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09-0083 (SIGN)44QP.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT 4 BUILDING PERMIT Application Number: 09-00000083 Owner: Property Address: 78435 HIGHWAY 111 U.S. BANK APN: 604-050-015-4 -000000- 800 NICOLLET MALL Application description: S(64 MINNEAPOLIS, MN 55410 Property Zoning: COMMUNITY COMMERCIAL (612) 872-2657 Application valuation: 5000 Contractor: Applicant: Architect or Engineer: NATIONAL SIGN/MARKETI C'� L 13580 5TH STREET CHINO, CA 91710 (909)591-4742 Lic. No.: 745030 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 Class: B -C10 -C45 LicenseNo.: 745030______ Date: � O�tractor: jl/��� OWNER -BUILDER DECLARATION 1 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 _ I 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.). (_) 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. , BAP.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: LQPERA11T VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/03/09 • 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 MAJESTIC INC Policy Number 020090667301 _ 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 • D 3700 of the Labor Code, I shall lfforthwit mpl i.th those provisions. Date: 2g pplicant: ZK 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 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. 1 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 county to enter upon the above-mentioned property for insp n purposes. \ Date: Signature (Applicant or Agent): !A r LQPERMIT Application Number . . . . . 09-00000083 Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee . . . . 32.25 Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date 8/02/09 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 2.25 1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SIGN PERMIT PER SA 2009-1346 (4)ILLUMINATED CHANNEL LETTER ILLUMINATED SIGNS "U.S. BANK" ---------------------------------------------------------------------------- Other Fees . . . . . . . . .. BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged -------------------- Paid Credited -------------------- Due ----------------- Permit Fee Total 32.25 .00 .00 32.25 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 33.25 .00 .00 33.25 Bin # City of LaQ uinta Building & 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: Owner's Name: U_5 k61e,.,L,.o A. P. Number: Address: Legal Description: Contractor:, M41/4*4y, 51("t) Te City, ST, Zip: W Ill(A aus 5s-� Telephone: Address: gv—` , 5 Project Description: City, ST, Zip: f� Telephone: 7 Z State Lic. # City Lic. #: Arch., Engr., Designer: Address: ✓ City, ST, Zip: Telephone: '` Construction Type: Occupancy: State Lic. #: Project type (circle one): 'New Add'n Iter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 9QCj— �%-7?J7 Estimated Value of Project: ' APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd- TRACKING . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Energy Calcs. 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:- 7nd 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 Ll Total Permit Fees e+.i To:4-a Quinta Building & Safety Page 1 of 1 2008-12-2109:38:45 (GMT) 13109430378 From: Jeff Manas i FREEDOM OF INFORMATION ACT REQUEST FOR INFORMATION I i BUILDING DEPARTMENT. ! eturn::com .leted: form;';po an . attachments.:to.:.:::::;::;:::::::`:; ...:....:..........:..: P...:.............:.................:.Y:;...:::.:..:.::.:...:.::..:......:.::::.:::.:....::..:.:::: G N ULT1N RO I. :::::::.::::::.