0110-200 (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
Date '!�'� �f Signature of Contractori��f'
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 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:
,k), 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.
( ) Chave 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:
Carrier i#'1A f E 1rUND Policy No. 1 3�4N 9'
(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 shell forthwith comply with those provisions.
Date: %` Applicant,.r�..4%'Lsrr�:...
`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.
Signature (Owner/Agent)��A''�.?�"���+— Date/11r'�✓ -, l.•
n .,
BUILDING PERMIT PERMIT#
DATE VALUATION LOT TRACT "
JOB SITE
ADDRESSvi:tiC�
APN
OWNER Y
CONTRACTOR / DESIGNER / EN &NEER
1500 3 �' S. AVEKC)r3,T,17
9333 9TH S°.
S �3At i 3 WA WrY
RAMCF1.0 CUCA�'.�?OR CA 91 730
`909>9 41.5-3555 C78M.. 6153
USE OF PERMIT
PFR. SA
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u
OCT 1 2001
CITY OF LA QUINTA
FINANCE DEPT.
SM-TOTM. C;;O1 3 iiC'i 109 AND Pf" CIRDOX
$45.00
EO PRR-PAJb F'��"
$0.00
TOTAL I'M= VMS D MR OW
S450)s
RECEIPT
DATE f
BY //
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION 177�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 Wall 'Insulation
Condensate Lines
Party Wall 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
Temp. Power Pole .�
Underground Conduit
Rough Wiring
Low Voftage Wiring
Fixtures
Main Service
Sub Panels
Exterior. Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
k I
r
INTERNALLY ILLUMINATED CHANNEL LETTERS
1 SCALE: 3/8" = TO"
.30' 0"
i
1' 6" I - ___`]N C.:I.:
°QUEJ1
TA
D TA
1
C1 ff OF LA OUFNTA
BUILDING & SAFETY DEPT.
APPROVED
PLOT PLAN FOR CONSTRUCTION
DATE IO $ 0 BY
e��I�C GO'Pi
ELEVATIONS
a�
LA QUINTA DENTAL GROUP
■ r I f• � — � ttt■ � ■ its titer � r
LA QUINTA DENTAL GROUP
Q ID O
APPROVED By COMMUNI
OAtE
BY
EXHIBit 7
CASE N0.
g65a9L$1-1 s��ArVt, ��acz V.1,. Piatr
A .r .. v
NSTALLATION DETAILS
STUCCO FACIA
3/4" WHITE
TRIM CAP
1 1/2" #10 SCREW WITH
3/4" SPACER
(MIN. 4 PER LETTER)
P 015 WHITE ACRYLIC
�- PLASTIC FACES WITH
F_ GREEN VINYL OVERLAY
ELECTRICAL
JUNCTION BOX
INTERIOR
CUT-OFF
SWITCH
TRANSFORMER
30MA OUTPUT
N CHANNEL LETTER
PAINTED WHITE
INTERIOR,
BLACK EXTERIOR
LA QUINTA DENTAL GROUP
FN.t�.s an original design and the property of ELECTRO LITE 78595 HIGHWAY 111 STE
not to be used for any purpose other than to convey thegn elements herein to the prospective client. Reproductionn or construction by other then ELECTRO LITE SIGNS LA QUINTA CA 92253
is design are prohibited and subject to legal remedy.
DRAWING DATE: 9/27/01
15mm WHITE
NEON UNIT
ELECTRO -BITS
ELECTRODE SLEEVE
ALUMINUM FLEX
& GTO COVERING
5" DEEP 24GA—Y--I
\
SHEET METAL
N CHANNEL LETTER
PAINTED WHITE
INTERIOR,
BLACK EXTERIOR
LA QUINTA DENTAL GROUP
FN.t�.s an original design and the property of ELECTRO LITE 78595 HIGHWAY 111 STE
not to be used for any purpose other than to convey thegn elements herein to the prospective client. Reproductionn or construction by other then ELECTRO LITE SIGNS LA QUINTA CA 92253
is design are prohibited and subject to legal remedy.
DRAWING DATE: 9/27/01
�y 414 `+6" opy
P.O. Box. 1504
78-495 CALLE TAMPICO (7 60) 777-7000
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101
October 12, 2001
Electro -Lite Signs
9241 Archibald Avenue
Rancho Cucamonga, CA 91730
SUBJECT: SIGN PERMIT 2001-579
To Whom it May Concern:
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 (La Quinta Dental Group). 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