BWFE2019-0095D � Qa4a
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the Following declarations:
9 {commencing with Section 7000) of Division 3 of the Business and Professions Code, I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: License No.: AEC789 oft rk for which this permit is issued.
have and will maintain workers' compensation insurance, as required by
Secti 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: Policy Number:
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: `� 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.
78-495 CALLE TAMPICO
VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253
FAX (760) 777-7011
DESIGN &DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 5/28/2019
Permit Type/Subtype:
WALL/FENCE/CITY STANDARD/PRE APPROVED
Owner: try
Application Number:
BWFE2019 0095
BEAZER HOMES HOLDINGS fRP
Property Address:
79963 VIA SAN MATED
1600 E IMPERIAL HWY STE 2 �
APN:
776220012
BREA, CA � 0
Application Description:
BEAZER / 113 LF OF 6' WALL AND WING WALL AT EAST PL
M
Property Zoning:
r-- CD _v
Application Valuation:
$2,825.00
r
M gj> ®o
Applicant:
Contractor: ED =c o
BEAZER HOMES HOLDINGS LLC
DAMES WRIGHT
BEAZER HOMES HOLDINGSTCxJAMEONRICP=
310 COMMERCE STE 150
310 COMMERCE STE 150
IRVINE, CA 92602
IRVINE, CA 92602
z
--1
(714)672-7017
Llc. No.: AEC789
Date:AjyContractor:
11
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).:
() 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 Ad
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: 5/28/2019
Application Number:
BWFE2019-0095
Property Address:
79963 VIA SAN MATEO
APN:
776220012
Application Description:
BEAZER / 113 LF OF 6' WALL AND WING WALL AT EAST PL
Property Zoning:
Application Valuation:
$2,825.00
Applicant:
BEAZER HOMES HOLDINGS
LLC -DAMES WRIGHT
310 COMMERCE STE 150
IRVINE, CA 92602
Owner:
BEAZER HOMES HOLDINGS CORP
1600 E IMPERIAL HWY STE 200
BREA, CA
Contractor:
BEAZER HOMES HOLDINGS LLC - JAMES WRIGHT
310 COMMERCE STE 150
IRVINE, CA 92602
(714)672-7017
Llc. No.: AEC789
Detail: 113 IF OF 6' WALL AND WING WALL AT EAST PL [ANGELUS SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT,
OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. THE AREA BETWEEN THE BACK OF CURB AND ANY FENCING SHALL BE
LANDSCAPED, HAVE A SUITABLE PERMANENT IRRIGATION SYSTEM, AND BE CONTINUOUSLY MAINTAINED BY THE PROPERTY OWNER. 2016 CALIFORNIA
BUILDING CODES.
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0
$16.01
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$53.37
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$66.71
Total Paid for BLOCK WALL: $136.09
DESCRIPTION
ACCOUNT QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
. 4
"VIA SAN MATEO
A
CITY OF LA QUANTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
WIRe', V5 V I P� 6Ao m wmt>
Project Address: )CI
APN #:
Applicant Name:�Z,,r
Address: SIC) 6j,,nLl„,
City, ST, Zip: ry V�,o
Telephone:
Email: �rknV,,-Le- eat
Contractor Name:
Address:
City, St, Zip
Telephone:
Email:
State Lic:
City Bus Lic:
Architect/Engineer Name:
Address:
City, St, Zip
Telephone:
Email:
State Lic: City Bus Lic:
PERMIT # f �� 1� 0?
Project Description: �C L
Valuation of Projecct $.
Q New SFD Construction:
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
Property Owner's Name:�,`�
Address:
City, ST, Zip
Telephone:
Email:
Construction
Grading:
Bedrooms: I Stories:
_SF
-SF
SF
SF
Occupancy:
# Units:
New Commercial / Tenant Improvements:
Total Building SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
DocuSign Envelope ID: 33C223BD-E1D1-4CD4-8468-C9E043DCE65F
Project:
Floresta
Tract No.
36762
Phase:
1A
Units:
4
DU: Single Family Dwelling
Version: Original
Last RevsisW:
First Issued: 12/21/18
Revision Summary:
Beazer �.
Homes _
Moresta
Sequence Sheet
Approved by � �1;,— AProject Management
,� � W
Approved by: �.�„ 'ttel�,
Approved b : 5rdk M suction
Approved by: ; #a ,r asipg
Approved by. ��. qn
Const
Seq.
JDE
Lot #
Div
Plan
Elev
Corp
Plan
Elev
Garage
Address
Color
Zt. � ZO91-
Enhanced
Elevation
1
2
3
4
0041
0040
0039
0038
3
1
3
2R
A
C
B
A
S812
S810
S812
S811
SCU
SCW
SCV
SCU
Right
Left
Right
Left
79-945 Via San Mateo
79-963 Via San Mateo
51-998 Via Santero
51-964 Via Santero
7
4
8
6
N/A "v 6
N/A 000's
N/A 0,004
N/A 000 3
0041
sU Iv►r1 N
PLAN 1 A
S810
SCU
0
PLAN 1 B
S810
SCV
0
PLAN 1 C
S810
SCW
1
PLAN 2 A
S811
SCU
1
PLAN[ 2 B
S811
SCV
0
PLAN 2 C
S811
SCW
0
PLAN 3 A
S812.
SCU
1
PLAN 3 B
S812.
SCV
1
PLAN 3 C
S812.
SCW
0
PLAN 1X A
S818
SCU
0
PLAN 1X B
S818
SCV
0
PLAN 1X C
S818
SCW
0
TOTAL MIX:
4
Elnya¢Inn 1 Color Scheme
A Elevations (LA QUINTA) 1 THRU 11
B Elevations (SPANISH REVIVAL) 1 THRU 11
C Elevations (HACIENDA) 1 THRU 11
7OI-aZ7
TOTAL
MM
§qn.
SQ. FT.
PLAN S810 (1)
2,302
2,302
PLAN S811 (2)
2,467
2,467
PLAN S812 (3)
2,497
4,994
PLAN S818 (1X)
3,087
0
TOTAL S.F.
9,703
Sta dr r Gara a ❑rientatian Reverse R
Plan 111X Left Right
Plan 2 Right Left
Plan 3 Right Left
Notes: Sewer BackFlows are not required