BSIG2015-004478-495 CALLE TAMPICO
LA'QUINTA, CALIFORNIA 92253
Application Number:
Property Address_ :
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
ROBERT PACKHAM
9108 W. 25TH ST
LOS ANGELES, CA 90034
Tw�t 4lwCtum*
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BSIG2015-0044
78611 HIGHWAY Ill"
643220007
IN -N -OUT / DIRECTIONAL/MENU/WALL MOUNTED SIGNS
$3,000.00
L DEC 02 2015
CITV OF LA OUINTA
C0htM1JNITvDEI,'EL0PVDJf DEPRRTfdENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C10. C45, D03 License No.: 11776699 1
Date: ' 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
($500).:
(� 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.).
(� I, 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 I I am exempt under Sec. . BAP.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:
1 60
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/2/2015
Owner:
IN -N -OUT BURGER
13502 HAMBURGER LN
BALDWIN PARK, CA 91706
Contractor:
CNP CALIFORNIA NEON PRODUCTS
4530 MISSION GORGE PL
SAN DIEGO, CA 92120
(619)283-2191
Llc. No.: 176699
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 o for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 370Qof the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensate n insurance carrier and policy number are:
Carrier:-11?dicyNumber: Z-a7a3Sy60/
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.1 should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: /Z "j""/r Applicant: 4 -
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 Building Official 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 city to enter upon the
above-mentioned property for inspection purposes. r^
Date: / Z � Signature (Applicant or Agent): A40-1
FINANCIAL .• {.
DESCRIPTION. ACCOUNT QTY AMOUNT . PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 12/2/15
PAID BY METHOD RECEIPT # ' _ CHECK # CLTD BY
PERMITWIZ CHECK R112S1 1339 SGU
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$24.17
12/2/15
PAID BY
METHOD ; :
RECEIPT #
CHECK # .
CLTD BY
PERMITWIZ
CHECK
R11251
1339
SGU
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$24.17
12/2/15
PAID BY
METHOD`
RECEIPT #
CHECK # •
CLTD BY
PERMITWIZ
CHECK
R11251
1339
SGU
Total Paid for ELECTRICAL: $48.34 $48.34
DESCRIPTION .
ACCOUNT..
QTY :
AMOUNT
PAID
PAID DATE`
WALL/AWNING SIGN, EA ADDITIONAL
101-0000-42404
0
$147.96
$147.96
12/2/15
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD..BY
PERMITWIZ •
CHECK
R11251
1339
SGU
DESCRIPTION
`ACCOUNT
QTY
AMOUNT
PAID'
PAID DATE
WALL/AWNING SIGN, EA ADDITIONAL PC
101-0000-42600
0
$147.96
$147.96
1212/15
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY.
PERMITWIZ
CHECK
R11251
1339
SGU
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WALL/AWNING SIGN, FIRST
101-0000-42404
0
$24.66
$24.66
12/2/15
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
PERMITWIZ
CHECK
R11251
1339
SGU
DESCRIPTION'
ACCOUNT
QTY
• AMOUNT..
PAID
PAID DATE
WALL/AWNING SIGN, FIRST PC
101-0000-42600
0
$87.02
$87.02
12/2/15
PAID BY
METHOD
RECEIPT #.
CHECK #
CLTD BY
PERMITWIZ
CHECK
R11251
1339
SGU
Total Paid for SIGN: $407.60 $407.60
•, $456.94
Description: IN -N -OUT / DIRECTIONAL/MENU/WALL MOUNTED SIGNS
Type: SIGN Subtype: Status: APPROVED
Applied: 11/24/2015 SGU
Approved: 11/30/2015 BHA
Parcel No: 643220007 Site Address: 78611 HIGHWAY 111 LA QUINTA,CA 92253
Subdivision: PM 18418 Block: Lot: 1
Issued:
Lot Sq Ft:0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $3,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
PLAN CHECK SUBMITTAL
RECEIVED
Details: 4 -QTY ILLUMINATED BUILDING WALL MOUNTED SIGNS; 2 -QTY ILLUMINATED DIRECTIONAL SIGNS WITH FOUNDATION AT DRIVE -
THRU; 1 ILLUMINATED MENU BOARD WITH FOUNDATION. 2013 CODES.
Printed: Wednesday, December 02, 2015 1:49:05 PM 1 of 3 �
�L.l I{..//J
SYSTr: ti1S
ADDITIONAL
CHRONOLOGY
CHRONOLOGY.TYPE
STAFF NAME
ACTION DATE
COMPLETION DATE
NOTES _
PLAN CHECK SUBMITTAL
RECEIVED
STEPHANIE GUMPERT
11/24/2015
11/24/2015
TELEPHONE CALL
BURT HANADA
11/30/2015
11/30/2015
NOTIFIRD BOB PACKHAM THE PERMIT IS READY TO ISSUE.
COPY OF CURRENT WORKER'S COMP INSURANCE INFO
REQUIRED AT TIME OF PERMIT ISSUANCE.
CONDITIONS
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT.
