10-1234 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253•
Application Number:
110=00001234
Property Address:
78447 HIGHWAY, 111 SUITE A
APN: -
604-050-016-5 -000000-
Application description:
SIGN
Property Zoning:
COMMUNITY COMMERCIAL
Application valuation:
3400
T444vQuA!L
BUILDING & SAFETY DEPARTMENT,
BUILDING PERMIT
Owner:
HARSCH INV REALTY
1121 SW SALMON ST
PORTLAND, OR 97
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/10/10
#4TH
Contractor:
Applicant: Architect or Engineer: TNT ELECTRIC SIGN IN t!
3080 EAST 29TH S RE
LONG BEACH, CA, 9 6
(562) 595-7725
Lic. No.: 803133
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
.Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
Li ns e Class: C45 License No.: 803133 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Dater I 1 O • l (� ntractor:1 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier . EVEREST NATL Policy Number 76000015626101
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with those provisions.
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).:Dater �j% scant: \ 7(�
(_) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and /10
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGEI UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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. 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: 01 K
LQPERMIT
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 county ordinances and state laws relating to building construction, and hereby authorize representatives
,of this county to enter upon the above-mentioned, property for inspection purposes. •—
Date ��Q Si Lure (Applicant or Agentl:
Application Number . . 10-00001234
Permit _ . . . ELEC-ELECTRICAL SIGN -
Additional desc .
Permit Fee . . . . 33.00 Plan Check Fee
.00
Issue Date . . . . Valuation
0 -
Expiration Date 5/09/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT
15.00
1.00 3.0000"EA ELEC SIGN ADDITIONAL CIRUITS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
REMOVE AND REINSTALL (2) ILLUMINATED
WALL SIGNS TO NEW LOCATION, PER SA
#2010-1486 "RUBIO'S FRESH MEXICAN
GRILL". 2007 CODES'.
-----------------_-------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
•------------------------------------------------------
Due
Permit Fee Fee Total 33.00 .00 .00
33.00
Plan Check Total .00 .00 .00
.00
Other Fee Total 1.00 .00 .00
1.00
Grand Total 34.00 .00 .00
34.00
LQPERMIT
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Certificate of Compliance (Sign Lighting)
(Page 1 of 4) SLTG-1C
Project Name: c_
V�10 ,
l
Date: 1 -.
�o
Project Address:
Title 24, Parts I and 6 of the California Code of Regulations.
• The design features represented on this Certificate of Compliance are consistent with the information document
provided to
this design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the
Location of Sign 0163tdoor Signs ❑ Indoor Signs
Name:
Tengly Tan
Phase of Sign Construction 18J New Signs ❑ Sign Alterations
Company:
Type of Lighting Control New Lighting Controls ❑ Replaced Lighting Controls
❑ Not Installing Lighting Controls
This Certificate of Compliance includes the following components (check all that apply)
Address:
❑ Mandatory Measures (Lighting Controls) ❑ Maximum Allowed Lighting Power
❑ Specific Lighting Sources
1. Certificate of Compliance Declaration Statement (this may be a CIO, C45 or other eligible person)
• I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and
correct. I
• 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, Parts I and 6 of the California Code of Regulations.
• The design features represented on this Certificate of Compliance are consistent with the information document
provided to
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:
Tengly Tan
Signature
L�
Company:
Phone
TNT Flectric Sign, n
562 595-7725
Address:
License number (may be contractor's lie #)
3080 East 29th Street
803133
City/State/Zip:
Date
Long Beach, California 90806
08/02/10
2. Installation Certificate (to be signed by responsible person after installation)
' Pe#rmt� ri mxbeT}p #��ta k .. N+�t�i
��s 4 i'.
.-Checked by/Dater`' a Y�z ?i
'K `�fFwi.'M i�
`.+� �'i't5 I. 7 A .l�.
d.(lnforeementAgencYUse )u'�' , Y .,.Yxi, , r, �r
a.
��<., u. �, ']E i'y11',! 'l:'
.��gnforcement.A'enc User ✓ u �y j
g Y "x s ..; _ C t m perpe� •, i J
Installation Declaration statement
• I certify under penalty of perjury, under the laws of the State of California, the information on this form is true and
provided
correct.
