BSIG2015-000278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
I ,
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BSIG2015-0002
79024 HIGHWAY 111 103
600390029
(1) BUILIDNG MOUNTED SIGN FOR "WABA GRILL"
$4,000.00
Applicant:
DONG BANG SIGN
1300 W OLYMPIC BLVD #110
LOS ANGELES, CA 90015
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 Professions Code,
and my License is in full force and effect.
License Class: C45 License No.: 897933
D.a IZI U.LO_ Contracto—i n
�1W
OWNER-BUILDE CLARATION
I hereby affirm under penalty of perjury t t I am exempt from the Contractor's 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
Contractor's 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).:
(_) 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 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 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.).
(_) 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.).
(_) I am exempt under Sec. BAP.C. for this reason
Date:
Owner:.
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
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
15
Owner:
INLAND AMERICAN LAQUINPcA D
P O BOX 9271 ;M
OAK BROOK, IL 92253 �....
N
D 6JOT7
Contractor: z Ic
DONG BANG SIGN `"
1300 W OLYMPIC BLVD C
LOS ANGELES, CA 9001 Z O
Q Z
(213)385-3344
Llc. No.: 897933 �.
. V
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 and policy number are:
Carrier: —Policy Number:
{ r) 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.
Drte-.-61& / Applican't:VINAL
WARNING: FAILURE TO SECURE WORKERATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CALTIES 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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
Date: ��ignature (Applicant or Agent):
Description: (1) BUILIDNG MOUNTED SIGN FOR "WABA GRILL"
Type: SIGN Subtype: Status: INCOMPLETE SUBMITTAL
Applied: 1/6/2015 SKH
Approved:
Parcel No: 600390029 Site Address: 79024 HIGHWAY 111 103 LA QUINTA,CA 92253
Subdivision: PM 29351 Block: Lot: it
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $4,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
CHRONOLOGY TYPE
Details: SIGN PERMIT- (2) BUILDING MOUNTED INTERNALLY -ILLUMINATED CHANNEL LETTER SIGNS ON THE NORTH AND SOUTH BUILDING
ELEVATIONS. 2013 CALIFORNIA BUILDING'CODES.
Printed: Friday, January 16, 2015 1:11:56 PM 1 of 3 CRWV_STFAA.S
ADDITIONAL
CHRONOLOGY
CHRONOLOGY TYPE
STAFF NAME
ACTION DATE
COMPLETION DATE
NOTES
MR. BANG SUBMITTED BUILDING APPLICATION AT THE SAME
PLAN CHECK SUBMITTAL
TIME OF RESUBMITTAL TO PLANNING DEPARTMENT.
STEPHANIE KHATAMI
1/6/2015
1/8/2015
RECEIVED
APPLICATION WILL BE PROCESS PENDING APPROVAL FROM
PLANING.
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP PHONE FAX EMAIL
APPLICANT
DONG BANG SIGN
1300 W OLYMPIC BLVD
LOS ANGELES
CA
90015
#110
CONTRACTOR
DONG BANG SIGN
1300 W OLYMPIC BLVD
LOS ANGELES
CA
90015
#110
1
1
1
1
1
-
OWNER
INLAND AMERICAN LAQUINTA PAV
P O BOX 9271
OAK BROOK
I IL
1 92253
Printed: Friday, January 16, 2015 1:11:56 PM 1 of 3 CRWV_STFAA.S
FINANCIAL INFORMATION
CLTD
DESCRIPTION ACCOUNT. QTY AMOUNT
PAID
PAID DATE RECEIPT # CHECK # METHOD PAID BY
BY
BSAS SB1473 FEE 101-0000-20306 0 $1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$0.00
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$0.00
Total Paid for ELECTRICAL: $48.34 $0.00
WALL/AWNING SIGN,
101-0000-42404
0
$24.66
$0.00
EA ADDITIONAL
WALL/AWNING SIGN,
101-0000-42600
0 .
$24.66
$0.00
EA ADDITIONAL PC
WALL/AWNING SIGN,
101-0000-42404
0
$24.66
$0.00
FIRST
WALL/AW SIGN,
101-0000-42600
0
$87.02
$0.00
FIRSTT PC
PC
Total Paid forSIGN: $161.00 $0.00
TOTALS:00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES
DATE DATE
FINAL" .
REVIEWS
REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED _ STATUS REMARKS NOTES
DATE _T
Printed: Friday, January 16, 2015 1:11:56 PM 2 of 3
SV.CTFMS•
Printed: Friday, January 16, 2015 1:11:56 PM 3 of 3 CRWW Cy.�7FMS
Bin #
City of La Quinta
Building 8r Safety Division
P.O. Box 1504, 78 495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: y_ 1
Owner's Name:
A. P. Number: ' .
Address:
Legal Description: L� f) j, S`� M
City, ST, Zip:
Contractor: Vi
Telephone:
z>`:<
Address: �/Q [�t Q•� �►C I� (�
Project Description: '
City, ST, Zip:
Telephone:
State Lic. 4:-
City Lie. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
`4
Name of Contact Person: N %'�
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
t/
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionstiissue
Electrical
Subcontactor List
Called Contact Person
Plumbing.
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN I10USE:-
'`" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Pcrmi ,e , 20.
COMMUNE DE QUINTq
VELOPMEN7'
Bin #
Permit #
Project Address: —o
City of La Quinto:
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
�j l# 103. Owner's Name:
A. P. Number:
Address:
Legal Description: 'S, n-)
City, ST, Zip:
Contractor: �
1
S� .r•�
Telephone:
Address: - V0j LS -Y-41
C L
Project.Descrr`ip`�tion: WA 1 M
City, ST, Zip:.
Telephone:
`<>
-
State Lic. #: 11>
City Lic. #; 14m
Arch., Engr., Designer:
.Address:
City., ST, Zip:
Tele hone:
;:<•;:
Construction Type: Occupancy:
Y•
State Lic. #•
ProJect tYPa circle one): New Add'n Alter. Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Itcm
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Titic 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'a Review, ready for corrections/issue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN IiOUSE:-
Review, ready for correctionstiissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees