BPOL2018-020478-495 CALLE TAMPICO Tit!t D 66P Qub&
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype:
POOL/PUBLIC
Application Number:
BPOL2018-0204
Property Address:
79824 VIA SAN MATEO
APN:
776220012
Application Description;
FLORESTA / COMMUNITY POOL AND SPA
Property Zoning:
Application Valuation:
$130,000.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
BEAZER HOMES HOLDINGS CORP
310 COMMERCE STE 150
IRVINE, CA 92602
Date: 2/7/2019
Applicant: 1N3 IN*30 WN013A30 NJ�$30 BEAZER HOMES HOLDINGS LLC
BEAZER HOMES HOLDINGS LLC-LONNIE ELLISOR
310 COMMERCE STE 150 Ono vi joAx 310 COMMERCE STE 150
IRVINE, CA 92602 SUITE 190
61OZ 10 833 IRVINE, CA 92602
(714)672-7000
----------------------------------- _�_ Cl Llc. No.: 818129
_------------------------------------
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.: 818129 /
Date; % /7 Contractor:
I hereby affirm under penalty of perjury that I am exempt from the Contra o`r 3Mtt—
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 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 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
of the>orfor which this permit is issued.
I have a d will maintain workers' compensation insurance, as required by
Secti a 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: ACE AMERICAN INSURANCE COMPANY Policy Number: WLRC48580737
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 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: ZZ -7Y Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAG S UNLAW ,
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.
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 purposes.
Date: Signature (Applicant or Agent): ."
Date: '2/7120TSI
Application Number:
BPOL2018-0204
Property Address:
79824 VIA SAN MATEO
APN:
776220012
Application Description:
FLORESTA / COMMUNITY POOL AND SPA
Property Zoning:
Application Valuation:
$130,000.00
Applicant:
BEAZER HOMES HOLDINGS LLC-LONNIE-ELLISOR
310 COMMERCE STE 150
IRVINE, CA 92602
Owner:
BEAZER HOMES HOLDINGS CORP
310 COMMERCE STE 150
IRVINE, CA 92602
Contractor:
BEAZER HOMES HOLDINGS LLC
310 COMMERCE STE 150
SUITE 190
IRVINE, CA 92602
(714)672-7000
Llc. No.: 818129
fc--
Detail: POOL AND SPA AT COMMUNITY BUILDING ONLY [POOL ENGINEERING INC] HEALTH DEPARTMENT INSPECTIONS REQUIRED IN ADDITION TO
BUILDING DIVISION INSPECTIONS. THIS PERMIT DOES NOT INCLUDE. EN,CLOSURErbEPARAITE PERMIT REQUIRED WITH INSTALLATION OF BARRIERS PRIOR TO
PRE -PLASTER INSPECTION. 2016 CALIFORNIA BUILDING CODE
DESCRIPTION
ACCOUNT QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$6.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$6.00
DESCRIPTION
DETACHED SPA/WATER FEATURE/OTHER
ACCOUNT CITY
AMOUNT
101-0000-42404 0
$200.12
DESCRIPTION
SWIMMING POOL/SPA
ACCOUNT CITY
AMOUNT
101-0000-42404 0
$200.12
DESCRIPTION
SWIMMING POOL/SPA PC
ACCOUNT CITY
AMOUNT
101-0000-42600 0
$108.87
Total Paid for POOL / SPA:
$509.11
DESCRIPTION
RECORDS MANAGEMENT FEE
ACCOUNT CITY
AMOUNT
101-0000-42416 0
$10.00
Total Paid for RECORDS MANAGEMENT FEE:
$10.00
DESCRIPTION
TECHNOLOGY ENHANCEMENT FEE
ACCOUNT CITY
AMOUNT
502-0000-43611 0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT
FEE:
$5.00