BELC2015-006878-495 CALLE TAMPICO
LA QU4NTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
ULRICH SAUERBREY
74948 LIVE OAK STREET
INDIAN WELLS, CA 92210
T4'^r44 Q,If &
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BELC2015-0068 I I"III �II'I I'll I'II
80497 PLATINUM WY#A 48
775220021
SIGNATURE TM 36537 ELECTRICAL PEDESTALS
$10,000.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisio oiof Chapter
9 {commencing w.th Section 7000} of Division 3 of the Business and Prof,ns Code,
and my License i in full force and effect.
License Cla : B License I . 927267
Date: r� Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the C ntracto s State
License Law for the following reason (Sec. 7031.5, Business and Profes i ode: 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/24/2015
Owner:
RREF II CWC LAQ LLC
5927 PRIESTLY DR STE 110
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 ermit is issued, I
shall not employ any person in any manner so as to become subject t 'the workers'
compensation laws of California, and agree that, if I should become ubject to the
workers' co pensation provisions of Section 700 of the L r, o , I shall forthwith
comply wit those provisions. `
Date: Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION OVERAGE I UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ND CIV INES 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.
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 to laws relating to uilding
construction, and hereby authorize representatives of thi city to enter n t e above•
ment roperty for inspection purposes.
Date: ( Signature (Applicant or Agent):
IF INANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY 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
: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 for PERMIT ISSUANCE: $91.85 $0.00
TOTALS: $129.11 00
Permit Details PERMIT NUMBER
IMT 2
City of La Quinta BELC2015�-Q068
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: 80497 PLATINUM WY #A LA QUINTA,CA 92253
Subdivision: PM 20426
Block: Lot: J
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
EMAIL
Details: INSTALLATION OF 100 AMP 120/240V 1 PHASE ELECTRICAL PEDESTAL TO INCLUDE MISC. IRRIGATION
CONTROLLERS AND LANDSCAPE
LIGHTING.
INDIAN WELLS
CA
FINANCIAL INFORMATION
Printed: Monday, August 24, 2015 2:50:44 PM 1 of 2 CR
SYST:MS
CONTACTS
NAME TYPE
NAME
ADDRESS1
CITY
STATE,
ZIP'
PHONE.
FAX
EMAIL
APPLICANT
ULRICH SAUERBREY
74948 LIVE OAK STREET
INDIAN WELLS
CA
92210
(760)918-2839
(760)918-
ulrichs@uslandlink.co
6749
m
CONTRACTOR
CALIFORNIA WEST CONSTRUCTION 1
5927 PRIESTLY DRIVE
CARLSBAD
CA
92008
(760)918-2839
(760)918-
LBELLOSO@CALWESTC
STE 110
6749
1 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
FINANCIAL INFORMATION
Printed: Monday, August 24, 2015 2:50:44 PM 1 of 2 CR
SYST:MS
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
LTD
CBY
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 --T-101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
INSPECTIONS
SEQID INSPECTION TYPE
INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
ELECTRICAL FINAL"
BLD
BOND INFORMATION
Printed: Monday, August 24, 2015 2:50:44 PM 2 of 2
SY57EM5
sn.#
City Of La Qutnta
Buiiding a Safety Divi w
;� . P.O. Box 1504,78-495 Calle Tampico
14.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Pwn t #
C4- ;
Project Add=* 80-497 Platinum. Way "A"
Owner'sxame:. CalWest Communities
A- P. Number
Address: 5927 Priestly Drive, Suite 110
Legal Description: TTM 36537
City, ST, zip: Carlsbad, CA 92008
Contractor. CalWest Communities'
Telephone: 760-918-6768
Project Description:
Address: Same as above
City, sT, zip: Installation of Dual 100 Amp,
t;
Telephone:g)ed at Fast entrw to include
StateLic.#: On File CityLic.#; On File, mise including motors and
Arch, Engr., Designer.
Landseape'ligh ing
Address: Primary Contact: Liz Belloso
City., ST, zip: Cell: 760-710-9912
Telephone:
State Lic. #: ,,,, •=, Mw
Name of contact Person: Alt: Ulrich Sauerbrey
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq.'Ft.: #stories: #units
Telephone # of Contact Person: 760-610-9410
Estimated Value of Project: $10,000
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FM
Plan Sets
Plan Check submitted
Item Amount
Structural Cales
Reviewed, ready for corrections
Ptah Check Deposit. .
Truss Cates.
1.
Called Contact Person
Plan Check Balance_
Tide 24 Cates.
Plans picked up
Construction "
Flood plain plan
Plans resubmitted.'.
Mecharilcal
Giading plan
2" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'i° Review; ready for correctionstissue
Developer Impact Fee
Planning Approval.
Called Contact Person
AJ.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees "
Total Permit Fees
CITY: F'LA�QUINTA
o
BUILDING & SAFETY DEPT .
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