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06-4284 (SIGN)r 'P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 1 Application Number: f-06-00004284 Property Address: -_79255 HIGHWAY 111 STE APN: 649-030-999-8 -30420 Application description: . SIGN Property Zoning: REGIONAL COMMERCIAL Application valuation: 3000 T'ht " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT, Applicant: Architect or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: '12/14/06 Owner: STAMKO DEV CO C/O PROVIDENT FINANCIAL MGMT 10345 W OLYMPIC BLVD 2 FL LOS ANGELES, CA 90064 e Contractor: D PARAGON SIGNS 77650 ENFIELD LANE DEC 2202006 PALM DESERT, CA 9221 (760)345-3340 _J Lic. No.: 637739i���� ------------------------------------------------------- ----------------------=------------------ LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with .1 hereby ffirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C45 D42 License No.: 637739 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is is ed. Date: ontractor: I e 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 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 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 improvis thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' Slate License Law.). (_ 1 I am exempt under Sec. A, B.&P.C. foythis reasow=!, f9 CONSTRUCTION.LENDING AGENCY I hereby affirm under penalty of perjury At 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: 04_ Lender's Address: IJ 114 LQPERA1IT insurance carrier and policy number are: Carrier S ATE FUND Policy Number 1735081 1 certify that, in the perfor ance of the work for which this permit is issued, I shall not employ any person in any manner as to become subject el!a orkers' compensation laws of California, and aree that, if I sh uld become ubject to a work rs' compensation provisions of Section L700 -of th abor C de, I shall f hwith'co ply wi those provisions. <ate/ � pplicant: - ARNING: AILURE TO SECURE RKERS. 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. 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 to above information is torr t. I gree to comply with all city and county ordinances and state laws relating to b +Iding construction, and her y au oriz representatives of this c un y to enter upon he above-mentioned prop rty for ins pe n purposes i nature (Applicant or Agent): LQPERMIT • •Application Number . . . . . 06-00004284 Permit . . ELEC-MISCELLANEOUS INV FEE Additional desc " Permit Fee . . . . 66.00 Plan Check Fee 8.25 Issue Date Valuation . . . . 0 Expiration Date 6/12/07, Qty Unit Charge Per. Extension BASE FEE 30.00 .1.00 30.0000 EA ELEC SIGN 1ST CIRCUIT 30.00 - 1.00 6.0000 EA ELEC SIGN ADDITIONAL CIRUITS 6.00 Special Notes and Comments • 2 INTERNALLY ILLUMINATED SIGNS, "CONTOURS EXPRESS", AT FRONT & REAR -OF BUILDING, PER SA# 020O(v-10->5 2006.1035INVESTIGATION FEE ASSESSED PER 1997 UNIFORM ADMINISTRATIVE CODE §304.5 FOR WORK BEGUN WITHOUT BUILDING PERMIT. Fee summary Charged Paid Credited -----------=---------------------------------------------- Due Permit Fee Total 66.00 .00 .00 66.00 Plan Check Total 8.25 .00 .00 8.25 Grand -Total •74.25 .00 .00• 74.25 LQPERMIT CITY OF LA QUINTA PUBLIC WORKS DEPARTMENT GREEN SHEET PUBLIC WORKS CLEARANCE FOR RELEASE OF BUILDING PERMIT Form updated & effective 11/17/2006 Green Sheet approvals are forwarded to the Building & Safety Department directly by Public Works. Please DO NOT submit the Green Sheet (Public Works Clearance) Packet to the Public Works Department until ALL requirements listed below are complete. Incomplete applications or applications which cannot be processed will be returned to applicant. Date: ZZ Developer: Tract No.: Tract Name: Address(s-0<„ 1 n91 The following: are the requirements'for Public Works Clearance to authorize issuance of'a building permit from the Building & Safety Department: ❖ CUSTOM HOMES: PROVIDE ITEMS #2 #3 #4 AND #5 BELOW ❖ TRACT HOMES: PROVIDE ITEMS #1 #2 #3 #4 (AS APPLICABLE) AND #6 BELOW ❖ COMMERCIAL BUILDINGS/OTHER: PROVIDE ITEMS #1 #2 #3 AND #5 BELOW WALLS: PROVIDE ITEMS #7 BELOW 4• SIGNS: PROVIDE ITEMS #8 BELO 1.. Attach Pa eva ion er i icates in compliance with the approved design elevation for building pad (maximum allowable deviation of +/- 0.1 .foot). Pad Elevation Certificates must be current (within 6 months of current date). If a "precise grading plan creates the pad for approval, please withhold green sheet submittal until a Pad Elevation Certificate can be provided. 2. Attach geotechnical certification of grading plan compliance. 3. Attach recorded final map showing proposed building locations are legal lots. 4. Attach a completed < 1 acre per lot or infill project Fugitive Dust Control project information form, PM 10 plan & agreement or provide alternative & valid City approved PM 10 plan set reference number or hard copy plan. PM10 plans for commercial & residential developments (beyond 1 lot) are submitted separately with grading plans & are subject to additional requirements. 5. Attach an approved precise grading plan for the building location(s). AO flood zone developments will require an approved flood plain development plan. 6.. Attach an approved rough grading plan for the building location(s). 021 7: Attach wall plan & related approved grading plana Afa> Attach sign layout/plan & related precise grading/landscape plan. OK –� aF WW �--� cc.ft43 have reviewed and confirmed the requirements fisted above as presented and find the improvements to be sufficiently complete for construction of the propo3q buildings/structures/walls/signs on the subject lot(s). Pursuant the vnpAoJe released for building permit issuance. Recommended b7V�dihgs, c---Q ct rn Dated: l Public Works Distribution: { ) Green Sheet to Building & Safety counter 6-4—Green Sheet to Community Development Declined for approval for reason(s) as follow(s), please correct and resubmit: