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BSIG2014-101178-495 CALLE TAMPICO D VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/25/2014 Application Number: BSIG2014-1011 Owner: Property Address: 78932 HIGHWAY 111 MICHEAL SHOVLIN APN: 643080009 78932 HIGHWAY 111 Application Description: (1) INTERNALLY ILLUMINATED MONUMENT SIGN [2013 ENERGY] LA QUINTA, CA 92253 Property Zoning: Application Valuation: $3,500.00 D Q �. Applicant: Contractor: CERTIFIED SIGN SEP CERTIFIED SIGN 0 OUTSIDE CITY LIMITS 2 5 2014 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 CITY OF LA QUINTA LA QUINTA, CA 92253 _ COMMUNITY DEVELOPMENT DEPARTMENT (951)928-2480 Llc. No.::LIC-0005300 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: _ License No.::LIC-00 Date: Contractor: OWNER -BUILD 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. (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 ) 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: 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: _ Policy Number: _ 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 s Id become subject to the workers' compensation provisions of Se 3700 o th bor Code, I shall forthwith comply ywi h those plows ns. Date: Ii Zs—w 11 L Aoolicant: 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 Building Official 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 r ting to building construction, and hereby authorize representatives is city t ter pon the above- mentionoprope�,ty for inspection purposes.Date.Signature (Applicant or Agen DESCRIPTION FINANCIAL INFORMATION ACCOUNT QTY AMOUNT PAID PAID DATE HOURLY PLAN CHECK - YES 101-0000-42600 0.75 $52.50 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HOURLY PLAN CHECK - YES 101-0000-42600 0.75 $52.50 $0.00 PAID BY METHOD . RECEIPT # CHECK # CLTD BY Total Paid forBLDG CITY STAFF - PER HOUR: $105.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $2.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL: $48.34 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE MONUMENT SIGN, FIRST 101-0000-42404 0 $72.52 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE MONUMENT SIGN, FIRST PC 101-0000-42600 0 $133.43 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forSIGN: $205.95 $0.00 TOTALS:oo Description: (1) INTERNALLY ILLUMINATED MONUMENT SIGN [2013 ENERGY] Type: SIGN Subtype: Status: APPROVED Applied: 9/2/2014 KHE Parcel No: 643080009 Site Address: 78932 HIGHWAY 111 LA QUINTA,CA 92253 Approved: 9/23/2014 THA Subdivision: PM 25865 Block: Lot: 11 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $3,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: (1) INTERNALLY ILLUMINATED MONUMENT SIGN [HOBBY LOBBY] SIGN PERMIT NO. SA13-1730 [JW] THIS PERMIT DOES NOT INCLUDE ELECTRICAL SERVICE OR RUNS TO ELECTRICAL POWER SOURCES - PER CONTRACTOR A SEPARATE PERMIT WILL BE OBTAINED FROM ELECTRICAL CONTRACTOR. 2013 CALIFORNIA BUILDING CODES. ADDED $52.50 FOR OLD PLAN CK 13-1466 . PER JJ Process Summary Applied to Approved,. .. '. •: .. .,,v f aw •.. .r•t:+'. r`-Kye. � �:. �`. Fi`'iF.. •'t j_Y •_-' _ ' Y� }`i�-Y ��1�2�ry7�,,�... -� �3?PtF Y''�../. i �. � ti APN ADDRESS 643080049 78850 HIGHWAY ill CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES PLANS SUBMITTED REPLACING EXPIRED P/C. PER BH 1 SET TO P/W, 1 SET TO PLANNING VERIFYING NO CHANGES FROM ORIGINAL PLAN CHECK SUBMITTAL KAY HENSEL 9/2/2014 STRUCTURAL SENT TO YOUNG ENGINEERING DUE 9/9/14 STRUCTURAL BACK FROM YOUNG - RFC. STRUCTURAL ABLE TO BE APPROVED BY T.H. PERMIT BUILT AND PRINTED 000 Printed: Thursday, September 25, 2014 12:54:24 PM 1 of 4 C 47 R V./ 11TFMC Fars • D FaTIEVITP Murky,M. SOFT' NAME TYPE NAME ADDRESS1 CITY ' STATE ZIP PHONE FAX EMAIL APPLICANT CERTIFIED SIGN 0 OUTSIDE CITY LIMITS LA QUINTA CA 92253 CONTRACTOR CERTIFIED SIGN 0 OUTSIDE CITY LIMITS. LA QUINTA CA 92253 OWNER MICHEAL SHOVLIN 78932 HIGHWAY 111 LA QUINTA CA 92253 