BELC2015-0071$7 495,CALLE TAMPICO
LA QWNTA, CALIFORNIA 92253
Application Number: BELC2015-0071
Property Address: 80451 KIAWAH WY
APN: 775220021
Application Description
Property Zoning:
Application Valuation:
Applicant:
ULRICH SAUERBREY
74948 LIVE OAK STREET
INDIAN WELLS, CA 92210
Tity/ 4 4 0".
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
SIGNATURE TM 36537 ELECTRICAL PEDESTALS
$10,000.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under prov'ions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and R ofessions Code,
and my License is in full force and effect.
Licensl ss: License No.: 927267
Date: Contractor:
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt fro the Contra pr's State
License Law for the following reason (Sec. 7031.5, Business and ons 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 Nan
Lender's Add
t•:
r•
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
I/
Owner:
RREF II CWC LAQ LLC
5927 PRIESTLY DR STE 110
CARLSBAD, CA 32008
Contractor:
CALIFORNIA WAST CONSTRUC
5927 PRIESTLY DRIVE STE 110
CARLSBAD, CA 92008
(760)918-6768
Llc. No.: 92726,7
Date: 8/24/2015
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 3!00 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 perormance 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 mannerso as to become subject t the workers'
compensation laws of California, and agree that, if I should become Object to the
workers' compensation provisions of Sectim 3 0 of the Lab d l,7with
forthwith
comply wi thos provisions. - C '
Dater ` i Applicant:
WARNING: FAILURE TO SECURE WORKERS' ==COMPENSATIONCO ERAGE IS NLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ND CIVI ES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100.000). IN ADDITI E COST OF
COMPENSATION, DAMAGES AS PROVIDED :OR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKIIOWLEDGEMENT
IMPORTANT: Application is hereby made tc the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this aF plication 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 -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 dateof issuance of such permit, or cessation of
work for 180 days will subject permit to car cellation.
I certify that I have read this application and state that the above informatio is correct.
I agree to omply with all city and county ordinances and state laws relatir o building
constructio , and hereby authorize representatives of this ity to ent p n he above
menti o�g property for inspection purposes.
Date: Signature (Applicant or Agent):
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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 3!00 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 perormance 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 mannerso as to become subject t the workers'
compensation laws of California, and agree that, if I should become Object to the
workers' compensation provisions of Sectim 3 0 of the Lab d l,7with
forthwith
comply wi thos provisions. - C '
Dater ` i Applicant:
WARNING: FAILURE TO SECURE WORKERS' ==COMPENSATIONCO ERAGE IS NLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ND CIVI ES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100.000). IN ADDITI E COST OF
COMPENSATION, DAMAGES AS PROVIDED :OR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKIIOWLEDGEMENT
IMPORTANT: Application is hereby made tc the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this aF plication 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 -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 dateof issuance of such permit, or cessation of
work for 180 days will subject permit to car cellation.
I certify that I have read this application and state that the above informatio is correct.
I agree to omply with all city and county ordinances and state laws relatir o building
constructio , and hereby authorize representatives of this ity to ent p n he above
menti o�g property for inspection purposes.
Date: Signature (Applicant or Agent):
FINANCIAL O•
DESCRIPTION ;
; ACCOUNT . } t x? '=, ,QTY
AMOUNT
F = PAID :`
PAID DATE
BSAS SB1473 FEE
101-0000-20306 0
$1.00
$0.00
PAID BY
3> METHOD ' RECEIPT#'
T
# ' g CLTD BY
."
,CHECK
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION ��
* .r ACCOUNT :.
QTY
AMOUNT
��- PAID. ,_'. �_
-PAIDDATE:
SERVICES
101-0000-42403
0
$24.17
$0.00
PAID BY
RECEIPT#,
CHECK ,# ° ,
CLTD 6Y
DESCRIPTION,
ACCOUNT
QTY
AMOUNT
PAID ; $ °
PAID DATE
�`q
s
SERVICES PC
101-0000-42403
0
$12.09
$0.00
PAID BY ' '
': METHODq'
RECEIPT #
CHECK #,
CLTD BY
Total Paid forELECTRICAL: $36.26 $0.00
DESCRIPTION
,�"'; ACCOUNT
QTY
m .AMOUNT
"PAID _ .
`PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
F� PAID.BY �e
a. METHOD
RECEIPT#
;,{HECKCLTD
BY.
Total Paid forPERMIT 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: 80451 KIAWAH WY LA QUINTA,CA 92253
Subdivision:
Block: Lot:
Issued:
Lot Scl 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
Details: INSTALLATION OF 100 AMP 120/240V 1 PHASE ELECTRICAL PEDESTAL TO INCLUDE MISC. IRRIGATION CONTROLLERS AND LANDSCAPE
LIGHTING.
........
w..r, .............
.
. t O�NDITIONS . ..
FINANCIAL INFORMATION
Printed: Monday, August 24, 2015 2:58:12 PM 1 of 2 srsTEMS
DESCRIPTION
ACCOUNT
QTY
AMOUNT
�c..
PAID
PAID DATE
RECEIPT #
CHECK # .
; METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
ELECTRICAL FINAL*"
BLD
Total Paid for BUILDING 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
• 00
•
SEQID'
.. w.
�INSPECTION,TYPE .-"
�e.
INSPECTOR
_. _
_ '. SCHEDULED COMPLETED
.
RESULT REMARKS,a: NOTES '
DATE' .DATE.
,;
::'•
0
ELECTRICAL FINAL*"
BLD
PARENT PROJECTS ,,..
BOND INFORMATION
ATTACHMENTS
Printed: Monday, August 24, 2015 2:58:12 PM 2 of 2
' SYSTEMS
#
Pemtit # .
C �
City. of La Qulnta
Bullding 8L Safety Division
P.O. Box 1504,78-495 Calle Tampico
f -! � -
La.Quinta, CA 92253 -:(760) 777-7012
Building PermitA lication and Tracking Aeet
AP g
Project Address:
80-451
Kiawah Way
Owner's Name:. CalWest Communities
A. P. Number.
Address -.5927 Priestly Drive, Suite 110
Legal Description: TTM 36537
City, ST, Zip: Carlsbad, CA 92008
Contractor-. CalWest Communities'
Address: Same as above
Telephone: 760-918-6768 IF:r --:
Project Description:
city, ST, zip:
Installation of 100 Amp,
Telephone:
r." 1
20 ,.1 phase, a ectrlea
tied to
.controllers and Landscape
state Lic. # : -On File
Arch., �•, Designer.
city Lie- #. On Fi le ,
Address: Primary
Contact: Liz Belloso
lighting
City., ST, zip: Cell: 760-710-9912
Telephone:
State Lie. #:
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: $1 0,000
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMG
FERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Tress Cates.
Called Contact Person
Plait Check B:dance
Tide 24 Calci6
Plans picked up
Construction
Flood pin plan
Plans resubmitted.' .
Mecharilcal
Grading plan
2'' Review, ready for correctionsrwue
Electrical
Subcontactorl.ist
Called Contact Person
Plumbing
Grant Deed
Plans picked up
H.O.A. Approval
Plans resubmitted
Grading
IN IIOl1SE:-
''" Review; ready for correctionslissae
Developer Im,3aet Fee
Planning Approval.
Called Contact Person
A i P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit:Eees
- METER% EDD TIALPANE
AMP, 120/240V.,1 0,3y'�
kC� � L V Y- � ✓�� i 4I�N
♦ �r rr W9 /
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v
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE BY
4
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