'BY METHOD RECEIPT '# = " CHECK #' " t CLTD BY. .,DESCRIPTION ' ACCOUNT QTY. ' AMOUNT PAID.' PAID DATE WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 PAID BY - .METHOD . RECEIPT # CHECK # p. - CLTD BY ' -DESCRIPTION, ACCOUNT. QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 $0.00 �' PAID BY, METHOD RECEIPT # ' . CHECK # ` `. CLTD BY Total Paid for PLUMBING FEES: $338.51 $0.00 DESCRIPTION .r ACCOUNT ,, _ QTY AMOUNT . t PAID, PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $30.65 $0.00 PAID BY r ,. METHOD', " RECEIPT # CHECK # CLTD BY -Total Paid for STRONG MOTION INSTRUMENTATION SMI: $30.65 $0.00 • ',,�' `DESCRIPTION ti . �r .. ACCOUNT • '' `CRTY; .AMOUNT`:f n At PAID, t' PAID DATE SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 $0.00 . ' PAID: BY ti r - "�' `METHOD „. RECEIPT # = ' CHECK # CLTD BY � Total Paid for TUMF - RESIDENTIAL: $1,837.44 $0.00 TOTALS:• •• { � J l J � a r f T { l J � a Description: MONTERRA / TM32742 / LOT 31 / PHASE 1 / PLAN 4A Type: BUILDING, RESIDENTIAL Subtype: DWELLING - SINGLE Status: UNDER REVIEW Applied: 9/17/2015 SKH FAMILY DETACHED Approved: Parcel No: 767860031 Site Address: 55102 SUMMER LYNN CT LA QUINTA,CA 92253 Subdivision: TR 32742 Block: Lot: 31 Issued: Lot Sq Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $235,785.30 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 3,642 FT DWELLING - PLAN 4A, LOT 31 [VB/RES-3/CLASS A-FR/13D] THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2013 CALIFORNIA BUILDING CODES. ADDITIONAL SITES CHRONOLOGY CONDITIONS FINANCIAL INFORMATION Printed: Wednesday, September 23, 2015 5:14:43 PM 1 of 4 CR SYSTEMS ""DESCRIPTION ~ ACCOUNT," QTY ~AMOUNT .,. - PAID PAIDDATE .RECEIPT# CHECK#, METHOD=' PAIDBY.- C ;•BY ART IN PUBLIC PLACES - 270-0000-43201 0 $89.46 $0.00 - RESIDENTIAL Total Paid for ART IN PUBLIC PLACES - AIPP: $89.46 $0.00 BSAS SB1473 FEE 101-0000-20306 0 $10.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $10.00 $0.00 BSA: DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $0.00 DIF - COMMUNITY 254-0000-43200 0 $129.00 $0.00 CENTERS DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 $0.00 DIF - LIBRARIES 253-0000-43200 0 $344.00 $0.00 DIF - PARK 256-0000-43200 0 $40.00 $0.00 MAINTENANCE DIF - PARKS/REC 251-0000-43200 0. $2,048.00 $0.00 DIF - STREET 255-0000-43200 0 $116.00 $0.00 MAINTENANCE DIF -TRANSPORTATION 250-0000-43200 j 0 j $2,842.00 $0.00 Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 $0.00 TEMP POWER SERVICE 101-0000-42403 0 $24.17 $0.00 Total Paid for ELECTRICAL: $24.17 $0.00 RESIDENTIAL, EA 101-0000-42403 0 $49.32 $0,00 ADDITION 1,000Sf RESIDENTIAL, FIRST 101-0000-42403 0 $145.03 $0.00 1,000SF Total Paid for ELECTRICAL - NEW CONSTRUCTION: $194.35 $0.00 Printed: Wednesday, September 23, 2015 5:14:43 PM 2 of 4 0? _, srsrenu Printed: Wednesday, September 23, 2015 5:14:43 PM 3 of 4 c w U7 SYSTEMS 77- " DESCRIPTION a 'ACCOUNT CITY -AMOUNT ;PAID = PAID RECEIPT # CHECK # : ;METHOD r. PAID BY RESIDENTIAL PRECISE y GRADING - TRACT 101-0000-42408 0 $133.43 $0.00 HOME Total Paid for GRADING: $133.43 $0.00 CONDENSER/COMPRES 101-0000-42402 0 $108.78 $0.00 SOR EXHAUST HOOD 101-0000-42402 0 $12.09 $0.00 FURNACE 101-0000-42402 0 $108.78 $0.00 VENT FAN 101-0000-42402 0 $84.63 $0.00 Total Paid for MECHANICAL: $314.28 $0.00 MULTI STRUCTURE 101-0000-426000 $48.34 $0.00 PLAN CHECK - EACH Total Paid for MULTI STRUCTURE PLAN CHECK - EACH: $48.34 $0.00 MULTI -SPECIES RESIDENTIAL 0-8 UNITS 101-0000-20310 0 $1,301.00 $0.00 - 2015 UPDATE Total Paid for MULTI -SPECIES RESIDENTIAL: $1,301.00 $0.00 NEW CONSTRUCTION 101-0000-424000 $601.73 $0.00 PERMIT Total Paid for NEW CONSTRUCTION PERMIT: $601.73 $0.00 BACKFLOW DEVICE 101-0000-42401 0 $12.09 $0.00 BUILDING SEWER 101-0000-42401 u $1[.uy $0.00 FIXTURE/TRAP 101-0000-42401 0 $253.89 $0.00 GAS SYSTEM, 5+ 101-0000-42401 0 $36.26 $0.00 OUTLETS WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 Printed: Wednesday, September 23, 2015 5:14:43 PM 3 of 4 c w U7 SYSTEMS DESCRIPTION ' ` : ACCOUNT . QTY r AMOUNT G ;' PAID— �� PAID DATE . RECEIPT.# CHECK # METHOD ' PA6 BV, " "T. CLTD BY WATER SYSTEM 101-0000-42401 0 $12.09 $0.00 " INST/ALT/REP Total Paid for PLUMBING FEES: $338.51 $0.00 SMI - RESIDENTIAL 101-0000-20308 0. $30.65 $0.00 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $30.65 $0.00 SINGLE FAMILY 224-0000-203200 $1,837.44 $0.00 DETACHED Total Paid for TUMF - RESIDENTIAL: $1,837.44 $0.00 TOTALS:00 BOND INFORMATION 1 Printed: Wednesday, September 23, 2015 5:14:43 PM - 4 of 4 Cff? srsreens