WE 7PA71D CLTD DESCRIPTION ACCOUNT CITY AMOUNTPAID DATE RECEIPT # CHECK # METHOD PAID BY - I BY HOURLY PLAN CHECK - 101-0000-42600 0.75 $52.50 $0.00 YES HOURLY PLAN CHECK - 101-0000-42600 0.75 $52.50 $0.00 YES Total Paid for BLDG CITY STAFF - PER HOUR: $105.00 $0.00 BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $2.00 $0.00 BSA: DEVICES, FIRST 20 101-0000-42403 0 $24.17 $0.00 DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 Total Paid for ELECTRICAL: $48.34 $0.00 MONUMENT SIGN, 101-0000-42404 0 $72.52 $0.00 FIRST MONUMENT SIGN, 101-0000-42600 0 $133.43 $0.00 FIRST PC Total Paid forSIGN: $205.95 $0.00 �* �l ;.,.� T..W �d t'. Ct ,.:.t k Vim- .ny # 3 :.i�.t`i`.�. ..x. Printed: Thursday, September 25, 2014 12:54:24 PM 2 of 4 t VCiFMC PARENT PROJECTS REVIEW TYPE REVIEWER SENT DATE DUE DATE REVIEWS RETURNED STATUS REMARKS NOTES DATE The edge of the sign closest to Highway 111 should be at least 15 feet from the north curb TRAFFIC NAZIR LALANI 9/2/2014 9/11/2014 9/9/2014 COMPLETED face of Highway 111 to make sure that the sign does not restrict sight distance. This dimension should be shown on the plans. Contacted Michael Shovelin 9/23/14 and asked NON-STRUCTURAL TOM 9/2/2014 9/23/2014 9/23/2014 APPROVED with cond for document to show that sign is in common HARTUNG W/CONDITIONS area and not on Taco Bell site. Permit may be issued once that is received. STRUC RFC STRUCTURAL BUILDING BUCKET 9/2/2014 9/17/2014 9/23/2014 APPROVED Notes made to plans. Structural Approved TH 9/23/14 ASSIGNED TO JW 9.2 PLANNING JAY WUU 9/2/2014 9/16/2014 9/10/2014 APPROVED HOBBY LOBBY ? NO PLANS FOUND Public Works has the following Comment: 1. 9/8/2014 4:55:03 PM (NAZIR LALANI) BRYAN APPROVED The edge of the sign closest to Highway 111 PUBLIC WORKS MCKINNEY 9/2/2014 9/16/2014 9/9/2014 W/CONDITIONS should, be at least 15 feet from the north curb face of Highway ill to make sure that the sign does not restrict sight distance. This dimension should be shown on the plans. PUBLIC WORKS 9/9/2014 9/9/2014 9/9/2014 COMPLETED JONASSON Printed: Thursday, September 25, 2014 12:54:24 PM 3 of 4 ��cycrFM� BUILDING Permit Details PERMIT NUMBER:, City of La Quinta BSIG2,614%19-_ ATTACHED PARCEL MAP 25865 AND SITE PLAN SHOWING INSTALLATION OF MONUMENT SIGN AJ ORTEGA 9/24/2014 9/24/2014 9/24/2014 COMPLETED IN LANDSCAPE EASEMENT ON TACO BELLS SITt - APPLICATION MOVED FROM HOBBY LOBBY ADDRESS TO ACTUAL PARCEL ADDRESS. BOND INFORMATION Attachment Type CREATED ATTACHMENTS OWNER - DESCRIPTION PATHNAME - SUBDIR° ETRAKIT ENABLED - PARCEL MAP NO-25865 PARCEL MAP NO-25865 DOC 9/24/2014 AJ ORTEGA - MONUMENT SIGN -MONUMENT SIGN 0 LOCATION LOCATION.pdf SITE PLAN - SITE PLAN - DOC 9/24/2014 AJ ORTEGA MONUMENT SIGN MONUMENT SIGN 0 LOCATION LOCATION.pdf Printed: Thursday, September 25, 2014 12:54:24 PM 4 of 4 ��CyC iFMC �clow% r 'Din # City Of La Quin V� Building &r Safety Division Permit # P.O. Box 1504, 78-495 Calle Ta ico N0V j ' �0 La Quinta, CA 92253 - (760) 777-7(�1�A-CI�.OF 9 2013 ��' Building Permit Application and Track76 Q� Project Address: 1 UjQ,-.)h i ne5i- n 5 ' lq (�Ui n+ci C ri Owner's Name: �` /�/l•� A. P. Number: �'� Address: r Legal Description: City, ST, Zip: Contractor: 1 �r6✓✓'�.�^ ►rt � � n Telephone: Address: 2Q2I rj cc, I e-' >— 6CL X(\ (05 Project Description: k K'o i6(t) City, ST, Zip: &0-11 11-k C44 I�Dbby L--b�jy r �1Lv Z� S`�::..�:•:.:•>::#.<:«.:>•:<:;:.>; k {{:i� %.:vr.ri�n>..:+f F:i%i: 1.ylry'h::. .Telephone:'g5t Elf..:�„s<..�::>:<; li'Lwt2 (A-t;i�ti}-b- State Lic. # : T5\ 5 � t-A City Lie. #: Arch., Engr, Designer: ( �hfC � 5L, S Address: �� 1 Lo j3 City, ST, Zip: Telephone: O ► `�Q State Lic. # —t7l> 1 < :;'•;:.::.:;s:-::•::•::. ::<:«<:::;'l:.:... < :•<%<:::<>:<<:::<:> :::::':<:; ` ' < N>.'.<`•%";v>? :=:ss:::?