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BWFE2015-017378-495 CALLE TAMPICO LA OUINTA,ICALIFORNIA 92253 Application Nuinber: Property Address: APN: Application Description Property Zoning: Application Valuation: BWFE2015-0173 80402 CHAMPIONS WY 775220021 D VOICE (760) 777-7125 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 6/9/2015 Owner: RREF II CWC LAQ LLC 5927 PRIESTLY DR STE 110 SIGNATURE_ ESTATES TM36537-1 P $3,348.00 [7D Q g Applicant: _ Lf!_�f CALIFORNIA WEST CONSTRUCTION 1 5927 PRIESTLY DRIVE STE 110 CARLSBAD, CA 92008 _CITY OF LAQU)NTA 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.: 927267 Date: V' r Contractor: r OWNER -BUILDER DECLARATIO I hereby affirm under penalty of perjury that I am exempt rom the ntractor's State License Law for the following reason (Sec. 7031.5, Business nd fessions 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 Address: CARLSBAD, CA 92008 Contractor: CALIFORNIA WEST CONSTRUCTION 1 5927 PRIESTLY DRIVE STE 110 CARLSBAD, CA 92008 (760)918-6768 Llc. No.: 927267 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 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 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 to the workers' compensation laws of California, and agree that, if I should become ubject to the workers' compensation provisions of Section 3700 of the Labor Cc e, I shall forthwith comply with those provisions. Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSAT N COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES AND CIVI FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). INAQDITION TO T COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEC706 HE 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 thisapplication 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 upo 9Ahe above• mentioned property for inspection purposes. /l a � Date: Signature (Applicant or Agent): FINANCIAL .• 1 DESCRIPTION ACCOUNT CITY AMOUNT : PAID PAID DATE ` BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE WALL/FENCE - EA ADDITIONAL 50 LF 101-0000-42404 0 $14.50 $0.00 PAID BY METHOD RECEIPT.# CHECK# CLTD BY ' DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $47.86 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $60.91 $0.00 PAID BY .. METHOD RECEIPT # CHECK # CLTD BY Total Paid for FENCE OR FREESTANDING WALL $123.27 $0.00 TOTALS:00 Description: SIGNATURE ESTATES TM36537-1 PH 1 LOT 71 Type: WALL/FENCE Subtype: Status: UNDER REVIEW Applied: 6/5/2015 MFA Approved: Parcel No: 775220021 Site Address: 80402 CHAMPIONS WY LA QUINTA,CA 92253 Subdivision: PM 20426 Block: Lot: 71 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $3,348.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 124 LF GARDEN WALL [ORCO SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES. Printed: Tuesday, June 09, 2015 10:35:40 AM 1 of 2 MMMYs7EMS ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES PLAN CHECK SUBMITTAL MARY FASANO 6/5/2015 6/8/2015 RECEIVED CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT CALIFORNIA WEST CONSTRUCTION 1 5927 PRIESTLY DRIVE CARLSBAD CA 92008 LBELLOSO@CALWESTC STE 110 OMMUNITIES.COM CONTRACTOR CALIFORNIA WEST CONSTRUCTION 1 5927 PRIESTLY DRIVE CARLSBAD CA 92008 LBELLOSO@CALWESTC STE 110 1 1 1 1 OMMUNITIES.COM OWNER RREF II CWC LAQ LLC 5927 PRIESTLY DR STE CARLSBAD CA 92008 110 Printed: Tuesday, June 09, 2015 10:35:40 AM 1 of 2 MMMYs7EMS ATTACHMENTS Printed: Tuesday, lune 09, 2015 10:35:40 AM 2 of 2 SYSTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD. PAID BY - BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: WALL/FENCE - EA 101-0000-42404 0 $14.50 $0.00 ADDITIONAL 50 LF 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 IF PC Total Paid for FENCE OR FREESTANDING WALL $123.27 $0.00 TOTALS:00 ATTACHMENTS Printed: Tuesday, lune 09, 2015 10:35:40 AM 2 of 2 SYSTEMS