ROBERT PACKHAM
9108 W. 25TH ST
LOS ANGELES
CA
90034
(626)813-8279
CONTRACTOR
CNP CALIFORNIA NEON PRODUCTS
4530 MISSION GORGE
PL
SAN DIEGO
CA
92120
(626)813-8279
OWNER
IN -N -OUT BURGER
13502 HAMBURGER LN
BALDWIN PARK
CA
91706
(626)813-8279
Printed: Wednesday, December 02, 2015 1:49:05 PM 1 of 3 �
�L.l I{..//J
SYSTr: ti1S
INSPECTIONS
PARENT PROJECTS
Printed:. Wednesday, December 02, 2015 1:49:05 PM 2 of 3 C§?
sysTr•Ms
FINANCIAL
INFORMATION
DESCRIPTION
ACCOUNT QTY
AMOUNT
PAID
PAID DATE
RECEIPT 4
CHECK #
METHOD
PAID BY
CL
...
..BY
BSAS SB1473 FEE
101-0000-20306 0
$1.00
$1.00
12/2/15
1 • R11251
1 1339
1 CHECK
PERMITWIZ
SGU
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00
$1.00
BSA:.
DEVICES, FIRST 20
101-0000-42403
0•
$24.17
$24.17
12/2/15
R11251
1339
CHECK
PERMITWIZ
SGU
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$24.17
1 12/2/15
1 R11251
1339
CHECK
I PERMITWIZ
SGU
Total Paid for ELECTRICAL:
$48.34
$48.34
WALL/AWNING SIGN,
101-0000-42404
0
$147.96
$147.96
12/2/15
R11251
1339
CHECK
PERMITWIZ
SGU
EA ADDITIONAL
WALL/AWNING SIGN,
-R11251
101-0000-42600
0
$147.96
$147.96
12/2/15
1339
CHECK
PERMITWIZ
SGU
EA ADDITIONAL PC
WALL/AWNING SIGN,
101-0000-42404
0
$24.66
$24.66
12/2/15
R11251
1339
CHECK
PERMITWIZ
SGU
FIRST
WALL/AWNING SIGN,
101-0000-42600
0
$87.02
$87.02
12/2/15
R11251
1339
CHECK
PERMITWIZ
SGU
FIRST PC
Total Paid for SIGN:
$407.60
$407.60
TOTALS:
INSPECTIONS
PARENT PROJECTS
Printed:. Wednesday, December 02, 2015 1:49:05 PM 2 of 3 C§?
sysTr•Ms
Printed: Wednesday, December 02, 2015 1:49:05 PM 3 of 3 C
srsrcins
ATTACHMENTS
Attachment Type
CREATED
OWNER
DESCRIPTION
PATHNAME
SUBDIR
ETRAKIT ENABLED
APPROVED WALL MTD.
APPROVED WALL MTD.
DOC
11/30/2015
BURT HANADA
SIGN PLANS - IN-N-
SIGN PLANS - IN-N=
0
OUT.pdf
OUT.pdf
APPROVED SIGN
APPROVED SIGN
DOC
11/30/2015
BURT HANADA
LIGHTING ENERGY
LIGHTING ENERGY
0
FORMS - IN-N-OUT.pdf
FORMS - IN-N-OUT.pdf
DOC
11/30/2015
BURT HANADA
APPROVED SIGN PLANS
APPROVED SIGN PLANS
0
- IN-N-OUT.pdf
- IN-N-OUT.pdf
APPROVED
APPROVED
STRUCTURALCALCS-
STRUCTURAL CALCS-
. DOC
11/30/2015
BURT HANADA
DIRECTIONAL SIGN - IN-
DIRECTIONAL SIGN - IN-
0
WOUT TYPE Cl and
WOUT TYPE Cl and
C2.pdf
C2.pdf
APPROVED
APPROVED
DOC
11/30/2015
BURT HANADA
STRUCTURAL CALCS -
STRUCTURAL CALCS -
0
MENU BOARD - IN-N-
MENU BOARD - IN-N-
OUT.pdf
OUT.pdf
DOC
11/24/2015
STEPHANIE GUMPERT
APPLICATION.pdf
APPLICATION.pdf
0
DOC
11/24/2015
STEPHANIE GUMPERT
TITLE 24.pdf
TITLE 24.pdf
0 .
STRUCTUAL
STRUCTUAL
DOC
11/24/2015
STEPHANIE GUMPERT
CALCULATIONS
CALCULATIONS
0
DIRECTIONAL SIGNS.pdf
DIRECTIONAL SIGNS.pdf
STRUCTUAL
STRUCTUAL
DOC
11/24/2015
STEPHANIE GUMPERT
CALCULATIONS MENU
CALCULATIONS MENU
0
BOARD.pdf
BOARD.pdf
EXHIBITS-DIRECTIONAL
EXHIBITS-DIRECTIONAL
DOC
11/25/2015
STEPHANIE GUMPERT
SIGNS-MENU
SIGNS-MENU
0
BOARD.pdf
BOARD.pdf
DOC
11/25/2015
STEPHANIE GUMPERT
EXHIBITS-WALL
EXHIBITS-WALL
0
SIGNS.pdf .
