BWFE2015-0268C&t
4,444biri78-495 CALLE TAM PICO �' VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT . .
LICENSED CONTRACTOR'S 'DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisio s of Chapter
9 {commencing with Section•7000).of Division 3 of the Business'and:Pr essions Code,
and my License is in full force and effect.
L
ense Cla s: B License No.: 927267er I Coor:
OWNER -BUILDER DECLARATION ,,
I hereby affirm under penalty of perjury that I am exemp- , the Contractor's State
License Law for the following reason (Sec. 7031.5, Business an rofessions Co ' Any
city or county that requires a permit to construct, alter, irriprove; demo is , 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 ofthe
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 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:
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 thew rk for which this permit is issued.
1 have and will maintain worker's' 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: _ Policy Number:
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 tot a workers'
compensation laws of California, and agree that, if I should become su Ject to the
workers, compensation provisions of Section 00 of the Code shall forthwith
comply with t se rovisions� L%
Q a 1
Dat` e:: �'' I Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIONUANDCIVILFI
LAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIEUPTO
ONE HUNDRED THOUSAND DOLLARS ($100,000). INADDITOF
COMPENSATION,:DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST. AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT:Application.is�I, ereby rrade:to.the.Building Official for a permit subject to
the conditions and.restri.aions�sei forth on this application.
1:" Each person upon whose behalf this `application is made, each person at whose
request and.for.whose benefft,work is.performed under or pursuant to any permit
issued as a result of tfiis 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
followi%issuince bf 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 relatin to bu• ding
construction and ereby authorize representatives of this ch y to en upon th bove•
menti r opfty fo-*pection purposes. r J
nata'� ' Sianatura+(Gnnlirant.nrGoantl• -
Date: 8/31/2015
Application Number:
BWFE2015-0268
Owner:'
Property Address:
56000 PGA BLVD
RREF II CWC LAQ LLC
APN:
775220021
5927 PRIESTLYDR ST
Application Description:
SIGNATURE TTM36537 1 COMBO WALL 50 LF
CARLSBAD, CA 921 z
Property Zoning:
Application Valuation:
$10,000.00
Cr
O o �o
Applicant:
ULRICH SAUERBREY
z
Contractor: ' cq
CALIFORNIA.WEST RUON
74948 LIVE OAK STREET
5927 PRIESTLY DRI 11g3 j>—:o
INDIAN WELLS, CA 92210
CARLSBAD, CA 92 08 C/') v
r
(760)918-6768 C>
Llc. No.: 927,267
LICENSED CONTRACTOR'S 'DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisio s of Chapter
9 {commencing with Section•7000).of Division 3 of the Business'and:Pr essions Code,
and my License is in full force and effect.
L
ense Cla s: B License No.: 927267er I Coor:
OWNER -BUILDER DECLARATION ,,
I hereby affirm under penalty of perjury that I am exemp- , the Contractor's State
License Law for the following reason (Sec. 7031.5, Business an rofessions Co ' Any
city or county that requires a permit to construct, alter, irriprove; demo is , 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 ofthe
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 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:
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 thew rk for which this permit is issued.
1 have and will maintain worker's' 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: _ Policy Number:
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 tot a workers'
compensation laws of California, and agree that, if I should become su Ject to the
workers, compensation provisions of Section 00 of the Code shall forthwith
comply with t se rovisions� L%
Q a 1
Dat` e:: �'' I Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIONUANDCIVILFI
LAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIEUPTO
ONE HUNDRED THOUSAND DOLLARS ($100,000). INADDITOF
COMPENSATION,:DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST. AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT:Application.is�I, ereby rrade:to.the.Building Official for a permit subject to
the conditions and.restri.aions�sei forth on this application.
1:" Each person upon whose behalf this `application is made, each person at whose
request and.for.whose benefft,work is.performed under or pursuant to any permit
issued as a result of tfiis application ,'the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
followi%issuince bf this permit.
2. Any, permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days;will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county;ordinances and state laws relatin to bu• ding
construction and ereby authorize representatives of this ch y to en upon th bove•
menti r opfty fo-*pection purposes. r J
nata'� ' Sianatura+(Gnnlirant.nrGoantl• -
I
x rcr,r,.,�arR"$.4L"51..2• S, 3�4%.'.n,'. �4thrc';.; a�rwi{^ .'.` n,c�,`ti v'u ' .y .- fit.. as 314�yr'¢S` :,::?'s�:9l p -.vain...:: Cts yVt D$s. p.:
x�. `.[��'1. `K � �4A ',�-_"' :. t, Z S� T 3 •x�:...x�vr .� ,. .:� `! av 2 �' �'P� �Yr . fieri
v �ryyq«''°`�.:.•.;gam=�DESCRIPTIQN,,��,. "� ,-:q4 � .: ..:j:.....A000UNT 5::; ht #;
3°�v.?4+`51.R,w13i:5ia±�.'cN.-]¢;v.�'7n,�
qT .S'. •3.'r f. "^ i ,:,...C�,',n-CM 4.-; ' k;,i !Y''S�.f'{" 4.: ^i:P:.'4n° -rs'.,�rc,si'.,5:
� � ��r•%..: �i � Y f -{:. ' ,$- %'`��P�. ° ' Y' .K ,> ie a�j` ,
.':: PAI1; ,DAT'E.
