04-3618 (SIGN)0 0
BUILDING. &.SAFETY DEPARTMENT
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Py . pox l��O (7.60)-777=7012
tppfc.� 78i49iS�ZC'ALL AMPICO FAX (760).777-T011
p,PR LA .Q.UI . A CA IFoitKIA 92253 INSPECTION REQUESTS (760)777-7153
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1A oEN�I�
GN�NCE BUILDING PERMIT
Application Number .,r04-00003618 Date 4/21/'04'
Property Address .E: '7,8790 HIGHWAY`'111
APN: 643-080-042-4. -0000.00-
`Application description SIGN
Property Zoning .... REGIONAL COMMERCIAL.
Application valuation 500
Owner Contractor
----------- ------------------=-
JAVIER MENDOZA OWNER
78-790:HWY 111
LA .QUINTA.. CP; 92253,
-
Permit ELEC=ELECTRICAL- 'SION ----y ---
Additional. desc ..:.:
Permit Fee "3.0:00 .. Plan' -.Check, Fee ,.:.'' . .. .00
Issue Date. Va uation p
Qty Unit Charge. Per Extension
BASE FEE 15.00
1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT 15.00
--------.--------.-------
Special.Notes and Comments
ONE ILLUMINATED CHANNEL LETTER SIGN
.PERSA=04-785
.Fee 'summary Charged. Paid Credited Due
Permit Fee Total" 30.00 .00 :00 30.00
Plan Check Total .00. ,.00 .00 .00.
Grand Total. 30.0.0 .00 .O.Q 30.00:
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P.O. BOX 1504 �
VOICE (760) 777-7012
78-495 CALLE TAmpico FAX (760) 777-7011
LA QUINTAL CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Numbers 6( Date: - 21 ' o
Applicant: ;
Applicant's Mailing Address:
r^ 5' 3
Architect or Engineer.
Architect or Engineer's Address:
Uc. No..
BUILDING PERMIT DECLARATIONS .
LICENSED CONTRACTOR'S DECLARATION
1 hereby affumh under penalty of perjury that I am licensed under provisions Of Chapter 9 (WmMncirg with Section 7000) of Division 3 of the Business and' Prolessionais
Code. and my License is in 6Al face and effdct.
License Class License No.
Data • Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that l am exmro from the contractors• state License Law for the following reason (Sec 7031.5, Business and Professions Code: Any
City or county fiat requires a permit lo construct, alter. Improve. demolish, or repair any structure, prior 10 its issuance, also requires the applicant for the permit lo file a signed
statement that he or she is icersed pursuant to the provisions of the Cwdractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that to or she Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty 0 not more than five hundred dollars ($500).):
1, as owner. of the property. or ry employees with wages as their sae 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 or though his or her own employees, provided that the improvements are not Intended or offered for sale. H. however, the budding or improvement is
sold within one year of completion, the ownara,aderwill have the burden Of proving that he or she did not build or improve for the purpose of sale.).
U 1. as owner of.the property. am erdhnively contracting with rices contractors 10 construct the project (sec 7044, Business and Professions Code: The Contractors•
State License Law does not appy to an owrm of property who builds or improves thereon, and who contracts for the projects with a contractor(s) rmcensed pursuant to
are contractors• state License Law.).
U I am exempt under sec. . B.a P.C. for this reason
Date
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declaration:
—I have and will maintain a certificate of consent to sea -insure for workers' cog, nation, as provided for by Section 3700 of the Labor Code. for the perfomnanoe
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 tiis permit is
issued. My workers• conpensatiom insurance carrier and policy number are:
Cartier Policy Number
�O 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 haws of Cafifomia, and agree tat, if 1 should become subject to to workers' compensation provisions of Section 3700 of the Labor Code, l shall
torthwifh comply with toss provisions.
Date ^ O t �- 2 /- e- 1 t Applicant A-,7 -,7 pt c Z y
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE S 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 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. .
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of e0ury that there is a construction lending agency for the performance of the work for which this pend is Issued (Sec. 3097, Civ, C.).
Lenders Name
I V
Lenders Address --
APPLCANT ACKNOWLEDGEMENT
IMPORTANT Application Is hereby made to the Director of Budding and Safety 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 pursuard to any permit
Issued as a result of this application. the owner, and the applicant each agrees to, and shad, defend, indemnify and hold harmless the City of La Omenta, its
officers, agents and employees for any ad or omission related to the wok 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 wok for 180 days will subject penrit to cancellation.
I certify that I have read this application and state tat the above information is correct I agree to comply with all city and county ordinances and stale laws relating to building
construction. and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
Date__Qti-2i-c11 Signature (Applicant or Agent): 1c,i /�rndar�h
.0
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the 66lder of ft e'prop'eity,
improvements specified.
For your protection you should be aware that as "Owner/ Builder'' you are the responsible party'6f'record on—
such-a'-`
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you mayrprotect yourselfrfrom-possiblV.
liability if that person applies for the proper permit in his or her name. ,
Contractors are required by law to be licensed and bonded by the State of California: and to hav�e'a-busitiessliien�se' "`= ": '
from the City or County. They are also required by law to put their license number 'on ail''peamits fpr.wfi` ch' they.
apply.
If you plan to do your own work, with the exception of various trades that you plan to 's'[ttiroti�ci;.youa.ou d;:be, 0ieie,•
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors -or..
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you arc aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
,DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7012
FAX (760) 777-7011
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OWNER'S SIGNATURE/DATE
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PROPERTY ADDRESS
PERMIT NUMBER(s)
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LA CASITA MEXICAN FOOD
Side view of Installation
METAL RETURNS
PAINTED BLACK
MADE OF 22 GAUGES
SHEET METAL
Face made of
3/16 yellow acrylic
13 mm neon tube
End cups UL Listed
Mounted to the wall with
plastic an and 21/2
galvanized screws
Neon tube suports
-Self toping screws
APPROVED BY COMMUNITY Y DEVELOPMEN DE ARTMM\hold the face
BY G�� �(L`i,tih�� DATE ✓1 Q Stucco wall
EXHIBIT
t,ASE NO. 2 - '65
1/2" DIA. FLEXIBLE METAL
CONDUIT WITH IN-LINE
5 AMP FUSE PROVIDED
BY P.N.
30MA TRANSFORMER
IN GALVANIZED
TRANSFORMER BOX
2161 U.L. LISTED.
i'
LA CASITA MEXICAN FOOD
Side view of Installation
METAL RETURNS
PAINTED BLACK
MADE OF 22 GAUGES
SHEET METAL
Face made of
3/16 yellow acrylic
13 mm neon tube
End cups UL Listed
Mounted to the wall with
plastic an and 21/2
galvanized screws
Neon tube suports
-Self toping screws
APPROVED BY COMMUNITY Y DEVELOPMEN DE ARTMM\hold the face
BY G�� �(L`i,tih�� DATE ✓1 Q Stucco wall
EXHIBIT
t,ASE NO. 2 - '65
1/2" DIA. FLEXIBLE METAL
CONDUIT WITH IN-LINE
5 AMP FUSE PROVIDED
BY P.N.
30MA TRANSFORMER
IN GALVANIZED
TRANSFORMER BOX
2161 U.L. LISTED.
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