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13-0933 (SIGN)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO t /�� FAX (760) 777-701.1 ' LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 . BUILDING PERMIT Date: 7/25/13 Application Number: 13-00000933 Owner: Property Address: 47100 WASHINGTON ST STE 101 MCDERMOTT COLIN. J APN: 643-200-023- - 75200 CHIPPEWA Application description: SIGN INDIAN WELLS, CA 92210 V v Property Zoning: COMMUNITY COMMERCIAL Application valuation: 600 . Contractor: • Applicant: Architect or Engineer: BEST SIGNS INC 1550 S. GENE AUTRY TRAIL �®,� PALM SPRINGS, CA 92264 p (760)320-3042 Lic. No.: 524483 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION Thereby affirm under penalty of perjury that I am Ii nsed under provisions of Chapter 9 (commencing with - I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and fessionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Cl a C45 D42 C License No.: .524483 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is t issued. Date: ZS I3 Contractor: _ 1 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 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 COMPANIAN PROPT Policy Number CPCA16846 following reason (Sec. 7031.5, Business and Professions Coder Any city or county that requires a permit to I certify that, in theperformance of the work for which this permit is issued, I shalt 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 beco a ubject 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, if I should ome ect to the workers' compensation provisions of Section License Law (Chapter9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code sh f ith com I with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by r�[[ any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date:- �lApplicant: 1—) 1, 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 WARNING: FAILURE TO SECURE W RK '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 TO CRIMI ENALTIESIAND 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 (_ ). 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, (_ 1 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 within 180 days from date of issuance of such permit, or 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 that the above informati 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 buildin tructi and hereb orize representatives of this cou ty to enter upon the above-mentioned property or in Lender's Name: • - Date: / Z� / Signature (Applicant or Agent): • Lender's Address:. LQPERMIT Application Number, . . . . . 13-00000933 Permit . . . ELECTRICAL 2013 Additional desc . Permit Fee 35.75 Plan Check Fee .00 Issue Date Valuation 0 - Expiration Date 1/21/14 Qty Unit Charge Per Extension 1.00 35.7500;EA ,.ELEC NEW COMM, ADD'L.2 KSF 35.75 ------------------------------------------------------- Special Notes and Comments SIGN PERMIT (1) PERMANANTLY CHANNEL LETTERESD .SECOND ONE NPN ILLUMINATED LETTER SIGNS "KELLER wILLIAMS" SPA 2013-1713 2010 CBC. ----------------------------------------- ----------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PLAN CHECK, ELECTRICAL 47.67 PERMIT ISSUANCE M/P/E 90.57 Fee summary Charged Paid Credited Due ------ ---------- ---------- ---------- Permit Fee Total 35.75 .00 .00 35.75 Plan Check Total .00 .00 .00 .00 Other Fee Total 139.24 .00 .00 139.24 Grand Total 174.99 .00 .00 .174.99 8►n # City Of La Quinti Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # l " Project Address: _100FfJ NG T N Owner's Name: l L(,L {2 P(W/�-Aul " A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: J s%�it S l /t,/ G Telephone: Address:? 5�� s �E/V �` �i (�� ✓L`' (%tel (, Project Description: SIA City, ST, Zip:S�/2-/ Nz-; 4 Z Z L y �C r!j-6G/i' (Tl OAJ TeleP ho . . neO- O y 2 2 :CityLic. State Lic. #: SZ y Ll 1� 3 #; FA (7 ` 1-7 1 3 Arch., Engr., Designer: u -I✓ r_ (b'('t A -0A .5 Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic Project tYPa circle one): New Add'n Alter Repairair Demo Name of Contact Person:('j�-�/l/ �p S f Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: (o O. 0. Z4 Estimated Value of Project:. �$` eO APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction " Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for correctionslissue 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 corrections/issue . Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. , Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees