09-0617 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 009'00000617 -
Tihf
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Property Address: 78477 HIGHWAY
111
APN: . 604-050=008-
-
Application description: SIGN
Property Zoning: COMMUNITY COMMERCIAL
Application valuation: 5000
Applicant:
Architect or Engineer:
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.
LicenseClass�C45 D42 LicenseNo.: 637739
Date: ��'Contractor:
c _ /
�15WNER-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).:
(_ 1 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 _ 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.).
(_ ) 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:
HARSH INVESTME
78-401 HIGHWAY
LA QUINTA, CA
(760)771'-4580
Contractor:
PARAGON SIGNS
77650 ENFIELD
PALM DESERT, C
(760)345-3340
Lic. No.: 6377
VOICE (760) 777-7012 „
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/12/09
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 SPARTA INS CO Policy Number 003WK0173
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 Code, I shall fort�Iyprovisions.
Date: Applicant: /
WARNING: FAILURE TO SECURE WORKERS' C SATION 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.
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 by authorize representatives
of this county to enter upon the above-mentioned property for inspectiosa
Dater Signature (Applicant or Agent):
Application Number . . . . . 09-00000617
• Permit . . . ELEC-ELECTRICAL SIGN
Additional desc .
Permit Fee . . . .. 33.00 Plan Check Fee•.
.00
Issue Date Valuation . . .
. 0
- Expiration Date 12/09/09
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
". (2) SETS INTERNALLY'ILLUMINATED CHANNEL '
LETTER SIGNS PER SA 2009-1381 "THE
' 'CARLYLE DELI"
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit 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 -
Bin #
City of La Quinta
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
I ,,1 \
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Project Address: 7?—V77
Owner's Name: ,/dam y 1Uvr ..T
A. P. Number:
09rd
Address: _ A�Iejy !/l j-7,c, c
Legal Description:
Contractor: PCO f.#r.5 J J,
City, ST, Zip: 4,4 ?'Z413'
Telephone: 77 M
Address: _`T-o 1-.t1A/ 4 ,D /i✓1
Project Description:
City, ST, Zip: �? ozr'!rO.4. 922! /
2 Sery.Guwva.4Tc� �N Evac
Telephone:
Ztc v
State Lic. # :�j ,? 7 i 3
City Lic. #:Q
zs
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
p
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: p-j ��� L
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: yS 3 D
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 Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
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:-
'^' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
I. -CERTIFICATE OF COMPLIANCE (Part 1 of 2) OLTG-1-C
PROJECT NAME
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.
DATE
7f
incorporate in schedules on the plans.
6" 2 69
PROJECT ADDRESS
1. Use LTG -1-C if the project consists solely of indoor signs
Budding Permd�
PRINCIPAL DESIGN ER -LI GHTIN
PARAGON SIGNS
TELEPHONE
760-345-3340.
3. Use OLTG-1-C if the project consists solely of outdoor signs
4. Use OLTG-I-C if the project consists of outdoor lighting, and indoor or outdoor signs, but no other indoor
e
ztr.. ec e _ a.4-
yAge
DOCUMENTATION AUTHOR
DON SWINDEL
TELEPHONE
Signs)
❑ OLTG-3-C
760-345-3340
n rc M
11'y Sem },
GENERAL INFORMATION
outdoor signs.
DATE OF PLANS
OUTDOOR LIGHTING ZONE ✓ One ❑ LZ1 ❑ LZ2 ❑ LZ3
❑ LZ4
FUNCTION TYPE
❑ OUTDOOR LIGHTING
OUTDOOR SIGNS ❑ INDOOR SIGNS
PHASE OF CONSTRUCTION
NEW CONSTRUCTION
❑ ADDITIONS ❑ ALTERATIONS
STATEMENT OF COMPLIANCE
This Certificate of Compliance lists outdoor lighting system specifications 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.
DOCUMENTATION AUTHOR SIGNATOR DATE
D. SWINDEL /
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. Please ✓ one:
❑ 1 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.
❑ I 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.
sections of the Business and Professions Code are printed in full in the Nonresidential
D. SWINDEL I e I r/Zg/et 1 637739
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
incorporate in schedules on the plans.
Either LTG -1-C or OLTG-1-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-I-C if the project consists of outdoor lighting, and indoor or outdoor signs, but no other indoor
lighting
❑ OLTG-2-C
LIGHTING 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.
FQ OLTG-4-C
SIGN LIGHTING COMPLIANCE. Required for all intemally and externally illuminated signs, for both indoor and
outdoor signs.
2005 Nonresidential Compliance Forms . April 2005
SIGN LIGHTING COMPLIANCE OLTG-4-C
PROJECT NAME
DATE
Alternative 2 — For Signs that ONLY use one or more of the
Alternative 1 — Lighting Power Allowances
technologies listed in M through S
Check all that a
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—T For Allotted LPD use 12 watts/square foot for Internally Illuminated Signs, and use 2.3 watts/W for Externally Illuminated Signs.
Note: If an Internally Illuminated or Externally Illuminated sign contains light sources and ballasts other than those included in columns (M) through (S), such
as incandescent lamps, medium base sockets, magnetic ballasts, etc, then the sign must comply under Alternative 1. However, unfiltered signs, and
. J r..�_..__11.. :11....,,:..,,i„•1 n �.� nn4 rnm iiroel t(1 moot tt1PRP. St9nd2rdS. I
UI IIIIICI CV JJVI UVI IQ VI mace 1 1-4 c.. ...-..•�+•••�•••• ••• -- -- --- - - - -
July 2005
2005 Nonresidential Compliance Forms f