-::.:::.:::.:::::::::.:::::::::::::.::.: TELEPHONE: 951:296."04581 -:FAX 951.296 3759:................:::.......:......:::::: Date 12/13/08 _ To La Quinta Building & Safety POC Jeff Manas From: Nova Consulting Group Inc. ! Email , Tel No ,' 310.948.1083 j Tel No (760) 777-7012& an e Fax Not 310.943.0378 I Fax No (760) 777=7011 Site Downey Savings ! 78435 US Highway 111 i La Quinta, California 92253 I _ Proj No E08-2231__ Nova Consulting Group, Inc. has been commissioned to conduct a condition assessment survey on the above referenced site ! As part of our research and report compilation, we seek public information from municipal agencies regarding compliance with state and local building codes. We would appreciate your response to the following documentation/information requests I! 1. What is the current use group? B j i 2. What is the current construction classification? VN 3. What is the seismic zone? D i I r 4. What is the current applicable building code and date, including amendments? 2007 I I 5. Does the Site have any material outstanding building code violations or notice of deficiencies? ❑ Yes (If "Yes", please fax copies) a No 6. Please fax a copy of the current certificate of occupancy. 1 attached i i 7. What is the flood zone? I According to Pane! No 2233G dated 8/28/08 the Property is located in Flood Zone X Flood Zone region consists of regions of flood risk. The distance to the nearest 100 - year flood plai is appy ximately. miles north/south/east/west of the Pro erty. Areas 3etermin�iro to = be outsie the 0.2% annual chance flood plain. —( one ThZanks or your assistance. Should you have any questions associated with providing the requested information, or if you require a fee, please call me at the number above. Signature 12 Date D n e,, A-4, <cC — Printed Name C1j Title -7 © icl P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLS TAMPICO (760) 777-7000 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101 January 30, 2009 Mr. Ed Blend 13580 5`h Street Chino, CA 91710 SUBJECT: SIGN APPLICATION 2009-1346; U.S BANK Dear Mr. Blend: The Planning Department has reviewed and approved your request to replace the existing Downey Savings signs with U.S Bank signs at the existing Downey Savings building, located at 78=435 Highway 1 1 1 . The approval of this sign permit is subject to the following Conditions: 1. This sign permit is for four permanent building -mounted, L.E.D illuminated channel letter signs. The sign color, materials and location are per approved plans on file with. the Planning Department. 2. The North -facing building -mounted sign, shown on pg. E-12 of the submitted sign, application, shall not exceed an area greater than twenty-six (26) square feet.. Sign letter height shall not exceed 24 inches, and logo height shall not exceed 30 inches. 3. The West -facing building -mounted sign, shown on pg. E-01 of the submitted sign application, shall not exceed an area greater than twenty-six (26) square feet. Sign letter height shall not exceed 24 inches, and logo height shall not exceed 30 inches. 4. The East -facing building -mounted sign, shown on pg. E-1 1 of the submitted sign application, shall not exceed an area greater than twenty-six (26) square feet. Sign letter height shall not exceed 24 inches, and logo height shall not exceed 30 inches. 5. , The South -facing building -mounted sign, shown. on pg. E-08 of the submitted sign application,,shall not exceed an area greater than sixteen (16) feet. Sign letter height shall not exceed 18 inches, and logo height shall not exceed 24 inches. 