13-1646 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
IT -4w -t44
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 13-00001646
Owner:
Property Address: 78383 HIGHWAY 111
CHRIS OPPENHIEMER
APN: 604-050-008- - -
78-383 HIGHWAY 111
Application description: SIGN
LA QUINTA, CA 92253
Property Zoning: COMMUNITY COMMERCIAL
(
Application valuation: 2800
Contractor:
Applicant: Architect or Engineer:
SIGNARAMA
/� AA
41945 BOARDWALK, "L"
PALM DESERT, CA 92211
(760)776-9907
LiC. No.: 830131
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 Clas : D 2 C45 License No.: 830131
DateContractor: �
Y
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).:
(_) 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 ISec. 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.).
(_) 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
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: - 12/19/13
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.
l'have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
G Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier GRANITE STATE Policy Number WC065256570
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 Cm/. I shall forthwi Comply with those provisions.
late:)3 Applicant:
6
WARNING: FAILURE TO SECURE WORKERS' COMPEN TION 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 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 Quints, 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 couryytq enter upon the above-mentioned property ;f"' spection pur ses.
0q
Date:I.3 Signature (Applicant or Agentl:
J f�
LQPERMIT
Application Number . . 13-00001646
Permit . . . . . SOTB 2013
Additional desc . .
Permit Fee . . . . 24.31 Plan Check Fee
.00
Issue Date . . . Valuation . . .
. 0
Expiration Date 6/17/14
Qty Unit Charge Per
Extension
1.00 24.3100 LS MISC WALL SIGN, FIRST
-------------------------------------7--------------------------------------
24.31
Permit . . . . ELECTRICAL 2013
Additional desc .
Permit Fee . . . . 35.75 Plan Check Fee
.00
Issue Date Valuation . . .
. 0
Expiration Date 6/17/14
Qty Unit Charge Per
Extension
1.00 35.7500 EA ELEC SIGNS
35.75
-----------------=----------------------------------------------------------
Special Notes and Comments
SIGN - BUILDING MOUNTED SIGN "MONGOLIAN
GRILL" WITH ONE DISCONNECT SWITCH. 2010
CALIFORNIA BUILDING CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, ELECTRICAL
47.67
PLAN CHECK, SOTB
85.80
Fee summary Charged Paid Credited
----------------------------------------
Due
------------------
Permit Fee Total 60.06 .00 .00
.60.06
Plan•Check Total .00 .00 .00
.00
Other Fee Total 134.47 .00 .00
134.47
Grand Total 194.53 .00 .00
194.53
Bin #
- City of La Q uin to
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
��✓
Project Address: �� �� ST 1 j'
Owner's Name: G
A. P. Number:
Address: - �-_ 3 F3 N w X11
Legal Description:
City, ST, Zip: (4 G
Contractor:
Tel e hone
....:...........:.
Address: L�� p Ll S /1® a,,tJ fti A, L
Project Description: G /
ij YJ
City, ST, Zip:
Telephon(I,,
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6 g
State Lic. # : E -3Q 1371,
City Lie. #: t) 7 Ira P11 /
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
<'r<'::::>:::>?::s:>c;<Y:::;: >:.;;;::.:.:......: :
€'<#.'•;•:::.>. <', :.;> ,>
...................;.>.
Construction Type: Occupancy:
State Lic. #
type (circle one): NwAdd,
Project n Alter Repair Demo
Name of Contact Person: %�, vL w�l s��
Sq. Ft.:
# Stories:
#Units:
Telephone #,of Contact Person 6 3 /,S
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Certificate of Compliant
Project Narne
In e m b >J
Project Address:
-79 - -7 zr3
Si n.Li htin
Phase of Construction
a+-`�+�61. Function Type
Date.
(Pae 1� of 2) - SLTG-1C
O New Construction O Addition O Alteration
O Outdoor Signs O Indoor Signs
Compliance Method Used ❑ Maximum Allowed
Li¢hting Power ❑ Alternate Lighting Sources
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate and complete.
Name
Signature
§133(a)l. All signs with permanently connected lighting are controlled with an automatic time switch control
13
571,�-
Company41f
,9
Address
applicable:
IL �%—� -
CEPS #
City/StaterLip ,Q �,
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 I 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:
Signature
Company: )� Q
Phone
❑
Address:
`-1 l 9 las i s 0.� �. 1 lC�
License is . p j /
a
City/State/Lip:
Date
Sign Mandatory Measures
Indicate location on building plans of Mandatory Sign Measures Note Block:
Mandatory Sign Lighting Controls
Yes
No
§133(a)l. All signs with permanently connected lighting are controlled with an automatic time switch control
13
❑
1
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.
®
i ❑
2
Exception to §133(a)2. Outdoor signs are in tunnels or large covered areas that require illumination during19
❑
daylight hours.
§133(a)3. All outdoor signs are controlled with a dimmer that provides the ability,to automatically reduce
M
❑
sign power 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.
ca
❑
3
Exception 2 to §133(a)3. Outdoor signs are in tunnels or large covered areas thatrequire illumination
❑
during daylight hours.
Exception 3 to §133(a)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps are used to
❑
12
illuminated signs or parts of signs. ;
§133(a)4. An Electronic Message Center (EMC) having a new connected lighting power load greater than
Y
N
N/A
15 kW has a control installed is capable of reducing the lighting power by a minimum of 30 percent when
O
❑J
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. s
❑
❑
19
2008 Nonresidential Compliance Forms August 2009
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City of Ga Quinta
78-495 Calle Tampico
La Quinta, California 92253
PHONE: 760.777.7125 FAX: 760.777.1233
OfficetUse`'Onl
Case/Permit Number
Accepted Assigned 30 -Day
By To Deadline
NA
Notes:
SIGN PERMIT APPLICATION
- PERMANENT SIGNS -
.RECEIVED
DEC 1 1 2013
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT
Planning Stamp
e D
D
Fn_7r11 2013
nTY OF LA QUIN'
FINANCE DEPT
Finance Stamp
No applications will be accepted by mail or fax
SECTION A — SIGN INFORMATION
Type of sign: J Permanent wall sign(s)
❑ Permanent freestanding/monument sign(s)
❑ Other
Name of —� c
business:
Site address//
location: /J? 1 %y�✓ it % ��... i ?-"L 5 -
Sign program Informationregarding if a City approved sign
(Application #): program is applicable -to the proposed location
is available at the Planning Department.
Sign location: Z✓v a._??�-4 Vs �
Sign text: C3 --o L_ i .Q A.1 G
Dimensions: Sign width: Sign height: y 17
Structure width: -412 Structure height:
Single or double sided: ,� lam_, Total square feet of sign area:
Sign Permit Application - Permanent Paget of 2
City of La Quinta • Planning Department - 760.777.7125 11.08.10
PAApplication Submittal Forms\Hpplications%SA\SA-P Application - 11.08.10.doc
PREPARED 12/11/13, 11:23:48 PAYMENTS DUE INVOICE
CITY OF LA QUINTA PROGRAM PZ821L
---------------------------------------------------------------------------
PROJECT NUMBER: 13-00000249 SA 2013-1749 CJ'S STIR -IT -UP
FEE DESCRIPTION" AMOUNT DUE
----------------------------------------------------------------------------
SIGN PERMIT (F) 200.00
TOTAL DUE 200.00
Please present this invoice to the cashier with full payment.