0305-156 (SIGN)LICENSED CONTRACTOR DECLARATION
VI ,hereby affirm under penalty of perjury that I am licensed under provisions of
C1apter 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
41MM6 tiahW11111"
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 t 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:
Cartier Policy No.
M`AII,TR',,Vk1D 0414•Ve.
(This section need not be completed if thepermit 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.
Date: 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, ih
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees. J
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.
Signature (Owner/Agent) Date
r
BUILDING PERMIT PERMIT#
DATE VALUATION LOT ('g(p}j„ TRACT
JOB SITE AP
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
CIA 9454.5
XWARMI 0280i:5
54-0099. MB
USE OF PERMIT
). 01100: d AEK01i
8d0P6UA1n4T E'PAt;.=F ' PXk1 1fT1l .APP. # S&Z-0 4 LtxC A.1'lt;i'>A.'f Ty.0
CORMl Cip PFOf ( CSHM , ISTA` ION),
•`lrAWATI a Y
Sy�ssipplyylpp��h?;:lAb�?k'
'
a�.7d��py�E'//;1"��:+gfii�6rr` yy n/�//i� ry/•� QQyy pp
�1�?.BTR?�D7Fi..Ys i'.3eL •.. ��,J1''{t4iV"'i•el.�"o`�tf? �����iW .
)'zT.t CTP CAL FEE • 101-000-4AO-WO
59';2CMA4.0T= FrZ • 1 �iv:PA . I0(?MCIQ0•iU1-0(30 V -n
•�X by , 7FW AVE) 11PLCL4`s t Irfr C
i,.
RECEIPT
DATE
BY. j✓
DATE FI A ED
INSPECTOR
__
13
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
nderground Ducts
Forms & Footings
20 D 3 / D
cts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX 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
S 6
POOLS - SPAS
BLOCKWALL
APPROVA S
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:
6i�llGK— ?39.V — Sjrr�L'r� ��
OA/4
/5
Final/t/t7
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
Utility Notice (Perm)
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
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 & Professional's
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.
(,yyj 1 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 NTATE' j� 014D Policy No. _ 044.02 0004 °31
(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 f Section,3700 of the Labor
Code, I shallJo hwith comply with thosegprovls o s, ,
,Date: �7 Applicant .��t�.�r ✓:N1: t
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 J 1 certify that I have read this application and state that the above information is
/ correct. I agree to comply with a%City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for.inspjcliion'�p/urpose�s*- y
Y� $ignature (Owner/Agent) y �• b �%�" ;/ Date �%�' a�(
`i..-BUIiLDING PERMIT PERMITt
DATE VALUATIONti�aG�%,tift� LOT TRACT
JOB ADDRESS-f:'lrla',1l�fi kr %
APN
OWNER
CONTRACTOR/ DESIGNER / EN (NEER
i�d�. i Y t�1 .IS IZI y?i�S
:1)C114toc) & Boris, Tac.
CA 9454S
CA 92,806
USE OF PER/MMIT
yjy�
-C!NtEN•:•.
.tt__
,f9it,1+•1 MR .52i .){sp�,.�•�54AJ s•�t FY v�
C01114M 0 Pk1K3gk.RTY' (41M , STATION)
ES'i'3IM370? G*"►a":€' OF
PERVIErIola! STMNLYtRy'
PLAN CXIVA:i-u FEUE 101-000,439-318 35€?: iO
ELECTRIC:&, We 't M -.Qt, t3, 420- `L 00 S30.0
'
a°"i'IdOW3 (V1OT?OX Y -F- , -COMM Ci$1.37
4 ts"'kMIMAL C11MR 01109 AWL PLAM Crf E -CM
$175.87
L ES3 ftE PAM MES
0, i?
.. ' L• .•. A'Ll.7t�.{' . r ,E"'.'i.i:P.Jxtr C .NTAS :tle`-F.VO 99
.. �8� I:1,i+• l
Of
{ Ct NAiyCE D r • 1-
RECEIPT E
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
^ PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
- Plumbing Top Out ^'
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole -
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
S
�- City of La Quinta
Building at Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
0'5,96/Building Permit Application and Tracking Sheet
Project Address: 7 `d C? g 1I 1< Owner's Name: - r�
A. P. Number: Address: Lk C_
Legal Description: City, ST, Zip:
Contractor:C's-
Address:
g ` names
tic• FTelephone: '
Address: k\_ V__'> S l Project Description: t V-J�.ki
City, ST, Zip: - 9 GI2u�c�C.
