05-0005 (SIGN)BUILDING & SAFETY DEPARTMENT
Box 1504 (760).777-7012
760 OFTt�9�\495 CALLE TAMP[CO FAX ( ) 777-7011
INTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
App1i-£tion Number . . . . . 05-00000005 Date 2/23/05
Pro�errty�Address . . . . 79125 HIGHWAY 111
APN: 649-030-078-2.- -28525 -
A , ication-description SIGN
Property.Zoning . . . . . REGIONAL COMMERCIAL¢
Application valuation . . . . 9000
Owner Contractor
----------------------- ------------------------
LATORRE ROBERT N IMAGE POINT, INC.
C/O TOM KELLY 13489 SLOVER AVENUE, STE #B'
83368 HIGHWAY 111 FONTANA CA 92337.
INDIO CA 92201 (909) 823-1239
WCC: MILLER AGENCY
WC: 31WEOC2042 03/01%05
CSLB: 722172 05/31/06
CCC: C45 -C10
---------.--------------------------------------------------------------------
Permit . . . . . . ELEC-ELECTRICAL SIGN
Additional desc .
Permit Fee . . . . 51.00 Plan Check Fee .00
Issue Date Valuation .0
Qty Unit.Charge Per Extension
BASE FEE 15.00
1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT 15.00
7.00,.. 3.0000 EA ELEC SIGN ADDITIONAL CIRUITS 21.00
Permit SIGN PERMIT
Additional desc
Permit Fee, _108.00 Plan Check Fee .70
Issue Date Valuation . . . 9000
Qty'. Unit Charge Per Extension
BASE FEE 45.00
7.00 9.0000 THOU BLDG 2,001-25,000 63.00
-------------------------------------------=-------------------------------
Special Notes and Comments
Monument & Channel signage per approved
Plan:-
-----------------------------------------------
Fees . . . . . . STRONG MOTION (SMI) - COM 1.89
Fee summary Charged Paid Credited Due
------------------ ---------- ---------- ---------- -----'-----
Permit Fee Total 159.00 .00 .00 159.00
Plan Check Total .70 .00 .00 .70
6
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
VOICE (760) 777-7012
FAX (760) 77-7=7011
INSPECTIONS (760) 777-7153
Application Number: G�,: — 0,06) Date:
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Address: -
Lic. No..
BUILDING PERMIT DECLARATIONS
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 Professionals
Code, and my License is in full force and effect.
License Class License No.
da-a-te" Contractor 6
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U '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 or 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.).
U 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date
WORKERS' 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
Xof 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 perfornance of the work for which this permit is
issued. My workers' compensation insurance carrier and policy number are:
"Gamer 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.
tate A,,plica
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.
CONSTRUCTION LENDING AGENCY
I hereby affirn 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
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety 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 county to enter upon the above-mentioned property for inspection purposes.
/are Signature (Applicant or Agent):
Page 2
Application Number 05-00000005 Date 2/23%05
Other Fee Total 1.89 .00 .00. 1.89
Grand Total 161.59 .00 .00 161.59
CITY OF LA QUINTA
PLAN CHECK CORRECTION LIST
Image Point - February 17, 2005
P. O Box 59043
Knoxville, TN 37950-9043
PLAN -CHECK NO. 05-0005 SECOND CHECK
ADDRESS 79-125 Hwy 111 OCCUPANCY U-1
SCOPE OF WORK Signs (Torre Nissan) TYPE -OF -CONST. V -N
9
PLAN CHECK FEE 3 Hours
The submitted plans and specifications have. been reviewed by the VCA CODE GROUP. In our
professional opinion the plans are in substantial conformance with the building codes and regulations
adopted by the CITY OF LA QUINTAand the State of California Amendment.
APPROVAL FOR A'BUILDING PERMIT IS HEREBY RECOMMENDED SUBJECT TO OBTAINING
APPROVALS/CLEARANCES FROM ALL APPLICABLE CITY DEPARTMENTS, AGENCIES, AND
ASSOCIATIONS.
Plans checked by: Hue C. Luu, PE
VCA CODE GROUP
2200 W Orangewood Ave, Ste 155
Orange, CA 92868
(714) 363-4700 ext.#752 VCA File No. LQ -17186
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