9903-059 (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
r
521415 015 5f311100
ate - `"t `; Signature of Contracttor=��� ---
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License. Law for the following reason:
(;) d, 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)... ` -
O am exempt under Section' ` B&P.C. for this reason
Date". Signature of Owner
'WORKER'S COMPENSATION DECLARATION,
1 Hereby affirm under penalty of. perjury one of the following declarations:
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.
ZENITH NISURANICM, ZN. 53 .1 15 10.11
(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
C9
de, l shall forthwith comply with those provisions.
ODate: y a Applicant
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
applicatiori.
,1. Each person upon whose behalf this application is made & each person at
whoserequest 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.
'
ySignature (Owner/Agent),_ �---^^11 Date
BUILDING PERMIT PERMIT#
DATE VALUATIONS LOT TRACT
JOB SITE
ADDRESS 7&742 B�J[�cI'�.WA,N' 7i.11R ESTE 1;APN e «
OWNER CONTRACTOR/DESIGNER/ENGINEER
78,142 HIMMULY I 1 SMF 13 5458 CC7NYFLEX STREET 0401
LA Q!ANTA {."A 922.53 SAIN DIEGO CA W2113
(619, %9-6716 C131,14
USE OF PERMIT 4
i
fZ Std 918447
VALUATION 4,000.403 ML .v
PE, TcMTf''FEX SB.JMMAJI1i'
KI:SCELLAtNEOUS 101-000-423-000 $63.00
USS P,RE-3>.t`�:M PEES $0.00
TUFAL PERMIT FRES DUE NOW $63.00
�\1xR `t, �ty� DATE By DATE FINALED INSPECTOR
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
Fireplace T.O.
Fans & Controls o
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 I
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 Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final 7 -
Utility Notice (Perm) �--
Utility
tcv
ceih, 4
78-495 CALLE TAMPICO — LA QUINTAL CALIFORNIA 92253 – (760) 777-7000
TDD (760) 777-1227
January 13, 1999
Mr. Jerry Murdock
Ultraneon Sign Company
5458 Complex Street, Suite 401
San Diego, Calif. 92123
� r
SUBJECT: sign Application 98-447 for Quizno's Subs
Dear Mr. Murdock,
The Planning Commission at its meeting of January 12, 1999, approved your request
for permanent identification signs at the One -Eleven La Quinta Shopping Center for
Quizno's Subs, pursuant to the submitted plans and subject to the following
conditions:
G 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. :
'y 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 MRECTOR '
,
STAN B. SAWA
Principal Planner
sbs'
C : Rob Sanford; Real, Property Associates
c:\Itr epp sa 98:447
MAILING ADDRESS — P.O. BOX 1504 — LA QUINTA, CALIFORNIA 92253
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ELECTRICAL EASUAENT 1
M PARKWAY TREES TO RHANN
BUILDING COVERAO:
5900 SF
781
LANDSCAPE
6,740 SF
773
WALKS / PAT10
2,761 SF
91
PAVING / TRASH / ETC
75749 SF
511
SITE AREA
30950 SF
1001 .
PARKING SPACES PROVIDED LSS/MM
30 SPACES
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AC PAVING
TRE WELL
NEW PARCNC LOT UGHTFNC TO
MATCH o05TNG DEVELOPMENT
STANDARD _
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CONCRETE .
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One Eleven at La Quinta Center
Real Property Associates
1706 B Newport B-kvwld corm mes, CagoNTa 92627 949.64&9000
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104
ARCHITECTS
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