9903-060 (SIGN)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
Signature of Contractor
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:
() 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:
Carrier Policy No.
71st IS7'F1'ftiSl RZANC ki X5°31 10,
c
(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.
v6ate; 4.4 Applicant r
Warning:Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition'to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions` set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
Whose request and for whose benefit work•is performed under or pursuant to
• any permit issued as a result of this applicaton agrees to, & shall, indemnity
& hold harmless the City.of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work isnot commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property fof inspection purposes.
✓Signature '(Owner/Agent) ^-^-moi n,-"'", '_ 't'Date
1
BUILDING PERMIT
PERMIT #
DATE ) 3/4)91 VALUATION 55,1%)0.00 LOT
TRACT
JOB SITE ADDRESS `/9- 42, 0100W Y AIA S��E A
APN _
OWNER
CONTRACTOR / DESIGNER / ENGINEER
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ION
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58
.LA QUINT,A CA 922.53
'S*'AN illIFiW CA 92.123
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-
USE OF PERMIT
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VALUATION
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,SST$, :ip FED COST
OF CONISURUCTION
5,000,"
PERMIT ITES4304TVIARN'
X.I1SC',' LLA2 NOUS 101-000-423-000
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PLAN CHIECK
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`RECEIP • �l
DATE
By[ "'
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE.
INSPECTOR
OPERATION
DATE
TINSPECTOR
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 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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
i
"Final
Utility Notice (Perm)
COMMENTS:
..
9'103 0&0
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OF l'1'1*.��`' 78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 (760) 777-7000
'
TDD (760) 777-1227
January 13, 1999
Mr. Malcolm Hale
Promotional Signs
20361 Hermana Circle
Lake Forest, Calif. 92630
SUBJECT: Sign Application 98-441 for Starbucks Coffee
Dear Mr. Hale,
The Planning Commission at its meeting of January 12, 1999, approved your request
for permanent identification signs at 78-742 Highway 111, for Starbucks Coffee,
pursuant to the submitted plans and subject to the following conditions:
1. Obtain a building permit prior to any work on the sign being started.
2. Final` plans shall be reviewed by the Community Development Department
prior to obtaining building permit showing the required revisions.
3. The logo on the tower shall be reduced to 36" in'diameter and centered on the
stucco surface.
The action of the Planning Commission is .final unless appealed within 15 days. Should
you wish to appeal, please contact this office. Should you have any questions, please
call me at (760) 777-7064.
Very truly yours,
JERRY HERMAN
COMMUNITY DEVELOPMENT DIRECTOR
STAN B. SAWA
Principal Planner
sbs '
c: Jerry Murdock, Ultraneon Sign Company
Rob Sanford, Real Property Associates
c:Utr app sa 98-441
MAILING ADDRESS - P.O. BOX 1504 - LA OUINTA, CALIFORN IA 92253
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10 June 1998
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One Eleven at La Quinta Center
Real Property Associates ARCHITECTS
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