BSPN2015-004078-495 CALLE TAMPICO
LA.QUINT9,, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
ULRICH SAUERBREY
74948 LIVE OAK STREET
INDIAN WELLS, CA 92210
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BSPN2015-0040
80292 REDSTONE WY
775220021
SIGNATURE VILLA MODELS V92 - V9S LOT 93
$3,500.00
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under pri
9 (commencing with Section 7000) of Division 3 of the Business and
and my Li nse is in full force and effect.
License Cla /s: B > License No.: 927267
Date: r Contractor:
of Chapter
ons Code,
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt froLtheontracto 's State
License Law for the following reason (Sec. 7031.5, Business aode: 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 Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
RREF II CWC LC.Q LLC
5927 PRIESTLY"DR STE 110
CARLSBAD, CA 92008
Contractor:
CALIFORNIA WEST CONSTRU
5927 PRIESTLY DRIVE STE 11(
CARLSBAD, CA 92008
(760)918-6768
Llc. No.: 927267
Date: 8/24/2015
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
f 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 thew k for which this permit is issued.
1 have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the pertormance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity 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 o as to become subject tot workers'
compensation laws of California, and agree �rt, if I should become su ed to the
workers' compensation provisions of Secti 3700 the La 6, shall forthwith
comply with those provisions.
Date: I Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION (DCIVILFINESUP
E IS UNLA UL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES 0
ONE HUNDRED THOUSAND DOLLARS ($100,)00). INADDITIOCOSTOF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3HE LABO CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to :he 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 ower, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless tF a City of La Quinta, its officers, agents, and
employees for any act or omission related tc 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 rrect.
I agree to comply with all city and county orjinances and state laws relating to uilding
construction, and hereby authorize representatives of this city enter a above.
menti one ro erty for inspection purposes.
is
Date: ( Signature (Applicant or Agent):
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WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
f 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 thew k for which this permit is issued.
1 have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the pertormance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity 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 o as to become subject tot workers'
compensation laws of California, and agree �rt, if I should become su ed to the
workers' compensation provisions of Secti 3700 the La 6, shall forthwith
comply with those provisions.
Date: I Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION (DCIVILFINESUP
E IS UNLA UL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES 0
ONE HUNDRED THOUSAND DOLLARS ($100,)00). INADDITIOCOSTOF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3HE LABO CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to :he 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 ower, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless tF a City of La Quinta, its officers, agents, and
employees for any act or omission related tc 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 rrect.
I agree to comply with all city and county orjinances and state laws relating to uilding
construction, and hereby authorize representatives of this city enter a above.
menti one ro erty for inspection purposes.
is
Date: ( Signature (Applicant or Agent):
• f
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CIAL INFORMATION
DESCRIPTION t; ,
e'aFf
R ACCOUNTS,
QTY
AMOUNT:
` y : PAID PAID DATE
.-'SPECIAL INSPECTION PC
101-0000-42600
1
$181.29
$0.00
' -PAID'BY :.`
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Y:
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RECEIPT # -�
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, CHECK # �� � ` CLTD BYE-
Total Paid forCOMPLIANCE SURVEY/SPECIAL INSPECTION:
$181.29
$0.00
TOTALS:00
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�S�►�a��l S•o0`,t
g�n•13 Ctiy. Of La Quint'a
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Building er Safety Division
Permit # P.O. Box 1504,'78-495 Calle Tampico
La.QWnta, CA 92253 --(760) 777-7012
Building Permit Apglicadon' and Tracking Sheet
rrojecx Address:IIQ:292 Redstone Way Owntr'sNamc: CalWest Communities
A. P. Number.Addtw . 5927 Priestly Drive, Suite 110
{ Le A Dewiptioa: TTM 36537 city. ST, Zip: Carlsbad, CA 92008
Contta�or. : -.� •.•
i CaMest Communities' Tcicphotm 760-918-6768 t
Arc= Same as above-mje4DerApdow.
City, ST, GPs
Teieptwnw. °: - Installation of tern or
.r s teLic n On Pile c3ryLrG On dile generator to power the Villa
A
Arch, _ 'o uh ,Co
Addrem" Primary Contact: Mike Pike
City, ST, Cell: 764-851-9998
Telephone: %' Cons wOon Type:. ocavancy.
I - State Lie. 0: "' Project type (ekrde one): New Add'n Alter RApair Demo
'Name of con= Person: Alt: Ulrich Sa uerbrey sq: FL: StDr e O Utut;
Telephone li of Con= pet9mn: 760-610-9410 EsfumaW value of rraje l: $3,500
APPLICANT: DO 140T WME BELOW TM UNE
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Svwttal
Req -d
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TAC IG PERMIT ]FI ;S•
Ilan Sets
flan Qedt submitted Item Amount
Strvetural Cake.
Reviewed, ready for eowcrAoas Phn chta Deposit • .
TV= Cares.
Called canractPerson nail s1eek Balance,
•ride lA Cares.
Plant picked up Coostrotticu
Flood Piero plan
Plans resubmitted MethaAic�l
Givdtnb plan
r Rtview, ready for ewree6ons!usue iaeemeal
Sabeowtnttor List
Catlin C4atsetPer9oa Plumblug
&rant Dem
Nans pieked up MIL
IMA. Approval
Plansresubmitted
nIN
HOUSE;-
adl�
"° Review, ready for ew�nwficnirmueaper Iroaet Fee
PhnolngApproval.
Called Contaet Pcrsow P.
rub. yow. Appr -
Date of pe3m7jt issue
School Fees
Total rermit Fees