0108-153 (ELEC)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
,r tai :t 36 C41 T).3-9 (: 10
Date �; , 44A
f 8i t Signature of Contractor 'r i"i ' 'r )4tf j
-- 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 owneCof the property, or my employees witti'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 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 ofthe 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. are:
Cartier Policy No.
-STATE AM J4249"-Wi
(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
Code, I shall forthwith comply with those provisions.
Date: Applicant $NJI 4 -+ti, K- !i e�a Taw
I
"" W ri5iW.-Failure' secure"Workers'"Ci9mpensatien-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 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 purposes
Io
Signature (Owner/Agent) Date
.._.�nr....v'..,..... .. ti.. •'-ms's
BUILDING PERMIT PERMIT#
DAV %F VALUATION LOT MS -153 TRACT
JOB SITE APN
ADDRESS
793=HWAY I 11 CULD 4) _ ..
OWNER I CONTRACTOR / DESIGNER / EN (NEER
VALE 1.:\.
I '-w'- 'a' y 'i 21 (BLit 3)
C, 4., Q'L MT.A. CA 92253
USE OF PERMIT
.MP'.V/. YI:LCAL
a:aM: CHANNEL LF_T T?,R:S1t7N PF& SA, 2W1,531
RECEIPT
VALUAVON
461 it) C"'ALHOtal
- qM0 CA 92201
(760)347.35" 1-MML9 223
%,200.00 L:I
F9TM_ AT M. CO TT OF MNSTRU CTIMN
UG 14 20p
FA
�.�,aTop,xor myl kiMT-I{aii;tif.aw, o1.m}'I.kaP3%
DATE / l I BY
DATE FINALED
INSPECTOR
r
$30.00
$0,00
OD
INSPECTION RECORD
OPERATION
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 Wali Insulation
Condensate Lines
Party Wali Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
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
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
w
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)
T
]IMPERIAL
]IM illr�j�
SIGN CO INC
•�
C COON STREET
CA 92201
(760) 347-3566
FAX (760) 347-0343
CONTRACTOR5 LIC.#
207136, G45,C1o, c61
,
BU51NE55 NAME: Enchante
DATE: 1- -2001 DESCRIPTION OF WORK:
na�,wN Bi=
ALBERTTORREB
PHONE NUMBER
CU5TOMER APPROVAL ANDLORD APPROVAL
FAX NUMBER
[created is an original unpublished drawing,
by IMPERIAL SIGN. n Is submitted
our personal use inconnnstionwith;746-120
ct being planned for you by IMPERIALINDIO,
. n Is not to be shown to anyone out -
your organization, nor Is It to be repro -
d, copied or a:hlbked In any fashion.
CU5TOMER NAME: Larry Lethcoe
WORKMANSCOMP#
1424837-99
MAIL ADDRE55: 72-345 Highway 111
CITY LICENSE #
815
JOB LOCATION: Palm Desert, CA. 92260
8'-101/2"
18.33 5Q. FT.
18"
24"
_ _ ?F
51'ECIFICATION5:
24" and 18" Illuminated Channel Letters
Plex Face: Custom Black/White
Returns: Black
Trim -cap: Gold
Transformers to be remotely mounted behind facia required.
Power to be by others )
Lettering to be mounted flush to wall, center on facia bands.
271/4" 24" 28"
13.55Q. FT
381 /4"
day spa asalon I 12"
51'ECIFICATION5:
.an avnU..,n Muti r.{a•
12" Illuminated Channel Letters
Plex Face: Custom Slack/White
Returns:
u:�z)a» c{c
Trim -cap: Gold EMIaFu
4 ----------
T
---
APPROVED BY COMMUNITY DEVEL �� T�DEP
ca'�EIMIi a N..
BYL-
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EXHIBIT
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CASE N0.
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Ci of La Quinta
Developers Project Approval Form
CONSTRUCTION PLAN/S APPROVAL
Prior to the issuance of Building Permit for the project listed below, please review the Building
plans, return this form and plan/s to 'the Building and Safety Department with your comments.
Contact applicant for resolution of conditions preventing or delaying approval.
Project: TI - Enchante - Sign permit
78-555 Highway 111 - La Quints Court -
Applicant Contact: Mark 347 3566
Circulation Date:
Community Development Department
Christine di Iorio, Planning Manager
07/17/2001
Date
Case number SA 2001-551
Approved by MR on 6/4/01
Since this approval they have changed the format of the lettering of the signage, please
review asap.
PMENT DEPT
PROVED BY COMMUNITY DEVE� O
AP,� DATE rf
BY
EXHIBIT
CASE NO.� . .
Nickie Gormley
Counter Tech. Building & Safety