12-0620 (SIGN)P.O. BOX 1504
78-495 CALLE TAM PICO
LA QUINTA, CALIFORNIA 92253
Application Number: J 12 -0 0 0 0062.0 -
Property Address:
APN: 643 -220 -004 -
Application description: SIGN
Property Zoning: REGIONAL COMMERCIAL
Application valuation: 3500
Applicant:
VOICE (760) 777-7012
FAX (760).777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
?S &Qct 111
Architect or Engineer:
p( k
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am 'censed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busi n P fes o als Cod a y License is in full force and effect.
License Cl C45 Lice 36512
Date: ontractor:
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 ISec. 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.).
(_ 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:
TM QU!ENT* LC
7 20h':24
92121 "D
Contractor:
PROMOTIONAL SIGNS, I
.3301 S. SUSAN STREET
SANTA ANA, CA 92704
(714)540-5454
Lic: No.: 636512
Date: 6/05/12
d
JUN o, 2012 p!�/
ry�F4A 0111 � _
WORKER'S COMPENSATION DECLARATION
1 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 EXPLORER INC Policy Number WSD500131804
_ 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 shoul come bject to tl a orkers' compensation provisions of Section
}3700 of the Labor ,-I call f co It ith those provisions.
Date: J pplicant: -
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 whoserequest 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, indemnity 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 the b information is c r agree to comply with all
city and county ordinances and state laws relating to uildi co stru i ,and a thorize representatives
of t is cp ty o ente;upon the above-mentioned pr pe ori pec on urpos�: !/Y_ ure (Applicant or Agent):
Application Number . . . . 12-00000620
Permit . . . . ELEC-ELECTRICAL SIGN
Additional desc .
Permit Fee . . . 36.00 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 12/02/12
Qty Unit Charge Per
Extension.
BASE FEE
15.00
1.00 .15.0000 EA ELEC SIGN IST CIRCUIT
15.00
2.00 3.0000 EA ELEC SIGN ADDITIONAL CIRUITS
6.00
----------------------------------------------------------------------------
Special Notes and Comments
(3) INTERNALLY ILLUMINATED CHANNEL
LETTER SIGNS, PER SA# 2012-1608 "THE
VITAMIN SHOPPE" 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 36.00 .00 .00
36.00 .
Plan Check Total .00 .00 .00
.00
Other Fee Total 1.00 .'00 .00
1.00
Grand Total 37.00 .00 .00
37.00
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
12-00000620
78692 HIGHWAY ill*
643-220-014-16 -000000-
SIGN
REGIONAL COMMERCIAL
3500
T46f 414 Q��
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
1•• Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C45 License No.: 636512
Date: Contractor:
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).:
(_ 1 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 (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 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
Date: 7/03/12
Owner:
111 LA QUINTA CENTER PARTNERS
C/O ROBERT P SANFORD
78060 CALLE ESTADO
LA QUINTA, CA 92253
Contractor:
PROMOTIONAL SIGNS, INC.
3301 S. SUSAN STREET
SANTA ANA, CA 92704
(714)540-5454-
Lic. No.: 636512
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 EXPLORER INC Policy Number WSD500131804
_ 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 forthwith comply with those provisions.
Date: Applicant:
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.
I certify that 1 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: Signature (Applicant or Agent):
Application Number . . . . . 12-00000620.
Permit . . . ELEC-ELECTRICAL SIGN
Additional desc .
Permit Fee . . . . 36.00 Plan Check Fee
.00
Issue Date . . . . 6/05/12 Valuation . . .
. 0
Expiration Date 12/02/12
Qty Unit.Charge Per
Extension
BASE FEE
15.00
1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT
15.00
2.00 3.0000 EA ELEC SIGN ADDITIONAL CIRUITS
6.00
----------------------------------------------------------------------------
Special Notes and Comments
(3) INTERNALLY ILLUMINATED CHANNEL
LETTER SIGNS, PER SA# 2012-1608 "THE
VITAMIN SHOPPE" 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid. Credited
Due
Permit Fee Total 36.00 36.00 .00
.00
Plan Check Total .00 .00 .00
.00
Other Fee Total 1.00 1.00 .00
.00
Grand Total 37.00 37.00 .00
.00
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
May 17, 2012
Mr. Scott Christe
Promotional Signs
3301 S. Susan Street
Santa Ana, CA 92704
SUBJECT: SIGN PERMIT APPLICATION 2012-1608
. THE VITAMIN SHOPPE
Dear Mr. Christe:
(760) 777-7000
FAX (760) 777-7101
The Planning Department has reviewed and approved your request for three building -
mounted internally -illuminated channel letters with oval backer sign for "The Vitamin
Shoppe"; located at 78=692 Highway 111, within the One Eleven La Quinta shopping
center. The approval is subject to the following Conditions:
1:
"This' sign permit grants three permanently -mounted building identification signs for
"The Vitamin Shoppe". The signs shall be located on the building's south, west, and
north elevations. The signs shall be individual. channel letters with an oval backing.
