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04-7146 (SIGN)Tihf - 4 4 a" BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . . (0_4-= 000-071'46 Date 11/.09/04 Property Address . . .1 78950 HIGHWAY 111 APN: .643=080-004-6 -000000- Application description . . . SIGN Property Zoning . . . . . . . REGIONAL COMMERCIAL Application valuation . . . . 15000 Owner Contractor , s KOHL'S SWAIN SIGN, •INC. N56 W 1700 RIDGEWOOD DR 1384 E. 5TH STREET ONTARIO CA 91764 ( 90) 946-0253 WCC: STATE FUND WC: 0440019981 10/01/05' CSLB: 643004 04/30/06 CCC: C45 ---------------------------------------------------------------------------- Permit . . . . . . SIGN PERMIT Additional desc Permit Fee . . . . 162.00 Plan Check Fee .00 Issue Date Valuation . . . . 15000 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000 THOU BLDG 2,001-25,000 117.00 ---------------------------------------------------------------------------- Special Notes and Comments, SINGLE ILLUMINATED CHANNEL LETTER SIGN PER SA2004-814 Fee summary. Charged Paid Credited Due Permit Fee Total 162.00 .00 .00 162.00 Plan Check Total .00 ..00 .00 .00 Grand Total 162.00 00 .00 162.00 f9�DCITY 0 O'ntw.�_ P.O. BOX 1504 • '�C�� 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: d -Z1 Applicant: Applicant's Mailing Address: Architect or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: // — 5- o Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 Professionals Code, andmy Licen�eµi ll force and effect. 2 D License Clas sC CC..: ,Licen a No. J Date I I Contract cs�"; OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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 violation 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).): U 1, 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner. WORKERS' 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. Myworke compensation insurance carrier an olicy�umber are: Carrier 5 T�R'C �jo V) Policy Number l `19 A _ 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 WORK RS' 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. 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 APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building 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 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. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the ab ntioned property for inspection purposes. Date(( c7 Signature (Applicant or Agen ` P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 October 21, 2004 Mr. Kevin Parker - Swain Sign, Inc. 1384 E. 5th Street Ontario, CA 91764 (760) 777-7000 FAX (760) 777-7101 SUBJECT: Sign Application 2004-814 - ID,Sign for Kohl's Department Store 78950 Highway 111 Dear Mr. Parker: In regards to the above subject, this Department has approved your request to install one building -mounted, business identification sign, on the south elevation of Kohl's, as shown on Exhibits A, B and C (approved copies enclosed), subject to the following conditions: 1. The applicant is responsible for proper sign maintenance and compliance with other general sign standards as set forth in the . City's sign code, Section 9.160.030, as well as procuring any required building permit. . 2. This approval is for one-, building mounted individual business identification sign, not to exceed five feet in height and 193 square feet in area. The sign shall be established within one year,. commencing October 21, 2004, which shall constitute the date of approval for this sign. 3. Installation, design, maintenance and removal of the sign shall conform to the standards set forth in Chapter 9.160 of the Zoning Code, pertaining to permanent signs. A. All aspects of the sign construction not available on the approved plan exhibits shall meet the criteria specified in the approved Sign Program for the 1 1 1 La Quinta Center. Prior to issuance of any building permit to install these signs, the applicant, Swain Sign Company, shall submit written authorization from Federal Heath Sign Company to use their plans and specifications as submitted _. under this sign application'. This decision may be appealed to the Planning Commission pursuant to Section 9.200.120, provided the application requirements of said Section are met within 15 days from the date of this letter. The filing fee for an appeal application is $175.00 Should you need any clarification or other information in regard to this matter,'or if you have any questions, .please do not hesitate to contact the undersigned at 760- 777-7069. Very truly yours, OSCAR W. ORCI INTERIM COMMUNITY DEVELOPMENT DIRECTOR Wallace Nesbit .Associate Planner WN/wn Enclosure c: Building and Safety Department Code Compliance FEDERAL i HEATH SIGN COMPANY October 27, 2004 City of La Quinta 78-495 Calle Tampico La Quinta, CA.92247 RE: KOHL'S Department Store 78950 Hwy 111 La Quinta, CA. 92247 To Whom It May Concern: Swain Sign has the authority to use all drawing produced by Federal Heath Sign, including but not limited to drawing # PO4-1214, required for permit procurement or in any way they see fit to complete all work required for the above mentioned sign project. Please contact me at 210-229-1753 with any questions. Sincerely, Russell R. Middleton Program Manager Federal Heath Sign 501 S. Main Ave Suite 107, San Antonio, TX 78204 • Phone (210) 229-1753 Ext. 110 • Fax (210) 229-2091 RMiddleton@federalheath.com