0212-009 (ELEC)LICENSED CONTRACTOR DECLARATION
1 -hereby affirm under penalty of perjury that I am licensed tF.ider 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
rp#pper,A,{ �C1 rr�� ., Liic.. Class te
yy Exp. D(a)?Vyp�}}Iy/r
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Date Signature of Contractor•` �`•�-P.
OWNER -BUILDER DECLARATIONt
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 1, 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 & 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
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:
Carriert�' 1�;i? g'-1100 Policy No. 046.11.41-H
(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: t :i « X k, I. Applicant A A,ti.t rl-A t ..E? A OZ
Warning: Failure to secure Workers' Compensation 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.
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;Signature (Owner/Agent) x�•� �J?*-f.•dr Date) 2- '.t) 4 ,
HUNG PERMIT PERMIT#
DATE VALUATION LOT 02112-W9 TRACT
JOB SITE
APN
y
ADDRESS'Ay1.A, 4ot
OWNER
CONTRACTOR / DESIGNER / ENGINEER
DALE FRANT.
BM' 'C ui'1.G10, Me,
LA QMITTA CA 92253
xr .VI1AIR 403 CA 422,
CBLA 3705
USE OF PERMIT
YLECTIUCAL
�E
IL,LVDA1'N,h TED C r;e4MEL, LF_T TXR SION APWROVE6 P1,A-1,43
94. 002-446
I W1. V ZUUZ
VAM&TION 4000,00 11's
I
CITY OF LA QUINTA
FINANCE DEPT.
i
r, XMIAMM, SUMMARY'
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f SS 1-IRE141AM EEO
$0.00
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RECEIPT
DATE
BY
INSPE OR
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
Fimplac a T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wail Firewall
Exterior Lath
Drywall - Int. Lath
Final
BLOCKWALL APPROVALS
Final
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
Sewer 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: ,
Y
J f' f
ice'?./✓YN I''i ,.%✓.+�. Sc �-.: ���A �'
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
December 2, 2002
1
Ms. Nancy Cobb
Best Signs
1 550 Gene Autry Trail
Palm Springs, CA 92264 t
Subject: New Sign for Revolution Ride Shop (SA 2002-666)
Dear Ms. Cobb;
(760) 777-7000
FAX (760) 777-7101
The Community Development Department has received your application for a sign
permit for Revolution Ride Shop at 78575 Highway 111, Suite #400, in La Quinta
Court and hereby approves it as submitted. Enclosed are two approved copies of the
plans for your use. As you know, an electrical permit from the Building and Safety
Department is needed prior to installation of the sign.
+
Should you have any questions, please contact me at (760) 777-7064.
Very Truly Yours,
Jerry Herman
COMMUNITY DEVELOPMENT DIRECTOR
Stan B. Sawa
PRINCIPAL PLANNER
c: Oscar Orci, Planning Manager
Ed Randall, Building and Safety Department
p:\stan\Itr sa 02-666 wpd
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.r
CITY OF LA QUINTA
l BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DA1o 0 L .......
Internally Illuminated Channel Letters
Notes:
-Channel Letters - Plexiglass Faces (Black/ White Material)
•Stars- Red Plexiglass Faces
-White Neon
-Sign Cabinet - Plexiglass Face with Red Vinyl
•Flourescent Lamps
78-575 HWY 111 • Suite 400
11'- 3" IV
30"
IN1111111111,I)T I ( .
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38"
All ideas, designs, arrangements and plans indicated ;
or represented this drawing are owned and Y tem: Internal) Illuminated Channel Ltrs. cost:
property of BESTT SIGNS, INC. and were created,
I N c o n v o a n T e o evolved and developed for use on and connection
with the specified project. None of such ideas, designs, project name: Revolution.CDR qty: 1 set scale: 3/4" = 1'.0"
760436=1492 arrangements or plans shall be used by or disclosed to
any person, firm corporation any purpose
er roved b date: 11.19.2002
without the written
approved permission of .BEST SIGNS, INC. pp y•
.:6w,
•
All ideas, designs, arrangements and plans indicatedEaroved
ernal) Illuminated Channel Ltrs. cost:
I� or represented by this drawing are owned re andY
Property of BEST SIGNS, INC, and were created,
r N c o R P o RAT E D evolved and developed for use on and in connectionrne: Revolution.CDR qty: 1 Set scale: 1/4" = 1'.0" with the specified project. None of such ideas, designs,
760-836-1492 arrangements or plans shall be used ur or disclosed to er
wit person, a or corporation for any purpose whatsoever b d
ate: 11.19.2002withoutthe written permission of BF.S'f SIGNS, evY
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.063 ALUMINUM
W/WELDED SEAMS
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INSTALLATION INSTRUCTIONS
1,.090 ALUMINUM FACE=
?_.ELECTRODE INSULATING BOOT
>O SLEEVING
3. 13MM OR 15MM NEON TUBING
4. GLASS STAND TUBE SUPPORT
5. CONDUIT LOCKNUTS
6. NEON TRANSFORMER -UL 2161 LISTED
7.20 AMP DISCONNECT SWITCH
8..063 ALUMINUM WALL MOUNTING
9, 1/4" THRU BOLT W/WASHER AND NUT BACKING
10. I /8" LEXAN BACKING.
Ut„ LISTING SUB#763140-001
Im
ALUMINUM
RETAINERS
063 ALUMINUM
CABINET
SERVICE
DISCONNECT
Sign Cabinet -.Wall Mounted
I - A- - I I . 1 .1 1-1- .11