0207-144 (ELEC)LICENSED CONTRACTOR DECLARATION
1 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
800997 C-45 IT -C e_1 10113 1 /0121
Date "% t - Signature of Contractoru-
;;•
OWN ER-BUILDER'bECLARATION
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 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:
Carrier STAB°? ID Policy No. "ai913°Y-�i9fa
(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
Code, I shall forthwith comply with those provisions.
/� ,
.Date: ��+ *' Applicant
licant •� �" ��"-•---�'`
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.
Signature (Owner/Agent) Sym' y Date
BUILDING PERMIT
PERMIT#
6AT'E"''a , t VALUATION F LOT
�s
TRACT
JOB SITE
ADDDH SS ••.T.(ai 4 .�e�fyYC&.i.1 96.-
1
APN
OWNER
CONTRACTOR/DESIGNER/ENGINEER
DAM ffAR,,
COUNIT.Zi� IRC+IA111 MOMS Wpa
'19-225 FJOKIKAY l T
27 620 COMM �.: �' DWMk fZ L► 19
Lf+, C?CIIWA CA 92253
`Y' 3,". M' CA 92.500
("9)676-58,20 QB14
USE OF PERMIT
ELECTRZIAL
I INI'l?AR- 7AU,Y' IL.LLIMINATIPl) SItYNR MR. APPROVT&D SA24002,62I'
14AXIDA
%AW,A`: "iOW
836.00
NAIMUM CWT OF CQNSTXY'UCTION
W.DD
alEICTRICAL FEE 101-000-410-000
F
�30,€►t9
^Y
SUB -=M, CO),,R%�i't�'d ON AND AM CHUCK K .
430.00
L► I \ 4"
LE -1133 P_V1-•blPAil MES
MOD
FERMnES DUE NOW
MOD
CI1f'OFLAQUINTA
FINANCEDEPT.
RECEIPT
DATE
BY
DAT FINALED
INSPE T R
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
0. 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
POOLS - SPAS
BLOCKWALL
APPROVALS
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 Oft.
'' ' -
Egiiip'irnent Enclosure
-
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
, . , ,
Pool Cover,
�i
Sewer Connection.
Encapsulation -
Gas Piping
Gas Test * :
Appliances
Final
COMMENTS:
,
-- .
Final
Utility Notice (Gas) -
.._ .,ELECTRICAL APPROVALS
Temp. Pow*r•Pole • I_.•!,:
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) {j
t
Shiaing Brighter Than
July 19, 2002
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Country Signs & Designs, Inc.
ATTN: Brian Leanza
79225 US Highway 111
La Quinta, CA 92253
(760) 777-7000
FAX (760) 777-7101
RE: SIGN APPLICATION 2002-628; ID Sign for La Quinta Auto Centre (Mazda)
Dear Mr. Leanza:
In regards to the above subject, this Department has approved your application to establish a
building mounted Dealer Identification ' Sign (approved Exhibits A and B; enclosed) for the
referenced auto sales use. The proposed sign is consistent with Chapter 9.160 of the Municipal
Code, in that it is in conformance with the approved sign program guidelines of Specific Plan
97-029 for La Quinta Auto Centre. This approval is 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(s).
2. Installation of the sign shall comply with approved Exhibit A, and the applicable
provisions of the approved sign program for Specific Plan 97-029 (La Quinta Auto
Centre).
3. No portion of the sign may overhang the building fascia.
Should you need any clarification or further information in regard to this matter, or if you have
any questions, please do not hesitate to contact me.
Very truly yours,
JERRY HERMAN
COMMUNITY DEVELOPMENT DIRECTOR
Wallace Nesbit
Associate Planner
WN/wn
encl.
c: CBu'ilding-and`Safety
Co6_Complianpce Division
Specific Plan 97-029 file
C:\W rkgrp\Letters\sa2002628.wpd
f Approved by: Reso
O Planning Commission
❑City Council
OTOMM404 Dev. Dept.
Initials
Case No. s�v2-iozg
Exhibit
AFWith Conditions St4�'4:"-f
2'-6"
F""]
11'-7"
2'-9 11 /8
24.. 15 /8..
File Name: Maz W-32 Wall sign
u Plasti-Lime, Inc. Scale: 1:24 Approved Br:
Pmp" cfwade., hw. Mot ro be aged Date: 20 jury 00 Date:
1i
2'
3 Existing KIA
q New Sign Location
SIGN LOCATIONS ARIEL
=Pool
S113N LOCATION
D
m U
=
0 o—
SERVICE
�
I- '
SUPERSTORE
KIA
p
l0z
W p
V
(71 D 0
aO
i
p-3
OD m
Q
O 1
g�
m
a r-
k n
01
m <
to Z m
N
l m C
HWY 111
N m
VICINITY MAP
A
J
1i
2'
3 Existing KIA
q New Sign Location
SIGN LOCATIONS ARIEL
=Pool
_.Amm
m U
=
0 o—
SERVICE
r7 ^+
SUPERSTORE
KIA
ID 0
D 0
l0z
n
(71 D 0
aO
o
p-3
OD m
W
NO Z
O 1
m
a r-
k n
01
m <
to Z m
N
l m C
N m
A
J
v N O
0
O OD
r
1i
2'
3 Existing KIA
q New Sign Location
SIGN LOCATIONS ARIEL
SCALE IS 1
EAST ELEVATION VIEW
Location: 795 Hwy 111, .La Quinta CA..92255
T -IN
SERVICE
r7 ^+
SUPERSTORE
KIA
SCALE IS 1
EAST ELEVATION VIEW
Location: 795 Hwy 111, .La Quinta CA..92255
Drawn 159:
B RIAN
.1o6:
MAZDA
1/02
Page 1 0�.1
T -IN
= m v
03tn
Z m N
m 0 O
ID 0
D 0
ton3
(71 D 0
v n
0tom
to Ul n
OD m
W
NO Z
O 1
m
a r-
k n
01
m <
to Z m
N
l m C
N m
A
J
v N O
mco —
O OD
Drawn 159:
B RIAN
.1o6:
MAZDA
1/02
Page 1 0�.1