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04-7728 (SIGN)o- uli�w BUILDING & SAFETY DEPARTMENT 504 (760).777-70.12 78-495 LETAMPICO FAX (760) 777-7011_ oOJTL U;IIai-TA, ALIFORNIA 922'53 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT C App, cation Number . . . . 04-000.07728 Date 12/09/04 Property Address . . . . 50660 EISENHOWER DR APN: 773-370-028-3 -000000- Application description . . . SIGN Property Zoning . . . . . .. . LOW DENSITY RESIDENTIAL Application valuation 14000 Owner Contractor CAMEO HOMES HOKE OUTDOOR ADVERTISING INC 1103 QUAIL STREET 195:5 Ni MAIN STREET NEWPORT BEACH CA 92658 ORANGE CA -92865 (714) 637-3610 WCC: STATE FUND WC: 1768940 01/0.1/0.5 CSLB: 719612 03/31/06 CCC:. D42 Permit . . . . . . SIGN PERMIT Additional desc . . Permit Fee . . . . 153.00 Plan Check_ Fee .99 Issue Date . . . . Valuation . . . . 14000 Qty Unit Charge Per Extension BASE FEE 4.5..0 0 12.00 9:0000 THOU BLDG 2,,00'1-725,00,0 .108.00 Special Notes and Comments COMMERCIAL MONUMENT SIGN ON 4' BLOCK WALL(CITY STANDARD) PER SA 2004-=835 Fee summary Charged Paid Credited Due Permit Fee°Total 153.00 .00 .00 153.00 Plan Check Total .99 .00 .00 .99 Grand Total 153.99 :00 .00 153.99 P.O. BOX 1504�� VOICE (760) 777-7012 78,49.5 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 1 BUILDING & SAFETY DEPARTMENT Application Number:' 7%Z S Date: Z— Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7010) of Division;3 of the Business and Professionals Code,r and my License i in fuli force d eff Uoense Class G 1 "' License No. Date - Contractor O ER -BUILDER DECLARATION I' hereby affirm underpenalty of perjury that I am exempt from the Contractors' State License Law.for the folkmwing 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 Nuance, also requires the applicant for "Wpennitlo file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' 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 byerrrmi any applicant for a pt subjects the applicant to a civilpenalty, of not more than five hundred dollars ($500):)' U 1, as owner of the property, or;myemployees 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 or through his or her own employees, provided that the improvements are not intended or offered for sate. 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.). U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sac. 7044, Business and Professions Code: The Contractors' State License Law does notapply town owner of property who builds or Imp roves thereon, andwho,00ntracts for the projects with a contractors) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , B.& P.C. forthis reason Date Owner i WORKERS' 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, forthe performance - of the work for which This permit.is issued. _ I have and will maintain workers' compensation insurance; as mquired,by,Secton 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' cQmpensationi surance carver n Iiy; �eyei� Cartier SIAl w! K Policy Number � fD �f V _ I certify that, in theerforrnance of the work forwhich thls permd is Issued, l shall not employ any person many manner so as to become subject to the workers' compensatioI laws of California, and agree that, If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith.compiy with those provisions. Data Applicant WARNING: FAILURE`TO SECURE WORKERS' COMPEN?$T OR COVERAGE IS UNLAWFUL, AND:SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE. HUNDRED THOUSAND DOLLA($100,000),',IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 -OF THE LABOR CODE,.INTEREST, ANDORNEY'S'FEES. CONSTRUCTION LENDING AGENCY , I hereby affirm under penalty of perjury that there is?a construction lending agency for the.perfornance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lenders Name Lenders Address 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 personupon 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 Quints, its officers, agents and employeesfor any act or omission related to time work being perfommed under or following Issuance of this permit: 2. Any permit issued as a result of this application becomes null and void if work isnot commenced within 180 days from date of issuance -of such permit, or cessation of work for 160 days'will.subject permitto cancellation. I certify that; l have read this application and state that the above Informatiomis correct: I agree to complywith all city end county ordinances and,state laws relating to building construction, and hereby authorize -representative a of this county to enter upon the above-7riti, onV property for inspection purposes.. Date Signature (Applicant or Agent):.