BELC2015-0072LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Prof ssions Code,
and my License is in full force and effect.
License Cla : B , .License No.: 927267
S Cl-
Date:f
- Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt fromhe Contra 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 Name:
Lender's
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 t the workers'
compensation laws of California, and agree that, if I should become Wbject to the
workers' compensation provisions of Sectio 3700 of the L . Co , I shall forthwith
comply hose provisions.
1.
Dke:— _Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATILNCOVERAGE UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALV FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADHE 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.
1 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 ate laws rel 'to bu ing
construction, d hereby authorize representatives of thi city to a er upon the ove•
menti
opr perty for inspection purposes. _
Date: Signature (Applicant or Agent):
QUM&
VOICE (760) 777-7125
78-r+95 CA;� E, MP CO
t
D
"'
LA QUINTA, CALIFOfNIA 92253
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS
(760) 777-7153
BUILDING PERMIT
Date: 8/24/2015
Application Number:'
BELC2015-0072
Owner:
Property Address:
80226 REDSTONE WY
RREF II CWC LAQ LLC
APN:
775220021.
5927 PRIESTLY DR STE 110
Application Description:
SIGNATURE TM 36537 ELECTRICAL
PEDESTALS
CARLSBAD, CA 92008
s
Property Zoning:
UI) a01-1
Application Valuation:
$10,000.00N
z o
C=3z
L„
Applicant:
Contractor:
o 0 0
ULRICH SAUERBREY
CALIFORNIA WEST CONSTRUCT�_ o
74948 LIVE OAK STREET
5927 PRIESTLY DRIVE STE 110 v� c3
INDIAN WELLS, CA 92210,
CARLSBAD, CA 92008
g
(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 7000) of Division 3 of the Business and Prof ssions Code,
and my License is in full force and effect.
License Cla : B , .License No.: 927267
S Cl-
Date:f
- Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt fromhe Contra 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 Name:
Lender's
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 t the workers'
compensation laws of California, and agree that, if I should become Wbject to the
workers' compensation provisions of Sectio 3700 of the L . Co , I shall forthwith
comply hose provisions.
1.
Dke:— _Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATILNCOVERAGE UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALV FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADHE 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.
1 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 ate laws rel 'to bu ing
construction, d hereby authorize representatives of thi city to a er upon the ove•
menti
opr perty for inspection purposes. _
Date: Signature (Applicant or Agent):
FINANCIAL INFORMATION
'aESCRIPTION
,t ;ACCO.UNT-
QTY ' AMOUNT
, ;:PAID,
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
'PAID BY
' ,
METHOD
RECEIPT # r>
:`$ `CHECK # '
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA
$1.00
$0.00
4 DESCRIPTION
`* , x,y z
+ ACCOUNT ''r
:
QTY
s "AMOUNT;
PAID . _.
:PAID DATE
.,
SERVICES
101-0000-42403
0
$24.17
$0.00
'PAID:B
a
,
CLTDBY.a'
t � DESCRIPTION
ACCOUNT
CITY
AMOUNT;
< PAID,'
PAID DATE'
SERVICES PC
101-0000-42403
0
$12.09
$0.00
�. PAID,BY
METHOD'
n."
RECEIPT #. _ `�
':CHECK #:
'CLTDBY
Total Paid for ELECTRICAL:
$36.26
$0.00
DESCRIPTION ;;"
ACCOUNT
QTY r
:AMOUNT
;: PAID`*
PAID DATE'
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
. s= PAID,BYz m,
a ' `
METHOD
RECEIPT #
;CHECK # `
CLTD BY
Total Paid forPERMIT ISSUANCE:
$91.85
$0.00
TOTALS:
$129.11
$0.00
Description: SIGNATURE TM 36537 ELECTRICAL PEDESTALS
NAME q- -• •.
Type: ELECTRICAL
Subtype: Status: APPROVED
Applied: 8/24/2015 MFA
Approved: 8/24/2015 MFA
Parcel No: 775220021 Site Address: 80226 REDSTONE 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
Details: INSTALLATION OF 100 AMP 120/240V 1 PHASE ELECTRICAL PEDESTAL TO INCLUDE MISC. IRRIGATION
CONTROLLERS AND LANDSCAPE
LIGHTING.
INDIAN WELLS
CA
-�� . -- .,. - -.r i` V •.4.'.. Y -,,T, !?Rl�-.-. .A F.. 1.!�l'..•-ry ..x.11 V�.:'�: ': ��. �. .. ................. -.._ . ... ��� ... ...
CONDITIONS
71UTC
NAME TYPE
NAME q- -• •.
ADDRESSI
CITY.
STATE
ZIP,
PHONE
FAX EMAIL
„ _.
„ ..r
,
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 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•
•
•
Printed: Monday, August 24, 2015 3:00:18 PM
1 of 2
OF&VIYSTEMS
L0
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 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
INSPECTIONS
`SEQ[Dv INSPECTION TYPE S � � INSPECTOR [SCHEDULEDCOMPLETED, •RESULT � REMARKS' �� � � �; NOTES
Y
.a.e _._
.3 z.. DATE � DATES � . ,�
0 ELECTRICAL FINAL'"* BLD
PARENT PROJECTS
Printed: Monday, August 24, 2015 3:00:18 PM 2 of 2
SYSTEMS
#
City Of La Qurnta
Buttdtng 8r Safety Ai won
- P.O. Box 1504,78-495 Calle T'amptco
La.Quinta, CA 92253 -:(760) 777-7012
Building pP Permit A lication and TrackingSheet
Permit #
�,-
Project Address: 80-226 Redstone Way
Ownes'sName:. 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
Address: Same as above
Project Description:
City, 4T, zip:
Installation of 100 Amp,
Telephone: f3 "
20 0 V,. I phase, aledtFical.
state Lic. # : -On File City Lic. M. On File ,
Arch, Engr-, Desig►e'
ped to
controllers and Landscape
Address: pjirrlary COntact: Liz Belloso
lighting
City., ST, Zip: Cell: 760-710-9912
Telephone:
State Lic. #:
Name of Contact Person: Alt: Ulrich Sauerbrey
Construction Type:. Occupancy:
Project type (ctrele 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
H
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Phan Check Deposit. .
Truss Calcs.
Called Contact Person
Pian Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
Z'! Review, ready for correctionsfissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SMI.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7r° Review; ready for correctlonslissue
Developer Impact Fee
Planning Approval.
Called Contact Person
Pub. Wks. Appr "
Date of permit issue
School Fees
Total Permit Fees
--
M?
TS
4
METFR/PFQFS:[AJ�PlANFL
100 AMP, 1.20 /2.40V, IPH. 3W
CITY OF LA
QUINTA
BUILDING & SAFEW DEPT.
APPROVED
FCYR-COIV
,ST.
Ruc ON
DATE �Z—
L_4! �-ZL15F BY pol
.........................
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