>:<::>; Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: n7 Sq. Ft.: # Stories: # Units: Telephone #,of Contact Peerson: V G Z� Estimated Value of Project: / VO u � om .124 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd 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 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan god 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: 'rd 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 lees ZO . Total Permit Fees l 21 b 13 04T To &444"sew. . VI*- 6rWAA. Vq&'I I3-1I►1-4'4U4tLAr Ca *rc .. . 12112 2et3 rl AWX4m-%s A J D Alivfv-,�cv 78eso khC�,� aid I > I Certificate of Compliance (Sign Lighting) (Page 1 of 4) SLTG-1C Project Name: Date: Z7 / Project Address: Location of Sign Phase of Sign Construction T pe of Lighting Control Outdoor Signs ❑ Indoor Signs Er E IV{ew Signs ❑ Sign Alterations ❑ New Lighting Controls ❑ Replaced Lighting Controls . ❑ Not Installing Lighting Controls This Certificate of Compliance includes the following components (check all that apply) ❑ Mandatory Measures (Lighting Controls) ❑ Maximum Allowed Lighting Power - 'SPecific Lighting Sources 1. Certificate of Compliance Declaration Statement (this may be a C 10, C45 or other eligible person) _i 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 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the lighting design. F;,,*' This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with Title 24, Parts 1 and 6 of the California Code of Regulations. �K 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: JGL.'Sc. Signature Company: r- S r �^ Phone Z.�/,Pv, Rod .1 7?—r- Address: ? ry 3 Kim License number (may be contractor's lic #) 7 5-t S'XY City/State/Zip:. v _ L C/t- `7 25 4 Date , .7 2. Installation Certificate (to be signed by responsible person after installation) Permttnumber 4 =;s 4 a' r C}icckcd by/Data, i x '` 4 it6 orcemenCA enc .Use x, "+ , `yam{'' l.' t., .`, . , ...:° " ,. iri;"� _(Enforcem6nhA eno .Use. Installation Declaration. statement C! I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. ❑ 1 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 conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. G 1 certify that the requirements detailed on this Certificate of Compliance have been met. 17 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: Responsible Person's Name: Responsible Person's Signature: License number (may be contractor's tic #) Date Signed: Position With Company.: 17. r-� Kck-oj � ��/ 2008 Nonresidential Compliance Forms .a0,ZC' J*r 2010 5 CITY OF [(.lj!'i'{ COMMUNITY DEV`t.f-)t=ri;z,=\r-r Certificate of Compliance (Sign Lighting) (Page 2 of 4 SLTG-1C Project Name: (( t` Dater A{�lJ'JJ' Z 3. Mandatory Sign Lighting C ntrols NOTES: 1. The same responsible person may install both the sign lighting power and the sign lighting controls, or a different responsible person may install the sign lighting controls than the responsible person installing the sign lighting power. 2. The Mandatory Measures (sign lighting controls) are required for compliance with the sign lighting Standards. If the person responsible for installing the sign lighting power 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 responsible 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 or the entire construction. 3a. Statements of Responsibility: Any person signing the Certificate of Compliance Declaration Statement on page 1 of 4 on this SLTG-IC shall complete Part 3a. Check Yes or No for all of the following statements: 1 I have responsibility for installing the sign lighting controls 2 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 algo 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 , ❑ Yes 2 No There are existing sign lighting controls that do not comply with the applicable provision of § 119 and § 133 and someone else L will be responsible to install compliant sign lighting controls ❑ Yes E No 3b. Mandatory Sign Lighting Controls If the person signing the Certificate of Compliance Declaration Statement on