0111-054 (SIGN)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
2M t 36 e45 W8 C1 0 0443WX
�I . > 'tl
Date r Signature of Contractor -•� ��� %"�``�.�, r !
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason: 1.
( ) I, as owner,of. the property, or my employees witfi wages as their sole
compensation, will do the work, ane' 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 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.
( ,) I have and will maintain workers' compensation insurance, as required by
Scion 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. 'are:
Carrier 'w'PA3X F1; r, Policy No. 14 48,1'i 3t
(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 Section 3700 of the Labor �rr
Code, I shall forthwith comply with those provisions. �.
Date: t ..: Applicant—
Warning:
pplicant ,Warning: Failure to secure Workers' Compensation coverage is unlawful and I
sHAII 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 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 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
the above-mentioned property for inspection�yyppurposes,
,9' ori11
Si nature (Owner1A ent) ;✓ .�rr,� � e • ^� Date r1/ o, .
PERMIT# .D .
WING PERMIT
BUILD7
011.1,4)5 CLEA�7
DATE iim-r�VALUATION !; �r� LOT t i' TRACT
ADDRESS 8— RLi:4.�.F:r: WAN t 4 1 SUrr � C, JOB
APN
OWNER
CONTRACTOR / DESIGNER / EN (NEER
Jup uc
ie". • tIAT SIGN a..ti?.
1$d7d 2 T.K:tAVEi IXEME
4617-0 CA) A -1f." IT
t��' zSC JK WA 9- 80ei7
I -WHO - CA 92701
(760)34-7•3.566 (:S. t 723
USE OF PERMIT
''V.if 1,U.AT10714- 1A
(NOWf (MCO:li'SINUCHC):Ci'd
g194711AIATM)
p. N5,14'i.Cgi$S .$ .L wC� 6911.fY.6.[?'.AtiaF'K�
COP(STRU !`tC' N TIE,> ' 101-000,:418-000
.
1a L+.r,`J' 1C A,L FEE i 101:000-420- i �at7.tt�s
i NOV 07 2001
1
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Tfs`IA7.,�4'Ki r 1111=5 DIX, HOW
11.00
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
A�-,
INSPECTION RECORD
OPERATION
DATE .
I INSPECTOR
OPERATION
I 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 Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final I1
BLOCKWALL APPROVALS
POOLS -SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. 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 Plaster
Sewer Lateral
Pool Cover
Seger 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
Final
Utility Notice (Perm)
COMMENTS:
M�
T -d T- 4
P.O. Box 1504
78-495 CALLE TAMPICO (760) 777-7000
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101
November 5, 2001
Mark Ross
Imperial Sign Company
46-120 Calhoun Street
Indio, CA 92201
SUBJECT: SIGN PERMIT 2001-583
Dear Mr. Ross:
The Community Development Department has approved your proposed signs located at
the southeast corner of Highway 111 and Washington Street in the La Quinta Court
development (P.D. Cleaners II). The signs were found to be in compliance with the sign
program for that development.
Please contact me at (760) 777-7068 if you have any questions.
Sincerely,
JERRY HERMAN
COMMUNITY DEVELOPMENT DIRECTOR
MICHELE RAMBO
Associate Planner
cc: Code Compliance
OF A GLAN 1A
B"JI._DIN � & SAFETY DE 'T.
:;:�f ED
FOR CONSiHUCl 11�ION
IMPERIAL
SIGN CO , INC
•
46-120 CALHOUN STREET
I N DIO, CA 92201
(760) 347-3500
FAX (700) 347-0343
CONTRACTORS LIC,#
207136, c45,c1o, c61
BU51NE55 NAME: f aim Desert Cleaners
DATE: 6-27-2001
75GRIFTION OF WORK:
Highway 111
Elevation
This �8 an original unpublished drawing,
crated by IMPERIAL In
nis ion with a
for your personal use in connection with a
project being planned for you by IMPERIAL
SIGN. It is not to be shown to anyone out -
side your organization, nor Is it to be repro -
duced, copied or exhibited In any fashion.
CUSTOMER NAME:
DRAWN BY
WORKMANS COMP #
1424837-99
MAIL A D D K E 5 5 : 75-583 High way 111
PHONE NUMBER
CITY LICENSE #
1 1345 98-01484
JOB LOCATION: La Quinta Court
FAX NUMBER
CU5TOYER AFTKOVAL
LANDLORD APPROVAL
M
L.
P.D. CLEANERS3118"
26C4Tlft0F LA QUINTA
i
5f ECIFICATION5: BUILDING & SAFETY DEPT
18 " Illuminated Channel Letters APPROVED j
Flex Face: Custom Dark Red FOR CONSTRUCTION �(
Returns: Black
Trim -cap: Black DATE BY
Transformers to be remotely mounted behind facia re ufred.
flower to be by others
Lettering to be mounted flush to wall, center on facia bands.
Z
a
APPROVED BY COMMUNITY DEVEt OPMENT DEPT +
l�.l �.
BY DATE ,
EXHIBIT �3
CASE
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SIGN CO INC
•
46-120 CALHOUN STREET
,. INDIO, CA 92201
(760) 347-3566
FAX (760) 34-7-0343
CONTRACTORS LICA
207136, C45,C10, C61
B U 5 I N E S 5 NAME: ('a I m De 5 e rt C I e a n e r 5
DATE; 627 2Q01
PE5GKJF710N OF WORK
East Facing
Parking Lot El ve.
This is an original unpuMislf W drawing,
created by IMPERIAL SIGN. It Is submitted
for your personal use in connection with a
project being planned for you by IMPERIAL
SIGN. h is not to be shown to anyone out
sj Yourorgenixatlon,norlstttoberapro-
duced, copied or ezhibiled In any fashion.
CUSTOMER NAME:
. DRAWK BY
WORKMAN5 COMP #
1424837-99
MAIL APPKE55 : 73-583 Highway 111
PHONE NUMBER
CfTYLtCENSE #
134598-01484
AL
LANDLORD APPROVAL
JOB LOCATION: La Quinta Court
FAX NUMBER
14' CITY OF Lia CL.i"f`"
BUILDING
Pm■CLEANERS 11
12"
5FECIFICATION5: Ft.
12 " Illuminated Channel Letters
Flex Face: Custom Dark Red
Returns: Black
Trim -cap: Black
Transformers to be remotely mounted behind facla required.
Power to be by others
Lettering to be mounted flush to wall, center on facia bands.
m
APPROVED BY COMMUNITY DEVELOPMENT DEPT
BY M DATE
L-44PL—
EXHIBIT
CASE N0.
NFVN�Ory SEC��,
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