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04-3691 (SIGN). QgMrC4(j. BUILdING & SAFETY DEPARTMENT c4 P.O. BOX 1504 (760) 777-7012 �toF�9 78-495 CALLS TAMPICo FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777.7153 BUILDING PERMIT Application NumberX04-0.OA-03 1 Date 4/26/04 Property Address 50921 WASHINGTON ST APN: 770-020-.019-5 -000000= Application description . SIGN Property Zoning NEIGHBORHOOD COMMERCIAL .Application valuation 1500 Owner Contractor LQ.INV PROMOTIONAL SIGNS, INC. C/O ROSETTE CADRY20361 HERMANA CIRCLE 4.0.1 S BARRINGTON AVE '1.0 0 LAKE FOREST, CA 92630 LOS ANGELES CA 9.0049. (949) 418'-1000 WCC,:. ..STATE FUND WC:.. 478000.0100 04/01/05 CSLB: 636512': 01/31/06 CCC: C45 Permit . . . . SIGN PERMIT 'Additional desc Permit Fee 35.00 Plan Check Fee .23 Issue' Date Valuation 1500 Qty Unit Charge, Per- Extension BASE FEE; .' 15.00 .10..00 2.0000 HND BLDG 501-2;00.0: .20.00 Special Notes -and -Comments. , .. ` ONE ILLUMINATED CAN.SIGN.PER sA04-773 2 0 01 'CBC . . .Fee summary. Charged ` Paid- Credited Due'�� _ ------------ Permit Fee Total: 35.00• .00. .00� 1. %Y� Plan' Check: Total .23 ,' : .00 00 .23 Grand Total' 135.23 00 .0 -,5.2- P.O. BOX 1504 a �l,/�� V VOICE (760) 777-7012 78-495 CALLS TAM►1Co FAX (760) 777-7011 LA QUINTA. CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: _Q L/ - Applicant: Applicant's MalUu g Address: Date: '"- � -d Architect or Engineer: Architect or Engineer's Address: t-ic. No. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am ioensed under provisions Of chapter 9 (WmmenmV with Section► 7000) of Division 3 of the Business and Rofessionals Code. and my License is in ,brce and efFed / License Class,, C - y License No. A/1 2l G I hereby affrin under penalty of perjury that I am OWNERARIILDER D�RATION enrerpt from the Contractors' Stab License law for the followirp mason (Sec. 7031.5. Business and Prolessionc Cods: Any cityorwurdyviat-mpmmstaternerM that he a pmm b ahem, kgwove,.dermoislh, a repay 8^Y $buctuM prior b lts issuaroM also requires the appfimfd for the pentyl b ib a siq►ad the Is e b the provtciors a the Corntracbrs' Stale License Law (Chapter 9 (oonrrheneirng with Section 7000) of Division 3 of the Business Qie applicant bb dviProfessions ) or that he or she k exempt rierefiom and the basis ler the 849900 exemption. Any vbbtion a Section 7031.5 by any applicant for a permit Subjects U 1, as owner a the f of not more than five hundred ao4ars (5500)-r property, or n►Y employees with wages as their $01e oorpensaion• wE do the worm and the structure is not intended or offered for sale (Sec 7044• Business and Professions Code: The Contractofs' Stab License Law does not apply to an owrm of property who builds or improves lhere0n• and who does the work himselfwithin oar a trough his or her own enpbyees. provided that the irprovemerhb are not intended or offered for sale. tl, however. the buiQsp or inprover0nt is U Las owner a the 1� a completion, the ow1ef-bdOr ��w� linden a hat have the deprowV the or she did not build or i nprove for the purpose a sale.). SW State License Law roperty- am does rhe v with tractors b construct the project (Sec 7044. Business and Professions Code: The Contractors' ' the Contractors' State Licensee Law.) an owner a property who bolds or improves thereon, and who contracts ler the projects wlth a Conaacbr(s) licensed pursuant b U I am exempt under Sec . B.& P.C. ler this reason Date Owner WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to seg4nsm for workers' compensation, as provided for by Section 3700of the Labor Code. ler the perfamwhoe a the wok for which this permit Is issued I hand willmaintain ai workers! compensation insurance. as required by Section 3700 a the Labor Code, for the Performance a the work for which this prarn4 is i compensation insurance Carnerpnd policy number m. 1 oertdy Must. b the Parley Number -N % 00 n/> /� nt e p laws� mance —woo work ler wfhiclh Mrs Perm hs issued. I cha4 not employ any Person in any mercer so as b bacon subjod b the wwkeW forthwith �y Willi those ,ir�d spree Mrat. Y 1 should become subject b Mme workers' compensation provisions a Section 37l>0 a the Labe Code. l slha4 O W FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFLA, SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED Tl IOUSIM{D DOLLARS ($100.000). IN ADDITION TO THE C T OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. MEREST. AND ATTORNEYS FEES. . CONSTRUCTION LENDING AGENCY I hereby affirm ander penalty d perju two is aruction bn&V 89NCY ler the Warnance of the work ler which this permit is issued (Sec. 3097. Civ. C.). Lenders Name Lendees Address IMPORTANT Application is APPLICANT ACKNOWLEDGEMENT thereby made b the Director a Bu40tng and Safely ler a permit subject to the conditions and restrictions sal forth on this appkaior. 1. Issued as a result Each person upon whose behalf this application is made. each Person at whose request and for whose benefit wok is performed under of pursuant b any permit Officers. agents and application, the owner. and the appicent, each sprees b. and shall. defend. indemnify and hold harmless the City a La Oulnta. its 2 �Y perml Issued � d � for a ac or omission related b the work beiq performed under or following Issuance a 1Ns pertNL cessation tI work ler * result f O �tio 1 becomes null and void if wok is not cormmenced within 180 days from dale a issuance a such par.. or days subject pemhit to cancellation. 1 certify that l (have read this a00irasnn and wt.#. *—# #6— -w-h- -- .- my ordinances and stale buss regaling to hddkV urposes-