6. All repair work shall be done in a clean and professional manner. The area behind the existing Downey Savings signs shall be repaired and painted to match the existing building color. I have included a copy of the approved sign submittal. The copy has been stamped by the Planning Department and should be used for your submittal the Building and Safety Department. Should you have any questions or need additional information, please feel free to contact me at (760) 777-7125. Sincerely, ERIC CEJ Assistant Planner c: Building, & Safety. Department .a M 0 T m Q (A m v cr- �CD Z= m0 vim O �'v a mO Z MCI) ZEM Moo m M -1 r --1 m m "v N 7c —1=1m T m m l7 m D .—MUM" N O n in N O 0 C 0 9 W O r 0 0 ♦C V/ N USI -18 SCALE: 3/4" = 1' 7+_9 15.5' SO FT. Q .o�D pOs `v O O sv a N WHITE EXISTING PROPOSED I G_n_ I attar Cross Section natail N.r.S. WWrtl(M.W USI -18 A listed disconnect switch B fasteners as re 'd C primary electrical 120 V source D Metal box to house power supply E Electronic Power Su F 5' .063 alum.reWrns G V trim ca H 316' thick PLEX face while I Pb3 or BLACK PLASTIC BUSHINGS J Weop holes K GE POWER WHITE L.E.D. "us" "bank" 11RED 1'BWE TRIMCAP TRIMCAP S/18'WHITE PIE% 3/10'WNTE PIEx W/TRANSWSCENT VOM TO MATCH ASt RETURNS PMS IW RED AM RETURNS PAWS. N870.p PAWT.S HUTCH PMS 2168 THEWS 1UP tools PROPOSED FLUSH MOUNT REMOTE L.E.D ILLUMINATED CHANNEL LETTERS CUENT. - - EIINV e " TICKET A': DRAWING N: DATE REVISION HISTORY PROJECT MANAGER: :DCIGNER: ADDRESS: OU ELECTRONIC FILE LOCATION a NAME: REVIEWED BY. DATELA sign un. Partner with the. best. NOTICE: PRINTS ARE THE EXCLUSIVE PROPERTY OF'MC SIGN COMPANY' ANY UNAUTHORIZED USE OR DUPLICATION WILL RESULT INA 20% CHARGE PER OCCURRENCE PER THE VALUE OF THE DISPLAY0MC SIGN CO.1998 c SCALE: 1/2" =1' 10'-2" 25.4 SQ :0 WHITE CUSTOM 30" LOGO USI - 24 I F n I attar Croce Section retail A listed disconnect switch fasteners as re 'd C pdmary electrical 120 V source D Metal box to house power su E Electronic Power Supply F 5 .063 alum atoms G 1° trim ca H 16, thick PLEX lace white I Pb3 or BLACK PLASTIC BUSHINGS J weep holes K GE POWER WHITE L.E.D. IiIIW NI�EbO ' .us" "bank" I' RED 1•BWE TRIMCAP TMMCAP a/Ie' wNRE PLJIX 116• WHITE PM W/TMN6W6CENT VWYPLMT10 RE RED C UETSWO RETURNS MATCH MS 2748 M RAOITMATNB PAIT N63OP IMP 10616 EXISTING PROPOSED PROPOSED FLUSH MOUNT REMOTE L.E.D ILLUMINATED CHANNEL LETTERS CLJENT. TICKET M: DRAWING p: I flEVISION HISTORY I I US PROJECT MANAGER: ADDRESS:ELECTRONIC FILE LOCATION 8 NAME: CLIENT SIGNATURE 8 APPROVAL DATE78435 "1 REVIEWEDRY. - NOTICE: PRINTS ARE THE EXCLUSIVE PROPERTY OF •MC SIGN COMPANY' ANY UN.AUTHORIZED USE OR DUPLICATION WILL RESULT INA 20Y CHARGE PER OCCURRENCE PER THE VALUE OF THE DISPLAYOMC SIGN CO.1998 SCALE: 1/2" =1' 10'-2" 25.4 SQ FT. 3'3.9/32" O Nf N WHITE CUSTOM 30" LOGO USI - 24 I F_11_ Lefler Cross Sectinn �el21 - N.T.S. il;nWzm w A listed disconnect switch B fasteners as re 'd C primary electrical 120 V source 0 Metal box to house power supply E Electronic Power Supply F Y .063 Num.returns G i"trim ca H 16'thick PLEXface while I Pb3 or BLACK PLASTIC BUSHINGS J I weep holes K I GE POWER WHITE L.E.D. "us" "bank" 1'RED TRIMCAP ,-BLUE TRILICAP W�yItNYyL PL�ONT PMa,w TAeD 9= L/e pWWME PLED( '�N sy PMP,�ii I EXISTING PROPOSED PROPOSED FLUSH MOUNT REMOTE L.E.D ;,�- ILLUMINATED CHANNEL LETTERS ®bank <9.6e9 It eo197s 3 1 1107/09 E: CHANGESMADE ; NICOL TRAU9 , DP #9737USe 790.75 HY 111 LA OUINTA. CA UIUSR/DOWNEY/Y9737LAOUNITAWCA � TM MH Ont. Partner with the best. NOTICE: PRINTS ARE THE EXCLUSIVE PROPERTY OF IMC SIGN COMPANY" ANY UN -AUTHORIZED USE OR DUPLICATION WILL RESULT IN A20% CHARGE PER OCCURRENCE PER THE VALUE OF THE DISPLAYmMC SIGN CO. 1998 EXISTING SIGNS TO REMAIN ` 1 i s .._2. ail _ A �`a4 i- CLIENT: - - nh� TICKET I: DRAWING Y: DATEp REVISION HISTORY \. i4w��Yrh �� :�4• �Y ADDRESS: ELECTRONIC FILE LOCATION 8 NAME: • SKATEOUQRUING •.'tic`..