05-0100 (SIGN){
BUILDING & SAFETY DEPARTMENT
cam• �_ �ti�w P� 1504 •
, (760).777-7012
z �4978-CLLE TAMPICO
lY 11 FAX (760) 777-7011
2na+5QU�I15TA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
pF4�1yNTA BUILDING PERMIT
F►NApCE ®�'�
Application Number . . . . . Date 1/12/05
Property Address . ... . . . 79305 HIGHWAY 111 STE 5
APN: 649-030-999-7 -30420 -
Application description . . . SIGN
Property Zoning . . . . . REGIONAL COMMERCIAL
Application valuation . . . . 2360
Owner _�• - ;Contractor �• ,
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -r '" 4 s- - - - -- - - - - - - - - - - - - - t- - - - -
STAMKO DEV CO BEST SIGNS, INC.
C/O PROVIDENT FINANCIAL MGMT 1550 S. GENE AUTRY TRAIL
10345 W OLYMPIC BLVD 2 FL PALM SPRINGS, CA 92264
LOS ANGELES, CA 90064 WCC: STATE FUND
-WC: 0460011501 03/01/05
CSLB: 524483 02/28/06.
CCC: C45-D42
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P.O. Box 1504 ` •^
"78-495VOICE (760) 777-7012-
CALLE O FAX (760) 777-7011
LA QUINTA, CALLIFORIFOR NIA 9225344 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant: Date:
Applicant's Mailing Address:
Architect or Erigineer:
Architect or Engineer's Address:
Lic. No..
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of DMsion.3 of the Business and Professionals
Coderand-rrry=License is in full force add"hffect_
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit t construct, alter, i prove, 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 p uant to the p isions of the Contractors' State License law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he or she i erefrom 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).):
U 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 or 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.).
(--) 1, 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a . cate 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 is perm ' issued.
_ I have and will maintai workers' co nsation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued M ers mpensation in rance camer and poli y pumber are:
Or, um
artier` IPo ' ber- - -!7 lD O O 1 Sd
CO -= kertify that, in the perf mance of_the �vortc f which this permit issued, I shall not employ any person in any manner so as to become subject to the workers'•
compensation laws o California, and agree t t, ii I should"become ubject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall
hwith comply with ose prove ns.
_v-Daetei $ p i-- (cant k.
WARNI G: FAILURE TO SECURE WO ERS' COMPENSATION C VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED TH SAND DOLLARS($100, 0), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, IN REST, AND ATT ORNE 'S FEES.
ONSTRUCTION LENDING AGENCY
hereby affirm under penalty of perjury that there is a c Ghon lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lenders Name
Lender's Address
IMPORTANT Application is hereby made to the Director
1. Each person upon whose behalf this applica
issued as a result of this application, the ovw
officers, agents and employees for any act
2. Any permit issued as a result of this applica
cessation of work for 180 days will subject
1 certify that I have read this application and state that t
const on, hereby authorize representatives of Ifi
j-- ate ", ,—Signature,(Applicant or Ag
APPLICANT ACKNOWLEDGEMENT
f Building d Safety for a permit subject to the conditions and restrictions set forth on this application.
on is made, ch person at whose request and for whose benefit work is performed under or pursuant to any permit
v. and the app nt, each agrees to, and shall, defend, indemnity and hold harmless the City of La Ouinta, its
omission related the work being performed under or following issuance of this permit.
n becomes null an 'd if work is not commenced within 180 days from date of issuance of such perrnk or
'mit to cancellation.
above infom►ation is I agree to ply with all city and county ordinances and state laws relating to building
county to
an
upon n r inj-ru-yYnv/n purposes.
w 1 �N �r',. 3V
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u's
.,Application Number 05-00000100
Permit ELEC-ELECTRICAL SIGN
Additional desc
Permit Fee 18.00 Plan Check Fee .00
Issue Date Valuation . . . . 0
Qty, Unit'Charge Per Extension
BASE FEE 15.00
1.00 3.0000 EA ELEC SIGN ADDITIONAL CIRUITS 3.00
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Special Notes.and•Comments
CHANNEL`LETTER SIGNS PER SA#r0
Fee summary Charged Paid Credited Due
--------- ---------------- ---------- ---------- ----------
Permit Fee Total 18.00 .00 .00 18.00
Plan Check Total .00 .00 .00 .00
Grand Total 18.00 .00 .00 18.00
Jan 14 05 11:51a
Stamko Development Co. 760-777-7687 p.l
0
BY FAX
Date: January 14, 2005
To: Jesse
Company: Best Signs
Fax #:
From: Russ Beckner, STAMKO Development Co.
Telephone: 760-777-7686
Fax: 760-777-7687
E -Mail: STAMK02@aol.com
You should receive 2 pages including this cover page. If you do not, please call
760-777-7686. Thank
I have marked the subject building and the location of Golf Etc. in that building. If you
need anything more, please call.
Russ