06-3514 (SIGN)Er
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
0.6=0 0 0 0 3-5 1 4
Property Address:
79245 CORPORATE CENTRE DR
APN:
649-820-017- - -
Application description:
SIGN
Property Zoning:
COMMERCIAL PARK
Application valuation:
1000
Tiht 4 4 Q"
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that ;1& licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business Professionals Code, and my License is in full force and effect.
icens
LeG'cla s: B-C2/7�-� icerts'�No.: 390365
Date: '/i Con( .tractoi
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).:
1 _ 1 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.).
1 _ 1 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—) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/02/06
Owner:
CODY MURPHY
41910 BOARWALK A-10
PALM DESERT, CA 92211
Contractor:
e
KLEINE BUILDING AND N�JU I-N_C
41910 BOARDWALK, SUITE A-10
PALM DESERT, CA 92A A;�� 0
(760)776-4840
Lic. No.: 390365 -
CITY OF LA QUINTA
------------------
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 STATE FUND Policy Number 1769113-2005
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 t become subject to the workers' compensation laws of California,
and agree that, if I should a subject to the workers' compensation provisions of Section
3pA7�0�/07 of the Labor e I forthwith comply with those provisions.
17 �Z V y pp
WARNING: FAILURE TO SECURE KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,000). 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 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 relatingoebuilding construction, and hereby authorize representatives
of this ounty to ent upon the abov - io property for inspection purposes.
Date: D S. tr. tl:
Application Number . . . . . 06-00003514
Permit ELEC-ELECTRICAL
SIGN
Additional desc . .
Permit Fee . . . . 30.00
Plan Check Fee
.00
Issue Date
Valuation
0
Expiration Date 4/30/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT
----------------------------------------------------------------------------
15.00
PermitSIGN PERMIT
Additional desc .
Permit Fee . . . . 25.00
Plan Check Fee
16.25
Issue Date
Valuation
1000
Expiration Date 4/30/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
5.00 2.0000 HND BLDG 501-2,000
10.00
----------------------------------------------------------------------------
Special Notes and Comments
momument sign per planning dept and
approved plans.November 1, 2006 4:43:26
PM jjohnson
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Grand Total
LQPERMIT
Charged Paid Credited Due
55.00 .00 .00 55.00
16.25 .00 .00 16.25
71.25 .00 .00 71.25
CN Sc% �� ' / � cS w o �,4'/� a-,'/�
is � c� b
N S S Building U Safety Division 'f�'�' "S Z
/ 3513 ( pX1 s .O. Box 1504 78-495 Calle Tampico S � �o
Permit # 7 Q ' 0
�c Uinta, CA 92253 - (760) 777-7012
S llding Permit Application and Tracking Sheet spy
Project Address: -- Z S CQ O( i Owner's Name: "Ei L KLEINE ! nV
A. P. Number: 6
Address: 41
Legal Description: %2LP Z11)?!'S�
Contractor: V -t VA 0� W 6%
City, ST, Zip: ��/� U r CAa "% M
Telephone:
Address: , " Q
Project Description:
City, ST, Zi
Telephone:
State Lic. # : City Lic. #:
Arch., )nge:-BesTgner '{(� -J� ' /��(e�
i •�
• ��
Address: ' 3fs ,�:&}C. 4tt, �, c;
AOP
City, ST, Zipt44'm C�'P Z 2-f//c>
• ��►
Telephone: �)2S 77 e
'
Construction Type: Occupancy:
Stat: Lic. #:
Name of Contact Person: �Ibo L �L 1�
Project type (circle one): .New Add'n Alter Repair Demo
-T
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: 7-1176 8
00
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
I TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans pick;4up11211-)1.Construction
Flood plain plan
1.
Plans resubmitted
-V.
Mechanical
Grading plan
2n' Review, ready for correcti s/issue
Z
Electrical
Subcontactor.List
Called Contact Person
0
Plumbing
Grant Deed
Plans picked up Zy
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
"d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
I
School Fees
r
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ON
/o/4-06 �kw
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a ��y��.✓
Total Permit Fees
1012- 1 0(n ---=:P BZQLZ Due -- 10113 10 (o /0 7106 5712 RFC. —-Ort•8 (90#0121 0(4P`-� CDC) 1'0113 J.O(o(4GV-eCVAee�7zWO-n9
d vert
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