\'.w;. •.;, tier BICYCLING r SCOVERING I s �;s ON THIS "• , •. `• } . PROPERTY I"'�` )s1 1� T1�Sct t rrr ` 1 i s .._2. ail _ A �`a4 i- CLIENT: - - nh� TICKET I: DRAWING Y: DATEp REVISION HISTORY PROJECT MANAGER: DESIGNER: = ADDRESS: ELECTRONIC FILE LOCATION 8 NAME: • O -_ REVIEWED RY. DATE � rR CDEW SIGNATURE 8 APPROVAL DATE: NOTICE: PRINTS ARE THE EXCLUSIVE PROPERTY OF IMC SIGN COMPANY' ANY UNAUTHORIZED USE OR DUPLICATION WILL RESULT IN A 209/6 CHARGE PER OCCURRENCE PER THE VALUE OF THE DISPLAY* MC SIGN CO. 1998 XISTING SIGNS TO REMAIN /, Sf 'gyp w;i '�• ! �•/ 20 MINUTE rf ;p' •yr J .Ora. PAM. I N G -e/ > •' �. �r 41, y }pp - ,r 1' i t 1'»•M O (• l.a u° 3 � � �.5 � v j j4 4{ �qq'' 4� v �' �O CUEM: us TICKET N: DRAWING N: DATE: REVISION MISTONV PROJECT AN MAGER: DESIONER: = ADDRESS: #9737 US8 LA QUINTA. CA ELECTRONIC FILE LOCA710N 8 NAME: .. _ REVIEWED NY. DATE IN CUEM SIGNATURE 8 APPROVAL DATE 1110�11mlwl NOTICE: PRINTS ARE THE EXCLUSIVE PROPERTY OF'MC SIGN COMPANY' ANY UWAUTHORIZED USE OR DUPLICATION WILL RESULT IN A 20Y CHARGE PER OCCURRENCE PER THE VALUE OF THE DISPLAYmMC SIGN CO.1998 EXISTING SIGN TO BE REMOVED CLIENT. TICKET W DRAWING A: DATE: MS PROJECT MANAGER: DESIGNER: REVISION HISTORY ADDRESS: OUINTA, CA ELECTRONIC RLE LOCATION 8 NAME REVIEWED W. DATE:LA - � TN CLIENT SIG HE 8 jAPPROVAL DATE:• S9 NOTICE: PRINTS ARE THE EXCLUSIVE PROPERTY OF -MC SIGN COMPANY" ANY UNAUTHORIZED USE OR DUPLICATION WILL RESULT INA 20% CHARGE PER OCCURRENCE PER THE VALUE OF THE DISPLAYCMC SIGN CO. 1998 EXISTING SIGN TO BE REMOVED CLIEM: TICKET N: DRAWING C: DAIS us PflOJECT MANAGER: DESIGNER: REVISION HISTORY - ADDRESS: ELECTRONIC FILE LOCATION 8 NAME: REVIEWED BY. DATE SRO CIJEM • SIGNATURE S APPROVAL DATE: NOTICE: PRINTS ARE THE EXCLUSIVE PROPERTY OF IMC SIGN COMPANY' ANY UNAUTHORIZED USE OR DUPLICATION WILL RESULT INA 20% CHARGE PER OCCURRENCE PER THE VALUE OF THE DISPLAYQMC SIGN CO. 1998 EXISTING IGN TO BE REMOVED CLIENT. USc TICKET/: DRAWING N: REVISION HISTORY PROJECT MAN AGER: JOESIGNER: ELECTRONIC FILE LOCATION a NAME:09737 ADDRESS: US8 78435 OU IMMWTAY. SCIAl REVIEWEDBY. -LA � TY CLIENT SIGNATURE 8 APPROVAL DATE:' " t� NOTICE: PRINTS ARE THE EXCLUSIVE PROPERTY OF'MC SIGN COMPANY" ANY UN -AUTHORIZED USE OR DUPLICATION WILL RESULT INA 20% CHARGE PER OCCURRENCE PER THE VALUE OF THE DISPLAY®MC SIGN CO. 1998 � bank INTERIOR PHOTOS CUENP.. US TCKEf N: DRAWING N: DATE: ��S11S16:f REVISION HISTORY - PROJECT MANAGER: DESIGNER: ELECTRONIC FILE U]CATION 8 NAME: ADDRESS: 09737 UPS QUINTA. CA - REVIEWED Br. DATELA I I CLIENT SIGNATURE & APPROVAL DATE NOTICE: PRINTS ARE THE EXCLUSIVE PROPERTY OF'MC SIGN COMPANY' ANY UN -AUTHORIZED USE OR DUPLICATION WILL RESULT INA 20% CHARGE PER OCCURRENCE PER THE VALUE OF THE DISPLAYQ MC SIGN CO.1998 � bank INTERIOR PHOTOS CLIENC TICKET M: DRAWING 0: DATE REVISION HISTORY ' I IMMM us �srmNER, � PROJECT MANAGER: DESIGNER: ADDRESS: ELECTRONIC FILE LOCATION 8 NAME: CLIENT SIGNATURE 8 APPROVAL DATE REVIEWED SY, DATE - NOTICE: PRINTS ARE