BSIG2015-001678-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
MATTHEWS SIGNS, INC.
550 WEST 6TH AVENUE
ESCONDIDO, CA 92025
Tit,�p 4 X� Qu!K&
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BSIG2015-0016
79440 CORPORATE CENTER DR 104
.600390021
SIGN FOR "STATE FARM"
$1,000.00
A
JUN 2 2015
CITY OF LA OUNTA
COINL1l1N1TY R,"J.�! riP1tM:PvT pFPA:� i;;'':v-i
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect. -7
License Class(��License No.q_"
Date: te taf Contractor:
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).:
( 11, 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 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. . 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
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/2/2015
Owner:
JAMES PAUL
55585 CHERRY HILLS
LA QUINTA, CA 92253
Contractor:
MATTHEWS SIGNS INC:
550 WEST 6TH AVENUE
ESCONDIDO, CA 92025
(760)7.35-3282
Llc. No.:
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: _• Polity Number: _
_ 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.
Date: Applicant: 4 -ee
WARNING: FAILURE TO SECURE WORKERS' 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 Building Official 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 hereby authorize representatives of this city.to enter upon the above-
mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
FINANCIAL INFORMATION
DESCRIPTION - ACCOUNT
QTY
AMOUNT PAID
PAID DATE
BSAS 581473 FEE 101-0000-20306
0
$1.00 $1.00
6/2/15
PAID BY METHOD
RECEIPT # CHECK #
CLTD BY
MATTHEWS SIGNS INC. CHECK
MR178 .2986
MFA
'Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00
DESCRIPTION =
ACCOUNT,
QTY
AMOUNT
PAID
PAID DATE
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$24.17
6/2/15
PAID BY
METHOD .
RECEIPT #
CHECK #
CLTD BY
MATTHEWS SIGNS INC.
CHECK
MR178
2986
MFA
DESCRIPTION =
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$24.17
6/2/15
PAID BY
METHOD
RECEIPT #
'CHECK #
CLTD BY
MATTHEWS SIGNS INC.
CHECK
MR178
2986
MFA
Total Paid for ELECTRICAL: $48.34 $48.34
DESCRIPTION =
ACCOUNTQTY
AMOUNT
PAID
PAID DATE
WALL/AWNING SIGN, FIRST
101-0000-42404
0
$24.66
$24.66
6/2/15
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
MATTHEWS SIGNS INC.
CHECK
MR178
2986
MFA
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WALL/AWNING SIGN, FIRST PC
101-0000-42600
0
$87.02
$87.02
6/2/15
PAID BY
METHOD .
RECEIPT #
CHECK #
CLTD BY
MATTHEWS SIGNS INC.
CHECK
MR178
2986
MFA
Total Paid for SIGN: $111.68 $111.68
TOTALS:•
Description: SIGN FOR "STATE FARM"
Type: SIGN
Subtype: Status: ISSUED
Applied: 6/2/2015 MFA
Approved: 6/2/2015 MFA
Parcel No: 600390021 Site Address: 79440 CORPORATE CENTER DR 104 LA QUINTA,CA 92253
Subdivision:
Block: Lot:
Issued: 6/2/2015 MFA
Lot Scl Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $1,000.00
Occupancy Type: Construction Type:
Expired: 11/29/2015 MFA
No. Buildings: 0
No. Stories: 0 No. Unites: 0
APPLICANT MATTHEWS SIGNS INC. 550 WEST 6TH AVENUE
Details: ILLUMINATED SIGN FOR "STATE FARM" PER 2013 CALIFORNIA BUILDING CODE
CA
CHRONOLOGY
CONDITIONS
NAME TYPE NAME ADDRESSI
CONTACTS
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT MATTHEWS SIGNS INC. 550 WEST 6TH AVENUE
ESCONDIDO
CA
92025
KRISTINA@MATTHEWS
SIGNSINC.COM
CONTRACTOR MATTHEWS SIGNS INC. 550 WEST 6TH AVENUE
ESCONDIDO
CA
92025
KRISTINA@MATTHEWS
SIGNSINC.COM
OWNER JAMES PAUL 55585 CHERRY HILLS
LA QUINTA
CA
92253
Printed: Tuesday, June 02, 2015 11:37:40 AM 1 of 2
CRWSYS7EMS
Permit Details PERMIT NUMBER
City of La Quints BSIG2015v'010 ,6
DESCRIPTION
ACCOUNT
QTY_
AMOUNT
PAID
PAID DATE
EC
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
6/2/15
MR178
2986
CHECK
MATTHEWS SIGNS
MFA
INC.
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $1.00
BSA:
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$24.17
6/2/15
MR178
2986
CHECK
MATTHEWS SIGNS
MFA
INC.
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$24.17
6/2/15
MR178
2986
CHECK
MATTHEWS SIGNS
MFA
INC.
Total Paid forELECTRICAL: $48.34 $48.34
WALL/AWNING SIGN,
101-0000-42404
0
$24.66
$24.66
6/2/15
MR178
2986
CHECK
MATTHEWS SIGNS
MFA
FIRST
INC.
WALL/AWNING SIGN,
101-0000-42600
0
$87.02
$87.02
6/2/15
MR178
2986
CHECK
MATTHEWS SIGNS
MFA
FIRST PC
INC.
Total Paid forSIGN: $111.68 $111.68
TOTALS:
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
FINAL" BLD
BOND INFORMATION
ATTACHMENTS
Printed: Tuesday, June 02, 2015 11:37:40 AM 2 of 2 CR
SYSTEMS
1N3Wd013A3C1 AiINnwwo:)
srn.#
�!
City Of L Qutnta
Buikupg ar Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Perrrtft #
Project Address: q
l_IO U
e Ubifil.
Owner's Name:. `1 S ar \ NlC.tU
A. P. Number.
�� V —1.
Address: .
Legal Description:
Contractor. U'i�V \�,ti1 S JC
Address: 5, '0 N U
(�
City, ST, Zip:
Telephone: '
ProjectDescription:
City, ST, Zip: escb
CPC`�
Telephone: p. 3S 2 6
State Lic. # : qS ZC)
Gl \\ �\ u - ' X\u MN
City Lie'. 9, c1 C � q � C0
Arch., Bngr., Designer.
Address:
City., ST, Zip:
Telephone:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lie. M
Name of Contact Person:
r 1 \
'
• Sq. FL: Z - v:�
# Stories:
#Units:
Telephone # of Contact Person: U•
13 5'- 162
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Rtq'd
Recd
TRACICYIVG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Cheek Deposit. .
Truss Cale$.
Called Contact Person
Plan Check Balance-
alance_Title
Tide24 Cale&
Plans picked up
Construction
Flood plain plan
Plans resubmltted..
Mecharilcal
Grading plan
2'' Review, ready for correctiotemue
Electrical
Subeontactor fist
Called Contact Person
Plumbing
Grant Deed
Plans #inked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
N HOUSE:-
''" Review; ready for torreetions/issae
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
TOtal Permit Fees