13949 (SIGN)' •
414
1504
Building 78-692 Hwy 111 78-1050CALOLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner Stonington Properties,LTD
maning
Address 1706E Newport .Blvd. -
City Zip Tel
cos.ta Mesal, C 92627 (710650-171
Contractgr
13mericawest - aSign
Address
ILDING: TYPE CONST.
P. Number
Legal Description
No.
OCC: GRP.
139+9
Project Description Si"' for Blockbuster Video
42170 Sarah Way
BY:
Minimum Setback
9
ZIP 929hvya
T609) 676-3833
-
State Lic. :533571 C-45
City
FINAL DATE
INSPECTOR
& Class if.
Lic. #
Sq. Ft.
No. No. Dw.
'
Arch.; Engr.;
Size
Stories Units F
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
LICENSED CONTRACTOR'S DECLARATION 1�
>
_..
I hereby affirm that I am licensed under provisions oof'Ch'apfer'9'(commen� g with Section
7900) of Division -3 of the Business and Professions Code, and my lice se is in full force andN,
fect. �.�.%t. "t 0- T
IIGNATURE
f
r' _:. _ '^ DATE i
' OWNER -BUILDER DECLARATION
hereby
Estimated Valuation
�} ��
I affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions .Code: Any city or ' county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
PERMIT
AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
Plan Chk. Bal. ,
❑ 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, Buisness and
Const.
�.. ��
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
Mech
provided that such 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
Electrical
-
of proving that he did not build or improve for the purpose of sale.)
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
.S•M.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) r-
_
Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason x
Driveway Enc
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Polic No. Company
Co i filed with the city. ❑ Certified copy is hereby furnished.
r'
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (5100) valuation
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.
Date Owner
NOTICE TO APPLICANT., If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
F. Signature of applicant Date
Mailing Address
City, State, Zip
Infrastructure
TOTAL rJK . VV
REMARKS
ZONE:
BY:
Minimum Setback
Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Cent" ]�L/ne
Side Setback from Property-ine�"y
A 417^
FINAL DATE
INSPECTOR
U Permit 9
Issued,by:
Date
Validated by:
�
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
UNDERGROUND
A.C. UNIT
COLL. AREA
1ST FL. SQ. FT. @ $
UNITS
ROUGH PLUMB.
r
2ND FL. SQ. FT. @
HEATING (ROUGH)
Y
ARD SPKLR SYSTEM
POR. SQ. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. @
DRAINAGE PIPING
WALL SQ. FT. @'
HEATING (FINAL)
DRINKING FOUNTAIN.
SQ FT @
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GRADING
cu. yd.
$ -plus-x$-=$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP.
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
FIRE ZONE ROOFING
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -plus-x$-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC. UUU
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
mi
BLOCKBUSTER VIDEO
F
NORTH ELEVATION
WEST ELEVATION
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WITH S4COE) 5UKFAC 9 YIKYL
CRAPDlCS.
I2930 BLUE BACKCROUND
01090 YBLLUW FOR LINES
AND BURDER
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CABINET SP$CIFIUT]0H8'
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CIRCUIT rIXg4tJ4RLlP
END VIEW 4.s
CIT°zOF I T 14
BUILDING & SAFETY DEPART MEAT
oiNoiTIONALLY
ACCEPTED FOR C()NSTRUCTION
SOF, E;-.?T TO INSTALLVI 101N AS PER
A1D ALL. APPL1
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