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BELC2015-0074VOICE (760) 777-7125 78-495 CALLS TAfl,1PIC0 T4t!t 4 4 Qumrcu FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 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 provisions of Chapter 9 {commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is i full force and effect. License Class B License No.: 927267 t - Date: f ,Contractor: OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt froLContracto s State License Law for the following reason (Sec. 7031.5, Business ande: Any city or county that requires a permit to construct, alter, impror 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 Lender's 21 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 700 of the or Co e, I shall forthwith comply with tIlPse provisions. Date: ( Applicant: WARNING: F ILURE TO SECURE WORKERS' COMPENSATIO COVERAGE UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE ND CIV FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION 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 relati to b Iding construction, and hereby authorize representatives of thi city to en upon the bove• mentiggedproperty for inspection purposes. (_�l�l t Date: Signature (Applicant or Agent . Date: 8/24/2015 Application Number: BELC2015-0074 Owner: Property Address: 80503 CHAMPIONS WY RREF II CWC LAQ LLC APN: 775220021 5927 PRIESTLY DR STE 110 Application Description: SIGNATURE TM 36537 ELECTRICAL PEDESTALS CARLSBAD, CA 92008 a a Property Zoning: D N _z Application Valuation: $10,000.00 U ,y s� o Us Applicant: Contractor: W o> o ULRICH SAUERBREY CALIFORNIA WEST CONSTR CTI N I c/3 z 74948 LIVE OAK STREET 5927 PRIESTLY DRIVE STE INDIAN WELLS, CA 92210 CARLSBAD, CA 92008 (760)918-6768 Llc. No.: 927267 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 {commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is i full force and effect. License Class B License No.: 927267 t - Date: f ,Contractor: OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt froLContracto s State License Law for the following reason (Sec. 7031.5, Business ande: Any city or county that requires a permit to construct, alter, impror 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 Lender's 21 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 700 of the or Co e, I shall forthwith comply with tIlPse provisions. Date: ( Applicant: WARNING: F ILURE TO SECURE WORKERS' COMPENSATIO COVERAGE UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE ND CIV FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION 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 relati to b Iding construction, and hereby authorize representatives of thi city to en upon the bove• mentiggedproperty for inspection purposes. (_�l�l t Date: Signature (Applicant or Agent . FINANCIAL •• {. f• DESCRIPTION ACCOUNT QTY . AMOUNT PAID PAID DATE BAS 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 QTY AMOUNT PAID PAID DATE SERVICES 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SERVICES PC 101-0000-42403 0 $12.09 $0.00 PAID,BY METHOD. RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL: $36.26 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forPERMIT ISSUANCE: $91.85 $0.00 TOTALS:• 00 Description: SIGNATURE TM 36537 ELECTRICAL PEDESTALS , Type: ELECTRICAL Subtype: Status: APPROVED Applied: 8/24/2015 MFA Approved: 8/24/2015 MFA Parcel No: 775220021 Site Address: 80503 CHAMPIONS WY 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. Stories: 0 No. Unites: 0 74948 LIVE OAK STREET Details: INSTALLATION OF 100 AMP 120/240V 1 PHASE ELECTRICAL PEDESTAL TO INCLUDE MISC. IRRIGATION CONTROLLERS AND LANDSCAPE LIGHTING. 