THE EXCLUSIVE PROPERTY OF'MC SIGN COMPANY" ANY UNAUTHORIZED USE OR DUPLICATION WILL RESULT INA 20% CHARGE PER OCCURRENCE PER THE VALUE OF THE DISPLAY®MC SIGN CO. 1998 bank #9737 SITE PLAN LA QUINTA, CA F 4 e-0 E E E FA E ND 114* -0: . Q e B1-0 S S2 A e1 = E el, /] e.1. ADAMS STREET E' i LEGEND Sign Symbol o 152'-0' Sign El Designator Photo Point O Traffic Flow d''P CLIENT: c® TICKET N: DRAWING N: DATE REVISION HISTORY PROJECT MANAGER: DES GNER: ADDRESS: ELECTRONIC FILE LOCATION It NAME: ttttttttttttttttttttttt. ttttttttttttttttttttttt. REVIEWED aY. GATE: sign on. Partner with the best. I NOTICE: PRINTS ARE THE EXCLUSIVE PROPERTY OF'MC SIGN COMPANY" ANY UN -AUTHORIZED USE OR DUPLICATION WILL RESULT INA 20% CHARGE PER OCCURRENCE PER THE VALUE OF THE DISPLAY®MC SIGN CO. 1998 M CERTIFICATE OF COMPLIANCE (Part 1 of 2) OLTG -1-C ..„­ . VU UVV uyinniy system specmcauons need to comply with Title 24, Parts 1 and 6 of the California Code of Regulations. This certificate applies only to building lighting requirements. The documentation,preparer hereby certifies that the documentation is accurate and complete. AUTHOR j SIGNATURE G4_3 _L>&z'Nll The Principal Lighting Designer hereby certifies that the proposed outdoor, lighting and signs design represented in this set of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted. with this permit application: The proposed building has been designed to meet the lighting requirements contained in the applicable parts of Sections 110, 119,130 through 132, 146; and 149 of Title 24, Part 6. Pease ✓ one: ❑ I hereby affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code to sign this document as the person responsible for its preparation; and that I am licensed in the State of California as a civil engineer or electrical engineer, or I am a licensed architect. ❑ I affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code by section 5537.2 or 6737.3 to sign this document as the person responsible for its preparation; and that I am a licensed contractor performing this work. ❑ 1 affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code to sign this document because it pertains to a structure or type of work described as exempt'pursuant to Business and Professions Code Sections 5537,5538 and 6737.1. (These sections of the Business and Professions Code are printedin full in the Nonresidential Manual. PRINCIPAL LIGHTING DESIGNER -NAME SIGNATURE DATE LIC. # ` INSTRUCTIONS TO APPLICANT OUTDOOR LIGHTING COMPLIANCE & WORKSHEETS (✓ box if worksheet is included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms, please refer to the Nonresidential Manual published by the California Energy Commission. OLTG-1-C Certificate of Compliance. Required on plans for all submittals for outdoor lighting. Part 2 of 2 may be incorporated in schedules on the plans. Either LTG -1-C or OLTG-I-C may be used for signs as follows: . 1. Use LTG -1-C if the project consists solely,of indoor signs 2. Use LTG -1-C if the project consists of indoor lighting, and outdoor or indoor signs, but no other outdoor lighting. 