15345 (SIGN)g 414
P.O. BOX 1504
Building 78-495 CALLE TAMPICO'
Add 50-855•"Washinriton Ste r, LAOUINTA CALIFORNIA 92253
A
No...15.345.
ress . •
Owner All Lbic SS & • Dooks ,
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address S-wne
A:P. Number
City zip - ]Tel.
La Qui ` a.,..CA 92253. Legal Description
'. '. t fir
Contractor 12 . .
Project' Description 9
sisf.ilw & Services i J
..Address
143980' Boatman Ave.
City . Ip . T I.: • r
St�x>to'n." �A .90 tj ��I�} 761 -840Q eKS
State Llc. ':43. 9ia City 3a�3& Classif.. Lic. # " ;
Sq. Ft. No No. bw.
Size - Stories- -Units
Arch. Engr
Designer New ❑. Add ❑ _Alter ❑ Repair
Address • .Tel.
City . .. s?.,' JZip State
'
Lica#
.LICENSED CONTRACTOR'S DECLARATION:
;1 hereby affirm that am licensed under provisioti of Chapter 9 (commencing with' Section
7000) of Division 3 of 1h Business and Prof sis`Code;, and my license,is in full force and
Demolition.;❑ " .
tel t,6
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SIGNATURE-. �.. L✓.�- DATE
•.
_ OWNER BUILDER DECLARATION
I hereby affirm that'l am exempt from the Contractors License, Law for the following .
Estimated Valuation -11-11,2,00A0 V,
-
•reason:. (Sec. 7031:5,Buslness.and Professions Code: Any, city or county which requires a
,-
permit to construct„ after, .improve, demolish, or repair .any structure, prior to its issuance `also
requires. the applicant for such :permit to file a signed statement -that he is 'licensed'pursuant to,
"wfth.Section
�..
PERMIT 'AMOUNT, ,^.
�-
the provisions of the Contractor's License law, Chapter 9 (commencing 7000) of,
,•'
- -
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the ':exemption. Any Section 7031.5 'by -any for
- -
Plan Chk. Dep.
alleged violation of applicant a permit
subjects the applicant to a civil penalty of not more than hve.hundred dollars ($500). -
- • - - _ - -
Plan. Chk. Bal.
01, 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, Buisness and
Const. '
Professions Code:,The. Contractor's License•Law does not apply. to an owner of. property. who
- '
builds or Improves thereon.and,who does such work himself or through. his own employees,
' "improvements
Meoh. • £, t -
.provided, that such 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' zElectrical
'
of proving that. he did. not build or Improve for the purpose of sale.) -
'
O"I, as owner of the property; am exclusively contracting with licensed contractors to con-
Plumbing .
struct the project: (Sec. ;7044, Business and Professions Code:. The Contractor's License Law
- -
does not apply to an owner of property -who builds or Improves thereon, - and who contracts for '
S.M.I. - •• -
such projects with'a contractors) licensed pursuant to the Contractor's License Law.)
Grading
•❑ 1 am exempt -under SecB. & P.G. for this reason
Driveway Enc. .;
'Date * Owner 1
Infrastructure
_
Miscellaneous 35.430-
WORKERS' COMPENSATION DECLARATION
I hereby affirn.that I have a certificate o•Lcyn'sent to'self-insure, or a certificate of -
Worker's Compensation Insurance,.or a certified.copy thereof. (Sec. 3800, Labor Code.)-.
-
PolioY N0 rr Company . y/
(�3opy Is filed with the city, ❑ Certified copy.is hereby furnished.
-
TOTAL 3' o0 43 ;
!J CERTIFICATE OF EXEMPTION FROM -
REMARKS
WORKERS' COMPENSATION INSURANCE '•
`valuation
r ' .
(This section need not be completed if the permit is for one hundred dollars ($10l))
'S'•
. or legs!) .. . - r
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. `
-
Date-r
NOTICE TO APPLICANT, n, after making this Certificate of Exemption you. should become .•
ZONE: •BY..
subject . to- the Workers' Compensation provisions of the Labor Code, -you must forthwith
comply with such provisions or this permit shall be deemed revoked. •' •
Minimum Setback Distances:-.. '` - • v -.
Front Setback from Center�Line
WARNING: FAILURETOSECURE WORKERS'COMPENSATIONCOVERAGE-IS UNLAWFUL, AND
op.
