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11-0244 (SIGN).. �, 1. . - P.O. BOX.1504 �. VOICE (760) 777-7012 .78-405 CALLE TAMPICO FAX (760) 777=7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT ' INSPECTIONS. (760) 777-7153 BUILDING PERMIT Date: 3/23/11 Application Number: 11-000_0_024.4 Owner: . Property Address: 50991 WASHINGTON ST TFG LQV APN: 770-020-021- - - 3857 BIRCH ST. #496 Application description: ' SIGN NEWPORT BEACH, CA 92660 Property Zoning: NEIGHBORHOOD COMMERCIAL -..... Application valuation: 8000 D Contractor: Applicant: Architect or Engineer' SUPERIOR' ELECTRICL' RT,SNG IN. 1700'W. ANAHEIM ��44�%'. LONG BEACH, CA . • 9 0 13 C4e.4 (562)495-3808 Lic:, No.: 271598 �Q LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION ' I hereby affirm under penalty of perjury that 1 am licensed 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 Professionals 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 Class: C45 . License No.: 271598 for by Section 3700 of the Labor Code, for the performance.of the work for which this permit is /� issued. Date!'1' Contracto I have acid will maintain workers' compensation insurance, as iequired'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 TRAVELERS INDEM Policy Number PJUB2772N06A10 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 fo its issuance, also requires the applicant for the person in any manner so as to become 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, if'I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 70001 of Division 3 of the Business and•Professions Code) or 3700 o/f she Labo Coodd//e,}/hall fort/hw/ith com ly With those provisions. ' that he or she is exempt therefrom and the basis for,the alleged exemption. Any violation of Section 7031 .5 by �� Z / i� any-applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: DAW1 Applicant: - (_) 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 WARNING: FAILURE TO SECURE WORKERS' 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 CRIMINAL PENALTIES 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 (S 100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered foFsale. 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 ' 1 I 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 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 .186 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 1 certify that I have read this application and state that the above information 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 building construction, and hereby authorize representatives . • of this county to enter upon the above-mentioned prop y for ' pection purposes Lender's Name:.' Dat#'-Sgnature (Applicant or Agentl: - Lender's Address: - - LQPERAIIT - bb ..Application Number.. 11-00000244• Permit ELEC=ELECTRICAL SIGN Additional deso . Permit Fee . . 30.00 Plan Check Fee .00 Issue Date _ Valuation 0 Expiration Date 9/19/11 Qty -Unit Charge Per. Extension ' BASE FEE 15.00 1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT` -------------------------------------------- 15.00'" Permit SIGN PERMIT Additional desc MONUMENT SIGN - Permit Fee 99.00 - Plan Check Fee :64.35 Issue Date. . . . . Valuation 8000 Expiration Date 9/19/11 e Qty Unit•Charge- Per Extension BASE FEE 4'5.00 6.00 9.000-0 THOU BLDG 2.,001-25,000' 54.0.0 Special Notes.and Comments '. INTERNALLY ILLUMINATED MONUMENT SIGN (5..25 HGT X 9 FT WIDE) 'ENGINEERED FOUNDATION. 2010 CODES. SING PERMIT # 2011-1516. --- Other Fees BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW .FEE 6.43 STRONG MOTION (SMI).- COM 1.68 -Fee summary Charged Paid, Credited Due, Permit Fee Total 129.00 .00 ..00 129.00 Plan Check Total 64.35 .00 .00" 64.35 Other Fee .Total 9.11 :00 .00 9'.11 Grand, Total_ 202:46 .00 .00.•• 202.46 LQPERA7IT - .. .. Bart # Qty of La QuInta 'Building 8r Safety Division' P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # IF 01 Project Address: 50 L WAS44ji-IG72p" ,Owner's Name: —L4UV LL6,' A. P. NumbcrF" 20 OZ' Address:!��7 Legal Description: City, ST, zip:bjrAA4a2gX: Mar—w Contractor, CAL,ePhM, (©`s Address: 1=2W, ALJA Project Description: 7 rion:o#4 s�:r.7d5;tjj*L4F EACE— City, ST, ZipLy L&5�81 F lid Telephonc:ffC:;/49S -39119vis — C?) State Lie. # G S City Lie. I L LU 1A t" T4;17 Arch., Engr., Designer: ;e)m EF1:16WIT74(16-J. AC-TU4L— Address: !'JA91FA- 15P -410"x " 6-'225. City, ST, Zip: 15ja4j r2l r=C, 9ZIJ-7 FACE APUE-A IS- f& 1:77 Telephone Construction Type -.AW $4 t&A440ccupancy: State Lic. #4�46 9 9,4 'Project type (circle one): ew Add'n Alter V-11,00 ".5, . . . I Repair Demo Name of Contact Person: M42!V-- Sq. Ft:glz 9 Stories: # Units: Telephone # of Contact Person: -7(4-,/7;2 _A3—IM64 Estimated Value of Project - ,4 APPLICANT; DO NOT WHITE BELOW THIS LINE N Submittal Reqld Rec,d TRACWNG PERMITFEES Plan Sets Plan Check submitted I Item Amount Structural C.alcs. Reviewed, ready for corrections Plan Check Deposit Truss C21cs, Called Contact Person Plan Check Balance Title 24 Cala. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2 Review, ready for correction sue 3 -a.;, Electrical Subcontactor List Called Contact Person 01 4 Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading' IN HOUSE:- Review, ready . for correctlonslissue Developer Impact Fee Planning Approval Called Contact Person AJ.P.P, Pub. Wks. Appy Date of permit Issue School Fees • Total Permit Fees 2-997 .3 (I