08-1122 (SIGN)P.O.' BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
08-00001122
Property Address:
78555 HIGHWAY 111 STE 200
APN:
643-020-003- - -
Application description:
SIGN
Property Zoning:
COMMUNITY COMMERCIAL
Application valuation:
5000
Applicant:
Architect or Engineer:
D\`/�
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury tha licensed under provisions of Chapter 9 (commencing with
Sectio 7000) of Divi on 3 of th?rvthat
nd Professionals Code, and my License is in full force and effect.
Licen C ss: C4 D38 Cl LicenseNo.: 207136
'D7 O 4Contracto
NER-BUILDER DECLARATION
I hereby affirm under penalty of pam 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 _ 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 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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.). .
( 1 I am exempt under Sec.. , B.&P.C. for this reason
Date:
Owner:
CONSTRkJCTION 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:
LQPERMIT
Owner:
JDD LLC
1500 18TH AVE
ISSAQUAH,. WA
ISSAQUAH, WA
N. E.
98027
Contractor:
IMPERIAL SIGN CO, INC.
46120 CALHOUN STREET
INDIO, CA 92201
(760)347-3566
Lic. No.: 207136
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
G
Date: 7/01/08
-----------------------------------------------
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.
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 STATE FUND Policy Number 1424837-2007
I certify that, in the performance of the k for which this permit is issued, 1 shall not employ any
person in any manner so as to ome subject to the workers' compensation laws of California,
and agree that, if I ome s ct to a the
c pensation provisions of Section
� 0 of the Labo Cod s c ply with tho provisions.
Date Applicant:
r.
WARNING: FAILURE TO SECURE W RSCOM15ENSATION 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 suchpermit, or ce sation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the abov ' or ion is correct. I agree to comply with all
city and ountvy
y ordinances and state laws relating t i in nst cti , a hereby authorize representatives
of th' upon the above-mentioned rope for i pposes.
Dat . 1ignature'(Applicant or Agent):
Application Number . . . . . 08-00001122
Permit . . . ELEC-ELECTRICAL SIGN
Additional desc .
Permit Fee . . . . 48.00 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 12/28/08
Qty Unit Charge Per
Extension
BASE FEE
30.00
1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT
15.00
1.00 3.0000 EA ELEC SIGN ADDITIONAL CIRUITS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
(2)ILLUMINATED CHANNEL LETTER SIGNS
(2)CIRUITS PER APPROVED PLANS & PER SIGN
AP #2008-1266 "MIRELA'S SPA DU JOUR"
Fee summary Charged Paid Credited
Due
---------------------------------------------------------
Permit Fee Total 48.00 .00 .00
48.00
Plan Check Total .00 .00 .00
.00
Grand Total 48.00 .00 .00
48.00
Bin #
- City of La Quints T
Building 81 Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Per rtt #
0 11
Project Address:g
Owner's Name:
J
A. P. Number: 1,
Address:
Legal Description:
City, ST, Zip:
Contractor:�?
Telephone:
Address:
City, ST, Zip: T�\&'Q I
Telephone:
Project Description: C U
r
State Lic. # : J
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: ` Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: -
# Stories:
rg Units:
Telephone # of Contact Person:
Estimated Value of Project: '�> 0 00
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2vd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
"4 Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Certifica to of Occupancy
c� OFT1Buildin & Safet Department
g Y p
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 78-555 HIGHWAY 111, STE. 200
Use classification: COMMERCIAL "MIRELA'S SPA DU JOUR" Building Permit No.: COURTESY
Occupancy Group: B Type of Construction: VN Land Use Zone: CC
Owner of Building: JDD, LLC Address: 1500 18TH AVENUE NE
City, ST, ZIP: ISSAQUAH, WA 98027
By: A.J.ORTEGA
_
Date: JULY 7, 2008
Building Official -'
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