SIGNS.pdf
Printed: Wednesday, December 02, 2015 1:49:05 PM 3 of 3 C
srsrcins
" .
Bin #
cis of La Qurnta
Building S Safety Division
P.O. Box 1504,7$-495 Calle Tampico
La.Quinta, CA 92253 --(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
�1 [�
Project Address: 8 I ! L-�(Gl{'LvA I I
Owner's Name:.
A. P. Number:
Address: .
Legal Description:
City, ST, Zip:
Contractor. CAV / CA L tF /l/�O,U P&DUG1j
Telephone:
Address: Y130 M LSS 101J GS% a6k 0.(.
Project Description:
City, ST, Lip: 5Ai) fi1 660. c,14 qzi?(-)
5TAU. -T 1
Telephone: & L. R o2 � 3. 21 r4 M . � < �w
it N e Y 2
State Lic. 4 City Lid. ih
Arch., Eagr., Designer.
C I C Z (]
Address:D
I .. r7 Y1'1 &I S I (7/j 2p•
City, ST, Zip:
Lj v. i7
Telephone:
State Lic. 4:
y�''',b"s. "y
M.
?y'�Sr, •V M '!
Construction Type: Occupancy:
Project type (circle one): New Add'n. Alter Repair Demo
Name of Contact Person: &0A P/4 CICYA-M Sq. Ft.: y(?, () 1 4 Stories: f1 Units;
Telephoncii of Contact Person: .3 rO G ZS Z(, y0 Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Plan Sets
Req'd
Recd
TRACItIIVG PERWrFEES•
Plan Check submitted Item Amount.
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs,
Caned Contact Person
Pian Check Balance
Tide 24 Calci.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanics[
Grading plan
2" Review, ready for correctionsirmue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S_4LL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
"a Review, ready for correetionsAssue
Developer Impact Fee
Planning Approval.
Called Contact Person
21111116 V
Pub, Wks. App"
Date orpermit issue
School Fees
KlnV 9. A7015
NT
'� e
SECTION B - APPLICANVOWNER INFORMATION
Applicant Information and Certification
I certify that I have read this application packet in its entirety and have read and
understand the City's sign regulations (LQMC 9.160) along with any City approved property
specific sign program applicable to the proposed location. I further certify that each
application item submitted is consistent with the requirements listed in the following
Section C and all proposed temporary and permanent improvements included in this
application are proposed in compliance with all applicable regulations. 1 understand and
agree that if during the processing of the application, it is determined the information
submitted does not strictly meet such standards or contains errors or omissions,
clarification and/or supplemental information may be required which will delay the
processing of this appJiption. ,
Applicant's Signature j ��f�, �i�,i.�i---- Date: (3141, 20/J
Print Name: ' R O 6 Eft - A4 ClLlfA-M . Phone: 3 10 - G 2,9'- —2,6 V0
Mailing Address: Cf l0 8 l,U . s? Si (..4 q0 o 3 y Email: ape I'm lu;3 60 A co
wta i 1. cod
Property Owner Information and Certification
I certify under the penalty of the laws of the State of California that I am the property owner
of the property that is the subject matter of this application and I am authorizing and
hereby do consent to the filing of this application and acknowledge that the final approval
by the City of La Quinta, if any, may result in restrictions, limitations and construction
obligations being imposed on this real property.
Owner/Authorized Agent Signature Date: 10- log-,
Print Name: krh e IlGhQzz Phone: I0o?6• R 15 • ga't'+q
Mailing Address: Email: h.S 1 iJChe 7 0 C o ;
r
'An authorized agent or a owner must attach1a nOtIeNePer of authorization from the legal property owner.
SECTION C - APPLICATION SUBMITTAL REQUIREMENTS
APPLICATION SUBMITTAL REQUIREMENTS
O BE COMPLETED BY CITY STAFF
Each of the following items is required for submittal
# of
PDF
Waiver
unless a waiver is granted by City Staff. All plans shall
format
,
a
'R
be legible, accurately scaled, representatively colored
paper
iCD-
on
OK d by
r'
3
with identified dimensions on Wlx11" or 11 "x17" sheets
copies
ROM)
(initials)
C]
p
Filing Fees Receipt ($200) S e h �' �, Gh e�,�
1
NA
p
NA
Application /
1
NA
NA
E:]
NA
Site Plan (show location of proposed & existing signs to remain)
5
NA
NA
Q
NA
Building Elevations (show each sign & entire side of building)
5
NA
NA
Sign Construction Detail (identify size, colors, constructionNA
A
NA
materials, & lighting components for each portion of the sign)
,;!1VJJY
Sign Permit Application - Permanent Page 2 of 2
City of La Quinta - Planning Department ■ 760.777.7125 CITY OF LA pUINTA 05.20.13
P:%Application Submittal Forms%pplications\SMSA-P Application - 05.20.13.doc COMMUNITY DEVELOPMENT