12-0330 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number 2-'00000330
Property Address: 4-53-05 SEELEY DR
APN: 604 -040 -075 -
Application description: SIGN
Property Zoning: TOURIST COMMERCIAL
Application valuation: 2000
Applicant:
Tav14-4Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
1 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.
Lice e C ss: P45 ense No.: 799881
ate 1� contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty oferjury at 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 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.).
(_ 1 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:
LQPERMIT
Owner:
APPLEBEE'S
45305 SEELEY DRIVE
LA QUINTA, CA 92253
Contractor:
ULTRASIGNS, INC.
9025 BALBOA AVENUE
SAN DIEGO, CA 92123
(858)569-1400
Lic. No.: 799881
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/29/12
w !.l
1
Mm AIR
2 2012
CITY OF LA `%UifdTA.
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.
K' I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor.
7' 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 1711028-2011
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
/ $700 of the_Labor Code, I shall forthwith cpMply with those provisions. -
WARNING: FAILLRE TO SE URE WO KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER T0,CRIMINJL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($.100,0001• IN ADDWAQWTO 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 myoinan/endtate laws relating to building construction, a hereby a5�thorize representatives
of this untter above-mentioned pr erty for inspection p r ses.e,S 2Z pplicant or AgentL'
LQPERMIT
Application Number . . ... . 12-00000330
Permit . . . ELEC-ELECTRICAL SIGN
Additional desc .
Permit Fee -. . . . 30.00 Plan Check Fee
.00
Issue Date . . . . Valuation
0 -
Expiration Date 9/25/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT
15.00
----------------------------------------------------------------------------
Special Notes and Comments
RELOCATE EXISTING SIGN TO NEW LOCATION
PER SA #2012,-1601. 2010 CODES..
- --------------7----------------------------------
Other Fees . . .. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 30.00 .00 .00
30.00
Plan Check Total .00 .00 .00
.0.0
Other.Fee Total 1.00 .00 .00
1.00
Grand Total 31.00 .00 .00
31.00
LQPERMIT
Certificate of Co>zn fiance Si n LI htiit (Page 1'of 2) :. "S.'LTG-1C
• I certify that this Certificate of Compliance documentation is accurate and complete.
Pro' ct Name-
I ems
Phase of ConstructionP.New Construction ❑.A.ddition . ❑ Alteration
Function Type Outdoor Signs ❑ Indoor Signs
Company
Projed A dress:
3 �QL.1
Dat :
3 ZCl
Compliance Method Used ❑ Maximum Allowed
Lighting Power ❑ Alternate Lighting Sources
that complies with the applicable requirements of § 119.
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate and complete.
Name
Signature
Company
Date
Address
'If applicable:
that complies with the applicable requirements of § 119.
CEA #
CEPE #
City/State/Zip
Phone:
Principal Lighting Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the lighting
design.
• This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with
Title 24, Pages 1 and 6 of the California Code of Regulations.
• The design features represented on this Certificate of Compliance are consistent with the information provided to document
this design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the
enforcement agency for approval with this building permit application.
Name:Signa
re
eel
�1-M v lr oci
Comp.
� l �L , OJ�
OJ
Phone
5G? -0 0
�d
License
a t3z-r
fqfW
4Address:
tate/Zip:
DateMandatory
Measurefs
Indicate location on building plans of Mandatory Sign Measures Note Block:
Mandatory Sign Lighting Controls
Yes
No
1
§133(a)1. All signs with permanently connected lighting are controlled with an automatic time switch control
❑
that complies with the applicable requirements of § 119.
§133(a)2. All outdoor signs are controlled with a photo control or outdoor astronomical time switch control.
❑
2
Exception to §133(a)2. Outdoor signs are in tunnels or large covered areas that require illumination during
❑
daylight hours.
§133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce
❑
sign ower by a minimum of 65 percent during nighttime hours.
Exception 1 to §133(a)3. Signs are illuminated for less than one hour per day during daylight hours.