• I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized
representative of the person responsible for construction.
• I certify that the installed features, materials, components, or manufactured devices identified on this certificate to
conforms all
applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the
enforcement agency.
• I certify that the requirements detailed on this Certificate of Compliance have been met.
• I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building
permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand
that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the
building owner at occupancy.
Company Name:
TNT G
Responsible Pe -so 's Name:
Responsible Person's Signa ft
d�
a
License number (may be contractor's lic #)--1
Date Signed:
Position With Company:
I ELD3 l 3 c. y.�
[/# -/10— /6—
FAM
2008 Nonresidential Compliance Forms July 2010
Certificate of Com fiance (Sign Lighting) (Page 2 of 4 SLTG-1C
Project Name:
I -, 5
Date:
�, to
3. Mandatory Sign Lighting Controls
NOTES:
1. The Mandatory Measures (sign lighting controls) are required for compliance with the sign lighting Standards. The same
responsible person may install both the sign and the sign lighting controls, or a different responsible person may install the
sign lighting controls than the responsible person installing the sign.
2. If the person responsible for installing the sign is not also responsible for the sign lighting controls, then the owner of the
sign, general contractor-, or architect shall be responsible to have the sign lighting controls installed.
3. If more than one person has responsibility for compliance, each person shall prepare and sign a Certificate of Compliance
and an Installation Certificate applicable to the portion of construction for which they are responsible; alternatively, the
person with chief responsibility for construction shall prepare and sign the Certificate of Compliance Declaration Statement
for the entire construction.
3a. Statements of Responsibility:
The person signing the Certificate of Compliance Declaration Statement shall check Yes or No for all of the following statements:
1
I have responsibility for installing the sign lighting controls
§133(a)1 and 2. All outdoor sign lighting is controlled with an automatic time switch control plus a photo
❑ Yes, complete parts 3a and 3b of this form ❑ No, complete part 3a of this form
2
There are no existing sign lighting controls and I will be installing compliant sign lighting controls
2
❑ Yes ❑ No
3
There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls
❑
❑ Yes ❑ No
Exception to §133(a)2. Outdoor signs in tunnels or large covered areas that require illumination during
There are existing sign lighting controls that do not comply with the applicable provision of § 119 and § 133 and I will be
4
installing compliant sign lighting controls
daylight hours.
❑ Yes ❑ No
CR
There are existing sign lighting controls that do not comply with the applicable provision of §119 and §133 and someone else
5
will be responsible to install compliant sign lighting controls
N
❑ Yes ❑ No
3b. Mandatory Sign Lighting Controls
The person signing the Certificate of Compliance Declaration Statement shall answer all of the following questions if they are
responsible for complying with the sign lighting control requirements.
If there are construction documents, indicate where on the building plans the
mandatory measures (sign lighting control) note block can be located:
1
§133(a)l. All indoor sign lighting is controlled with an automatic time switch control that complies with the
Y
N
NA
applicable requirements of § 119.
❑
❑
I 1Z
§133(a)1 and 2. All outdoor sign lighting is controlled with an automatic time switch control plus a photo
Y
N
NA
2
control, or an outdoor astronomical time switch, that comply with the applicable requirements of § 119.
00
❑
❑
Exception to §133(a)2. Outdoor signs in tunnels or large covered areas that require illumination during
Y
NA
daylight hours.
❑
CR
§133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce
Y
N
NA
sign ower by a minimum of 65 percent during nighttime hours.
❑
W,
❑
Exception 1 to §133(x)3. Signs illuminated for less than one hour per day during daylight hours.
Y
NA
3
❑
0'
Exception 2 to §133(a)3. Outdoor signs in tunnels or large covered areas that require illumination during
Y
NA
daylight hours.
❑
0
Exception 3 to §133(a)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps used for
Y
NA
illuminating signs or parts of signs.
e
❑
§133(a)4. An Electronic Message Center (EMC) having a new connected lighting power load greater than
15 kW has a control installed capable of reducing the lighting power by a minimum of 30 percent when
Y
N
N/A
4
Lreceiving a demand response signal that is sent out by the local utility.