{e..VII �w*i�X��:f�'.?A3ZYal;�n �xyLQ�.::?'�::.SF
f 'BSAS SB1473•FEE 101 0000-20306
0 = • $1.00 $0.00 .
+y%.v"-. a ,K�..ey"°%'x-. �t
iII ^f „:w4'�iY C, •�},"'x .5•., ,.="a't, ,.K• e .. ... .14? r . `.$�,r .�..;�'+`•,.t:tr:.
'', "� $ �2 C
,METHOD �. .,
<�-,�:.?�i.�,s��`�,€�:>
4,,,5
.5;.. z, :4 .. t..� "�3"i¢ ar fE•'n'a?.,^5r
.a 9. "& ,.3,r �n r # , . ._,
M ' ;RECEIPT #; x �r ,, , ,, CHECK<#. CITD;BIf
� 'hez �:�a,�����z��s;��',..�;: �>���?�ti;��ntr,=>,an�.axi.��;�
Total Paid forBUILDING,STANDARDS ADMINISTRATION
BSA ,- $1'.00 $0.00
D.
*� z sDESCRFPTION�'°"�
%>
a+ Y1�
` A@ ° a UNTn^
VOW COaT*'MOUNT��s
� .,
zQnj
TY
°,, PZp' ,..'J3F �HSv.`.i'
��€
t
G ,.`E"6�� �.t4+. x;:4. x",5>
ik'N
;'y.
��� PAID $ a
:?..g h.\ :��k-.w"C,Y. b'ti��Y
MID?DATE€,
9aa.4,m¢-�'x*i�ID$'3i-r✓,+:-
WALL/FENCE.- FIRST 100 LF
'101-0000-424
0
$47186:.
$0.00
L»a f, s'.. .k .,y -A �,' 3' ::. � :'a .. .'
• - g;i-.y_ ij, yr `k _
Y� *_
wn?tG;1�a��-1e.
..:-`%i 331"c'R:"9 °A:Aq' h°q`i�.eA; i[ ixj' ,v: 6-^t" .;
,�"*& .y , ,:. rd`�.,,
�, ,, :METHOD pw y .:.
`2w�" ?F'M"r'.,z,'-�'Gii. a'o„;>{3s4:5 aA ''rc"rc,.i,T�
" :Y �%kr: P. .,. 5 t`[{W
Pia; x�. .w...`' }i''s
a .' ,RECEIPT#.�s..q,
, r.rwia"�'..�'e^n�xSKFfii v.Se',bi.»'<R`:5i�,�`. :s.
9 fix"
. -o ._ »`sa:"�
:. HECK<#.; r
z�(•*.`•:�z'�.'.,-°',k'"'.s+.,:..�,
..'�i•
';_. ` 4 x :, .,.. J..f
CLT,D,.36Y
icaw.;,.wDESCRIPTI N,:zr
y
::G..�!i -3.:°4.x+. ,rIIl..:, i,�e. $.'2:D .A.+$�.�'•.x.n�v^36�'.-. .. Hats,.,
�A, N _:.
p
a. .e:m�Ytt �ii. .wiYx�%�.,:�`�i�.* .' ✓Rlwih.w^{'�5,.2^`...x�fiZ..i4.,D./a.k1?°:.',.".cs;.n.�,'!::yi..��r=.5.��3->rw�§.�'f:.1xEf+iC3k:
QTY�ANIOUNT„
� Y^'yR `-tiL`'`•%`."E�Ss :� 4W.,�Y"`v�,"��R'f
F� r ,� � z
.'.. .- # .. 3R ,:, -.
PAID%
.:�d-.:�c'u!'P•.y'5�'�.T'S.�n"`�1
;PAID DATEt
WALL/FENCE - FIRST 100.LF PC
101-'0000-42600,'
0
$60:91
$0.00
,,F f,�S^•,a. ?i:-..`.'a.�F Tr.X :1-. .Sft:, •('�.4
IIc : �.• ? ` 'P.A1D' BY� :;�
'".4":33 i+�Y:.a?.': ."?-`r1-. c.'.i:.'F+
' 3°` .METH Dai
� x .. ama
< > ,:
?� f°€ RECEIPT°�# '=
" ry
# K #
E"%*
^ r,
sxCL D BY
Total Paid�for,FENCE OR'FREESTAN_ DING'WALL. . ` $108.77 $0.00
'N 4
�"'-••. n '� a+`4'J�,A*.,'�,.-",, .. :. ;r e.er�'•�-;.
