BSIG2014-1027A-495� CALLE 1AMPIC0
LA QUINTA, CALIFORNIA 92253
F — "&ht 4 4 Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
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.
Licen 5e Class:. B License No.: 678862
Da/-. A)AA) M Contractp/r:
f /
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, 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, 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:
I
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/22/2014
Owner:
LA QUINTA RETIREMENT RESIDEN
2264 MCGILCHRIST SE 210
SALEM, OR 0
Contractor:
COLSON & COLSON GENERAL CONTRA
2260 MCGILCHRIST STREET SE
SALEM, OR 97302
(503)586-7401
LIc. No.: 678862
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: - 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.
D a//o r
)e�c) �A4 Appliy(nt:
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.
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 city to enter upon the above
mentio7d property for inspection purposes.
Date: )a 14 Signature (Applicant?,<gent):
Application Number:
BSIG2014-1027
Property Address:
45190 SEELEY DR
APN:
604630056
DEC 2 2 2014
I
Application Description:
MONUMENT SIGN LA QUINTA RETIR _M NT
Property Zoning:
CITY OF LA QUINTA
Application Valuation:
$1,000.00
COMMUNITY DEVELOPMENT DEPARTMENT
Applicant:
COLSON & COLSON GENERAL CONTRA
2260 MCGILCHRIST STREET
SE
SALEM, OR 97302
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.
Licen 5e Class:. B License No.: 678862
Da/-. A)AA) M Contractp/r:
f /
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, 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, 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:
I
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/22/2014
Owner:
LA QUINTA RETIREMENT RESIDEN
2264 MCGILCHRIST SE 210
SALEM, OR 0
Contractor:
COLSON & COLSON GENERAL CONTRA
2260 MCGILCHRIST STREET SE
SALEM, OR 97302
(503)586-7401
LIc. No.: 678862
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: - 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.
D a//o r
)e�c) �A4 Appliy(nt:
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.
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 city to enter upon the above
mentio7d property for inspection purposes.
Date: )a 14 Signature (Applicant?,<gent):
3.421
Q..WL"
I -
2z
r
$1,VjVAj4-*M=
I RAVE REVIEWED THE ABOVE SPECIFICATIONS & HEREBY FULLY UNDERSTAND THE
CONTENT OF WORK TO BE PERFORMED & APPROVE THIS PROJECT TO BEGIN:
Vj
2 -5
6811 on center
CUSTOMER APPROVAL SIGNED BY:
:hanges or deletions by the customer not shown or charged here In will be billed separately,
5345 Ringgold Rd, Chattanooga, TN 37412
PRINT DATE:
ift DEPOSIT DUE AT TIME OF ORM (fullamount lfuncler$100), balancedue
Ph: 423-622-8079 Fax: 423-624-4439
LANDLORD APPROVAL SIGNED BY:
ipon time of installation or pick up. I HAVE READ MID AGREE TO ALLTERMS. INITIAL
Emag:chatt8noogasigneramaftmaii.com j
8
Z
E!z
--11
C:
UO -
0
0
0
Da
0
<
6,
45190
The Palms
at La Quinta
Gracious Retirement Living
6819
to center of holes
CONCRETE FILL
3" x 60" O.D. aluminum posts
36" in ground
24" in sign
Stone Type - Coronado Old Country Ledge
Sign Background - Standard Linen
Lettering Colors - Black
Top View 18" diameter hole
!.]M
t
Ve
t
G—d L.W
To ASSURE SAFETY AND QUALITY OUR PRODUCTS ARE @ LISTED @COPYRIGHT 2011, SIGNARAIVIA, INi
.rHIS RENDERING IS INTENDED AS A SAMPLE ONLY. COLOR, TEXTURE, MEASUREMENTS, AND ACTUAL APPEARANCE MAY VERY SLIGHTLY FROM COMPLETED WORK AND IS CONSIDERED NORMAL & USUA
-)
'lease check layout (artwork. spelling, dimensions) and fax bad with signalme- Prod on -not
)egIn until written approval is remind. Additional charges will be applia ny gs that are
a for. h:
r
$1,VjVAj4-*M=
I RAVE REVIEWED THE ABOVE SPECIFICATIONS & HEREBY FULLY UNDERSTAND THE
CONTENT OF WORK TO BE PERFORMED & APPROVE THIS PROJECT TO BEGIN:
*tiecled after approval is received. SIGNARAMA is not responsible for any errors in spelling, layout,
