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SA2016-0019 (SIGN)78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDINGPERMIT Application Number: SA2016-0019 Property Address: 19295 HIGHWAY 111 APN: 600340027 Application Description: WALMART / WALL MOUNTED SIGNS Property Zoning: Application Valuation: $3,200.00 Applicant: ARCHITECTURAL DESIGN & SIGNS INC 1160 RAILROAD STREET CORONA, CA 97882 LICENSED CONTRACTOR'S DECLARATION 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 Professions Code, and my License is in full force and effect. License Class: C45 License No.: 714309 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 constructthe 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. . B.&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 Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/12/2016 Owner: WAL MART REAL ESTATE BUSINES P 0 BOX 8050 BENTONVILLE, AR 92253 Contractor: ARCHITECTURAL DESIGN & SIGNS INC 1160 RAILROAD STREET -v- --CORONA; CA 92882 (951)278-0680 Llc. No.: 714309 WORKER'S COMPENSATION DECLARATION 1 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: _ Policy Number: _ 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 shall forthwith comply with those provisions. Date: 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 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. Date: • Signature (Applicant or Agent): DESCRIPTION FINANCIAL INFORMATION ACCOUNTQTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 S/17/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY Barbara COHEN CREDIT WE6801 2016051803493310395 ECON Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE Credit Card Fee 101-0000-43505 0 $13.39 $13.39 5/17/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY Barbara COHEN CREDIT WEB801 '20160513805 493310 ECON Total Paid for Credit Card Fee: $13.39 $13.39 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/AWNING SIGN, EA ADDITIONAL 101-0000-42404 0 $147.96 $147.96 5/17/16 PAIDBY METHOD RECEIPT # CHECK # CLTD BY Barbara COHEN CREDIT WEB801 2016051803493310 395 ECON DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/AWNING SIGN, EA ADDITIONAL PC 101-0000-42600 0 $147.96 $147.96 5/17/16 PAID BY METHOD RECEIPT # CHECK # : CLTD BY Barbara COHEN CREDIT WEB801 2016051803493310 395 ECON DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/AWNING SIGN, FIRST 101-0000-42404 0 $24.66 $24.66 5/17/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY Barbara COHEN CREDIT WEB801 2016051803493310395 ECON DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/ AWNING SIGN, FIRST PC 101-0000-42600 0 $87.02 $87.02 5/17/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY Barbara COHEN CREDIT WEB801 395 2016051803493310 ECON Total Paid for SIGN: $407.60 $407.60 DESCRIPTION ACCOUNT' QTY AMOUNT PAID PAID DATE SIGN PERMIT - PL 101-0000-42434 0 $200.00 $200.00 5/17/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY Barbara COHEN CREDIT WEB801 2016051803493310395 ECON Total Paid for SIGN PERMIT - PL: $200.00 $200.00 TOTALS: Description: WALMART / WALL MOUNTED SIGNS CONDITIONS NAME TYPE Type: SIGN PERMIT (WEB) Subtype: PERMANENT WALL Status: ISSUED Applied: 5/17/2016 ECON MOUNTED ILLUMINATED Approved: 5/24/2016 MFA Parcel No: 600340027 Site Address: 79295 HIGHWAY 111 