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BSIG2017-0024"TAMPICO 4 VOICE (760) 777-7125 78-495 CALLE LA QUINTA, CALIFORNIA 92253 FAX FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT (760) 777-7153 ' BUILDING PERMIT Date: 12/28/2017 Permit Type/Subtype: SIGN/ Owner: Application Number: BSIG2017-0024. CANYON SUNSET LP Property Address: 50680 EISENHOWER DR STE 103 3366 VIA LIDO APN: 773370029 NEWPORT BEACF, CA 92253 Gam. c Application Description: MANUEL MERAZ INSURANCE SERVICES / SIGNS Property Zoning: Q LLI o o Application Valuation: $2,000.00 i cV E5 Applicant: Contractor: U ; 0 o PD GROUP DBA SIGNARAMA PD GROUP DBA SGNARAMA >� W 41945 BOARDWALK SUITE L 41945 BOARDWRLK SUITE L PALM DESERT, CA 92211 PALM DESERT, CA 92211 o � (760)776-9907 Llc. No.: 830131 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: D42, C45 License No.: 8301331 Date: f < 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 am exempt under Sec. . B.&P.C. for this reason Date: Owner: WORKER'S COMPENSATION DECLARATION. I hereby affirm under penalty of perjury one o: the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 370C 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: ACE AMERICAN INSURANCE COMPANti Policy Number: RWCC64396857 I certify that in the performance of -he 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: Z� I 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 ($100,00*). 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 owne-, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the --ity 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 subjectpermit to cancellation. CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct. I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws relating to building the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representaives of this city to"enter upon the above-mentioned property for inspection purposes. Lender's Name: Date: z' f 7 Signature (Applicant or Agent): Lender's Address: Date: 12/28/2017 Application Number: BSIG2017-0024 Owner: Property Address: 50680 EISENHOWER DR STE 103 CANYON SUNSET LP APN: 773370029 3366 VIA LIDO Application Description: MANUEL MERAZ INSURANCE SERVICES / SIGNS NEWPORT BEACH, CA 92253 Property Zoning: Application Valuation: $2,000.00 Applicant: Contractor: PD GROUP DBA SIGNARAMA PD GROUP DBA SIGNARAMA 41945 BOARDWALK SUITE L 41945 BOARDWALK SUITE L PALM DESERT, CA 92211 PALM DESERT, CA 92211 (760)776-9907 Llc. No.: 830131 Detail: (2) CHANNEL LETTER LED SIGNS [MANUEL MERAZ INSURANCE SERVICES) [MEDICARE PLANS] SIGN PERMIT NO. 2017-0036. PER 2016 CALIFORNIA BUILDING CODES. FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $26.01 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES'JIRST 20 PC 101-0000-42600 0 $26.01 Total Paid for ELECTRICAL: $52.02 DESCRIPTION ACCOUNT QTY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 • DESCRIPTION ACCOUNT QTY AMOUNT WALL/AWNING SIGN, EA ADDITIONAL 101-0000-42404 0 $26.53 DESCRIPTION ACCOUNT QTY AMOUNT WALL/AWNING SIGN, EA ADDITIONAL PC 101-0000-42600 0 $26.53 DESCRIPTION ACCOUNT QTY AMOUNT WALL/AWNING SIGN, FIRST 101-0000-42404 0 $26.53 DESCRIPTION ACCOUNT QTY AMOUNT WALL/AWNING SIGN, FIRST PC 101-0000-42600 0 $93.62 Total Paid for SIGN: $173.21 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00