09-0853 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
• i��
.4 4v
BUILDING &SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 09-00000853
Property Address: 46702 WASHINGTON ST
APN: 643-020=063- - =
Application description: STRUCTURES OTHER THAN BUILDINGS {,
Property Zoning: REGIONAL COMMERCIAL
Application valuation: 13000
A plican : 'Architect or Engin r:
Owner:
WASHINGTON ill LTD
C/O JACK TARR
30240 RANCHO VIEJO,RD.
SAN JUAN CAPISTRANO, C
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/14/09
Contractor:
ARCHITECTURAL DESIGN/SI
2950 PALISADES DRIVE
CORONA, CA 92880
(951)278.-0.680
r' Lic. No.: 714309 \ /
'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 LicennseNo.:^7�1t4309
Date: A I%• Contractor: a, ' R U�Sr�taj
OWNER -BUILDER DECLARATION.
I hereby affirm under penalty of perjury that 1 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 asigned 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.).
(_) 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.).
1 1 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: '
LQPERnIIT
i
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 workerscompensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the workfor which this permit is issued. My workers' compensation
insurance carrier and policy number are: -
'Carrier INS CO OF WEST Policy Number WSD500023501 .
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 compllyyJ with those provisions. ,
Date 7,_-Applican_G.[�
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 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. .1 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 the above-mentioned property for inspect' purposes. A ✓1
Date: S-47,01 -Signature (Applicant or Agent):
t
C . - CJ
Application Number• . . . . . 09-00000853
Permit . . ..' BUILDING PERMIT
Additional desc .
Permit Fee . . . . 144.00. Plan Check
Fee
93.60
Issue Date . . . . Valuation
13000
Expiration Date 2/10/10
Qty Unit Charge Per
Extension
BASE FEE
45.00
11.00 9.0000 THOU BLDG 2,001-25,000
-------------------------
9'9.00
Permit . . . ELEC-ELECTRICAL SIGN
Additional desc
Permit Fee 30.00 Plan Check
Fee
.00
Issue Date Valuation
0
- Expiration Date 2/10/10
Qty Unit Charge Per
Extension
BASE FEE
15.00 .
1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT,
15.00
----------------- --------- ----------------------------------------------
=---- --
Special
Special Notes and Comments
INTERNALLY ILLUMINATED MONUMENT SIGN AT
_. WASHINGTON STREET ENTRANCE JUST NORTH OF.
AVENUE 47. 2007 CALIFORNIA BUILDING AND
ENERGY CODES
August 14, 2009 3:31:45 PM AORTEGA
---------------- - - - - -- - - -- -----------------------
---
Other Fees BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
9.36
ENERGY REVIEW FEE
9.36
Fee.summary Charged Paid. Credited
Due
Permit Fee Total.... 174.00 -. .00
.00
174:00
Plan Check Total 93.60 :00
.00
93.60
Other Fee Total 19.72 .00
.00
19.-72'
Grand Total 287'.32 00
.00
287.32
J
LQPERMIT
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City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
14 .- %Oa
Project Address: N1Cs�+W/�Y ill
Owner's Name: �t/P6irl�f�vM plc �2t�1i'IL
A. P. Number: 609E _(j 5 0 -� /3
� f'
Address: 10 3S�
Legal Description:
City, ST, Zip: L -I-\ Q V 1 to l A / CA '7Z 26-3
Contractor: CAFi �'
CTl! A'L
Address: 2q --go fpcA_c-�
t° S
FSIG� )Coit'Telephone:
q2.
En•:.;JJ�iii:;::ii'.,':iiiiiiij;•I
;,.<•. �•ri,..-:..:-:::.;:.,:
Project Description:
City, ST, Zip: (;U�OfJ%� �/� Z�� G.
Telephone: a
iii .4-i::i: iiiij:ii:'%{': rii•:
State Lie. # : 7 i T 3C
Arch., Engr., Designer:
City Lie. #•-.
Address:
City., ST, Zip:
Telephone:
,. f:,.
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i viii}:•F..::::;i>.:i4{'f:Yi/•i,+t...i;✓.:i::h'i\{
Construction Type: )NI -UM • Occupancy:
State Lie. #:`''''
Pro ecttyP /' a circle one) ew Add'n Alter Repair Demo
Name of Contact Person: A- C�Oi E�yv
Sq. Ft.:#Stories:
# Units:
Telephone # of Contact Person: 714-x,6-202
Estimated Value of Project: 080 "—
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal Req'd
RWd
TRACKING
PERMIT FEES
Plan Sets
19
Plan Check submitted
�j
V
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Review, ready for correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Personil
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
�e
otal Permit Fees
Ll
lt5n 1p"*A"4 Awp&hv, rpluu- /AmteauV41a L&I , ca lize AW$49^_z
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7950_ ,Palisades Dr. Corona, CA 9:28'80 Tel. ,95,1:2,78.0680 Fox..951.278,0681
'ARC.M.IT ECTURA'L
DESIGN "& S:16N5 - -
To: Business License /Planning / Buildino,8 Safety Departments-
Re- Authorlation Letter
to Whom Itdvlay Concern;
This letter will'serve, as- ;authoriiation for the 'following "person/company to act as agent on
behalf of Architectural Design & Signs; Inc., for.. the. purpose of' obtaining sign permits &
business licenses.
Bill.Sanchez- Washington Retail Center,
78-365 Highway 1,11
Lo Quinta, CA 92253
Tel: 760.48.5.5308
Sincerely,
Architectural Design & Signs, lnc.
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