. a x> ,..DESCRIPTIONS : •� ,Y
Y ,- - ,t -. 'L3_. ";a . y
` ACCO.UNTt ��z
'� .�ar:�
44!•y jr-
, . .:
a TI'
•x r Sx
i`. °'l
:� -AMOUNT
; ;PAID.
P.A1DHDATE:
RET WALL <=12-- FIRST 100 LF,
101 0000=4240.4'.
0
$.47.86
$0.00
,,'F' ` a Sf :.
dy!'�• ;a '1.+. 'P3e1,�.. -tx 3>SQey,
a s ;PAID,;BX�k
�yc'b�M �` ,4. L+ FSF':, I�,,�,=y
"S- ..x`J.-��,:�i5�•,'4.,.%�✓°sb"C-.iia
_
a.$m
METHOD ' ,<.�
F'� - f✓ x�
p'..;,y.4£A..°+P+'Y"°Xi
F -r:,,
vim"`
£RECEIPTy± #y.
�i,..".'S'��«t,+:.fiiai"k.vF,..c;�i�+-..na'S"?4i:..�45',..
t'•.•.:# '+A`,:K ,''3fi
x? CHECK #
r t
':T2d`y2-' `...
"CLTD;BY
tY,.�,p\xW ^kap
aF i
�' 4 '
a s_ y',k' •Rc ., ;a�.; ._;,e24,43r" nZ+:i;"f?i:.
{r�;s
ACCOUNT.
'..»S fk><"
x t ,:,Xi&.fx#,
TY ..
Q,s�.�`"���
�>.+P'
..uf't`ii4'i4?a b'fi;''e:
`"�
AMOUNT::n . I
`&
F'' f: <.Y. �ii
� . � PAIQ q Pli
HOW
1_.a..iT
F'.,
PAID?DAT,E
RET WALL <=12 -'FIRST 100 LF PC
"101-0000742600
0 '
$60.91
$0.00
',a ,. �
v- ..rp'.."
:.:,. ; '' &'�e..S
"" PAID BY :< .
WHIMun�r
Y. `.� ; !
'.?.'r i '- - "'!yr, --:;.:.:
; : . SMETHOD lR�,I!..
.. wuu .r ¢+a�
�
F �,5.,CeJ?x
RECEIPT # „&d Ai��N
CHECK# -
' CLTDgBY ,
; a x
."TotaPaidfor,RETAINING WALL _$108 77' $0.00
I
Description: SIGNATURE TTM36537-1 COMBO WALL 50 LF
Type: WALL/FENCE- Subtype: Status: APPROVED
Applied: 8/31/2015 MFA
Approved: 8/31/2015 MFA
Parcel No.:.775220021 Site Address: 56000'PGA BLVD LA QUINTA,CA 92253
Subdivision: -Block: Lot:
Issued:.... : .. .
Lot Sq Ft: 0 ` Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $10;000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings 0 . No :Stones 0: No Unites: 0
.. .. .
Details 5,0 LF COMBINATION WALL [ORCO SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH. STUCCO, 'PAINT, OR�
TEXTURED COATING WHERE VISIBLE' FROM OUTSIDE`THE PROPERTY' 4013 CALIFORNIA BUILDING;CODES.
_I X8/31/2015.. I.
APPLICANT
ULRICH SAUERBREY.
74948;LIVE OAK STREET
INDIAN WELLS
CA
92210 (760)918 2839
(760)918-
ulrichs@uslandlink.co
6749
Jr
CONTRACTOR
CALIFORNIA WEST CONSTRUCTION .
5927.PRIESTLY DRIVE
CAR LSBAD
CA
92008 (760)918=2839
(760)918- >
LBELLOSO@CALWESTC
INC
STE 110
6749
OMMUNITIES.COM
OWNER
RREF II -CWC LAQ LLC
5927. PRIESTLY DR STE
CARLSBAD
CA
92008 (760)918-2839
(760)918-
LBELLOSO@CALIFORNI
110
6749
AWESTCOMMUNITIES.
COM
Printed: Monday, August 31, 2015 11:58:04 AM
1 of 2
CRFWIYSTEMS
DESCRIPTION,
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT#
CHECK#
METHOD
PAID BY
CTD"
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
WALL/FENCE -FIRST
101-0000-42404
0.
$47.86
$0.00
100 LF
WALL/FENCE -FIRST
101-0000-42600
0
$60.91
$0.00
100 LF PC
Total Paid for FENCE OR FREESTANDING WALL $108.77 $0.00
RET WALL <=12 - FIRST
101-0000-42404
0
$47.86
$0.00
100 LF
RET WALL <=12 - FIRST
101-0000-42600
0
$60.91
$0.00
100 LF PC
Total Paid forRETAINING WALL $108.77 $0.00
TOTALS:•0
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Monday, August 31, 2015 11:58:04 AM 2 of 2 ORWlYSTEMS
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