BSIG2015-002078-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&t�.p 4 4 Q"
• u LC�I7�TrhPI%1
NG
Application Number:
BSIG2015-0020
VTJUN 2 2 W5
Property Address:
78722 -HIGHWAY 111
—. _•_.
APN:
643220015
s
ClypFLA0131'
Application Description:
RED ROBIN SIGNS 5 WALL ILLUMIII,T
�P�BNI(yDEVELOPMEPllI)Ei
Property Zoning:
Application Valuation:
$6,000.00
Applicant:
MALL SIGNS & SERVICE
12439 MAGNOLIA BLVD #113
NORTH HOLLYWOOD, CA
91607
LICENSED CONTRACTOR'S 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 Professions Code,
and my License is in full force and effect.
License Class:
%C45 License No.: 811074
Date: " Contractor:
,
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am 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 violatiorf 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).:
(_J 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.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project. (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 contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
(_) I am exempt under Sec. . B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION 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:
VOICE (760) 777-7125
FAX (760) 777-7011
ENT INSPECTIONS (760) 777-7153
Date: 6/22/2015
Owner:
WILLIAM MORROW
Contractor:
MALL SIGNS & SERVICE
12439 MAGNOLIA BLVD #113
NORTH HOLLYWOOD, CA 91607
(818)764-1909
Llc. No.: 811074
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 and policy number are:
Carrier:— Policy Number: _
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.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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:Applicetion is hereby made to the Building Official 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 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 county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes. _
Date: 7 Z r Signature (Applicant or Age G 3`
w FINANCIAL INFORMATION
DESCRIPTION;ACCOUNT QTY AMOUNT PAID'
PAID DATE
BSAS SB1473 FEE 101-0000-20306
0
$1.00 $0.00
PAID. BY METHOD
RECEIPT # CHECK #
CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 '
DESCRIPTION
ACCOUNT
'QTY
AMOUNT
PAID
PAID DATE
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
'PAID
PAID DATE
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$0.00
-PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for ELECTRICAL: $48.34 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT.'
PAID
PAID DATE
WALL/AWNING SIGN, EA ADDITIONAL
101-0000-42404
0
$98.64
$0.00
PAID BY ;; ... "
METHOD ..
RECEIPT #•
CHECK #
CLTD"BY'
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WALL/AWNING SIGN, EA ADDITIONAL PC
101-0000-42600
0
$98.64
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WALL/AWNING SIGN, FIRST
101-0000-42404
0
$24.66
$0.00
PAID BY
=METHOD
RECEIPT # -
CHECK #
CLTD BY
DESCRIPTION -
..,ACCOUNT... ';
QTY
...,AMOUNT:
PAID
PAID DATE
WALL/AWNING SIGN, FIRST PC
101-0000-42600
0
$87.02
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forSIGN: $308.96 $0.00
TOTALS:00
Description: RED ROBIN SIGNS 5 WALL ILLUMINATED
Type: SIGN
Subtype: Status: APPROVED
Applied: 6/22/2015 MFA
Approved: 6/22/2015 MFA
Parcel No: 643220015 Site Address: 78722 HIGHWAY 111 LA QUINTA,CA 92253
Subdivision: PM 25865
Block: Lot: 16
EMAIL
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
CONTACTS
CITY STATE
Finaled:
Valuation: $6,000.00
Occupancy Type: Construction Type:
12439 MAGNOLIA BLVD
#113
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: INSTALLS ILLUMIATED WALL SIGNS "RED ROBIN BURGERS & BREWS AND RED ROBIN".
PER 2013 CALIFORNIA BUILDING CODE
CHRONOLOGY
CONDITIONS
PHONE
FAX
EMAIL
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY STATE
ZIP
APPLICANT
MALL SIGNS & SERVICE
12439 MAGNOLIA BLVD
#113
NORTH CA
HOLLYWOOD
91607
CONTRACTOR
MALL SIGNS & SERVICE
12439 MAGNOLIA BLVD
#113
NORTH CA
HOLLYWOOD
91607
OWNER
WILLIAM MORROW
78030 CALLE
BARCELONA A
LA QUINTA CA
92253
FINANCIAL INFORMATION-.-,,
Printed: Monday, June 22, 2015 10:01:37 AM 1 of 2 ,
SYS TElviS
Printed: Monday, June 22, 2015 10:01:37 AM 2 of 2
SYSTEMS
..._.. .........
CLTD
DESCRIPTION
ACCOUNT •
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$0.00
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$0.00
Total Paid for ELECTRICAL: $48.34 $0.00
WALL/AWNING SIGN,
101-0000-42404
0
$98.64
$0.00
EA ADDITIONAL
WALL/AWNING SIGN,
101-0000-42600
0
$98.64
$0.00
EA ADDITIONAL PC
WALL/AWNING SIGN,
101-0000-42404
0
$24.66
$0.00
FIRST
WALL/AWNING SIGN,
101-0000-42600
0
$87.02
$0.00
FIRST PC
Total Paid forSIGN: $308.96 $0.00
TO00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
RESULT REMARKS NOTES
DATE DATE
FINAL" BLD
Printed: Monday, June 22, 2015 10:01:37 AM 2 of 2
SYSTEMS
.a
Bin #
City Of La Quionta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: -7 8 7 ZZ ry� '► ("W� '( I I I
Owner's Name: W I LL) JAYJ M p 12 n v u/
A. P. Number:
Address: -
Legal Description:
City, ST, Zip:
Contractor: M A L,�s1 $ �� S�I
CC--
Tele h e•
4
Address: IZ439 11 A6N0Q r4 _&::# 113
Project Description: A)S 77YG L S' 1CJ VF '
City, ST, Zip: },)0 Nall, ul000 CA gl60
�L c,v/yiivP47� l�/i4a- ,�/SNS
.Telephone: 4 f O
��7 b �
.....:.
<<
= s %� v
]i�p /1
l % 6 Brw v
State Lic. # : 011974—
City Lic. #;
Arch., Engr., Designer:
_ .33
Address:`
— , 3 SF` = Ar
CTD u u sQ
City, ST, Zip:
/ _ 26 9 S� �� &0 U f1Y6.
�u1e667&1&&Z✓
Telephone:
J-
1111111111",...
.
Construction ctionT anc
Type: Occupancy:
Y•
State Lic. #•
Ject hPPr e (circle e one : New Add'n Alter Repair air De
mo..............
.
--—
Name of Contact Person- V PE 24C
Sq. Ft.: / 95 9s
#Stories:
#Units:
Telephone # of Contact Person: 8 I Fj 6? S 841
Estimated Value of Projec `0 4 d
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
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
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr.
Date of permit issue
School Fees
Total Permit Fees