page 1 of 4 of this SLTG-1C is responsible for complying with the sign lighting control requirement s, that person shall answer all of the following questions: If there are construction documents, indicate where on the building plans the ma datory 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. ❑ ❑ B— §133(a)l 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. ❑ ❑ Exception to §133(a)2. Outdoor signs in tunnels or large covered areas that require illumination during Y NA daylight hours. ❑ .0- §133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce Y N NA sin power by a minimum of 65 percent during nighttime hours. ❑ ❑ -ff Exception 1 to §133(a)3. Signs illuminated for less than one hour per day during daylight hours. Y NA 3 .-a" ❑ Exception 2 to §133(a)3. Outdoor signs in tunnels or large covered areas that require illumination during Y NA daylight hours. ❑ I a, 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. ❑ .131, §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 receivinga demand response signal that is sent out b the local utility. ❑ El4 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. ❑ 8' Field Inspector Notes: 2008 Nonresidential Compliance Forms October 2010 Certificate of Compliance (Sign Lighting) (Page 4 of 4 SLTG-IC Project Name: Date: z � I 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 ower method of compliance) A B C D AE ... . OPTIONAL Specific light source used for `Field ENERGY Symbol VERIFIED compliance Inspector Check that or Description label Shall include only lighting Code (see instructions technologies listed below Sign . below) List all that apply Cornplies . ✓ :..�✓: '.. i � I I.C.Y � � �uminF. Lt1c.n�-l1 I .fL l- •- ❑ �'..p. 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 C OPTIONAL - Check this box only if this sign has a permanent, pre-printed, factory -installed ENERGY VERIFIED label, 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. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories (UL) or other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards Institute in accordance with ISO/IEC 17011. Surveillance by the Accredited Certification Body shall be an ongoing annual inspection , program carried out by a Type A Inspection body in accordance with ISO/IEC 17020. For signs with such an ENERGY VERIFIED label, column `D' is not required to be filled out. Note: Using an ENERGY VERIFIED label is an optional method to validate compliance. An ENERGY VERIFIED 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 I through 10 that apply in column D above for each row. I High pressure sodium lamps 2 Pulse start or ceramic metal halide lamps served by a ballast with > 88% efficiency 3 Pulse start metal halide lamps that are < 320 watts, are not 250 watt or 175 watt lamps, and are served by a ballast with > 80% efficiency 4 Neon or cold cathode lamps with transformer or power supply efficiency>_ 75% with rated output current < 50 mA 5 Neon or cold cathode lamps with transformer or power supply efficiency>_ 68% with rated output current > 50 mA D 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 mitting 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 1 Electronic ballasts with a fundamental output frequency > 20 kHz E This page doubles as a field inspection checklist. Field Inspector Notes: 2008 Nonresidential Compliance Forms October 2010 Certificate of Compliance. (Sign'Lighting) (Page 1 of 4) SLTG-IC Project Name: Date • ' : Project Address: Location of Sign Phase of Sign Construction Type of Lighting Control ErOutdoor Signs ❑ Indoor Signs tl'Rew Signs ❑ Sign Alterations ❑ New Lighting Controls ❑ Replaced Lighting Controls ❑ Not Installing Lighting Controls This Certificate of Compliance includes the following components (check all that apply) ❑ Mandatory Measures (Lighting Controls) ❑ Maximum Allowed Lighting Power -2' pecific Lighting Sources r 1. Certificate of Compliance Declaration Statement (this maybe a C I o, 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. l I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the lighting design. Ce 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. �K 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: r r /t Ji- Phone �1 �/ • p n �.