)r dimensions that have been approved by the customer. The proof is for listed Items only. Any
6811 on center
CUSTOMER APPROVAL SIGNED BY:
:hanges or deletions by the customer not shown or charged here In will be billed separately,
5345 Ringgold Rd, Chattanooga, TN 37412
PRINT DATE:
ift DEPOSIT DUE AT TIME OF ORM (fullamount lfuncler$100), balancedue
Ph: 423-622-8079 Fax: 423-624-4439
LANDLORD APPROVAL SIGNED BY:
ipon time of installation or pick up. I HAVE READ MID AGREE TO ALLTERMS. INITIAL
Emag:chatt8noogasigneramaftmaii.com j
PRINT* DATE:
!.]M
t
Ve
t
G—d L.W
To ASSURE SAFETY AND QUALITY OUR PRODUCTS ARE @ LISTED @COPYRIGHT 2011, SIGNARAIVIA, INi
.rHIS RENDERING IS INTENDED AS A SAMPLE ONLY. COLOR, TEXTURE, MEASUREMENTS, AND ACTUAL APPEARANCE MAY VERY SLIGHTLY FROM COMPLETED WORK AND IS CONSIDERED NORMAL & USUA
-)
'lease check layout (artwork. spelling, dimensions) and fax bad with signalme- Prod on -not
)egIn until written approval is remind. Additional charges will be applia ny gs that are
a for. h:
r
$1,VjVAj4-*M=
I RAVE REVIEWED THE ABOVE SPECIFICATIONS & HEREBY FULLY UNDERSTAND THE
CONTENT OF WORK TO BE PERFORMED & APPROVE THIS PROJECT TO BEGIN:
*tiecled after approval is received. SIGNARAMA is not responsible for any errors in spelling, layout,
)r dimensions that have been approved by the customer. The proof is for listed Items only. Any
WHOM THE WOMB 60" FCW SIGIVS1
CUSTOMER APPROVAL SIGNED BY:
:hanges or deletions by the customer not shown or charged here In will be billed separately,
5345 Ringgold Rd, Chattanooga, TN 37412
PRINT DATE:
ift DEPOSIT DUE AT TIME OF ORM (fullamount lfuncler$100), balancedue
Ph: 423-622-8079 Fax: 423-624-4439
LANDLORD APPROVAL SIGNED BY:
ipon time of installation or pick up. I HAVE READ MID AGREE TO ALLTERMS. INITIAL
Emag:chatt8noogasigneramaftmaii.com j
PRINT* DATE:
HIS ORIGINAL DESIGN AND ALL INFORMATION CONTAINED THERE IN IS THE PROPERTY OF SIGNAFIAMA AND ITS USE IN ANYWAY OTHER THAN AS AUTHORIZED IS EXPRESSLY FORBIDDEN, SIGN AND ARIWORK REMAIN THE PROPERTY OF SIGNARAMA
I
11-r 11
VERIFY wt 51GN
MANUP.
BLA15 5ASE
4
r—mom—WiTm
W1
-11E
mu 11#11glig
if In"', m
ILI T; mo
101, MIN,
CONCRETE SLA5
w/ 04 5ARS 10"
o�c. AND 04 IBAR
AT PERIMETER, 3"
CLR. 6 SIDES 4
50TTOM
IWO 5Y 36" DEEP
CONCRETE FOOTING
GENERAL NOTES;
1. MANUFACTURER-.
SIGN-A-RAMA
2. LETTERING: ALL
RAISED (SIGN
FORM-CU5TOM PANTED)
3. FOR FOOTING$ AND
INSTALLATION SEE
MANUF. IN5TRUCTION5
STONE TO MATCH THE
MAIN 5UILDING
SEE A50VE FO
REQUIREMENTS
-1L I A L. -�L 1- --j.
ELEVATION
PROJECT SIGN
SCALE; NOT TO SCALE
NOTE. PROVID:
SHOP DRAWING
TO ARCHITECT
FOR APPROVAL
lall
L --i L. �J
2411
mr-TION A -A
/DANIEL ROACH
C-33282
a
Renewal
Date
'�c
7
jqjjjty
ar itecture
Ll 11INT1
RETIREMENT
RESIDENCE
PROJECT SIGN DETAIL
DWG
1 OF 1
3W viliz
P503 M 1090 s=s6sWW=
Wrr
LA QUINTA, CA
10/16/14
rDRAWN BY.- DJP Z./HAUJTH0F;ZNVC:A-LA QUINTA/W1/1"ROJECT SIGN
0401,
10' MIN. CONCRETE SLAB ud 04
BARS 10" o,--. AND 04 BAR AT
PERIMETER, 3" CLR. 0 SIDES 4
BOTTOM
GENERAL NOTE�:
1. MANUFACTURER:
SIW-A-RAMA
113,10 BY 361,
2.�.LETTERM` ALL. IRAI�6ED
&�-3 112" (,SIGN F05�1��-%*TCM
CONCRETE
FOOT ING PANTED)
3.,,FOR W5TALLATION SEE
2 M4 UP. INSTRUCTIONS
. ........ .
1 6tALIE, 114 " = I I - 0"
CITY OF LA QUINT4
BUILDING & SAFETY DEPT.
A,PPRO ED
FOR CONSTR CTION
r(
NOTE: PROVIDE
SHOP DRAWINGS
0 ARCHI CT
FORAPPROVAL i
DATE
architecture
LA Ul
B T
E
PROJECT SIGN DETAIL
DWG
1 OF 1
55=11 kit'lo= T 7�
LA OUINTA, CA
9/16/14
lag R alearic000malifty
. . .............. . . . . . . . ................
DRAM BY, DiP Z:JHAUJTH0RN1CA-"lA QUINTA/WWROallECT 51G14
�--STONE
21/2 " VENEER
10 AIG
BUILDING
1 6tALIE, 114 " = I I - 0"
CITY OF LA QUINT4
BUILDING & SAFETY DEPT.
A,PPRO ED
FOR CONSTR CTION
r(
NOTE: PROVIDE
SHOP DRAWINGS
0 ARCHI CT
FORAPPROVAL i
DATE
architecture
LA Ul
B T
E
PROJECT SIGN DETAIL
DWG
1 OF 1
mo V11W
65
sawtjs&s.*VW.=.
LA OUINTA, CA
9/16/14
. . .............. . . . . . . . ................
DRAM BY, DiP Z:JHAUJTH0RN1CA-"lA QUINTA/WWROallECT 51G14