Letters are to be individually illuminated. Each sign is limited to a maximum of forty-
eight (48) square feet in area.
2. The applicant shall obtain building permits prior to placement of the signs on the
building. The Building and Safety Department can be reached at (760) 777-7012.
3. All signs approved as part of this permit shall conform to the One Eleven La Quinta
Sign Program'(Sign Application 2002-6.68).
Should you have any questions or need additional information please feel free to contact
me at (760) 777-7125.
.. .. ...
C: - Building & SafetyDepartmen..t
Bin #
.
City of La Quinta
Buildtng 8t Saky Division
P.O. Box 1504,78-495 Calle Tampico
1.a.Qutnta, CA 92253 -:(760) 777-7012
�. Building Permit Application'and Tracking Sheet
Permit # Q'
ILI
Project Address: 6411i' �.
Owner's Name:. P� L
A P. NumberAddress:
7 'G 0(o O C ) Oa
Legal Description:
Contractor.S ��1 TNG
City, ST, Zip.
eP �o O S -G �) O ..n
Te! hone:
Address: j 3p S U S
Project Description:
City, ST, Zip:
Telephone: 1
State Lic. 4: 3 2 City Lic. #;
Arch., Engr., Designer.
Address:
City., ST. Zip:
Telephone:
State Lia #: "77
Construction Type: Occupancy:
Project type (cmcle one): New Add'n Alter Repair Demo
Name of Contact Petson: S�-
Sq. Ft :
#Stories:
# Utdix
Telephone # of Contact Person: �' S
Estimated Value of Project: 3 sa O
APPLICANT:
DO NOT WHITE BELOW THIS UNE
q
Submittal
Rcq'd
Recd
TRACKING
PERMITFEES-
Play Sets
Plan Check submitted
Item Amount
Stmdural Calcs-
Reviewed, ready for corrections
P&U Check Deposit_ .
Truss Calcs.
Called Contact Person
Plan Check Balance.
Tide 24 Cal&
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2`! Review, ready for correcfioastissue
Electrical
Subeoutactor List
Called Contact Person
Plumblag
Grant Deed
Pians picked up
ML
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Review, ready for correctionsRssae
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 Colli ' fiance (Sigh .Li
htin
(Page h of 2) :. SLTG-IC
Project Name:
AN s �i `� r" '.
Phase of Construction
- ❑ New Construction O Addition ❑.Alteration .
1
Function Type
❑ Outdoor Signs O Indoor Signs
Projec re3s
Date:
Compliance.Method Used ❑ Maximum Allowed
G (,
%XS �'L
Lighting Power ❑ Alternate Lighting Sources
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate d Implete.
Name
Signature
§133(a)1. All signs with permanently connected lighting are controlled with an automatic time switch control
,�+
Company JV��W�ON At, S�VNS YN L
Date
t
that complies with the applicable requirements of § 119.
Address
�3a I SUSS
If applicable:
CEA#
CEPE #
City/State/Zip S ^ lor /
Phone: 71 '1 ��r[ ,
CJ 7
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 permita pli tion.
Name:, �[,� O ^ ( P �
�' 7 ` (� J
Signature
Company:
✓w+vVt� g� v N S
Phone
Address: ':3!3o S JS
License # 3 / 5/ Z
City/State/Zip: n ^ / ,17 b�
Date ./ �(D Z
Sign Mandatory Measures
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
qd
❑
that complies with the applicable requirements of § 119.
Y`
§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
sin 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.
❑
❑
3
Exception 2 to §133(a)3. Outdoor signs are in tunnels or large covered areas that require illumination
during dayli ht hours.
Exception 3 to §133(a)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps are used to
❑
❑
illuminated signs or arts of signs.
§133(a)4. An Electronic Message Center (EMC) having a new connected lighting power load greater than
15 kW has a control installed is capable of reducing the lighting power by a minimum of 30.percent when❑
Y
N
N/A
4
receivinga demand response signal that is sent out b 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
August 2009
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