❑
TQC
3
Exception 2 to §133(a)3. Outdoor signs are in tunnels or large covered areas that require illumination
❑
during daylight hours.
Exception 3 to §133(a)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps are used to
❑
illuminated signs or parts of signs.
9�
§133(a)4. An Electronic Message Center (EMC) having a new connected lighting power load greater than
Y
N
15 kW has a control installed is capable of reducing the lighting power by a minimum of 30 percent when
❑
❑"
I
4
receiving a demand response signal that is sent out by the local utility.
Exception to §133(a)4. The EMC is required by a health or life safety statue, ordinance, or regulation,
Y
N
N/A
including but not limited to exit signs and traffic signs.
❑
❑
2008 Nonresidential Compliance Forms
I
August 2009
Certificate of Compliance and Field Inspection Energy Checklist . (Sign Lighting) (Page 2 of -2)
SLTGr1C
Project Name: 7
Date:
Compliance Method .
Maximum Allowed Lighting
Power
A
B -
C D E F
G
H
i
J
K
O
v,
{
t Descri do or-loc tion and plan location
Allowed Watts
Design
Watts`
Complies?
Y/N
Light
Source
r;`~Field'O
Ins ector?.'
Cd
E E' 3 C'i
° u u
3 x
° CU
cm
o
o VI :
o
a
�
r ..,•„+
- �
❑
<❑` `,176:
-
❑
❑; .❑;
❑
Total Sign Area:
1. Design, Watts = total connected lighting load installed in the sign, including power used by lamps, ballasts, transformers, power supplies, etc.
2. ! Fail then describe on Page 1 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. Use additional sheets ifnecessary.
The sins identified above; use only one or more of the following technologies: list all applicable numbers that apply in column I -above)
1 High pressure sodium lamps
1 Pulse start or ceramic metal halide lamps served by a ballast with >_ 88% efficiency
3 Pulse start metal halide lams that are <_ 320 watts, are not 250 watt or 175 watt lamps, and are served by a ballast with > 80% efficiency
4 Neon or cold cathode lamps with transformer or power supply efficiency >_ 75% with rated output current < 50 mA
5 Neon or cold cathode lamps with transformer or power supply efficiency >_ 68% with rated output current > 50 mA
6 Fluorescent lamps with a minimum color rendering index (CR[) o 80
7 Light emitting diodes LEDs with a power supply with >_ 80% efficiency
8 Single voltage LED external power supplies designed to convert 110 volt AC input into lower voltage DC or AC output, having a nameplate output power less than or equal to 250 watts,- and
certified to the Energy Commission as complying with the applicable requirements of the Appliance Efficiency Regulations(Title 20
9 Coni act uorescent lams that do not contain a medium screw base sockets (E24/E26
10 Electronic ballasts with o azdamental out ut re uen >_ 20 kHz
Field Inspector Notes or Discrepancies
2008 Nonresidential Compliance Forms
August 2009
Bin. # . e : .
City. of:a Qurnta
Bu1krZPg a. Safety Division .
Permit #� . P.O. Box 1504,78-495, Calle Tampico.
La "Quinta, CA 92233 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:.-4.5 'Owner's Name:. S
A. P. Number•.
Address: ,
•
Legal Description:
Contactor. S (' S —�
City, ST, Zip:�-
Telephone:
Address:
L)�
Project Description:
City, ST, Zip: /I
:"" ; <• :,
Telephone: CA S%
State Lic. # :77 q q City Lia #,
Arch., Engr., Designer -
Address:
City., ST, Zip:
V
Telephone:
�:- .ice t:!'
State Lic. #: y�y" ' _ c
Name of Contact Person:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft :
#Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project;
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRAMING
PERMIT FEES
Plan Sets
Plan Check submitted.Item
Amount
Structural tales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance.
Tide 24 Cates.
Pians picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
2`i Review, ready for correcfioas/issue
Electrical
Subeostaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.NLL
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
3" Review; ready for corrections/issue
Developer Impact Fee
Planning Approval.
Called Contact Person
&LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees