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04-4566 (SIGN)BUILDING•& SAFETY DEPARTMENT P.O. BOX 1.504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . . 04-007004566 Date ,5/25/04 Property Address .. .. 46805 DUNE PALMS RD APN:.. 649-020-999-A -02377 - -Applicationdescription . . . ' SIGN Property Zoning . . . . . . . REGIONAL COMMERCIAL Application valuation. 4900 .. Owner Contractor REULMAN MARK GRAPHIC RESOURCES' 730Z8 8 HIGHWAY 11-11 P.O. BOX 1770 PALM DESERT CA 92260 LA QUINTA. CA 92253 (760) 863-0865 WCC: STATE FUND WC: 16409402004 02/01/05 CSLB: 617865. 04/30/05 CCC: C45 Permit . . . ELEC-ELECTRICAL SIGN •Additional desc . Permit Fee. 33.00 -Plan Check Fee .00 Issue Date Valuation . . . . 0 Qty..- Unit. Charge 'Per Extension BASE FEE 15.00 1.00 15.0000 Ek ELEC SIGN 1ST CIRCUIT 1,5.00• 1.0.0 3.0000 EA ELEC SIGN ADDITIONAL CIRUITS 3.00 Special Notes and Comments TWO NEON ILLUMINATED CFjUTNEL LETTER S'IGN'S .FOR "'RADIOACTIVE`" PER SA .04=7,8.7.. - - .'Fee summary Chaxged Permit Fee Total 33.00 Plan Check Total .00 Grand Total 33.00 Paid ------------ .00 :OG .00 .Credited :00 Due 33.00 P.O. BOX 1.50'Oaf :VOICE (760) 777-7012 73-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 9,2253 INSPECTIONS (760) 777-71'$3 BUILDING & SAFETY DEPARTMENT Application Numbers!t�66 Applicant: 11 nA _ Applicant's Mailing Address: Date: Archftec (neer. K;Tdect or Engineer's Address: lk..NO.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 hereby allb.. under peneltyof perjury Mat tam sensed under provisions of ChepMr 9 (0m*nendng with Serlion 7000) of Division 3 of the.Business and Prolessionah Cale, and myLicerre• iin l fma and effect. Class.................... G License C! .S License No. 4 1-[ S L S OWNER -BUILDER DECLARATION 1 hereby afrum under penalty of.parjuryahst Lam asaernpt 6om the Contractors' State Lkaenes Lawfor Me fo0owinp igistar (Sea 70315, 8uaineas and' Professions Code: Any city oc county that rgiqutrera permit fo caistrud alter, hnpr eve, demopsh, or repak army structure, prior fo Its iesuacnce, also rgiquires !le applicant far the pemrit to Me a signed etalerent that hie or she ts!tioensed pursuant b the provisions o f the CaMradors' Stats Lkxnse Law (CLtaplar 9 (oorrnerndrrp wlth'Sedion 7000) or D1Wsion S at the Bwkwm end atkged any a parnit subjects :Mrs aPP� to a civil penally of not oars than five Mmdred dollars (5500).):, . U I, as owner of the pcopeRy. a my:empbyees wlth wages es their sole compensation, wilt cloths woAc, and He si,ucbae fa not Intended or oMened•tor sale (Sec. 7044, Bushwjss and Professions Code: The Contractors' State lJceree Lawdoes rat apply io an owner d property who trnrbde or hnproves Hereon. and who does the work hhnseffor herself or through his or her own employees, provided that the Improvements are rat intended or offered for -sale. lf. Lawgiver, the buk2w or improvement is sold within one year of completion. the,owner4wilder win have the burden of provkg Met he or ate clod mat bu ld or irrrprove for the kMoas of sale.). U Los owner of to property. am axclusively contracting with licensed contractors to construct the pmjsd (Sea 7044, Business and Professions Code: The Contractors' State License law does notapply. to an owner of pmpetty who builds or Improves hereon, and who contracts for the projects with a confrodor(s):11ce used pursuant to the Contractors' State License L w; U 1 am eremo under Sea • ' . A P.C. for Ods reason . Date Owner WORKERS' COMPENSATION DECLARATION I. hereby alLlm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to sW4rksum icr workers' compensation. as provided for by section 3700 of the Labor Code, for tie Peiro . Once of the work,for which this pennitt is Issued. _ I have and will maintain workers' compensation Insurance. as required by Section 3700 of the Labor Code, for He performance of the work for Which Hes pemdl is is ue . rs' aorto ensation insurance carrier cqc� n r s Oartler _ ra 'i .j�.-Policy Number©� 1 ascii Het In the performance of the work forwhich ,Hit�t� ua , s pe1 she Lrat empty person In any mart er so as to beoo a subject to the workers' compensadaws i 10-ofIFCaftmia, and agthat. If f should beoans subject to tine workers' wns mpwmagm,pkwh* ' of Section 3700 of the Labor Cods. I shs0, . tonnwiMr oolmply with ase ree Date=�i: s'D T Applicant WARNING: FAILURE TO.- WORKERS' COMP COVE EIS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE:HUNDRED THOUSAND DOLLAR§ (3100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS, PROVIDED FOR IN SECTION,3706 OF THE LABOR CODE, INTEREST, AND.ATTORN"'S FEES. CONSTRUCTION LENDING AGENCY 1 hereby atflm miler penalty of pe4ury that Owe Is a construction lending agency for the paformenoe of the work for which thispemdt Is Issued (Sea 3097. Civ.,C.). Lender's Name Lendees Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Dlrecfor of Building and Safety fora pemdt subjed to the eonnerwons and, restrictions set foAh on Bite application. 1. - Each person upon whose behalf this application is made, each person.at whose request and for whose benefit work.is Perron, under or pursuant to any permit Musa arra ros+dtOf thisappiicatlCM the owner, and the applicant, each agrees to, and shag; defend. Indenrrdfy and hold hsmdess the City of La Quints, Its otlkers, agents and ernpioyess for any ad oromission related tole work 'being perfumed under or following issuance of this pemdt. 2 Any permit issued.as a result of this.apptreation becomes cool and void lf work Is not commenced within 1110 days horn dale of Issuance of such permit or oesgad o"of work for 160 days will subject permit to cancellation: 1 certify that I have reed finis application and slate that the above Info I correct Isom to oompty with all city and county ordinencea,and state laws relating to building consbuctiom anndd hereby authorize representatives of this county to the twned property for inspec on purposes. Date h "div "♦~%� Sigreture (Applieent or Agent):