0311-114 (ELEC)- LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
SS rxpter 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
69049.2 Cl0 045JUC 06/3(v2c
faf�ate 11-1Z% Signature of Contractod 'a
+� OWNER -BUILDER DECLARATION
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 STATE FUND Policy No. 000000-A03
03 _
(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.
//ate: f.. Applicant-
Warning:
pplicant Warning: Failure to secure Workers' Compensation coverage is unlawfu and
shall subject an employer to criminal penalties and civil fines up to $10070600, 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 t 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 propertyforinspection purposes.
S�nature Owner/A ent f�a �ol)ate f/`- ,>'42Z
9 ( 9 ),mow..
BUILDING PERMIT PERMIT#
1
_
DA?�,, u. VALUATION 'iVT , � ' TRACT
�•J� �1Ji��Ett: t3tltd,t3ei1
JOB SITE
,ADDRESSfa
APN
OWNER
CONTRACTOR / DESIGNER / EN &NEER
MMKO T}FIW. L0PW314J' CO.
TAX01" O WON ARD. T_ GITMIG 0"FIRVICI.l
3 556`VI ADOW7,
5010 V.(MMELV
MARINA DEL RE, Y CA 90292
LOS }ANG MEB CA $0019
(323)93-7,4443 CSLA
USE OF PERMIT
TWO PIER '
"VALUATION
f.'WW = C_ C*T OF CONSTA C t70K
�,f3QN►.t�E
y•��v� vq f� i�wW�t�+�t�g�,�����• Ap
.k.r'a1. = 3j SLAY Y7'+LI.L581Y.OARY
ELECTRICAL FU 10' •0(10,42M0.0
SUB -XYLA ; CONSU'PTI ON AL`s PLA9 CIT, CK
LHIN 1 PJf T Ms
Q...'D
D '
QTc :Mauir FKFS DUR HOW
NOV '1 3 2003
`CITY.OF. LA QUfNTA
FINANCE DEPT'
RECEIPT
DATE �:
/1 f �
BY
z-
DATE FI LE
X93
INVR
C 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
O.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
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
'
Equipment Location
r, a
Underground Electric
Underground Plbg. Test
Fhal
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final d
Utility Notice (Perm)
COMMENTS:
_
1.;
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED Z
FOR CONSTRUCTION
DATE Y.
39'- 6"
AN amedam f t I i
51DE ELEVATION
SCALE 1/&" = 1'- 0"
14'-1 'r'Z"
i5
J
Approved hZ Be so -
DPlanning Commissto> :...,.........�., .......•..••
OC y�jr Council ...,�.._..�.�. �..�...
67.Community Dev, Dept► ;; ; _':: ......_.....
Initials "� .�.....
Case No. aA a 3' ..._.�..,. ........_.�
Exhibit.,,% -- ..,,...._,...,.
O With Conditions.,...»
70% OF LENGTH OF 5TOKEFKONT = 27.65' FOR WIDTH OF SIGN
1.5 x 39.5 = 59.25 5Q FT ALLOWED
o ONE (1) 5ET OF INTERNALLY ILLUMINATED
CHANNEL LETTER5
o REMOTE TRAN5FORMER5
o UL L15TED
SIGN DETAIL o 5Q FT = 35.31
SCALE Sia" = 1'- 0" Pg. 2 of 3
north 5ALE5: TOM RICE DWG # 310127-01 PM FILE: LOCATION: l..L'1_LLI�'7f1 9
EM am®rican ACC. M.: HEATHER CHRISTENSEN KEV15101"J: - 5TORE #2504
Sign ART: RLP 10.16.03 CENTER AT LA QUINTA / LA QUINTA, CA.