-. .51 Address: License number (may be contractor's lic #) City/State/Zip:. _ Date 2. Installation Certificate (to be sign ed.bMy responsible person after installations , ..5 •: f te r. i .. t ' Ya. .. • �, }Z +h-, Y ?4-...i :- i�'�- &%-!v,r„p'( .. ,_,a., Permtt number, + t , r �x.3i{' : a r. s s ; r ? ,� ira a ?3a °`F kM`a55 A 4�?L' . q. f j`y �: X j•/= 2 4.+.1. Cficckcd by/Dart i T rk 3 " `� dS } M M � Gr' r. �� _M r� ,a. ,t _, d ,x •�•.. c, t <L;t+:�'H,i, au!.'•'`rS�F; tEnforcement`A enc ':Use. n. .h. �. ? r a ax. i t t: ,.: ia�t .G r. n- tr r -. r . ,' t t + ' , t EnforcembnbA enc Use. , z;r'iF? a- .?# ,3", . s .:.•.+� ? s ... +z:<; Installation Declaration statement U 1 certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct.' ❑ 1 am eligible under Division 31of 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 conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. U .'I certify that the requirements detailed on this Certificate of Compliance have been met. 0 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: Responsible Person's Name: Responsible Person's Signature: License number (may be contractor's lic #) Date Signed: Position. With Company: / A X C �V 2008 Nonresidential Compliance Forms - scp r 20Z&)*r 2010 CITY OF t,; . COMMUNTTY Certificate of Compliance (Sign Lighting) (Page 2 of 4) SLTG-1C Project Name: Date: 4)Z 7 i 3. Mandatory Sign Lighting C ntrols NOTES: 1. The same responsible person may install both the sign lighting power and the sign lighting controls, or a different responsible person may install the sign lighting controls than the responsible person installing the sign lighting power. 2. The Mandatory Measures (sign lighting controls) are required for compliance with the sign lighting Standards. If the person responsible for installing the sign lighting power 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 responsible 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 or the entire construction. 3a. Statements of Responsibility: Any person signing the Certificate of Compliance Declaration Statement on page 1 of 4 on this SLTG-1C shall complete Part 3a. Check Yes or No for all of the following statements: 1 1 have responsibility for installing the sign lighting controls ®'Yes, complete parts 3a and 3b of this form ❑ No, complete part 3a of this form There are no existing sign lighting controls and I will be installing compliant sign lighting controls 2 2'Yes ❑ No There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls 3 ❑ Yes 2-1Q'o 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 ❑ Yes 13-No 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 ❑ Yes B No 3b. Mandatory Sign Lighting Controls If the person signing the Certificate of Compliance Declaration Statement on page I of 4 of this SLTG-1 C is responsible for complying with the sign lighting control requirements, that person shall answer all of the following questions: If there are construction documents, indicate where on the building plans the mandatory measures (sign lighting control) note block can be located: §133(a)l. All indoor sign lighting is controlled with an automatic time switch control that complies with the Y N NA 1 applicable re uirements of §119. ❑ ❑ EEr— §133(a)l and 2. All outdoor sign lighting is controlled with an automatic time switch control plus a photo Y N NA. control, or an outdoor astronomical time switch, that comply with the applicable requirements of § 119. ❑ ❑ 2 Exception to §133(a)2. Outdoor signs in tunnels or large covered areas that require illumination