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07-2241 (SIGN)I . 1 4 4 " P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT - - Date: 8/06/07 Application Number: -07-00002241 Owner: Property Address: 4.6C60 -WASHINGTON ST STE 6- WASHINGTON 111 LTD -APN: 643-020-999-3 -30903 - C/O JACK TARR Application description: SIGN 30240 RANCHO VIEJO RD. STE. B - Property Zoning: REGIONAL COMMERCIAL SAN JUAN CAPISTRANO, CA 92675. Application valuation: 3500 Contractor: Applicant: Architect or Engineer: RIOFINE NEON 68895 PEREZ ROAD, I-18 CATHEDRAL CITY, CA- 922.34 (760)321-0484 �. 1v l r Lic. No.: 689256 ____--- _- ---- _--- _--- __ _____________ ____________ --- Co GGs 7�Jj LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATIOKATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following, declaratio Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. I have and will maintain a certificate of consent to self-insu �b ers' EFnsati as pr ided ,License Class C45 License No.:. 689256 for by Section 3700 of the Labor Code; for the performn i}ig"o�rork hich IN 's . issued. tei ntractor " t�(�/ - I have and will maintain workers' compensation insurance,: r r@ction�2 .Gabor Code, for the performance of the work for which this permit is i ed3'� pensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm underpenalty of penury that I am exempt from the Contractor's State License Law for the - Carrier STATE FUND Policy Number 1371851-20 7 - following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to I certify that, in the performance of the work for which this permit is issj' d, I.Ott II not employ any 'construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the - person in any manner so as to become subject to the workers' compens�6ifon laws of California, .permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State - and agree that, if I should become subject to the workers' compensation provisions of Section - license Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of'the abor.0 de, I shall hwith o ply with those provisions. - 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 acivil penalty of not more than five hundred dollars ($500).: Date Applicant: (_ I I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure isnot intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECU E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TOC MINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN - improvements are not intended or offered for sale: If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). APPLICANT ACKNOWLEDGEMENT - (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the - 7044, Business and -Professions Coder The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for - pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_) I am exempt under Sec. , B.&P.C. for this reason 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. Date: Owner: 2. Any permit issued as a result of this application becomes null and void if work is not commenced 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: LQPERA11T 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 county to enter upon th above-mentioned prop «y for insp tion purposes. ate: Si lure (Applicant or Agent): �✓i1� U I -Application Number. 07-00002241 Permit . . ELEC-ELECTRICAL SIGN Additional desc . Permit Fee 30.00 Plan Check Fee .00 Issue Date Valuation 0. Expiration Date 2/02/08 Qty Unit Charge -Per Extension BASE FEE _ 15.00 1.00 15.0000"EA ELEC SIGN 1ST CIRCUIT 15.00 ----- Special Notes ,and Comments -- ONE.INTERNALLY ILLUMINATED CHANNEL ` " LETTER SIGN, PER SA# 200.7-1167 "DIVAS OF THE DESERT". .Fee summary Charged Paid Credited Due, Permit Fee Total 30.00 .00 .00 30.00 ' Plan Check"Total .00 .0.0 .00"- .00 " Grand Total 30.00 .00 .00 30.00 " LQPERMIT