BWFE2015-028078-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&4 4`4 Q91itto
COMMUNITY DEVELOPMENT DEPARTMENT
Application Number: BWFE2015-0280 SEP 2 4 2015 Ll
Property Address: 80503 CHAMPIONS WY
APN: 775220021
CITY OF
Application Description: SIGNATURE AT PGA WESTTM36537 BLOCK WALL:SL24Q L� LF �QUINTA
VELOPA?ENT DEPgRT�1EN7
Property Zoning:
Application Valuation: $15,000.00
Applicant:
CALIFORNIA WEST CONSTRUCTION INC
5927 PRIESTLY DRIVE STE 110
CARLSBAD, CA 92008
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under pro v' ions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and rofessions Code,
and my License is in full force and effect.
License Class/13 License No.: 927267
`TZ CDated � � Contractor:
OWNER -BUILDER DECLARATLsandProfes
I hereby affirm under penalty of perjury that I am exemCont actor's State
License Law for the following reason (Sec. 7031.5, Busin 'ons Code: Any
city or county that requires a permit to construct, alter, olish, 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
Lender's Add
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/24/2015
F II CWC LAQ LLC
7 PRIESTLY DR STE 110
1SBAD, CA 92008
Contractor:
CALIFORNIA WEST CONSTRUCTION INC
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 thew rk for which this permit is issued.
7 1 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 t e workers'
compensation I ws of California, and agree t at, if I should becomes Jett to the
workers' compe ration rovisions of Sectio 3700 of the L or Co e I shall forthwith
comply with th se pro isions.
Date: Z Applicant: ` (r
L:
WARNING: AILURE TO SECURE WORKERS' COMPENSAT(ION
AGE)FINE
IS UNLAWFUL,
AND SHAL SUBJECT AN EMPLOYER TO CRIMINAL PENAIVILS UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADHEiCOST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTI 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 bui ing
construction7 and h5reby authorize representatives of this ,y to enter upo he
above -nn on d roperty for inspection purposes.
Date: 2 Signature (Applicant or Agent). `
FI NANCLP&IN FORMATION
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE
":.ZSA5S81473_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
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0
$43.50
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
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 =
QTY
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: $152.27 $0.00
TOTALS:00
Permit Details
City of la Qu i nta
Description: SIGNATURE AT PGA WEST TM36537 BLOCK WALLS 240 LF
Type: WALL/FENCE Subtype: SPECIAL/ENGINEERED Status: APPROVED
NUMBER
DESIGN
Approved: 9/24/2015 BHA
Parcel No: 775220021 Site Address: 80503 CHAMPIONS WY LA QUINTA,CA 92253
PERMIT
Issued:
Lot Scl Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $15,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: 240 LF GARDEN WALL [ORCO SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR
TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES.
BWFE�2t31�5-OZ$Q
o � o
Description: SIGNATURE AT PGA WEST TM36537 BLOCK WALLS 240 LF
Type: WALL/FENCE Subtype: SPECIAL/ENGINEERED Status: APPROVED
Applied: 9/21/2015 MFA
DESIGN
Approved: 9/24/2015 BHA
Parcel No: 775220021 Site Address: 80503 CHAMPIONS WY LA QUINTA,CA 92253
Subdivision: Block: Lot: T
Issued:
Lot Scl Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $15,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: 240 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.
Process Su' m a yI
3",
's
� � f
__j Applied to Approved
FINANCIAL INFORMATION
Printed: Thursday, September 24, 2015 11:20:26 AM 1 of 2
SYST: M S
�s e
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"'" NAME tYPE""
..., ,.., ........
... ,... _ AME
N
ADDRESS1'.
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
CALIFORNIA WEST CONSTRUCTION
INC
5927 PRIESTLY DRIVE
STE 110
CARLSBAD
CA
92008
LBELLOSO@CALWESTC
OMMUNITIES.COM
CONTRACTOR
CALIFORNIA WEST CONSTRUCTION
INC
5927 PRIESTLY DRIVE
STE 110
CARLSBAD
CA
92008
LBELLOSO@CALWESTC
OMMUNITIES.COM
OWNER
RREF II CWC LAQ LLC
5927 PRIESTLY DR STE
110
CARLSBAD
CA
92008
FINANCIAL INFORMATION
Printed: Thursday, September 24, 2015 11:20:26 AM 1 of 2
SYST: M S
1
T '• i�el'1'Yilt �E�tal�5 PERMIT N.9.MBER
% City of la Quinta MR, E-�20�15-0280
INSPECTIONS
REVIEW TYPE
REVIEWER
SENT DATE
DUE DATE
RETURNED
DATE
STATUS
REMARKS
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
$43.50
$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 LF PC
Total Paid for FENCE OR FREESTANDING WALL: $152.27 $0.00
INSPECTIONS
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, September 24, 2015 11:20:26 AM 2 of 2
LJ tJ SYSTEMS
.4a
REVIEW TYPE
REVIEWER
SENT DATE
DUE DATE
RETURNED
DATE
STATUS
REMARKS
NOTES
1ST BLDG NS (1 WK)
BURT
HANADA
9/24/2015
9/24/2015
9/24/2015
APPROVED
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, September 24, 2015 11:20:26 AM 2 of 2
LJ tJ SYSTEMS
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ta-QuInta, CA 92255- (760) 777-701
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