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12-1226 (SIGN)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12 00001226 Property Address: 78370 HIGHWAY "111 STE 110 APN: 604-050-068- - - Application description: SIGN Property Zoning: COMMUNITY COMMERCIAL Application valuation: 2500 Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Cl ss: D42 C45 License No.: 830131 J � Date /Z Zi Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions 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).: 1—) 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.). (_ 1 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: I/ LQPERMIT Owner: POINT HAPPY REALTY, LLC 260 S. BEVERLY DR. #201 BEVERLY HILLS, CA 90212 VOICE (760) 2 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/12/12 Contractor: SIGNARAMA Fq 41945 BOARDWALK, "L"PALM DESERT, CA 92211 (760)776-9907 CT 122012 ` 2 tLjo�� Lic. No.: 830131 F9J -------------------=------------------—t--- 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. 1 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 GRANITE STATE Policy Number WC065256570 I certify that, in the performance of the work for which this permit is issued, 1 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 Section 700 of the Labor Code, I shall to with comply with those provisions. e: A licant: at/2 IZ WARNING: FAILU E TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety 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 tate laws relating to building construction, and hereby authorize representatives of this c y to nter upon t above-mentioned proper[ for inspection purposes. D ���� `:.Sig ure (Applicant or Agent): Application Number . . . . . 12-00001226 Permit . . . ELEC-ELECTRICAL SIGN Additional desc Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date 4/10/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT 15.00 ----------------------------------------------------------------------------- Special Notes and Comments (1) INTERNALLY ILLUMINATED CHANNEL LETTER SIGN PER SA@ 2012-1652. "TAILS IN THE CITY". 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 30.00 .00 .00 30.00 Plan Check Total .00 .00 .00 .00 -Other Fee Total 1.00 .00 .00 1.00 Grand Total 31.00 .00 .00 31.00 i j ' Bin. # of La Quinta Butiding &r Safety Division Perinit # I P.O. Box 1504, •76-495 Calle Tampico La-Quinta, CA 92253 - (760) 777-7012 Building Permit-Application and Tracking Sheet Project Address: �� b t Owner's Name:. T �i A. P. Number. L Com-, 1 7- jr —7 Address: 7S---3-70 Legal Description: City, ST, Zip: Z i Contractor. /-Av,-stn Telephon :760 —744 _ 4 ;(s Address: y �- �%�% S' o �� i,,, L j(_ Project Description: 41 Aj-C- L City, ST, Zip: L 0 1 i TeIephon :%60 776- R1 u "j ; a i a i<W:, State Lic. # : 9-30 l ✓' City Lic. #; 9 7 p p ryq/ Arch., Engr., Designer Address: City., ST, Zip: Telephone: Construction Type: . Occupancy: State Lic- #: :~Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. FL: # Stories: # Units: ! Telephone # of Contact Person: Estimated Value of Project APPLICANT: DO NOT WRITE-BELOW THIS UNE p Submittal Req'd Recd TRACMG PERMIT FEES P14U Sets Plan Check submitted Item Amount . Structural Ca[es Reviewed, ready for corrections Plan Check Deposit. . Truss CAM Called Contact Person Plan Check Balance Title 24 Calci. Plans picked up Canstracttan '----- — Flood plain pian_ _Plans-resubmitted — -Mechanical -- - - - Grading plan 2'` Review, ready for correcfionstissue Electrical — Subeoatector List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN ii011SE:- '^' Review; ready for correctionsfissac Dcveloper Impact Fee Planning Approval. Called Contact Person A.LP.P. Pub. Wits. Appr ' Date of permit issue School Fees ' Total Permit Fees 15.5"r•:•TAILS IN THE CITY Illuminated Acrylic Faced Channel Letters Depth: 5" Face Color: Day/Night Acrylic Return Color: Black Trim Color: Black Mounting: Back Standoff: Flush L.E.D. Color: White APPROVED By PLANNING DEPART ENT BY DATE .z EXHIBIT CASE NO, �� A- I Z n 0 Sign Description: Frontage: 40 Linear Feet Customer: Telephone: 760-xxx-xxxx Jobsite: Customer Approval: Illuminated Acrylic Faced Channel Letters, Depth: 5" Tails In The Cit Y Fax: 760-xxx-xxxx Same Face Color: Day/Night Acrylic, Return Color: Black,Trim Color: Black Mounting: Back Address: Landlord Approval: Standoff: Flush 78370 Hwy 111, Suite #110 L. E.D.Color:White Total Signage 18.65.F. La Quinta,CA. 92253 South ELEVATION SIGN*A*IMMA Contractor's I-ic # 830131 C45,C61/D42 DWg. No.: 55817 Rev.: 1 YOUR SIGNATURE ACKNOWLEDGES FULL APPROVAL OF DESIGN CONTENT AND LAYOUT, RELEASING SIGN*A*RAMA FROM RESPONSIBILITY IN REGARD Workers COmp. #1938807 Date: 10-03-12 TO INCORRECT DESIGN AND INFORMATION. THE COLORS SHOWNARE ONLY REPRESENTATIVE OFACTUAL PMS COLOR CALL OUTS. FINAL COLOR WILL 41-945 Boardwalk, Ste. L JT- Palm Desert CA. 92211 BE MATCHED AS CLOSE AS POSSIBLE, COMMENSURATE WITH MATERIALS USED. THIS DESIGN IS PROPRIETARY PROPERTYAND MAY NOT BE USED WITHOUT City LIC. #97005491 Designer: PH 760-776-9907 • FX 760-776-9844 THE EXPRESSED WRITTEN CONSENT OF SIGN A*RAMA.