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9807-028 (SIGN)LICENSED CONTRACTOR DECLARATION .,,,a hereby affirm under penalty of perjury that I am licensed under provisions of F– Chapter 9 (commencing with Section 7000) of Division 3 of the Business and cel w Professionals Code; and my License is in full force and effect. O :D ch License # Lic. Class Exp. Date �0LO w � ; 07136 a 45 C61 CIO 4/'30/99 W I r- % tit s" CS Z r` /Date ©f Signature of Contractor O.11� J U � OWNER -BUILDER DECLARATION WWW rl- I hereby affirm under penalty of perjury that I am exempt from the Contractor's U) License Law for the following reason: Z ( ) 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). co () I am exempt under Section , B&P.C. for this reason LO O N Date Signature of Owner rn z WORKER'S COMPENSATION DECLARATION C) 2 Z I hereby affirm under penalty of perjury one of the following declarations: LO - O () 1 have and will maintain a certificate of consent to self -insure for workers' 'X W IL compensation, as provided for by Section 3700 of the Labor Code, for the O J Q performance of the work for which this permit is issued. CD Q U (X) I have and will maintain workers' compensation insurance, as required by O U Q Section 3700 of the Labor Code, for the performance of the work for which this rn F– permit is issued. My workers' compensation insurance carrier & policy no. are: .�t Z Carrier Policy No. J (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 3' Code, I shall forthwith comply with those provisions. t/Date: ^�'lApplicant f_ rcr+rtC^ "".• 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, 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. ti gnature (Owner/Agent) ���—���%�""� Date 1, h,� PERMIT# � CONTROL# BUILDING PERMIT '!8407-0.8 DATE f LOT TRACT 8079 ®7 9 tCF,F VALUATION $7'YXa.� lJ 0 JOB SIT 1 APN ADDRESS 74"22 HIGHWAY H! OWNER CONTRACTOR / DESIGNER / ENGINEER WAS'i41NCi* )N,AT)t"4S.d A,,FL7"KLitS.1in-' Itl=f.(sERIAL SiGM CO. 18960 HWY 114 15th 46120 CIV FIOL)1v f 7f►0)M /-3 bite CUP ft "27 USE OF PERMIT �fA�i,4Sfw iWITALL Li;J.'U INA`.i`ED.[vtOi3iNI-N'`1' 840N Hip, a[G2v ATPLICKI'ION 98-422) (L'I& i [H0W1: .LV.MF_DT. 1T, CARE C0N'MR) k,"ALUiVAON 7_100AK) LS CONS11R.IX"E IO N .F F.1 101-000-418-M 599.00 ?01-(3W420=OW WX)n ..t a a ,J U L 101998 , d. r _ 1 LJ Sx3`0-170TAt; C0NS11LI C.Tf0.'N AN[3 PLAN CIfEC.K. a ESS PRE -PAID FEES (Kf.Q0 l i•O :E.%.,t T, 6!i.f4.1Y36� `��i.L:.n7 100 R, F'V`►„ll!9r c$134.00 RECEIPT DATE BY DATE FINALED INSPECTOR INSPECTION RECORD V 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 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 Plbg. 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 r Final t'ltility Notice (Perm) COMMENTS: r c T4tif 4 4 Qum& J 78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 – (760) 777-7000 FAX (760) 777-7101 TDD (760) 777-1227 June 16, 1998 Mr. Ali Tourkaman Administrative Director, Facilities Management Eisenhower Medical Center 39000 Bob Hope Drive Rancho Mirage, Calif. 92270 SUBJECT: Sign Application 98-4.22 Dear Mr, Tourkaman, The Community Development Department hereby approves your request for a freestanding sign to replace the building sign facing Highway 111, per the attached exhibits. The sign location along Highway 111 is on private property within' the landscaped area adjacent to the parking lot-, approximately midway between the Eisenhower Immediate Care building and the Chief Auto Parts/Radio Shack building. The approval is subject to the following conditions: 1. A building permit shall be obtained from the Building and Safety Department prior to installation. 2. Letter style and colors to match those on building. x 3. Sign on south side of the building shall be removed at the time of installation of / the freestanding sign. . 4. The sign shall not encroach in to the Highway 111 right-of-way. Final location z �i shall approved by the Community Development Department. Should you have any questions, please call me at (760) 777-7064. Very truly yours, JERRY HERMAN COMMUNITY DEVELOPMENT DIRECTOR ` 5 STAN B. SAWA Principal Planner �a enol. c: r/Michael Shovlin, Washington Adams Partnership Christine di lorio, Planning Manager Greg Butler; Building and Safety Department MAILING ADDRESS c-lapor sa 98-422 — P.O. BOX 1504 — LA QUINTA, CALIFORNIA 92253 ZO `d iS�b[1.1.091. `ON Xd� A.3a S3I i I a A3S3a 1 Z 80 f1FI L 86-81-Nf1I` --------------------------