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BSIG2014-100178-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: BSIG2014-1001 79070 HIGHWAY 111 600390029 C� 0 D VOICE (760) 777-7125 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 7/16/2014 Owner: INLAND AMERICAN LA n r CALIFORNIA PATIO SA 2014-1789 $700.00 P 0 BOX 9271 OAK BROOK, IL 92253 JUL 16 2014 CITY OF LA QUINTA Applicant: Contractor: LCOMMUNITYDEVELOPMENTDEPARTMENT JULIAN PEARSON SIGNS OF SUCCESS 1614 S. CARLOS AVE STE. M 1614 S. CARLOS AVE STE.M ONTARIO, CA 91761 ONTARIO, CA 91761 (909)563-1823 Llc. No.: -------------------------------------------------------------------------------------------- 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: _ License No.: Date: I ` 1 Contractor: -- OWNER -BUILD t DECLA ATION I hereby affirm under penalty of perjury that I am exe pt 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).: (_)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 dr herself through his & 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. . B.&P.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 Name: Lender's Address: ` WORKER'S COMPENSATION DECLARATION I hereb 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: _ _ 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, 1 shall forthwith comply with Ithose provisions. n Date: lJ1 Applicant: 1 WARNING: FAILURE TO SECURE WORKER/MI'NAL PENSAT ON COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TOC PENA TIES 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 ofthis city to enter upon th ove- mentioned property for inspection purposes. Date: Signature (Applicant or Agent): 7 �� FINANCIAL INFORMATION ACCOUNT QTY AMOUNT PAID PAID DATE DESCRIPTION BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SIGNS 101-0000-42403 0 $35.75 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SIGNS PC 101-0000-42403 0 $47.67 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL: $83.42 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/AWNING SIGN, FIRST 101-0000-42404 0 $24.31 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/AWNING SIGN, FIRST PC 101-0000-42600 0 $85.80 $0.00 PAID BY METHOD RECEIPT # CHECK# CLTD BY Total Paid forSIGN: $110.11 $0.00 TOTALS:•4 i 00 Y- -DESCRIPTION- ACCOUNT • ' �-�.. r:•rrwn%sa+Ca�'•74'it'J",��,� .z, ` a., fir.. "�# �f€C.,:3,'rt T'� as ��dxF�3 "`�..�i F z'Y> 1 i ��'°' �xi };,: - � 0- � A +^�.a'-xs�% ^ €PermitTRAK'rl?�^4ss.�. :�rt�w. t� �?:_�wa^.,�riy-.. .��;:,e ,�.:,� �..= •„�:x � , sr ,, � � q��rshs?x'z� 'BSI�G2014 1001 Address ,79070FHIGHWAX,111- Apsn_ 600390029 �x �� ; � �x$194,53G . ? �BUILDINGST_ANDARDSA_DMINISTRATION.BSA $1;00,'' �- BSAS SB1473 FEE 101-0000-20306 0 $1.00 2 1',,jLECTRICAL?r'x Y4,._A - a r.S: a� s-', e r s �1. 'r` t"� i'a - ' � �� .:•x +e' i`k '"i - $8342 SIGNS PC 101-0000-42403 0 $47.67 SIGNS 101-0000-42403 0 $35.75 ^> > 3{ 110 whet .11 .,, w..:""s" '` �•'r ,:.;ir T: ,.: ^,,.r ': �r x •, •.a"� ,rM �: i r ` >rox -, 'r s :_ r." $ » WALL/AWNING SIGN, FIRST 101-0000-42404 0 $24.31 WALL/AWNING SIGN, FIRST PC 101-0000-42600 0 $85.80 TOTAL11 • Date Paid: Wednesday, July 16, 2014 Paid By: SIGNS'OF SUCCESS Cashier: PJU Pay Method: CHECK 3698 Printed: Wednesday, July 16, 2014 12:04 PM 1 of 1 grcYciFMc iiia # ` Permit �. , Qty of La Quints -Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico . La Quints,. CA 92253 - (760) 777-7012. Building Permit Applicatron and Tracking Sheet Project Address: Owner's Name: A. P. Number: Address: -19-MC) Legal. Description: City, ST, Zip: Contractor: U Tele hon ,:;k.;:i..;;:.;»;::s :;:>:�:>.:,::;� :i:>:;<•...::;;�,;:; Address: l Project Description: Irni 10 City, ST, Zip: Telephone: MaC) ,'L!l 1 2 State Lic. # : SS -City Lic. #: Arch., Engr., Designer: Address: City., ST, Zip: Telephone: :.vr::: N<<�:? ; >;A':.>:: =• • --.. i$y::t;?:H: . z.».<' :<>'-":`:: -:.•• �;:~ `> >~<-<.> •;'' Construction Type: Occupancy: Project type circle one): New Add'n Alter Repair Demo State Lic. # Name of Contact Person: Sq. Ft.: #Stories: nits: 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 Item Amount Structural Calcs. 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 correctionsrssue Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN IiOUSE:- '`" Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees