13-0280 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000280
Property Address:
50991 WASHINGTON ST STE 4
APN:
770-020-021- - -
Application description:
SIGN
Property Zoning:
NEIGHBORHOOD COMMERCIAL
Application valuation:
3600
Applicant:
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
4 �- Z1
BUILDING & SAFETY DEPARTMENT
. BUILDING PERMIT
D°
MAR 15 2013
CITY OF LA QUINTA
FINANCE DEPT.
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.
LicenseCl'ass: C45 LicenseNo.: 763401
Date: lb /3 Contractor:
- OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I 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 a signed 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 (5500).:
(_) 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.).
1 _ 1 1, 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.).
(_) I am exempt under Sec. , 8.&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:
LQPERMIT
Owner:
TFG LQV
3857 BIRCH ST. #496
NEWPORT BEACH, CA 92660
Contractor:
TOP OF THE LINE SIGNS
P.O. BOX 179
LA QUINTA, CA 92247
(760)341-8824"
Lic. No.: 763401
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/15/13
------=----------------------------------------
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 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
insurance carrier and policy number are:
Carrier HARTFORD CASLTY Policy Number 57WECD15736
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,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, -I all forthwith compl�se provisions.
C Date: /S't3 Applicant:
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. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this co u yto nter upon the above-mentioned property for i tion purposes.
/ n
Date: 3 /S Signature (Applicant or Agent): (���_-
LQPERMIT
Application Number. . . . . . 13-00000280
Permit . . . SIGN PERMIT
Additional desc .
Permit Fee . . . . 63.00. Plan Check
Fee
40.95
Issue Date . . . . Valuation
. . .
. 3600
Expiration Date 9/11/13
Qty Unit Charge Per
Extension
BASE FEE
45.00
2.00 9.0000 THOU BLDG 2,001-25,000
18.00
------ ---.----------------------------
Special Notes and Comments
INSTALL (2). PERMANENT NON -ILLUMINATED
SIGNS. SIGN APP. #2013-1687 "EVOLVE
YOGA". 20iO CODES.
----------------------------------------------------------------------------
Other Fees . . . . BLDG STDS ADMIN.(SB1473)
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 63.00 .00
00
63.00
Plan Check Total 40.95 .00
.00
40.95
Other Fee Total 1.00_ .00
.00
1.00
Grand Total 104.95, .00
.00
104.95
LQPERMIT
RIECC,
ED
Bin.#
Ory Of U Qif([1ta MAR 12 2013
Bullding a Safety Divfsfon
P.O. Box 1504, 78-495 Calle Tampico 7 OF UI
. QNIE
Lo Quinta, CA 92253 -:(760) 777-7012 4VNI('D
Building Permit Application'and Tracking Olt
Permit #
27
Project Address: 130 q f ( was k n. `(c>,1 S.f
Owner's Name:. (�rc &I W
U
A P. N.umber..
Address: (96 ?Z5 1//,L PS ro
Legal Description:City,
ST, Zip: t rt � '(� 9 Z2 S
Contractor. [ �� ��, �,,k N� S c
Telephone:
Address: !J/7S Crerc�o� F.�r
Project Description: �C
City, ST, Zip: �jR
p
Telephone: 7G0f
Z r.
� t1 AJQ cCS � N
State Lie. # : G C(O J City Lic. #;
Arch, Engr., Designer.
Address:
City., ST, Zip:
Telephone:
State Lic. #:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
submittal
Req'd
Recd
TRACIMG
PERMLT FEES
Plan Sets
Plan Cheek submitted
Item Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit.
Truss Calcs.
Called Contact Person
Plan Check Balance_
Title 24 Cates.
Pians picked up
Construction
Flood plain plan
Pians resubmitted
Mahariical
Grading plan
2`! Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
ML
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
1i6 Review, ready for corrections/issue
Developer Impact Fee
Phoning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
NT.