Telephone: -71L 2S`I -00cJ 'q
State Lic. # : t{35 -C,, l City Lic. #:
Arch., Engr., Designer: S;
Address: 60
City, ST, Zip:
Telephone: "`$
Construction Type: Occupancy:
'.
State Lic. #:,.
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person L� hj t Sq. Ft.: # Stories: #Units:
Telephone # of Contact Person: -7 «-t Zs - —c8 v stimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Rec'd TRACKING PERMIT FEES
Plan Sets Plan Check submittedLeo o• Item. Amount
Structural Calcs. Reviewed, ready for corrections Plan Check Deposit
Truss Calcs. Called Contact Person Plan Check Balance •
Energy Calcs. Plans picked up Construction
Flood plain plan Plans resubmitted Mechanical
Grading plan 2" Review, ready for correctio issue Electrical 3 v, o D
Subcontactor List Called Contact Person Plumbing
Grant Deed Plans picked up
H.O.A. Approval Plans resubmitted Grading
IN HOUSE:- '"' Review, ready for corrections/issue Developer Impact Fee
Planning Approval Called Contact Person A,I.P.P
Pub. Wks. Appr Date of permit issue O
School Fees
Total Permit Fees
TV �non/Z ALF_ 41 b/°
TV �non/Z ALF_ 41 b/°
0
l.1 ur UNG ENGINEERING SER VICES
• Engineering •Architecture•Surveying• Building & Safety Services
Letter of Transmittal
To: City of La Quinta Date: 6/13/03
Project. 78-998 Hwy 111
Attn: Ed Randall PC#: 306-156 (1" Check)
Tel No.: (760) 777-7012 Tract No.:
We are forwarding: X By Messenger By Mail Your Pickup
No. of Copies Description:
1 Set of plans/calcs
Comments: Plans are acceptable
Thanks
This Materia_ l Sent for:
Your Files Per Your Request
Your Review x Approval
Checking At the request of:
Other
By: Eric Frenzel
Phone # 760-360-5770`
77-804 Wildcat Drive, Suite C, Palm Desert, CA 92211 (760) 360-5770
Bronz Young
SECONDARY SIGN PROPOSAL
A NEW SECONDARY PRICE SIGI 1 13.5 13.5 TO ADDRESS TRAFFIC ON ADAMS ST.
INTERNALLY ILLUMINATED 4- TALL
TO MATCH OTHER ID SIGN ON PROPERTY
TOTAL SIGN AREA = 13.5 SQ.FT.
NOTE: THE FOLLOWING APPLIES TO ALL ELEC
U.L. LABELS
EXTERNAL DISCONNECT SWITCHES
CONNECT TO EXISTING ELECTRICAL Cl
GFr Y OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DA
DONCO & SONS, INC. VINTNERS DISTRIBUTERS
1410 N. DALY ST. 28456 CENTURY STREET
ANAHEIM, CA 92806 HAYWARD, CA 94545
714-254-0099 ATTN:
ST. LIC. 435616 N. GOYAU S. GOYAL
C10 C45 C61 PH: 510-293-9150
ADD SECONDARY
PRICE SIGN PER
WEIGHTS & MEASURES
DATE: 12/9/2002
SHELL STATION
78-998 HWY 111 & ADAMS ST
LA QUI NTA, CA 92253
.: �.,,.,
�.
:. ,, :,
�. �:
.:
;:
;:.
;:
:l.f..^^.� ..: ...:�� ` e �:
�.
per.. �. _._. .' ._�• .. i.. .�R. ....._.. ).... � ,.._... ...... Y �: ':
s
INLAND ENGINEERING AND CONSULTINGJNC. /
BY CHKD SUBJECT �&J Z v�TZM>-/
SHEET NO. 6P -
JOB NO.