NOTE: IF ANY FIELCJ MEA5UI'EMEN'TS PIFFEK F-K0M "T1105E ON T1115 PENNY I'LEA5E I'-10T1FY NOFT11 AMEI'IGAN 51GN5 (0 (e500) 25 5-5000
ti
-79vio51+���3
+e. 3
FRONT ELEVAMON
SCALE ie = f- Cr
14'-7W
i11
.a Q u't �+a CA
o ONE (1) SET OF INTERNALLY ILLUMINATED
CHANNEL LETTERS
' o REMOTE TRANSFORMERS
Lo UL LISTEDED
�2 p�
51GN DETAIL HI � � E O V
SCALE we = 1- 0'
CITY oo77yyF LAO INTA
COMM DEPARTMENTPMENT pg.1 Of
I1QPth 5ALE5- TOM RICE DWiG # 510127-00 PM FILE: LOCATION: � I
1
aI epican ACC. M.: HEATHER CHRISTEN5EN REV151ON: STORE #2504
Signs ART: RW 30.16.03 CENTER AT LA QUINTA / LA QUINTA, CA.
N=: 11= ANY FIELD ML'ASIJP'ENIENT5 DIFFER FIZOM -11-105L ON TH15 rr-i 1'f PLEA5E NOTIFY N01271 -i AMERICAN SIOaNO 0 (800) 51-5-5000
NOTL: IF ANY FIELD M. EASUKEME_N"fs DIFFEt, FROM TH05E ON THIS PKINT I�LEA:!5E= NOTIFY NOR7nl A.,AE_P?-JCAN 510- NO ZD C6-00) 2185-5000
•t�
a
14'-1 'i2" `v
JO" REMOTE CHANNEL
LET'ER5
T
"GAME" DETAILS
FACES: 7328 WHITE FLEX
30"
TRIM CAP: 1" BLACK
L(
'
NEON: 15MM 6500 WHITE
"
STOP DETAILS
W REMOTE CHANNEL LETTER DETAIL
FACES: 2793 RED PLEX
TRIM CAP: 1" BLACK
SCALE we = Y- 0"
NEON: 15MM 04 CLEAR RED
• 50 ET = 35.31
RETURNS
MATERIAL: .040 ALUMINUM
COLOR: PRE-FINISHED BLACK
WAS
OUTSIDE WRITE INSIDE
ALUMINUM BACKER
BACKS
(BLACK)
MATERIAL: .080 ALUMINUM
TRIM CAP
TRANSFORMERS
ELECTROBITS
TYPE: REMOTE
MA: 60MA 120 VOLT
NEON TUBE
.
�
PLEX FACE
3'° BORDER
MATERIAL: ALUMINUM
.050
------,GTO
CABLE
COLOR: PAINTED GLOSS BLACK
h40UNTING
NEON RISER
FLUSH TO FASCIA W/
NON-CORROSIVE FASTENERS
SUITABLE FASTENER
AS REQUIRED
ALUMINUM RETURN
11YR�tlu'EI>��iTf Cid
� II.�I�C1II�
TRANSFORMER
fLECTI2IC SIGN
CHANNEL SECTION THFU
N.T.S.
Pg. 3 of 3
lq nopth
5ALE5: TOM RICE
DCVO # 31027-00
FM FILE:
LOCATION:
arnencan
ACC, M., HEATHEK CHRJSTEN5EN
REYI:5IONr
STORE #2504
s�, ras
ART: KLF
10.16.03
CENTEK AT LA QJINTA / LA QUINTA, CA.
NOTL: IF ANY FIELD M. EASUKEME_N"fs DIFFEt, FROM TH05E ON THIS PKINT I�LEA:!5E= NOTIFY NOR7nl A.,AE_P?-JCAN 510- NO ZD C6-00) 2185-5000
;JCCv°YA'JC ► _.CAD:
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(CALIFORNIA
(C L'
cJLDING CODE 2001) .
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(CALIFORNIA
MEC-ANICAL CODE
2001)
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(CALIFORNIA
ELECTRICAL CODE
I L
T-15
24
?ROJEGT SHaLL CG`•�1pLY WITH T -.E 2001 EDITIG'1 OF
ADOPTS
T==
CAUFOR`JIA BUILINNIG
C'.%J- (TITLE 24). M41CH
AND THE 199° ^SEC
-�
1007
IIR _ 2000 UMC,
2000 UPC
tz r- v n i A
r\ r- j r L -t.\ VI
i�OJEC i ADDRESS:
-�� rE?J TRE AT L-A QUINTA
I:'T= P3
r.. CA 9225
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