SA2015-0060BUILDING PERMIT
DESIGN & DEVELOPMENT
DEPARTMENT
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type:
Sign
Permit Number:
SA2015-0060
Property Address:
78100 MAIN ST STE 208
APN:
770121010
Legal Description
Property Zoning:
Valuation:
$0.00
PHONE (760) 777-7125
WWW.LAQUINTACA.GOV
APPLIED DATE: 10/22/2015
ISSUED DATE:
CALIFORNIA
Owner: OLD TOWN LA QUINTA LLC
78010 MAIN ST NO 201, LA QUINTA, CA 92253
Applicant: CANDY JENG
78100 MAIN ST #208
Contractor:
PRIOR TO THE ISSUANCE OF THIS PERMIT FOR CONSTRUCTION, ALTERATION, IMPROVEMENT, DEMOLITION, OR REPAIR THE OWNER, APPLICANT AND/OR
CONTRACTOR UNDER PENALTY OF PERJURY HAVE AFFIRMED WHEN APPLICABLE, THROUGH THE SUBMITTAL OF FORMS OR BY OTHER ELECTRONIC MEANS, THE
FOLLOWING:
LICENSED CONTRACTOR OR OWNER -BUILDER DECLARATION (1 or 2)
1) They are licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professions Code, and the
referenced
License is in full force and effect, or;
2) That they are exempt from the Contractors' State License Law for the
reason(s) indicated by either (2)(a) and/or (2)(b), or (2)(c) where he or
she is exempt from licensure by a valid exemption. [Section 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 (commencing with Section 7000)
of Division 3 of the Business and Professions
Code] 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).)
a) As owner of the property, or my employees with wages as their sole
compensation, will do all of or portions of the work, and the structure is
not intended or offered for sale (Section 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an owner of
property who, through employees' or personal effort, builds or improves
the property, 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 it was
not built or improved for the purpose of sale.).
b) As owner of the property, will be exclusively contracting with licensed
c) Are exempt from licensure under the Contractors' State License Law.
As an Owner -Builder, they acknowledge that, except for their personal
residence in which they must have resided in for at least one year prior to
completion of the improvements covered by this permit, they cannot legally
sell a structure built as an owner -builder if it has not been constructed in
its entirety by licensed contractors. It is understood that a copy of the
applicable law, Section 7044 of the Business and Professions Code, is
available upon request when this application was submitted at the
following Web site:
http://www.leginfo.ca.gov/calaw.html.
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY (If
applicable)
A construction lender will be used for completion of the improvements
covered by this permit and the name and information of which is on file for
public inspection during the regular business hours of the public entity.
Failure of the applicant to indicate the construction lender on the
application does not relieve that person of the requirement to give the
construction lender preliminary notice from that duty.
WORKERS' COMPENSATION DECLARATION (1, 2 or 3)
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.
1) Has and will maintain a certificate of consent to self -insure for workers'
compensation, issued by the Director of Industrial Relations as provided for
by Section 3700 of the Labor Code, for the performance of the work for
which this permit is issued.
2) Has 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.
3) Certifies that, in the performance of the work for which this permit is
issued, shall not employ any person in any manner so as to become subject
to the workers' compensation laws of California, and agree that, if should
become subject to the workers' compensation provisions of Section 3700 of
the Labor Code, shall forthwith comply with those provisions.
NOTICE TO APPLICANT (1, 2 and 3)
1) Each person upon whose behalf this application was made, each person
at whose request and for whose benefit work is being 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 360 days from date of issuance of such
permit, or if cessation of work for 180 days will subject permit to
cancellation. On or after January 1, 2019, every permit issued shall become
invalid unless the work on the site authorized by such permit is commenced
within 12 months after its issuance, or if the work authorized on the site by
such permit is suspended or abandoned for a period of 12 months after the
time the work is commenced.
3) Certified that they read the application and state that the information
provided is correct. 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 -mentioned property for
inspection purposes.
IMPORTANT: An Application for Permit was made to the Building Official,
subject to the conditions and restrictions set forth at the time of application,
which is now hereby an Issued Permit. If any part of the information being
supplied on this permit is inaccurate or untrue, please contact the City of La
Quinta at (760) 777-7125 immediately for correction.
Printed: 5/14/25 9:36 am Page 1 of 3
BUILDING PERMIT
Permit Type: Sign
Permit Number: SA2015-0060
Property Address: 78100 MAIN ST STE 208
OLD TOWN LA QUINTA / OLD TOWN MASSAGE / FOAM SIGN
Location on premises Sign Illuminated? No
Type Group Sq Ft Value
Invoice No. Fee Fee Amount Amount Paid
PERMIT-SA2015-0060 SIGN PERMIT - PL $200.00 $200.00
Total for Invoice PERMIT-SA2015-0060 $200.00 $200.00
Grand Total for Permit $200.00 $200.00
Workflow Step / Action Name Action Type Start Date End Date
Review v.1
----------------------------------------------------------------------------------------------------------------------------------------
Sign Review v.1 Receive Submittal
Issue Permit v.1
Verify Contractor info & Conditions have been met v.1
Generic Action
----------------------------------------------------------------------------------------------------------------------------------------
Verify & Invoice Fees v.1
Generic Action
----------------------------------------------------------------------------------------------------------------------------------------
Verify Fee Payment & Issue Permit v.1
Generic Action
------------------------------------------------------------
Print, Attach, and Email Building Permit v.1
Create Report
Inspections v.1
---------------------------------------------
Building Site v.1
Inspection
-----------------------------------------
Footing v.1
Inspection
Final Inspections v.1
--------------------------
Final Building v.1
-..-
Inspection
Construction or work for which a permit is required shall be subject to inspection by the building official and such construction or work
shall remain visible and able to be accessed for inspection purposes until approved. Approval as a result of an inspection shall not be
construed to be an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Inspections
presuming to give authority to violate or cancel the provisions of the applicable code and other ordinances of the jurisdiction shall not be
valid. It shall be the duty of the owner or the owner's authorized agent to cause the work to remain visible and able to be accessed for
inspection purposes. Neither the building official nor the jurisdiction shall be liable for expense entailed in the removal or replacement of
any material required to allow inspection.