Rear Setback from ReEy
Side StreetSetbaCkfrCenteXineSHALL
SUBJECT ANEMPLOYER TO CRIMINAL PENALTIES AND CIVIL' FINES UP TO ONE:HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION.TO THE COST OFCOMPENSATION
Side Setback from�P LIIT
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE;. INTEREST; AND
ATTORNEY'S FEES.y../
/
. ✓�/
• This Is a building permit when properly filled out, signed and validated, and is subject.to
FINAL DATE f{VSPECTOfa/ " �_�\ •r .
expiration if work thereunder is suspended for 180 days.
I -certify that I have read this'application and state that the above information is correct - .,
"
. -Issued by.*. Date• •' Pefmltr�' 7 .:
I agree to comply with all -city and county. ordinances and state laws relating to building'.
construction, and hereby authorize: representatives this city to enter. the
-• r��7yS
.-Of ,•above
mentioned property for inspection purposes.: „• . ,
::.Validated by:
• Signature of applicant Date
Mailing Address
Validation:
City,. State_ zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
IST FL. SO. FT. ® $
2ND FL. SO. FT. &
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
_
MOBILEHOME SVC.
POWER OUTLET
VO
YARD SPKLR SYSTEM X,
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER I
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
f INAL INSP. _
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID a 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
f INAL INSP. _
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
CASE: S- 15 - 3-1 t
Your sign permit application is hereby approved, subject to the following provisions or
conditions:
The sign shall be installed- pursuant to the attached exhibits.
2. The permit shall expire on 1 A,
3. The maximum number ctfs ns ags/banners permitted shall be
.4. If the sign permit involves permanent electric facilities; a building permit shall be
obtained.
5. If the sign is a temporary sign, please, contact Mr. Don Whelchel in the Code
Enforcement Department once the sign(s) has been installed so that he can inspect
the sign (or signs) and verify compliance with the attached requirements. Mr.
Whelchel will need to see this memorandum so that he can attach a City decal to
your paperwork in the field. He can be reached by calling .777.7050. If the sign is
permanent, please contact Mr. Whelchel prior to installing the sign at•the site so that
he can, be present while the. sign (or signs) is being installed.
6. Additional Conditions: a �2\g„S
Thank you for your cooperation.
Sin rely;
i
�S
evelopment Department
Attachments
r
c: Code Enforcement Department
Building Department ,
f r
Caso'Number - 1)4
O� Date Received
Of T1r�' PLANNING i DEVELOPMENT DEPARTMENT
SIGN PERMIT APPLICATION
APPLICATION REQUIREMENTS
A. The following shall be submitted by the Applicant to the Planning 6
Development Department at the time of permit application unless otherwise
modified by the Planning Director:
1. Completed sign application. obtained from the City.
2. Appropriate sign plans with number of copies and exhibits as
required in the application..
3.. Appropriate fees-as.established by Council resolution..
4. Letter of consent or authorization from'property- owner, or
lessor, or authorized agent of the building or premises upon
which the sign is to be erected..
B. Plans Required - Information required - the following information
must' be shown on the, sign plan:
1. Sign elevation drawingindicating overall and
letter/figure/design dimensions,. colors, materials, proposed
copy and illuminat'iorn method.
2. Site plan indicating the location of all main and accessory
signs existing or proposed for the site with dimensions,
color, material,' copy and method of illumination, indicated for
each.
3. Building elevations with signs depicted (for non -freestanding
signs).
t f • * t t � t i i.� .f *'+ * t t '*1 * t'* � t t s * * • • :,t * t * t * r
Applicant i✓Vi�:
Mailing Address
. -
Phone:
Name of Business h;
Type of Business P.hone:0('1� / ^
I n
Address of Business -1)V
fit.!
rnnu 'AAA /1-e
Sign, Company Name �1�=,��-
L-;"ev?CL
Address k'1'1'1� A)47
Phone: t-7uc,) 76 I- -9 ?moi
Sign Company Representative ) lt✓ U I
Type of Signs Proposed•,,,
Number Number
Free Standing -
Main Trade Sign
I Wall-Mounted i
Directional Sign
Temporary °= z '
Offsite Advertising
Location ; of Proposed SignsL,�
Assessor's Parcel Number
Zone
-Overall dimensions of-sign (and of copy.
face if less10
Materials R? Uro `tuv
'Colors tobfI ff_�'
Type of Illumination -114 T0'0m.
Declared value or Contract Price
''Signature of-Applicant
Date
Signature of Property .Owner(s)*
Date
*(Written Authority'May be Attached),
Date
NOTE: Any false or'misleading information
shall be grounds for denial of
this application. M
FORM.004%CS -2.
,;�
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