CITY OF IA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE------"
� koFESS/04/
4-
0
n6969
EXP. 6-30-04
70 MPH WIND EXPO. "C"
(0-15) PW=(1.06)(1.4)(12.6)=18.7PSF
(60-80)PW=(1.53)(1.4)(12.6)=27.OPSF
(15-20)PW=(1.13)(1.4)(12.6)=20.OPSF
(20-30)PW=(1.23)(1.4)(12.6)=21.7PSF
(80-100)PW=(1.61)(1.4)(12.6)=28.40PSF
(100-120)PW=(1.67)(1.4)(12.6)=29A6PSF
(30-40)PW=(1.31)(1.4)(12.6)=23.10PSF.
40-60 PW= 1.43 1.4 12.6=25.23PSF
(120-160)PW=(1.79)(1.4)(12.6)=31.58PSF
PW L W SHAPE
PSF FACTOR
AREA FORCE H MOMENT
18.70 5.5 4
1
22.00 411.40 2
0.00 0.00 0
0.00 0.00 0
0.00 0.00 0
822.80
0.00
0.00
0.00
0.00 0 0 1
0.00 0 0 1
0.00 -6--o 1
0.00 0 0
1
0.00 0.00 0
0.00
0.00 0 0
1
0.00 0.00 0
0.00
0.00 0 0
0
0.00 0.00 0
,Sigma F = 411.40
Sigma M = 822.80
X = 2.00
Sr = 0.34
UBC FM(NON-CONSTRAINED)
ft. in.
diameter 2 0
depth 3 3
S = 288.17
A = 1.67
d = 2.92
bo
>
CITY OF IA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE------"
� koFESS/04/
4-
0
n6969
EXP. 6-30-04
Gl-a11
ALLWK oy OHR5MT1..
211 X211 XI/411 aft..4'5
W/ 1/ 2" 0 I VaI5
TO G01.. 8 vw
t0 GAB. (fr.)
AJJM, USB
BV nf$V- S
3" 0 117.5W. PK
Wl. -WPI
17131,, TACT 51CAN MWA110N
9tLL 5TA11ON
III & A17AM5
LA QUINA CALFORNIA
GENERAL NOTES
1. CONTRACTOR SHALL VERIFY ALL, DIMENSIONS AND CONDITION$.
2. STRUCTURAL PIPE SHALL CONFORM TO ASTM A501, ASTM A59 GRADE B i7PE
EORSFY=95 ESI. MIN.
9. STRUCTURAL TUBE SHALL CONFORM TO ASTM A500, GRADE B FY = 48ESI.
4. STRUCTURAL STEEL SHALL CONFORM TO ASTM A38.
5. ALL BOLTS SHALL CONFORM TO ASTM A307 W/WASHER U.N.O.
6. WELDING SHALL CONFORM TO AISC SPECS OR LOCAL CODES AND PERFORMED
BY CERTIFIED WELDER USING ARC PROCESS 9701L ELECTRODES. SHOP WELDS
BY APPROVED FABRICATOR. CONTINUOUS INSPECTION REQUIRED FOR ALL
FIELD WELDING.
7. FABRICATION, ERECTION AND PAINTING OF STRUCTURAL STEEL SHALL
CONFORM TO UBC SECT.205.
8. ALL STEEL LESS THAN 1/4' THICK SHALL HE GALVANIZED OR USE DOUBLE
COAT OF PREM
9. FLAMMABILITY OF ALL MATERIALS IN SIGN SHALL COMPLY WITH UBC
SECTION 207.
10. IDENTIFYING NUMBER REQUIRED ON SIGN AND WEIGHT OF SIGN CLEARLY
LABEL.
11. SAND CIAYEY RAVEL, ALL lWM ISAND SILTY �I�R�AL BEAR SAND SILTY
100 LBS./SQ. FT/FI'.
12. CONC. TO HAVE MIN. ULTIMATE COMPRESSIVE STRENGTH OF 2500 PSI
® 28 DAYS AND SHALL BE POURED AGAINST UNDISTURBED SOIL. (NO FORMS.)