It shall be the duty of the holder of the building permit or their duly authorized agent to notify the building official when work is ready for
inspection. It shall be the duty of the permit holder to provide access to and means for inspections of such work that are required by this
code.
Printed: 5/14/25 9:36 am Page 2 of 3
BUILDING PERMIT
Permit Type: Sign
Permit Number: SA2015-0060
Property Address: 78100 MAIN ST STE 208
A building or structure shall not be used or occupied in whole or in part, and a change of occupancy of a building or structure or portion
thereof shall not be made, until the building official has issued a certificate of occupancy therefor as provided herein. Issuance of a
certificate of occupancy shall not be construed as an approval of a violation of the provisions of the applicable code and other ordinances
of the jurisdiction. Certificates presuming to give authority to violate or cancel the provisions of this code or other ordinances of the
iurisdiction shall not be valid.
A person shall not make connections from a utility, a source of energy, fuel, or power, or a water system or sewer system to any building
or system that is regulated by the applicable code and other ordinances of the jurisdiction for which a permit is required, until approved by
the buildina official.
Printed: 5/14/25 9:36 am Page 3 of 3
City of La Quinta
78-495 Calle Tampico
La Quinta, California 92253
PHONE:760.777.7125 FAX: 760.777 . 1233
Office Use Only
Case/Permit Number Accepted Assigned 30-Day
By To Deadline
NA
Notes:
SIGN PERMIT APPLICATION
- PERMANENT SIGNS -
O CT 22 101 `i
i.a e.'t r i./" I ;l !; i",' .
(_l"M!ViU(i � StB� t 4.��'Ivii ! I
A!
karining p
Finance Stamp
Sections A and B are to be completed bV the applicant iri their entirety and shall be
accompanied bV a site plan and any other applicable information listed in Section C
unless specifically waived bV the appropriate CitV staff member and noted thereon.
No applications will be accepted by mail or fax
SECTION A — SIGN INFORMATION
Type of sign: ❑ Permanent wall sign(s)
❑ Permanent freestanding/monument sign(s)
Other N' aAI—503q '55;!�!/V
Name of
business:
Site address/ 7 � C /N S 1� QN ��� A
location: H /
Sign program Information regarding if a City approved sign
(Application #): 4&ZAprogram is applicable to the proposed location
is available at the Planning Department.
Sign location: 7/��JLi1��n(� G� 7� — j v 0 /� %Y�'
Sign text:
Dimensions: Sign width:
Structure width
Sign height: XL
Structure height:
Single or double sided: Total square feet of sign area: P'X 1' =- /6 ST
of
Sign Permit Application - Permanent Page 1 of 2
City of La Quinta • Planning Department ■ 760.777.7125 05.20.13
P:\Application Submittal Forms\Applications\SA\SA-P Application - 05.20.13.doc
SECTION B - APPLICANT/OWNER INFORMATION
Applicant Information and Certification
I certify that 1 have read this application packet in its entirety and have read and
understand the City's sign regulations (LQMC 9.160) along with any City approved property
specific sign program applicable to the proposed location. I further certify that each
application item submitted is consistent with the requirements listed in the following
Section C and all proposed temporary and permanent improvements included in this
application are proposed in compliance with all applicable regulations. I understand and
agree that if during the processing of the application, it is determined the information
submitted does not strictly meet such standards or contains errors or omissions,
clarification and/or supplemental information may be required which will delay the
processing of this application. -
Applicant's Signature:
Print Name:
7
Mailing Address: 7� ' -�01) Lwi ST AO Z-A
Property Owner Information and Certification
Date. —
Phone: GLL�- �> — Z 3 �7
Email: CYgN�X�iP�,N�l
I certify under the penalty of the laws of the State of California that I am the property owner
of the property that is the subject matter of this application and I am authorizing and
hereby do consent to the filing of this application and acknowledge that the final approval
by the City of La Quinta, if any, may result in restrictions, limitations and construction
obligations being imposed on this regl property.
Owner/Authorized Agent Signature r J Date: /0.11 i // 5
Print Name: Phone:
Mailing Address:
Email:yln� r acviv�-C
*An authorized agent for the owner must attach a notarized letter of authorization from the legal property owner.
SECTION C - APPLICATION SUBMITTAL REQUIREMENTS
APPLICATION SUBMITTAL REQUIREMENTS
TO BE COMPLETED BY CITY STAFF
Each of the following items is required for submittal
# of
PDF
Waiver
unless. a waiver is granted by City Staff. All plans shall
format
'�
be legible, accurately scaled, representatively colored
paper
(on CD-
OK'd by
with identified dimensions on 8�"x11" or 11 "x17" sheets
copies
ROM)
(initials)
❑
❑
Filing Fees Receipt ($200)
1
NA
❑
NA
Application
1
NA
NA
❑
NA
Site Plan (show location of proposed & existing signs to remain)
5
NA
NA
❑
NA
Building Elevations (show each sign & entire side of building)
5
NA
NA
NA
Sign Construction Detail (identify size, colors, construction
5
NA
NA
O
materials, & lighting components for each portion of the sign)
Sign Permit Application - Permanent Page 2 of 2
City of La Quinta - Planning Department ■ 760.777.7125 05.20.13
P:\Application Submittal Forms\Applications\SA\SA-P Application - 05.20.13.doc
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