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04-6215 (ELEC)Tedf 4 4 a" BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO `S r FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 A. Application Number C04-00006215 Date 9/09/04 Property Address APN: 78430 HIGHWAY 111 604-050-044- -U - Application description . . . ELECTRICAL Property Zoning . . . . . . COMMUNITY COMMERCIAL SEP 09 2004 Application valuation . . . . 2000 = �Y C! TA Owner `4 Contractor FINANCE ------------------ - - - - -- - MADISON DEV ELOPMENT - BEST SIGNS, INC. , 71361 SAN GORGONIO 1550 S. GENE AUTRY TRAIL RANCHO MIRAGE CA 92270 PALM SPRINGS CA 92264 WCC: STATE FUND WC: 00115012004 03/01/05 CSLB: 524483 02/28/06 ---------------------------------------------------------------------------- CCC: C45 -C61 -D42 Permit . . . . . . ELEC-MISCELLANEOUS Additional desc Permit Fee . . . . 45.00 Plan Check Fee .00 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE ,15.00 2.00 15.0000 EA ------------------------------ ELEC SIGN 1ST CIRCUIT ------'--=-----------------==---------------- 30.00 Special Notes and Comments 2 INTERNALLY ILLUMINATED CHANNEL LETTER SIGNS Fee summary Charged ----------------- Paid Credited Due ---------- Permit Fee Total ------------------------------ 45.00 .00 .00 45.00 Plan Check Total .00 .00 .00 .00 Grand Total 45.00 .00 .00 R 45.00 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Date: Architect or Engineer: Architect or Engineer's Address: Lic. No.: 13UILDING PERMIT DECLARATIONS 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 Professionals Cede, and my Lic se is in full force and effect. Z icensa Class—Le {dal ' �`?L icense No. 3 ate —i'll—a Ll :n<o—ntractor0 e-) Z S I (�,✓� j It,/ (� OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' 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 Aof 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 worke c�o4nsati ' urance carrier and polic �nu ber are: Carrier 0 -C F �"Policy Number _ Q O 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 Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Hate 4, /V W Ly ho WARNING: FAILURE 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. 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 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. I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes: ate �` Z— n` -_Sign.ture (Applicant or Agent): fM� o Wim, Condo�-on's 1.." 1.00 MOM oil scale - 1/4 = 1 in Parking Lot Entrance THE FALLS 78-430 Hwy I 11 .................. pre NANCYCOBB Dote: AUGUST 03, 2004 Client Approwl: E'ST"'IIIWVM S. Go— Autry Trait ip,i.q., CA 92264 320-3042 50.32n.2090 Country Club Dr. -it. 106 oda Dunes .D..-, C. 92201 345-9115 wing � � Q) 2-} \\ |® �® iE |� & § .■ ! �\ } }� ( «�) � 3}20} ;z ]2 .o � |J 2 � m MH RIs §• ! ; � � Q) Client: THE FALLS 78-430 Hwy 111 Project: Account Representative, NANCYCOBB AUGUST 03, 004 2 T� m 1111 Crept Approval: SESISIGM 1550 5. Gene A," Trail Nalm Springs, CA 92264 760) 320-3042 =AX 760-320-2090 ;8078 Coantry Clab Dr. wile 106 3e_d- Danas. Co 92201 (760) 345-9115 xxww.b—ignsf Xu 1aA5, Dfvan, RRBwrfxfxn woeuxs ixDNArtooR RfrrteifxrfD ergnDRArnxsuf iWN [0 BY wD PROPFRIY DE BfSISWS, aC wOWEXf 9FAiF0. fYOLY£0 w0 OFYFLW ED FDR IISF OM wO IN :ONNECiIOXYJrtN Pit SPF:81F0 PAOIF(I XONf OP Sllq �0 FIS. DESWNS, AAAwaMFNT OR Plw1 SMAS 9F JBEO D! DR OISQM[O t0 AMY PfKON, Flw OR :ORPOVIilON fOAANYPUAPDSEWHA150EYFA WIINOUf fNE WRffRX PEPAVSSIOX D{ BCSILGXf IX( Drawing 2 v"k�"( ") (, C--�(D -r 133" CIIeM: THE FALLS 78-430 Hwy 111 Project: T Account Represenlativa: I NANCYCOBB 15" a (� :1 Data: AUGUST 03 2 004 HE Revmo ns: ® Channel Letter 1. 1/8" Plexiglass face 2. Electrode Insulating Boot & GTO Sleeving 3. 13mm - 15mm neon 4. Glass stand tube supports 5. Conduit lock nuts 6. Neon transformer (UL 2161 Listed) 7. 20 amp disconnect switch 8. .063 Aluminum backers for front lighting 9..090 Aluminum raceway (RLISTINGSUBSCRIBER # 799046-001 Client Approval: 3ES151GNS 1 550 S. Gene Autry Trail Palm Springs, CA 92264 7601 320-3042 FAX 760-320-2090 '8078 Country Clab D,...4. 106 i.".da Duns, Co 92201 1760 345-9115 www.6estsignsl nc.ce All 1.40.0., owxro RY um rxORFRIYOF emzwv; we WowERf sono. EroYrcuxxo otrc�urca eov uu ux Wo w mxxEmox wfixmE LM(IxiEO xRa.O xaxE ac wEx IIXW.BY OR 01�Y10S� RSI W� PEYSOX VIYNI�R CO MORON FONWY PURPOSE WNMI W ER MOOT INE MRRIEN PERMISSION 0E#W.11 iIx( Drawing i 133" F 24" 15" THE Ij ,.,..� ,j .. In Channel Letter LS 1. 1/8" Plexiglass face 2. Electrode Insulating Boot & GTO Sleeving 3. 13mm - 15mm neon 4. Glass stand tube supports 5. Conduit lock nuts 6. Neon transformer (UL 2161 Listed) 7. 20 amp disconnect switch 8. .063 Aluminum backers for front lighting 9..090 Aluminum raceway SLISTING SUBSCRIBER # 799046-001 Creat: THE FALLS 78-430 Hwy 111 Pmiect: Account Represent.ti— NANCYCOBB Date: AUGUST 03, 2004 Rev sio ns. Cllent Approval: 4 W" 1550 S. Gene AWryTrail '.Im Springs, CA 92264 760) 320-3042 =A% 760-320-2090 ;8078 Country Clvb Dr. 21, 106 3ermuda Dunes, Co 92201 (76 0) 345-9115 www.6estsignsinc.co OWXFO Bt lYp PRpP[R(YOi &SiLGM5, IN(pNOWfAF uurEo, EvaLXEo Oxo o f XE(oPox PaR uu ax Xxo ix LOXMf(110N WIiN iNF SPF(IEIE� RRpIEC[ XOXf OF 511(H OFAS.OFSIGNS.ARAXXGFl1fNfS0R PWISSXALL BE JSFO NYOR �ISQOSF�t04XY PfRSOX, EIRMUR :O0.PoRAilOx FOR4NY IM, %N; X WRNpI THE WRRiEN PERMISSION OE NfTLf; INC :)mwlfl9 6