BELC2015-00761�
78-495 CAVE 14Iv PIC0
° LA QUINTA, CALI`t'ORNIA 92253
Titv4lwQ91hr�,
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
/ VOICE.(760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: .8/24/2015
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 Lice se is in full force and effect.
License Clas : B License No.: 927267
Date: ) �� Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from tQeContractor's tate
License Law for the following reason (Sec. 7031.5, Business and sions die: 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).:
(_) 1, 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
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury oneof 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.
7.1 have and will maintain workers'compensation insurance, as required by
Section 3700 of the Labor Code, for the perf-irmance 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 ;o as to become subject to the workers'
compensation laws of California, and agree :hat, if I should becomes ject to the
workers' compensation provisions of Section/8700 of the Cod , I shall forthwith
comply with Tose provisions.
Date: ( Applicant: G_...
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION TOVERAGE IS U LAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES kND CIVIL ES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100000). IN ADDITION HE COST OF
COMPENSATION, DAMAGES AS PROVIDED iOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKMOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on :his 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 t) the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this apolication 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 information is orrect.
I agree to comply with all city and county ordinances and state laws relating to uilding
construction, and hereby authorize representatives of this , ity to en upon t e above
mentioned property for inspection purposes.
Date: Signature (Appliont or Agent): t/
Application Number: '
BELC2015-0076
Owner:
Property Address:
80498 SIGNATURE WY
RREF II CWC LAQ LLC
APN:
-775220021
5927 PRIESTLY DR STE 110
Application Description:
SIGNATURE TM 36537 ELECTRICAL PEDESTALS
CARLSBAD, CA 92008
�—,UJ
Property. Zoning:
a
Application Valuation:
$10,000.00
o
z o
o c�
z
LU
Applicant:
Contractor:
®
S o
ULRICH SAUERBREY
CALIFORNIA WEST CONSTIRICL
C) o
74948 LIVE OAK STREET
5927 PRIESTLY DRIVE STE 11
w
INDIAN WELLS, CA 92210
CARLSBAD, CA 92008
cn
t
G
C)
(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 Lice se is in full force and effect.
License Clas : B License No.: 927267
Date: ) �� Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from tQeContractor's tate
License Law for the following reason (Sec. 7031.5, Business and sions die: 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).:
(_) 1, 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
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury oneof 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.
7.1 have and will maintain workers'compensation insurance, as required by
Section 3700 of the Labor Code, for the perf-irmance 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 ;o as to become subject to the workers'
compensation laws of California, and agree :hat, if I should becomes ject to the
workers' compensation provisions of Section/8700 of the Cod , I shall forthwith
comply with Tose provisions.
Date: ( Applicant: G_...
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION TOVERAGE IS U LAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES kND CIVIL ES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100000). IN ADDITION HE COST OF
COMPENSATION, DAMAGES AS PROVIDED iOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKMOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on :his application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related t) the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this apolication becomes null and void if work is
not commenced within 180 days from dateof issuance of such permit, or cessation of
work for 180 days will subject permit to car cellation.
I certify that I have read this application and state that the above information is orrect.
I agree to comply with all city and county ordinances and state laws relating to uilding
construction, and hereby authorize representatives of this , ity to en upon t e above
mentioned property for inspection purposes.
Date: Signature (Appliont or Agent): t/
FINANCIAL INFORMATION
K.: DIESCRIPTION , ,axACCOUNT
QTY
> AMOUNT PAID :$° PAID DATE
BSAS SB1473 FEE 101-0000-20306
0
$1.00 $0.00
_..
;';PAID BY METHOD
I
RECEIPT# CHECK# CLTDBY .
Total Paid forBUILDING 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 Y..
'METHOD
RECEIPT#7 CHECK.# ',
"�CLTD BY .'
DESCRIPTION
ACCOUNT 4 ;.
QTY
AMOUNT .',. „ "PAID :`;
PAID DATE
SERVICES PC
101-0000-42403
0
$12.09 $0.00
PAID BY
METHOD
RECEIPT # CHECK # T'>
CLTD:BY:.
Total Paid for ELECTRICAL: $36.26 $0.00
DESCRIPTION .:
ACCOUNT :
QTY
7AMO.UNT
"PAID,
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
:Y :RECEIPT # ., .
CHECK # :'`
CLTD'BY ;
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS: $129.11 $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: 80498 SIGNATURE 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.
6749
m
77,
CONDITIONS
FINANCIAL INFORMATION
Printed: Monday, August 24, 2015 3:17:44 PM 1 of 2 CR&VIYSTEMS
CONTACTS
NAME TYPE
y
``.NAME ADDRESSI,
CITY STATE ZIP
PONE fAX ;
H
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
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 3:17:44 PM 1 of 2 CR&VIYSTEMS
PARENT PROJECTS
BOND INFORMATION
Printed: Monday, August 24, 2015 3:17:44 PM 2 of 2 SYSTEMS
ACCOUNT
QTY
AMOUNT
PAID
_
PAID DATE
RECEIPT.#
CHECK #
METHOD
7 1.,—F
PAID BY
CLTD
LTD
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
• ••
PARENT PROJECTS
BOND INFORMATION
Printed: Monday, August 24, 2015 3:17:44 PM 2 of 2 SYSTEMS
Bin. #
............. ... ... ...................
City Of La Qurnta
Building eC Safety Division
Permit # lf..
P.O. Box 1504,"78495 Calle Tampico
L4.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
ProjwAddr=: 0-498
Si nature 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
Telephone: 760-918-6768
Address: Same as above
Project Description:
City, ST, zip:
Installation of 100 Amp,
Telephone:
^'
20 ,. I phase, a ectrlca
state Lic. # : n File
City Lie. #; On File,
ped to
Army Engr., Designer.
.controllers and Landscape
Address: Primary
Contact: Liz Belloso
lighting
city., ST, zip: Cell: 760-710-9912
Telephone:
Construction Type:. 4ccupw IV:
State Lie. #:a
.�'., Project type (circle one): New Add'n Alter Repair Demo
NameofContactPerson:
Alt: Ulrich SauerbreySq. 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
Reed
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
. Called Contact Person
Plan Check Balance
Title 24 Calci.
Plans picked up
Construction
Flood Phan plan
Plans resubmitted..
Mechanical
Giading plan
21! Review, ready for correctionemue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
1r° Review; ready for correctlondlissue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
............. ... ... ...................
` f'I,,.` }�I11 •.�; CITY OF LA QUIN
BUILDING &SAF TA
APPROVED
FOR CONSTRUCT ON
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METER AND CONTROLLER LOCATION
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