BSIG2018-001878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
c& I tyx 4 4 Q"
DESIGN & DEVELOPMENT DEPARTMENT
SIGN/
BSIG2018-0018
78364 HIGHWAY 111
604050046
CIRCLE K REBRANDING SIGNS
$10,250.00
Applicant: ^
PROMOTION PLUS SIGN CO INC
21034 OSBORNE ST
CANOGA PARK, CA 91304
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
CIRCLE K STORES INC
P 0 BOX 52085
PHOENIX, AZ 92253
P
Contractor:
PROMOTION PLUS SIGN CO INC
JUL 13 2018 21034 OSBORNE ST
CANOGA PARK, CA 91304
.—P.
CRY OF LA QUINTA (818)993-5406
DESIGN AND Of VEt +ONIiENT DEPARTMENT LIc, No.: 853228
--------------------------------
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.: 853228
'tDa _11Contracto : �1
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:
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:
Date: 7/13/2018
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.
11_have and will maintain workers' compensation insurance, as required by
Sec ioi n 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: CYPRESS INSURANCE COMPANY Policy Number: PRWC915668
_ 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 p_Z/rovissiions.
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
:ommenced 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.
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-
�nentioned property for inspection purposes.
r
Oa4�*_ Sig�(Applicant or Joe44
Date: 7/13/2018
Application, Number:
BSIG2018-0018
Owner:
Property Address:
78364 HIGHWAY 111
CIRCLE K STORES INC
APN:
604050046
P 0 BOX 52085
Application Description:
CIRCLE, K REBRANDING SIGNS
PHOENIX, AZ 92253
.Property Zoning:
Application Valuation:
$10,250.00
Applicant:
Contractor:
,PROMOTION PLUS SIGN CO INC
PROMOTION PLUS SIGN CO INC
21034.05BORNE ST
2103.4 OS60RNE ST
CANOGA PARK, CA 91304
CANOGA PARK, CA 91304
(818)993-5406
Llc. No.: 853228
Detail: REPLACE CANOPY.
MONUMENT AND [2) BUILDING SIGNS LIKE FOR LIKE SIZE ON EXISITING. PER 2016 CALIFORNIA BUILDING CODES
1 INFORMATION
FINANCIAL
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE
101-0006-20306 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, FIRST 20 PC
101-0000-42600
0
$26.01
Total Paid for ELECTRICAL: $52.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE
101-000042416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
MONUMENT SIGN, FIRST
101-0000-42404
0
$78.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT'
MONUMENT SIGN, FIRST PC
101-0000-42600
0
$143.56
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/AWNING SIGN, EA ADDITIONAL
101-0000-42404
0
$53.06
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/AWNING SIGN, EA ADDITIONAL PC
101-0000-42600
0
$53.06
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: $447.85
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY. ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Sorin Enache
From: cflores@la-quinta.org
Sent: Tuesday, July 10, 2018 5:06 PM
To: Sorin Enache; Sorin Enache; cflores@la-quinta.org
Subject: City of La Quinta - Permit Status Update (APPROVED)
This is to inform you that Permit Number SA2018-0020.for SIGN PERMIT PLANNING, STANDARD, CIRCLE K / SIGNS
located at 78364 HIGHWAY 111 has been APPROVED.
You may pay for and obtain your permit at the City of La Quinta Customer Center located at
78495 Calle Tampico, La Quinta, CA 92253 during normal business hours from 7:30AM to 4:30PM Monday - Thursday
and 8:OOAM to 4:30PM on Fridays.
Tell us about your customer service experience by clicking on the link below:
https:Hdocs.google.com/forms/d/e/lFAIpQLScvSKVbgOfiKh3Ss6CsUOfloHYQebugQ8juyTtgbg8miedjmQ/viewform?c=0
&w=1
If you have any questions, please contact your project reviewer directly or the Design and Development Department at
(760) 777-7125.
'Have a wonderful day!
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PERMIT #
PLAN LOCATION:
Project Address: 70 ?G�J /r l ` I
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Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
Applicant Name: •�
Address:
City, ST, Zip:
Telephone: 9 1.. L
Email:
Valuation of Project S Aq(�f
Contractor Name: /'
New SFD Construction:
Address: Z163 f OWA��
Conditioned Space SF
City, St, Zip �3�
Garage SF
Telephone: ar r .. (�G/
Patio/Porch SF
Email: .� �a - .�
Fire Sprinklers SF
State Lie: 5' 21 City Bus Lie:
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms:
Stories: # Units:
Email:
State Lie: City Bus Lie:
Property Owner's Name: C.
Lsfr- 1� .'.CW
New Commercial / Tenant Improvements:
Address: AG
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QU I NTA, CA 92253
760-777-7000