92210 (760)918-2839 pP v __j Applied to A roved CHRONOLOGY CONDITIONS STATE ZIP PHONE FAX EMAIL NAME TYPE NAME ADDRESS1 CONTACTS CITY APPLICANT ULRICH SAUERBREY 74948 LIVE OAK STREET INDIAN WELLS CA 92210 (760)918-2839 (760)918- 6749 ulrichs@uslandlink.co • m CONTRACTOR CALIFORNIA WEST CONSTRUCTION 1 5927 PRIESTLY DRIVE STE 110 CARLSBAD CA 92008 (760)918-2839 (760)918- 6749 LBELLOSO@CALWESTC OMMUNITIES.COM OWNER RREF II CWC LAQ LLC 5927 PRIESTLY DR STE 110 CARLSBAD CA 92008 (760)918-2839 (760)918- 6749 LBELLOSO@CALIFORNI AWESTCOMMUNITIES. COM FINANCIAL INFORMATION Printed: Monday, August 24, 2015 3:11:41 PM 1 of 2 CR?WSYSTEMS ,P ' Permit Details PERMIT N.U.MBER tµ City of La Quinta BELC�2015-0074 DESCRIPTION ACCOUNT QTY AMOUNT PAID -- -- [ PAID DATE RECEIPT # CHECK # -METHOD PAID BY CLTD BY .' BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: SERVICES 101-0000-42403 0 $24.17 $0.00 SERVICES PC 101-0000-42403 0 $12.09 $0.00 Total Paid for ELECTRICAL: $36.26 $0.00 PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 101121 e SEQID INSPECTION TYPE INSPECTOR SCHEDULED DATE COMPLETED DATE RESULT REMARKS NOTES , 0 ELECTRICAL FINAL" BLD PARENT PROJECTS BOND INFORMATION ATTACHMENTS Printed: Monday, August 24, 2015 3:11:41 PM 2 of 2 OW SY57EM5 REVIEW TYPE REVIEWER SENT DATE' DUE DATE RETURNED�� DATE STATUS REMARKS NOTES BOND INFORMATION ATTACHMENTS Printed: Monday, August 24, 2015 3:11:41 PM 2 of 2 OW SY57EM5 sin Cj� pf,..a QUinta Budding a Safety Division - P.O. Box 1504,"78-495 Carie Tampico 1.a.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet : Permit # LIC (;C� i ProjectAdd!m:80-503 Cham o ions Wav Owner's Name:. CalWest Communities A. P. Number Add.: 5927 Priestly Drive, Suite 110 Legal Description: TTM 36537 Contractor. CalWest Communities' City, ST, zip: Carlsbad, CA 92008 Telephone: 760-918-6768 Project Description: Address: Same as above City, ST, zip: Installation of 100 Amp, Telephone: Sb teLic. # : -On File city Lie "qFi�e 120 240 V,. I phase, a est. ped to ude Arch., Engr., Designer .controllers and Landscape Ada>:Prima Contact: Liz Belloso �9 tmg City., ST, zip: Cell: 760-710-9912 Telephone: State Lie. #: Construction Type:. Occupancy: Project type (dWe one): New Add'n Alter Repair Demo Name ofcoatactperson: Alt: Ulrich Sauerbrey Sq. Ft: # Stories: - -T#-Unita: Telephone # of Contact Person: 760-610-9410 Estimated Value of Project: $10,000 APPLICANT: DO NOT WRITE BELOW THIS UNE tl Submittal ReWd Recd TRACMG PERWT FEES - Pian Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit • . Truss Cales. Called Contact Person Plan Check Balance Title 24 CaW4 Plans picked up Construction Flood plain plan Plans resubmitted •' . Mecharileal Grading plan Z'' Review, ready for correctionsrmue Electrical Subcontactor List Called Contsetperson Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans mabinitted Gradin* W HOUSE:- 'ie Review; ready for correctionsirwae Developer Impact Fee Planning Approval. Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 1 CITY OF'LA QUINTA I Y,: BUILDING & SAFETY DEPT. .�.�.,.`, APPROVED FOR CONSTRUCT' N Lclyz I �� l .,.��•r-:wt�'�.�'I' ), �.1`q` ; }" r � ;. � �'^ � �"''�L?� " ..' � : �f r � �� i�f iii �lf 1i` •�� _ �II� f!!I •. 1 1 �'f,:, /f � J �� 1 1� �. �Ik.1'SiR� •' I�'i 1� l,hr 1:� •'!I III ,I jll �I�-, ! / �1•, "+`! I ,v. '` '� 'S � r J I � j� IIL, ! I Ill : ,I ` j•� I � , • 4 ;� `` ' 1� ! J�t' Iu"� ,1 i;! ilr 44wY :I,�•" ' .. •'�`w•� i.�� ;�.: *+o ` • �i t..'�I. h. I �i f �, �a Ill X11 �•' •I�. ! ',� � r 11 LEGE D "METERcWavu a LJ r r ! 3/4"'METER" F�, rt rr;.lirJ�� l�. 1, _ I�j J� "'•'I`, 'r.;Iy�:: i' I " METER" • lac�� ff�, ` !F y �5 I I I } I� r!: r�� c=6 3/4" METER c u,A'j al; �) r ! ,�'� :.� Rr ,mow 3/4" METE ! - ,+` C 7 7�; fz lnt,�ly /N[' t 40 80.498 a� A� :. " METER GRr ►w I w. I 7> f 1 • GG s�Err 1 METER WAY •� 1 1.-...,..�.. ! y 1 ha ,.lEi ..'� I Vin`s • {{?:'I Ir. K �'-"�""�(�CJ I'', Il�1 3/4r METER � i,,w t- � '��:. t I�,.. �tll� i' � r;;.� lr,,i '•.:.-� �r1Nu1H1 y; m 3/4" METER'N'22�° ar`I I _-rfl f:_. r ] ` . _'r P ff1, ,„�...;,• "3/4" METERY,9ST" ��71'I�a-r►nkMvlu.l 3/4" METER 1 If �- � I I l! 1 ' •� �� 11�•, I 1• 1. r j5y *py` •r +•y,•-r- \ ) I•� ; �`oc--7 A� iL..an��74`AR L!_CR j ` if /,rl[ tI LOCATIONS i \ r \ 'i�� "D-45i �44WAR WAI t I ` tI{{ •'\ \ i , ..R.y,. N t \ \ i•�,i "�'7e •^ (i `bj"RY='wt+•'� v.�f•1'15"- `� ''+ :'I:: f"I Z-Alkp. . PHYSICAL METER LOCATIONS\:" lr! !!' trr,«',� '„:_ I(��,��'r�� .I �!!f ,,,I��.�, 1' ..1'i . 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