❑
[7
Exception to §133(a)4. EMC required by a health or life safety statue, ordinance, or regulation, including
Y
NA
but not limited to exit signs and traffic signs.
❑
Field Inspector Notes:
2008 Nonresidential Compliance Forms July 2010
Certificate of Com fiance (Sign Lighting) Pa e 3 of 4 SLTG-1C
Project Name: Date: \
4. Maximum Allowed Li2liting Power Method of Compliance
Certificate of Compliance and Field Inspection Energy Checklist
Complete this part if there are signs using the maximum allowed lighting power method of compliance. (Complete part 5
of this Certificate of Compliance if there are signs using the S ecific li htfiig sources method of com liance
A
B
C
D E F-1 G
H
I
Allowed Watts
Design
Complies?
Watts
Y/N
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A^
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3
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Inspector
Check"than
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Complles
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Description
✓
,
f❑4:
a 3 1
A
Symbol or code used on the plans when plans are required) and other documents.
B
A narrative description of the sign, or location of sign on the building; and the location of sign on construction documents.
OPTIONAL - Check this box only if this sign has a permanent, pre-printed, factory -installed label, listed with Underwriters Laboratory
(UL) or other testing laboratory accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) or International
Standards Organization (ISO) 17025 in accordance with ISO/IEC 17011 with the products produced under an ongoing inspection program
C
carried out by a Type A inspection body in accordance with ISO/IEC 17020, confirming that the sign complies with the Section
148 of the
California 2008 Title 24, Part 6 Standards, using the Maximum Allowed Lighting Power method of compliance. For signs with
such a
label, columns `D' through `I' are not required to be filled out. Note: Using a label is an optional method to validate compliance. A label is
not needed for compliance.
D
The sign area insquare feet.
E
List "I" if the sign is internally illuminated. List "E" if the sign is externally illuminated.
F
Allowed watts per square foot. Enter 12 if the sign is listed as "I" in column E. Enter 2.3 if sign is listed as "E" in column E.
G
Multiply the square footage in column D times the allowed Lighting Power Density LPD = watts) in column F.
H
Show the total installed watts in the sign, as determined according to the applicable provisions of §130(d ore).
I
Enter Y if the number in column H is less than orequal to the number in colurrur G. Otherwise, the sign does not comply.
J
This page doubles as a field inspection checklist.
Field Inspector Notes:
2UU8 Nonresidential Compliance Forms
July 2010
Certificate of Compliance (Sign Lighting) (Page 4 of 4 SLTG-1C
Project Name:
T
Date: \
—
5. Specific Lighting Source Method of Compliance
Certificate of Compliance and Field Inspection Energy Checklist
Complete this part if there are signs using the Specific lighting source method of compliance. (Complete part 4 of this
Certificate of Compliance if there are signs using the maximum allowed lighting power method of compliance)
A
B
C
D
OPTIONAL
UL
Specific light source used for
`Field
z .
Symbol
or other
compliance
Inspector;:
or
Description
label
Shall include only lighting
Check,that
Code
(see
instructions
technolo ies listed below
g
u, SIS :3
below)
List all that apply
;� Complies ":
,.
✓
Ics,
x°
r 'i
F
i {A
A Symbol or code used on the plans when plans are required) and
F❑Fyy
other documents.
B
A narrative description of the sign,or location of sign on the building; and the location of sign on constriction documents
C
OPTIONAL - Check this box only if this sign has a permanent, pre-printed, factory -installed label, listed with Underwriters Laboratory
(UL) or other testing laboratory accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) or International
Standards Organization (ISO) 17025 in accordance with ISO/IEC 17011 with the products produced under an ongoing inspection program
carried out by a Type A inspection body in accordance with ISO/IEC 17020, confirming that this sign complies with the Section 148 of the
California 2008 Title 24, Part 6 Standards, using the Specific Lighting Source Method of Compliance. For signs with such a label, column
`D' is not required to be filled out. Note: Using a label is an optional method to validate compliance. A label is not needed for compliance.
