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BSIG2017-001578-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: PD GROUP DBA SIGNARAMA 41945 BOARDWALK SUITE L PALM DESERT, CA 92211 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT SIGN/ BSIG2017-0015 78469 HIGHWAY 111 604050059 MASSAGE TRILOGY SPA SIGN $500.00 A-0 uLf-C'r . 5 !2017 L CITYOFLAouwTA COIJJAUNffYDEVELOPVENTDFPARTP.IENT 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: D422/ C 5 License No.: 830131 Date: �D /� 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).: (__j 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: 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/23/2017 Owner: HARSCH INV REA-TY 1121 SALMON ST 4TH FL PORTLAND, OR 92253 Contractor: PD GROUP DBA S?GNARAMA 41945 BOA.RDWACK SUITE L PALM DESERT, CA. 92211 (760)776-9907 Llc. No.: 830131 WORKER'S COMPENSATaON DECLARATION 1 hereby affirm under penalty of perjury one ofithe 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 COMPANY Polity Number: RWCC64396857 I certify that in.the performance of fie work for which this permit is issued, I shall not employ any person in any manner so ;is to become subject to the workers' compensation laws of California, and agree thac, if I should become subject to the workers' compensation provisions of Section 3-00 of the Labor Code, I shall forthwith comply /with those 71i7 vsions.. Z . Date: / 6 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 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 th-e 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 cancellztion. I certify that I have read this application and sta-e that the above information is correct. I agree to comply with all city and county ordinances and statelaws relating to building construction, and hereby authorize representatiaes of this city to enter upon the above -menti ned property for inspection purpcses. Date:�b .moi 7 Signature (Applicant cr Agent): i Date: 10/23/2017 Application Number: BSIG2017-0015 Owner: Property Address: 78469 HIGHWAY 111 HARSCH INV REALTY APN: 604050059 1121 SALMON Sl 4TH FL Application Description: MASSAGE TRILOGY SPA SIGN PORTLAND, OR 92253 Property Zoning: *Application Valuation: $500A0 Applicant: Contractor: PD GROUP DBA SIGNARAMA PD GROUP DBA S:GNARAMA 41945 BOARDWALK SUITE L ` 41945 BOARDWALK SUITE L PALM DESERT, CA 92211 PALM DESERT, CA 92211 (760)776-9907 -------------------------------------- ------------------------------------------------------- Lic. No.: 830131 Detail: CHANNEL LETTER SIGN [MASSAGE TRILOGY] PLANNING PERMIT SA2017-0031. THIS SIGN DOES,INCLUDE ELECTRICAL. PER 2016 CALIFORNIA BUILDING CODE i 0 FINANCIAL DESCRIPTION INFORmATION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 l DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $26.01 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 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 MANAGEMENIT FEE: $10.00 DESCRIPTION ACCOUNT IQTY 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: $120:15 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: TOTALS: $188.17 0