0108-0089 (ELEC)46600 Adams Street
LICENSED CONTRACTOR 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
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
27 14 27 C45 munig
VDate r "✓ Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
() I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one,Of the.follbwing 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 & policy no. ars:
Carrier Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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 to the
workers' compensation laws of California, and agree that if I should become
subject to the workers' compensation provisions of Sectiorny3700 of the Labor
Code, I shall forthwith comply •with:.t ose provisions.:,,
Vl5ate: ` ' o `, Applicants
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on ;his
application.
1. Each person upon whose behalf this application is inade & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
t e.1above- mentioned.prope„ rty for inspection! purposes. fJ
"Signature (Owner/Agerzt) 0//- X t- ! 'o-A ` Date v 7/V
BUILDING PERMIT PERMIT#
DATE VALUATION LOT .Q-Z TRACTy
.. C -A 1 A W
JOB SITE
APN
ADDRESS 46-6W ADAMS STRM
OWNEiRR
CONTRACTOR / DESIGNER ENGINEER
tOVWr ENJCRRIQINC
496^600 ADAM brf
3 540 COMMERCE 9C O°
r A,Q1JXrAa Q4 92253
CORONA CA 928W
{9099714-6275 CUR 4323
USE OF PERMIT
1143x.A.LI, ONE WAU.•71+ OU14!'t O CHANNEL, LETTEP, SION (11J,f fMMA
VALi1.ATI011 .Z50DIN Ls
I aTMAIR, CIO.F OF CONS RUCTEO0.t4
1191 aE FEE SUWtlAi Y
RLLWTIUC AL ME 101_00(')_4Z0_000 $34100
p x x PRE -PAID FM,
a
I RRMITkIll M14 DUE.How
ow
, I
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IIIIIII III I III VIII IIT 34
IE
RECEIPT
DATE
By
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION j
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel -
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wali Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Piaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
'Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
FFinal
Utility Notice (Perm)
COMMENTS:
•
SOUTH ELEVATION
SCALE 1 /32"
SITE PLAN
SCALE 1/32" = 1'0"
CITY OF LA QUINTA
BUILDING& SAFETY DEFT.
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CITY
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FOR CONSTRUCTI&NID I
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DATE
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to Cy
AUTHORIZEDAPPROVAL Q0 <
1(have reviewed a . nd approved the�sign deWed herein Ln
to be fabricated per th6 specificatibris shaWn on this dra�viirig
xLAQUINTA3
GkCK ONE:--- PG 3 OFJ3
CLIENT DARCHITECT, QLANDLORD1 )l 71
7131/01
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CITY OF LA QUINTA
BUILDING& SAFETY DEFT.
VLW V)
CITY
FBUILDIN(
a p
A P p Ft OV '� i <
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FOR CONSTRUCTI&NID I
LLJ i.-
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DATE
< c:) :5
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to Cy
AUTHORIZEDAPPROVAL Q0 <
1(have reviewed a . nd approved the�sign deWed herein Ln
to be fabricated per th6 specificatibris shaWn on this dra�viirig
xLAQUINTA3
GkCK ONE:--- PG 3 OFJ3
CLIENT DARCHITECT, QLANDLORD1 )l 71
7131/01
SOUTH ELEVATION
SCALE J/32" =- 1'0"
181-0 1/811
STORAGE U
PI -90\111
v V,/
50 $F. CHANNEL LETTER SIGN
2- 6-5*/811 , x 1:8'0-1/8" = 49.:.68 sf
PARTIAL souTHaEVATION
SCALE 14! = 1' 0"
1.
2.
3.
4.
5.
6.
7.
8.
9.
jo
11
12
181-0'1/811 Lu
L7
71
CHANNEL LETTER SECTION DETAILS 8 <
0
21-85/411
t F�-
1. EXISTING FASCIA ;..STORAGE
2. NEON TUBE'
3. TUBE SUPPORT CITY OF LA QUINTA
4. GTO WIRE IN GTO SLEEVING BUILDING & SAFETY DEPT V) <
i METAL!' WREWAY, TO. MATCH BUILDING SIGN DETAIL L)
'; : i APPROV
6. 1/8" PLEN FACE, RED 2283 AND BLUE 2114 ED <
SCALE 1/4" 1'0" 015
7.3/4" TRIM CAP, WHITE 0041, FOR CONSTRUCTION
4. UL.LISTED ELECTRODE BOOT LLJ <
9. FLEX CONDUIT r edba
OV Commission DATE S-?-% 13Y z
nin
10. METAL.CHANNELLETTER, PAINTED 485 RED AND 281 BL planning 0
JtV Co Cie
11. TRANSFORMER WITH DISCONNECT ity Council
13 *,ty Dev. Dept. 7
12. INCOMING PRIMARY- EXISTING .13 Commum
<
initials�SAUTHORIZED APPROVAL
Case No. �
------- ffiatne reviewed and approved the sign detailed herein
1�
6hibit A3
tp be fabricated per the specifications shown on this drawing ,
13 With Conditions x
ckwoNrz: i PG 1 OF 3
1:3CLIENT DARCHITECT 0LANDLORD jI 7/31/01
41,