05-2985 (SIGN)ry
P.O eBOA504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05- 00 002 985"
Property Address: 79450 HIGHWAY 111
APN: 649 -820 -003 -
Application description: SIGN .
Property Zoning: REGIONAL COMMERCIAL
Application valuation: 7800
Applicant:
Architect or E
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
KLEINE NEIL WAYNE
41910 -BOARDWALK A-10
PALM DESERT
PALM DESERT, CA 92211
D U
Contractor -
PARAGON SIGNS
JUL 19 2005 77650 ENFIELD LANE
PALM DESERT, CA 92211
CITY OF LAQUINTA (760)345-3340
FINANCE DEPT. Lic. No.: 637739
LICENSED CONTRACTOR'S.DECLARATION
I 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 Class: C45 D42 .00� Liceqj9,.No.: 6739
�te:'7//T/ePJ actor
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.).
(_ 1 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 improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
I—) I am exempt under Sec. , BAP.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: r • -
l
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/19/05
FM
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.
V� 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 FLTND Policy Number 1735081-2005
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 subje to the workers' compensation provisions of Section
/ (�33777000.,o�f�the.Labo Code, I shall fort ith comply 'th those provisions.
WARNING: FAILURE TO SECURE WORKMPENSATION 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 the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction and her€ y auth rize representatives
of this county to enter upon the e -mentioned property for inspec ' _ purpo
Pate: 7 -moi lure (Applicant or Agent):
Application Number . . . 05-00002985
Permit . . . ELEC-ELECTRICAL SIGN
Additional desc .
Permit Fee . . . . 36.00
Plan Check Fee
.00'
Issue Date . . . .
Valuation
0
Expiration Date 1/15/06
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 15.0000 EA ELEC
SIGN 1ST CIRCUIT
15.00
2.00. 3.0600 EA ELEC
SIGN ADDITIONAL CIRUITS
6.00
------------------------------------------------
Special Notes and Comments -
----------------------------
3 INTERNALLY ILLUMINATED CHANNEL
LETTER
SIGNS, PER SIGN -PERMIT # 05-893,
(CLUB
ACHILLES)
Fee summary Charged
Paid Credited
----------
Due
-------------------------------------
- Permit Fee Total 36.00
----------
.00 .00
36.00
Plan Check Total .00
.00 .00
.00
Grand Total 36.00
.00 .00
36.00
din #
Permit # -
Project Address:
A. P. Number:
Legal Description:
Contractor: qo?/46-0Aj
Address: �7_ SO
/-�atlF 1E4i
City, ST, Zip:
Telephone:
State Lic. # : G 3 7
Arch., Engr., Designer: .
Address:
City, ST, Zip:
Telephone:
Lic. #:
y
r—
Constructio
nT
Type:
Occupancy:
Pan
C
Pr0J
ect
R e(circle one):. New Add', Alter of Contact Person: Repair Demo
Sq. Ft.: # Stones: # Units;
Telephone # of Contact Person:
Estimated ValueoCProjectb o0
q Submittal
Plan Sets
Structural Calcs.
Trusstalcs.
Title 24 Cales:
Flood plant plan
Grading plan
Subcontactor List
Crani Deed
II.O.A. Approval
IN IIOUSE:_
Planning Approval
Pub. Wks. Appr
School Fees
APPLICANT: DO 'NOT WRITE BELOW THIS LINE
Recd _
Plan Check submitted
Reviewed, ready for corrections
Called Contact Person
Plans kicked up
Plans resubmitted
2" Revien', ready for corrections/issue
Called Contact Person
Plans picked up .
Plans. resubmitted
'~ Reviel�eady for corrections/issue
Called Contact Person
Date of permit issue
PERMIT FEES
Item Amount
Plan Check Deposit
Plan Check Balance
Construction
htechanical
Fleclrical
Plumbing.
S.�i.f.
Grading
Developer Impact Fee
A.I.P.P.
Total Permit Pecs