19. ALL HOLES DRILLED OR PUNCHED.
14. ALL WORES SHALL CONFORM[ TO 1997 EDITION OF UBC.
15. REINFORCING STEEL SHALL COMPLY WITH ASTM A-615 GRD. 80 DEFORMED.
16. SIGNS TO BE 8 FT. HORIZ. A 12 FT. VERT. FROM HIGH VOLTAGE WIRES.
17. SIGNS TO BE U.L. LABELED AND COMPLY WITH ART. 600, NEC.
18. SIGNS TO BE ON SEPARATE CIRCUIT WITH UNDERGROUND FEEDER.
19. PROVIDE PEDESTRIAN PROTECTION DURING SIGN ERECTION PER SEC. 9903, UBC.
20. STRUCTURAL ALUM. 8081-T8, Fb=19000. PSI.
21. RED HEAD TRU BOIT WEDGE ANCHORS PER ICBO / ER -1972,
INSTALL PER MANUF. SPECIFICATION..
22. HILTI- HY 150 EPDXY ADHESIVE PER ICBO 5199 INSTALL PER MANUF. SPEC.
23. DESIGN WIND LOAD 70 MPH EXP. 'C'.
CITY OF LA QUINTA
BUILDING & SAFErY DEPT.
AP p RO E®
FOR CONSTRUCTION
DATE_..._- BY
OF I �pFEssr,,
SHEET NO.� ,(
Pow.0 & 5ab
CLIENT w
. 36969
"90-X EXP. 6-30-04
JOB NO.
12/9/02 qTE OF CA��F���
DATE:
&M @mm@m Bl@m9 Dlmo
121 N. 9. C~ Bwd. 3* 10B, Arch* . CA 9M
Tek (11 956.1790 FAX (114)93"W
SECONDARY PRICE SIGN
PER WEIGHTS & MEASURES DEPT.
NOTE:
SIGN FACE COLOR MAY CHANGE
PER NEW SHELL RVI SPECIFICATIONS
OLD COLOR: YELLOW FACE BIG
RED BIG ON LOGO, BLACK FONT
NEW COLOR: GRAY OPAGUE FACE BIG
WHITE BIG LOGO, WHITE+ONT
NUMERAL COLOR TO REMAIN THE SAME
BLACK FONT ON YELLOW BIG
FRONT VIEW
PLANTER GRADE 161, 1 SIDE VIEW
Ca
0���
0
0T G) 71
z -m 9
Qm e
z z
SECONDARY PRICE SIGN 13.5 SQ FT SIGN ARCHITECTURE TO MATCH
INTERNALLY ILLUMINATED QTY: ONE (1) PRIMARY ID PRICE SIGN ON PROPERTY
DATE: -
PROJECT NO.
050547
PROJECT ADDRESS:
SHELL STATION
111 & ADAMS
LA QUINTA, CA
1410 N. DALY STREET
, ANAHEIM, CA 92808
Donco & Sons, Inc.
(714) 254aN
ST. LIC. # 435818
C-10, 45, 61
SIGN PLAN
z LL
O
w
ai
REvlsro�2�2
2 11-23-02
SCALE:
1/Z" = 1
3
4
(714) 254-0099
Donco &. Sons, inc.
(714) 254-0199 Fax Signs • lighting • Electrical
LETTER OF AUTHORIZATION
August 8,'2003
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92253
1410 N. Daly St.
Anaheim, CA 92806-1502
To: Whom it may concern,
e
I hereby authorize the following person to act on my behalf in obtaining permits from the
Building Department and to sign permit applications for Donco & Sons, Inc.
t
Donco & Sons, Inc. is properly licensed as required by the State of California. I assume full
responsibility under the law for permits taken by persons authorized to act on Donco &
Sons, Inc. behalf.
This authorization shall continue until your cite is notified in writing that such
authorization is canceled.
Person authorized:
By: or �--��—
Donavon W. Fink — President
Company Name: Donco & Sons, Inc.
Contractor's State License Number: #435616
CA. LICENSE C 10 -C45 -C61 # 435616 • AZ. LICENSE L38 #097661 L11 #098214 • AZ. dba D & S Signage, Inc.