07-2534 (ELEC)P.O. BOX 1504
7 '78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253.
C
Application Number:
— -00002.5.34
Property Address:
46660 WASHINGTON ST STE 3
APN:
643-020-999-3
-30903 -
Application description:
ELECTRICAL
Property Zoning:
REGIONAL COMMERCIAL
Application valuation:
5000
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
WASHINGTON 111 LTD
C/O JACK TARR
30240 RANCHO VIEJO RD. STE. B
SAN JUAN CAPISTRANO, CA 92675
VOICE (760) 777-7012
FAX (760) 777-701.1.
INSPECTIONS (760) 777-7153,
Contractor:
IMPERIAL SIGN CO, INC '
46120 CALHOUN STREET
INDIO; CA 92201
(760)347-3566
Lic. No. 207136.
Date: 9/14/07
-----=-------------------------.--=-•------=---=---------------=----- - ---------
ONTRACTOR'S DECLARATION - • WORKER'S COMPENSATION TIO
I'hereby affirm under penalty of pe ury that I am lice ed under provisions of Chapter 9 (commencing with r I hereby affirm under penalty of perjury one of the following declaratio
Section 7000) of Division 3 of the usiness a Pr essionals Code, and my License is in full force'and effect. _ I have and will maintain a certificate of consent to self-insu fofpy kers' c provided
Licens Class- C45 D38 C1 License No.: 207136 for by Section 3700 of the Labor Code, for the Performa of t permit is
issued.
Da� Contractor. _ _ I have and will maintain workers' compensation insurance, as r uired b ion 3700 of the Labor
Code, for the performance of the work for which this permit i My workers' compensation
OWNER -BUILDER DECLARATION - - _ insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the - Carrier STATE FUND Policy Number 1424837-2006
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 issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any m*KERS'
subject to the workers' compensation 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, iject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 76001 of Division 3 of the Business and Professions Code) or 3700 of the Labhwith comply 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 a civil penalty of not more than five hundred dollars ($5001.: Da plicant:
1 _ 1 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 W NIN FAILURE TO SECURPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State I-icense'Law does not apply to an owner of property who builds orimproves thereon, SUBJECT AN EMPLOYER TO CES 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 purposeof 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 Code: 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 I am exempt under Sec. , BAP.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 Iissuance of this permit.
Date: Owner: 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,s c permit, cessation of work for 180 days will subject
'CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state in t the above inf matidn is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to buildi ruction, and hereby authorize representatives
of this c my to nter upon the above-mentioned pr o nsp ion purposes.
Lender's Name: v//�
Dater l ignature (Applicant or Ag , 1.
Lender's Address: -
LQPERMIT
Application Number . . . . . 07-00002534
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee 30.00 Plan Check Fee
.00
Issue Date . . . Valuation
0
Expiration Date 3/12/08
Qty Unit Charge Per
.,Extension
BASE FEE
15.00
1.00 15.0000 EA -ELEC SIGN 1ST CIRCUIT
15.00
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Special Notes and Comments
1 ILLUMINATED CHANNEL LETTER SIGN, PER
SA -07-1184 "OPTIX OF LA QUINTA
OPTOMETRY""
Fee summary Charged Paid Credited
Due
--------------------------
Permit-Fee Total 30.00 .00 .00
30.00
Plan Check Total .00' e00 .00
.00
Grand Total 30.00 00 00
30.00
LQPERMIT
Bin #
City of La Quinta
Building 81 Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Traciaing Sheet
Permit #
Project Address:',(p (p�0. (� N �T -'i�3
Owner's Name: --� 1 ��✓�
A. P. Number.
Address: Y A'3 E
Legal Description:
City, ST, Zip:,
Contractor. t r z 1 Yl t o, 1 W
Telephone:
Address: -`-.' Ca ` V-) � � ��
Project Description: (I l Urn \ y,.0
City, ST, Zip: tri CI l (i Com' c� a
i� `_" G CCS L T
Telephone: �1
State Lic. #
City Lic. #: 00aa3
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #: ID6 li[
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person J wN�-
Sq. Ft.: �r�-
#Stories:
#Units:
Telephone # of Contact Person: — �J� �Q
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Ree'd
TRACMG .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calve.
Called Contact Person
Plan Check Balance
Energy Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
i'' Review, ready for correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
A.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Review, ready for.correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date.of permit issue
School Fees
Total Permit Fees