3. Use OLTG-1-C if the project consists solely of outdoor signs ❑ 4. Use OLTG-1-C. if the project consists of outdoor lighting, and indoor or outdoor signs, but no other indoor lighting LIGHTING OLTG-2-C COMPLIANCE SUMMARY. Applicable Parts required for ALL outdoor lighting allowances (Except for Signs) ❑ OLTG-3-C AREA CALCULATIONS WORKSHEETS. Applicable parts required for all outdoor area calculations. LOLTG-4-C SIGN LIGHTING COMPLIANCE. Required for all internally and externally illuminated signs, for both indoor and outdoor si ns. 2005 Nonresidential Compliance Forms March 2005 CERTIFICATE OF COMPLIANCE (Part 2 of 2) OLTG-1-C PROJECT NAME Lighting Schedules .on Plans Show that Outdoor Lighting Meets Allowed Lighting Power ✓ ❑ Lighting power allowances for general site illumination on OLTG-2-C Part 1 of 4 CRT Not Applicable ❑ Lighting power allowances for local ordinances or for security multipliers on OLTG-2-C Part 2 of 4 Not Applicable ❑ Lighting power allowances for specific applications, other than vehicle service stations with canopies on OLTG-2-C Part 3 of 4 (�. Not Applicable ❑ Lighting power allowances for vehicle service station canopies on OLTG-2-C Part 4 of 4 Not Applicable Sign lighting compliance on OLTG-4-C ❑ Not Applicable Mandatory Measures on Plans Show that Outdoor Lighting Meets Outdoor Lighting Controls and Equipment Indicate locatiori on plans of Note Block for Mandatory Measure ❑ Installed lighting power has been determined in accordance with § 130(c)l Not Applicable ❑ All permanently installed luminaires with lamps rated over 100 watts either have a lamp efficacy of at least 60 lumens per wattor are controlled by a motion sensor § 132(a) Not Applicable ❑ All Luminaires with lamps rated greater than 175 watts in hardscape areas, including parking lots, building entrances, canopies, and all outdoor sales areas.meet the Cutoff Requirements of § 132(b) Not Applicable ❑ All permanently installed outdoor lighting meets the Control Requirements of §.132(c)l Not Applicable ❑Building facades, parking lots, garages, canopies, and outdoor sales areas meet the Multi -Level Lighting Requirements of § 132(c)2 ie Not Applicable MANDATORY AUTOMATIC CONTROLS CONTROL LOCATION CONTROL IDENTIFICATION CONTROL TYPE Auto Time Switch/Photosensor, etc AREA CONTROLLED NOTE TO FIELD 2005 Nonresidential Compliance Forms March 2005 N . ca L a ' ch U N cn c L -Q 0)C 0 - o N rn N (n C E N o c C U � � c U) Lm N cu 3 a C U = 3 a) N T L j � N c W a) Q L L O p a) N r N :3 N M O C U @ N ( z; a) -0 i a) C O C L ' vi N ch N rn o, E U) = C o N C N '@ C U C O N C vi ` N O L O C •,- N c o c L C cn o —0)-w � E a) ESE a) Y XU a' W 0 7 N > N o N -n�� N (V C X EaW a) D N -O N C o c o� Q cuo O C W O O U 0 Z .E fl. to 0 N U Electronic Ballasts with V o N N Output Frequency of x k k � � 20kHz or more o CFLs not containing r n c V o Medium Screw Base Sockets J QZ Barrier Coat Fluorescent N C O Lamps (includes most T5 2 L o and T8 lamps) Cz>. a Light Emitting Diode X x X c (LED) o .o — o �.CL H 10 O Neon and Cold Cathode — m N . N L o@ Z Pulse Start or Ceramic o C N Metal Halide Q av High Pressure Sodium Is G Smaller than K? Y/N y.Total ' Designed I.0 Sign Input watts Number of B11a C In o H NumbeQ — mLineal Feet of Q O E CL = Lamp Type c O Allotted Watts (1) X F) `Do (D E E - r Allotted LPD (12 or 2.3) Uj Q. LL / ci U a (W ft� Internally (1) OR Z. W Q Externally (E) Q Illuminated a o Sign Area (ftZ) uj O U o C C .2 .2 Z U a is _ U O N J V Quantity of Signs --- Z z z rn U V o Q Sign Symbol or Code /'� V i F0--j a N . ca L a ' ch U N cn c L -Q 0)C 0 - o N rn N (n C E N o c C U � � c U) Lm N cu 3 a C U = 3 a) N T L j � N c W a) Q L L O p a) N r N :3 N M O C U @ N ( z; a) -0 i a) C O C L ' vi N ch N rn o, E U) = C o N C N '@ C U C O N C vi ` N O L O C •,- N c o c L C cn o —0)-w � E a) ESE a) Y XU a' W 0 7 N > N o N -n�� N (V C X EaW a) D N -O N C o c o� Q cuo O C W O O U 0 Z .E fl. to 0 N U