BELC2015-007378-495 CALLE"ii4 1PIC!0'- C D "i VOICE (760) 777-7125
LA QUINTA, CALIFORt!I[A 92253 � FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT V FAX
(760) 777-7153
BUILDING PERMIT
Date: 8/24/2015
Application Number:
BELC2015-0073
Owner:
Property Address:
55759 ISLEWORTH
RREF II CWC LAC LLC
APN:
775220021
5927 PRIESTLY DR STE 110
Application Description:
SIGNATURE TM 36537 ELECTRICAL PEDESTALS
CARLSBAD, CA 92008
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Property Zoning:o
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Application Valuation:
$10,000.00
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Applicant:
Contractor:
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C)UJ
o
ULRICH SAUERBREY
CALIFORNIA WEST CONSTRU
10 cry
z
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 provisi sof Chapter
9 (commencing with Section 7000) of Division 3 of the Business Pr essions Code,
and my license is in full force andeffect.
License Clas : B. License No.: 927267
Date: �Y( I i S Contractor.
OWNER -BUILDER DECLARATN
I hereby affirm under penalty of perjury that I am exempt IOfro the Contract 's State
License Law for the following reason (Sec. 7031.5, Business an Professio ode: Any
city or county that requires a permit to construct, alter, improve, emolish, 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 Na
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 37DO 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 if the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the w rkers'
compensation laws of California, and agree hat, if I should become subject o the
workers' cpensation provisions of Sectio I/00 o he Labo e, I sha forth '
comply wi those provisions. 1/
Date: % Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER E IS UN WFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL'rrlqrS UP TO
ONE HUNDRED THOUSAND DOLLARS ($100000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED IOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made tc the Building Official for a permit subject to
the conditions and restrictions set forth on :his application.
1. Each person upon whose behalf this aFplication 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 miner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless -he 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 orrect.
I agree to comply with all city and county ordinances and state laws relating t uilding
construction, and hereby authorize representatives of this k'ty to enter 19n e above-
mentid p operty for inspection purposes. f"
Date: T Signature (Applicant or Agent): f
FINANCIAL INFORMATION
- s
-DO
.�y
"MU.PAID
AONT
.PAID DATE
WAS SB1473 FEE 101-0000-20306 0
$1.00
$0.00
Y" 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 "w
METHOD
RECEIPT#'
<, CHECK #.,:, '.
CLTD BY°
' `'DESCRIPTION
AMOUNT
PAID_
PAID DATE
SERVICES PC
101-0000-42403
0
$12.09
$0.00
PAID BY
r METHOD' t s
RECEIPT #.
CHECK#
CLTD BY
Total Paid for ELECTRICAL: $36.26 $0.00
DESCRIPTION' ,{
ACCOUNT
QTY
° f 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
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: 55759 ISLEWORTH LA,CA 92253
Subdivision:
Block: Lot:
Issued:
Lot Scl Ft: 0
Building Scl 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.
Printed: Monday, August 24, 2015 3:07:47 PM 1 of 2 YSTE as
CONTACTS
°NAMETYPE
NAME _
ADDRESSl
CITY
STATE ,.
* ^ZIP
PHONE;'a
FAX:,
EMAIL
_
APPLICANT
ULRICH SAUERBREY
(760)918-2839
(760)918-
CONTRACTOR
CALIFORNIA WEST CONSTRUCTION 1
5927 PRIESTLY DRIVE
CARLSBAD
CA
92008
(760)918-2839
(760)918-
LBELLOSO@CALWESTC
5I:E lit?
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 24, 2015 3:07:47 PM 1 of 2 YSTE as
'DESCRIPTION
ACCOUNT
QTY
AMOUNT
.PAID
PAID DATE
RECEIPT #
CHECK .#, <
:'METHOD
v 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 forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
.......... w ...,
PARENT PROJECTS
- BOND INFORMATION -
ATTACHMENTS `
Printed: Monday, August 24, 2015 3:07:47 PM 2 of 2
SYSTEMS
,
e,r..#
Permit #
-_;
(,� o� �-
citY.Of id QUif1ta
Bulitiing 8[ Safety Division
P.O. Box 1504,-78-495 Calle Tampico
.
1 a .Quints, CA 92253 - (760) 777-7012
-Ruildin Pe
g rmit Application and Tracking Sheet
Project`4dIress' 55-759
Isleworth
Owner's Name:. CalWest CommLnities
A. P. Number.
Atldr�: 5927 Priestly Drive, Si ite 110
Legal Description: 17M 36537
C;ty, STzip: Carlsbad, CA 92008
Contractor. CalWest Communities
Telephone: 760-918-6768 ., •'
Address: Same as above
Project Description:
City, ST, zip:
Installation of 100 Anp,
Telephone:
state L;c n File
Arm Engr., Designer:
city L;c. # On File,
20 ,. phase, a ilea
ped to
controllers" and Landscape
•Address: Primary
Contact: Liz Belloso
lighting
City., sT> zip: Cell: 760-710-9912
Telephone:
State Lic. #:
;r
A; %�
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Ft: #Stories: #units
Name of contact Person:
Alt: Ulrich SauerbreySq:
Telephone # of Contact Person:
Estimated Value of Project: $10,000
APPLICANT: DO NOT WRITE BELOW THIS UNE
M
Submittal
Req'd
'Rec'd
TRACMG
PERMIT FEES -
Plan Sets
Plan Cheek submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs•
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plea
2'! Review, ready for correctionsrssue
Electrical
Subcontactorl.;st
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7i6 Review; ready for correctioneissue
Developer Impaet Fee
Planning Approval
Called Contact Person
AJX.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Perm@ Fees
• C p .yam P �i � . ..
�IETEi I PEDESL :PANEL
0kM P- A.QC0 �-/-24�gV71, H-..3 -
7 ,.
*' a C F LA QUINTA
`' I l�IL`DI & -SAFETY DEPT.
- � �• fig.. C'-1,3 � •
2 #1000. 1 - #1 O i
v
CU. eG., 3/4►' �^�: `F ttiT),tUCTION
G SpA : -kSY �
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MSF WORK