BSIG2017-00114�aw
VOICE (760) 777-7125
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7011
BUILDING PERMIT
Date: 8/10/2017
Application Number: BSIG2017-0011D
wner:
Property Address: 79295 HIGHWAY 111 ® WAL MART REAL ESTATE BUSINES
APN: 600340027 P 0 BOX 8050
Application Description: WALMART /PICK UP SIGNS /)6��
ENTONVILLE, AR 92253'
Property Zoning:
Application Valuation: $600.00
Applicant: F� D�U�GU`�1TA c�4vtractor:
001 WJUAN C OSEGERSTROM AVE SPINAID �f�O?I�E.NT D�PARTMFUAN C OSPINA
SANTA ANA, CA 92704 DESIG 4001 W SEGERSTJiOM AVE
SANTA ANA, CA 92704
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. i
License Class: C45 License No.: 9746557. �—
Dat�6 10 Cont o
OWNER -BUILDER DECLARATION Y
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:
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:
(714)542-3780
LIc. No.: 974657
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 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: EXEMPT 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 withhoselrovisions.
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.
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
,onstruction, and hereby authorize representatives of this city to enter upon the
above -mention pro erty for inspection purposes.
Oa�e O Signatu� re-(Appolicant.or-Agent):- s
'
Date: 8/10/2017
Application Number:
BSIG2017-0011
Owner:
Property Address:
79295 HIGHWAY 111
WAL MART REAL ESTATE BUSINES
APN:
600340027
P 0 BOX 8050
Application Description:
WALMART / PICK UP SIGNS
BENTONVILLE, AR 92253.
Property Zoning:
Application Valuation:
$600.00
i
Applicant:
Contractor:
JUAN C OSPINA
JUAN C OSPINA
4001 W SEGERSTROM AVE
4001 W SEGERSTROM AVE
SANTA ANA, CA 92704
SANTA ANA, CA 92704
(714)542-3780
LIc. No.: 974657
Detail: (1) CHANNEL LETTER
LED SIGNS [PICKUP] SIGN PERMIT NO. 2017-0020 [CF] 2016
CALIFORNIA BUILDING CODES.
FINANCIAL .l.
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB 1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATIO4 BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$25.33
Total Paid for ELECTRICAL: $50.66
DESCRIPTION.
ACCOUNT
QTY
AMOUNT
WALL/AWNING SIGN, FIRST
101-0000-42404
0
$25.84•
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WALL/AWNING SIGN, FIRST PC
101-0000-42600
0
$91.20
Total Paid for SIGN: $117.04
DESCRIPTION
ACCOUNTQTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
f
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Bin#
City of La Quinta
Building & Safely Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit#
Project Address:
!
Owner's Name:
A.P. Number
Address: 7
Legal Description:. ��f /
City, ST, Zip: -
Contractor:
Telephone:
Address:(— f _,
4
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Project Description:
7_10�X��
City, ST, Zip:
Q
Telephone: [ rcP
State Lie. #: / 7 City Lic #:
1P
Arch, Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type:
Occupancy:
State Lic. #:
Proj. Type
New
Add'n
Alter
Repair
Demo
Name of Contact: 2
SgFt:
#Stories
# Units:
Telephone of Contact: O ^
C ^� �^ �.– .
7 1
Estimated Value of Project:
�
•��io�
i APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check Submitted
Item
Amount
Structural Calcs
Reviewed, ready for corrections
Plan Check Deposit:
Truss Calcs
Called Contact Person
Plan Ch=k Balance:
Title 24 Calcs
Plans Picked Up
Construction:
Flood Plain Plan
Plans Resubmitted
Mechanical:
Grading Plan
2nd Rev, Ready for corrections /
Electrica_:
Subcontractor List
Called Contact Person
Plumbing:
Grant Deed
Plans Picked Up
S.M.I.
HOA Approval
Plans Resubmitted
Grading
IN-HOUSE
3rd Rev, Ready for corrections /
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Apps
Date of permit issue
School Fees
Total Pernit Fees
ta a�W
GF;M of rhr DESERT —
August 8, 2017
Sergio Rodriguez
81211 Indio Blvd
Indio, CA 92253
SUBJECT: SIGN PERMIT APPLICATION 2017-0020: WALMART PICKUP
Dear Mr. Rodriguez:,
The Design and Development Department has reviewed and approved your request
for one internally illuminated sign for Walmart pickup, located at 79295 Highway 111,
within the Centre at La Quinta sign program. The sign is approved per the sign exhibit
on file, and subject to the following Conditions:
1. This sign permit grants one internally illuminated sign to be designed and
located per the approved plan on file (attached).
2. The applicant is required to obtain a building permit prior to the placement of
this sign.
Should you have any questions or need additional information please feel free to
contact me at (760) 777-7069.
Sincerely,
Carlos Flores
Associate Planner
78-495 Calle Tampico La Quinta, CA 92253 760.777.7000