Specific Light Source Compliance Method. The sign(s) identified above use only the following lighting technologies:
List all applicable numbers 1 through 10 that apply in column D above for each row.
1
High pressure sodium lamps
2
Pulse start or ceramic metal halide lamps served by a ballast with > 88% efficient
3
Pulse start metal halide lamps that are:5 320 watts, are not 250 watt or 175 watt lamps, and are served by a ballast
with > 80% efficient
4
Neon or cold cathode lamps with transformer or power supply efficiency>_ 75% with rated output current < 50 mA
D
S
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 (CRI) of 80
(Note: when using electronic ballasts for compliance, lamps with a CRI < 80 may be used
7
Light emitting diodes (LEDs) with a power supply with > 80% efficiency
Single voltage LED external power supplies designed to convert 120 volt AC input into lower voltage DC or AC
8
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
Compact fluorescent lamps that do not contain a medium screw base sockets E24/E26
10
Electronic ballasts with a fundamental output frequency > 20 kHz
E
This page doubles as a field inspection checklist.
.-,o11bPCUwi 1VULUS.
2008 Nonresidential Compliance Forms
Ju4v 2010
SCALE: 3/4" = 1 °-0"
80'-6"
+zz•�
WEST ELEVATION
m
28'-0"
SCALE:1/8" = V-0"
SIGN SPECIFICATIONS
�)]%li�� ��l.0 �J�..J �k?�'..'�Y �-iL�Y9Y}1T �� �`Y �'L�JI'V➢Y .
SIGN TO BE REMOVED AND INSTALLED TO NEW
LOCATION.
APPROVED BY PLANNING DEPARTMENT
By � DATE bl I d
EXHIBIT
CASE NO.
SIGN LIGHTING CONTROLS
❑ Controls for All Signs. All signs with permanently connected lighting
shall meet the requirements of Section 133.
❑ Automatic Time Switch Control. All signs with permanently
connected lighting shall be controlled with an automatic time switch
control that complies with the applicable requirements of Section 119.
❑ Photocontrol or outdoor astronomicaltime switch control. All
outdoor signs shall be controlled with a photocontrol or outdoor
astronomical time switch control unless exempted from the exceptions.
See Section 133(a)2.
❑ Dimming. All outdoor signs shall be controlled with a dimmer that
provides the ability to automatically reduces sign power by a minimum of
65 percent during nighttime hours unless exempted from the 6 possible
exceptions. See Section 133)a)3.
❑ Demand Responsive Electronic Message center Control (EMC), newly
connected lighting power load greater that 15 kW shall have a control
installed that is capable of reducing the lighting power by a minimum of
30% when receiving a demand response signal that is sent out by the
local utility. _
SCALE: 112" = V-0"
r3 -e
o-0
NORTH ELEVATION
9'-10"
12'-8"
SCALE:1/8" = 1'-0"
SIGN TO BE REMOVED AND INSTALLED TO NEW
LOCATION.
❑ Controls for All Signs. All signs with permanently connected lighting
shall meet the requirements of Section 133.
❑ Automatic Time Switch Control. All signs with permanently
connected lighting shall be controlled with an automatic time switch
control that complies with the applicable requirements of Section 119.
-❑ Photocontrol or outdoor astronomical time switch control. All
outdoor signs shall be controlled with a photocontrol or outdoor
astronomical time switch control unless exempted from the exceptions.
See Section 133(a)2.
❑ Dimming. All outdoor signs shall be controlled with a dimmer that
provides the ability to automatically reduces sign power by a minimum of
65 percent during nighttime hours unless exempted from the 5 possible
exceptions. See Section 133)a)3.
❑ Demand Responsive Electronic Message center Control (EMC), newly
connected lighting power load greater that 15 kW shall have a control
installed that is capable of reducing the lighting power by a minimum of
30% when receiving a demand response signal that is sent out by the
local utility.
WEST ELEVATION EXISTING SIGN TO DE REMOVED
------- & INSTALLED TO NORTH ELEVATION
1 1
f.'
f
s
� fJ
EXISTING SIGN -
INSTALLED TO WEST ELEVATION