05-3672 (SIGN)auf
P.Oi BOX 1504
78-4'k CALLE TAMPICO
LA QNTA, CALIFORNIA 92253
Application Number: IL
-05_00003672
Property Address:
79405 HIGHWAY 111 STE
APN:
649-030-999-6 -30420
Application description:
SIGN
Property Zoning:
REGIONAL COMMERCIAL
Application valuation:
1100
Applicant:
Ta�v 4 4 Q"
Architect or Engineer:
PIA
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am
li sed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3.of tie' usI Sand ssionals Code, and my License is in full force and effect.
License Class: C45 ! i 1 ice- License No.: 457406
OWNER -B DER DECLARATION
I hereby affirm under penalty of perjury that I am exempt fro he Contractor's State License Law for the
following reason (Sec. 7031.5, Business and .Professions Code: city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to ' suance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the 'ions 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 ISec. 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.).
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
17044, 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/25/05
Owner:
STAMKO DEV CO
C/O PROVIDENT FINANCIAL.MGMT
10345 W OLYMPIC BLVD 2 FL
LOS ANGELES, CA 90064
D °
Contractor: AUGC
SIGN TECH G 2 2005
4444 FEDERAL BLVD
SANTA BARBARA, CA 921 2 criy OF LA AUINTA
(619)S27-6100 FINMI;E DEPT.
Lic. No.: 457406
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 and policy number are:
Carrier STATE FUND Policy Number 0004780000021
1 certify that, in the performance of work for which this permit is issued, I shall not employ any
person in any manner so as to b e subject to the workers' compensation laws of California,
and agree that, if I should beco ubject to the workers' compensation provisions of Section
3700 or o&W, I shc=ith comply with those provisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO V GE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FI 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 the a4ri
is correct. I agree to comply with all
city and county ordinances and state laws rela ' wildinnd hereby authorize representatives
of this qty to enter upon above -menti ed prop fses.
�•,9/J�` (Applicant or Ag
LQPERMIT
Application Number . . . . . .05-00003672
Permit . . . ELEC=ELECTRICAL SIGN
Additional desc .
Permit Fee 15.00
Plan Check Fee
.00
Issue Date
Valuation . . .
. 0
�.
Expiration Date 2/21/06
Qty Unit Charge Per
Extension
BASE
----------------------------------------------------------------------------
FEE
15.00
Permit SIGN PERMIT
Additional desc .
Permit Fee . . . . 27.00
Plan Check Fee
17.55
Issue Date . . . .
Valuation
1100
Expiration Date 2/21/06
Qty Unit Charge Per
Extension
BASE
FEE
15.00
6.00 2.0000 HND BLDG
501-2,000
12.00
----------------------------------------------------------------------------
Special Notes and Comments
COMMERCIAL EXTERIOR SIGN "SPRINT"
27 SQ.FT. INTERNALLY ILLUMINATED
-
NEON. 2005 ENERGY, 2001 CODES.
=------------------------------
----------------------------------------------
Other Fees ... . . . . . . . ENERGY REVIEW FEE
1.76
Fee summary Charged
Paid Credited
Due
Permit Fee Total 42.00
.00 .00
42.00
Plan Check Total 17.55.
.00 .00
17.55
Other Fee Total 1.76
.00 .00
1.76
Grand Total 61.31
.00 .00
61.31
r
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FOToGRAFO
Warner LeMCnager
e-mail• " ��lore®eanhllnkneE
323)2,14 025 1 n
51-A North Bonnie Avenue
Pasadena, CA 91 106-2101; USA
Bin #
c Permit #
Project Address:
A. P. Number:
,4o,'5 -
Contractor:
4os'
Contractor: x
Address: 4 /
City. ST, Zip: Y1.
Telephone: X loll 5?-1—
State Lic. # : X, /45-74
Arch:. Engr.. Designer:
Address:
City. ST. Zip:
Telephone:
State Lic. #: -
Name of Contact Person:
Telephone # of Contact Person:
# Submittal Req'd
Plan Sets
Structural Calcs.
Truss Cates.
Title 24 Calcs.
Flood plain plan
Grading plan
KS
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City Of La Quinta
Building Bt Safety Division .
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
S12— l < < Owner's Name: x
Address: X
city, sT. zip: >C LA-OLL14I-f A , (!SA 224
`✓ Project Description:
1 'M
r- WAtJ- _ 51
1
II 1 Total Permit Fees �/ �j
Construction Type:
Oc cuPc
an v.
Project ect cl
type (circle r
eone): )Ne�
Add' n Alter Repair Demo
Ft.:
#
Stories:
# Units:
2%�n]Sq.
Estimated Value of roject: X 100
APPLICANT: DO NOT WRITE BELOW THIS LINE
Recd
TRACKING
PERMIT FEES
Plan Check submitted
8
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2"' Review, ready for correction issue
27
Electrical
Called Contact Person
Z
Plumbing
Plans picked up
S 111.1
Plans resubmitted
Grading
Review, ready for corrections/issue
Developer Impact Fee
Called Contact Person
A 1 P P
Date of permit issue
II 1 Total Permit Fees �/ �j