LA QUINTA,CA 92253 Subdivision: PM 30420 Block: 'Lot: 1 Issued: 6/1/2016 SIKH Lot Scl Ft: 0 - Building Scl Ft: 0 Zoning: Finaled: Valuation: $3,200.00 Occupancy Type: Construction Type: Expired: 11/28/2016 5XH No. Buildings: 0 No. Stories: 0 No. Unites: 0 CORONA Details:. Wall Signs 92882 (951)2.78-0680 ADDITIONAL SITES Applied to Approved , Approved to Issued CHRONOLOGY CONDITIONS NAME TYPE NAME ADDRESSI CONTACTS CITY STATE ZIP PHONE FAX EMAIL APPLICANT ARCHITECTURAL DESIGN & SIGNS INC 1160 RAILROAD STREET CORONA CA 92882 (951)278-0680 BCOHEN@AD-S.COM CONTRACTOR ARCHITECTURAL DESIGN & SIGNS INC 1160 RAILROAD STREET CORONA CA 92882 (951)2.78-0680 BCOHEN@AD-S.COM OWNER WAL MART REAL ESTATE BUSINES I P O BOX 8050 1 BENTONVILLE I AR 1 92253 1 (951)278-0680 Printed: Tuesday, July 12, 2016 1:26:01 PM 1 of 3 Pw SYSTEMS INSPECTIONS Printed: Tuesday, July 12, 2016 1:26:01 PM 2 of 3 I SYSTrmS CLTD . DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK #. METHOD PAID BY BY 201605180 BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 5/17/16 WEB801 349331039 CREDIT Barbara COHEN ECON 5 - Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: 201605180 Credit Card Fee 101-0000-43505 0 $13.39 $13.39 5/17/16 WEB801 349331039 CREDIT Barbara COHEN ECON S.. Total Paid for Credit Card Fee: $13.39 $13.39 WALL/AWNING SIGN, 201605180 101-0000-42404 0 $147.96 $147.96 5/17/16 WEB801 349331039 CREDIT Barbara COHEN ECON EA ADDITIONAL 5 WALL/AWNING SIGN, 201605180 101-0000-42600 0 $147.96 $147.96 5/17/16 WEB801 349331039 CREDIT Barbara COHEN ECON EA ADDITIONAL PC 5 WALL/AWNING SIGN, 201605180 101-0000-42404 0 $24.66 $24.66 5/17/16 WEB801 349331039 CREDIT Barbara COHEN ECON FIRST 5 WALL/AWNING SIGN, 201605180 101-0000-42600 0 $87.02 $87.02 5/17/16 WEB801 349331039 CREDIT Barbara COHEN ECON FIRST PC 5: Total Paid for SIGN: $407.60 $407.60 201605180 SIGN PERMIT - PL 101-0000-42434 0 $200.00 $200.00 5/17/16 WEB801 349331039 CREDIT Barbara COHEN ECON Total Paid for SIGN PERMIT -'PL: $200.00 $200.00 TOTALS: INSPECTIONS Printed: Tuesday, July 12, 2016 1:26:01 PM 2 of 3 I SYSTrmS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED REVIEWS STATUS REMARKS NOTES DATE IST PERMIT TECH — MARY 5/17/2016 5/18/2016 5/19/2016 REVISIONS REQUIRED ETRAKIT (1 DAY) FASANO PLEASE SEE PLANNING REMARKS 1ST PLANNING — CARLOS 5/17/2016 5/18/2016 5/18/2016 REVISIONS REQUIRED SQUARE FOOTAGE ON TWO NEW SIGNS EXCEEDS ETRAKIT (1 DAY) FLORES ALLOWABLE AMOUNT FROM SIGN PROGRAM. WALMART EMAIL SENT ON 5/23/16 GIVES 2ND PLANNING — CARLOS 5/24/2016 5/24/2016 5/24/2016 READY FOR APPROVAL JUSTIFICATION ON MINIMAL INCREASE IN ETRAKIT (1 DAY) FLORES SQUARE FOOTAGE 1ST BLDG NS - AJ ORTEGA 5/24/2016 5/25/2016 S/24/2016. READY FOR APPROVAL ETRAKIT (1 DAY) SIGN LIGHTING COMPLIANCE REVIEW ONLY PERMIT TECH — FST MARY 5/24/2016 5/25/_2016 5/24/2016 APPROVED RAKIT (1 DAY) FASANO BOND INFORMATION ATTACHMENTS Attachment Type CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED SA2016-0019 WALMART SA2016-0019 WALMART .DOC 5/24/2016 CARLOS FLORES JUSTIFICATION EMAIL 5- JUSTIFICATION 0 23-16 EMAIL.pdf DOC 5/17/2016 EtrakitContractor design file PDF wall 41231-R00(PS).pdf 0 signs DOC 5/24/2016 MARY FASANO WALMART APPROVAL WALMART 1 APPROVAL.pdf Printed: Tuesday, July 12, 2016 1:26:01 PM 3 of 3 .., sysrerts