during Y NA daylight hours. ❑ 1 43 §133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce Y N NA sin power by a minimum of 65 percent during nighttime hours. ❑ ❑ ` T Exception 1 to §133(a)3. Signs illuminated for less than one hour per day during daylight hours. Y -Er. NA ❑ 3 Exception 2 to §133(a)3. Outdoor signs in tunnels or large covered areas that require illumination during Y NA daylight hours. ❑ 1 a" 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. ❑ 0' §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 capable of reducing the lighting power by a minimum of 30 percent when ❑ ❑ 2- 4 receiving a demand response signal that is sent out by the local utility. 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 sig ns. ❑ Field Inspector Notes: 2008 Nonresidential Compliance Forms October 2010 Certificate of Compliance (Sign Lighting) Pa e 4 of 4 SLTG-IC Project Name: y to� 1—`> , Date: 1 2 � / 5. Specific Lit7hting 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 si ns using the maximum allowed lighting ower method of compliance) A B C D OPTIONAL Specific light source used for •Field:. '. - Inspector ENERGY Symbol VERIFIED compliance Check that: or Description label Shall include only lighting . Code (see instructions technologies listed below .`Sign.. Complies.: below) List all that apply 1.t.D?1i ❑ ❑. -. ❑ ❑ ❑ o 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.buildin ; and the location of sign on construction documents C OPTIONAL - Check this box only if this sign has a permanent, pre-printed, factory -installed ENERGY VERIFIED label, 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. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories (UL) or other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards Institute in accordance with ISO/IEC 17011. Surveillance by -the Accredited Certification Body shall be an ongoing annual inspection program carried out by a Type A Inspection body in accordance with ISO/IEC 17020. For signs with such an ENERGY VERIFIED label, column `D' is not required to be filled out. Note: Using an ENERGY VERIFIED label is an optional method to validate compliance. An ENERGY VERIFIED 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% efficiency Pulse start metal halide lamps that are < 320 watts, are not 250 watt or 175 watt lamps, and are served by a ballast 3 with > 80% efficiency 4 Neon or cold cathode lamps with transformer or power supply efficiency > 75% with rated output current < 50 mA S Neonor cold cathode lamps with transformer or power supply efficiency>_ 68% with rated output current > 50 mA D Fluorescent lamps with a minimum color rendering index (CRI) of 80 6 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 1 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. Field Inspector Notes: 2008 Nonresidential Compliance Forms October 2010 IN. THE CITY OF LA QUINTA, COUNTY OF RIVERSIDE, STATE OF CALIFORNIA SHEET 6 OF 7 SHEETS PARCEL MAP NO,* 25865, CIP�.'IN. io3S BEING A SUBDIVISION OF A PORTION OF THE SOUTHEAST QUARTER OF SECTION 19 AND OF A PORTION OF THE NORTHEAST QUARTER OF SECTION 30, TOWNSHIP 5 SOUTH, RANGE 7. EAST, SAN BER ARDINO MERIDIAN HALL & FOREMAN INC. <�'��Zg�.4`�, NOVEMBER, 1990 Co e SE SEE SHEET 7 FOR SURVEYOR'S NOTES SEE SHEET 2 SCALE 1•=80' QLV I/ \\\ tr S �� a ♦, .00. 1 �69 .32. J2 6J,6Z. b~ n = oass'sr .A� mry L 46.93' I /J I/ AiiGovan 95 Acceri 10' LANDSCAPE AND SIDEWALK EASEMENT DEDICATED HEREON TO THE CITY OF LA OUINTA 14' POWER LINE EASEMENT TO THE IMPERIAL IRRIGATION DISTRICT RECORDED APRIL 12, 1991 AS INSTRUMENT NO. 119854. O.R. G - 21.57*59' PARCEL 6 R _ 115 T - 14.6' l - 28.75' 13.134 ACRES N67'21 N 24'09'OD' E 72.81' �art •� rV�+e Mf/M N65'S1'00r 1_• 35.67' 1�• low Nil S 4' J4:f 06, � `40 `�Z '9CA\ 'PCgQ, ♦ 0 AA9\ ,S J ry\ Q. ,O,�p 64S4 z 2 ; p� z q� °ti'o N 89'16'29' E n r4. o2e^ OY R 313.00' m I rc 4�HL4i // G♦\d ?\ �jY.. OF T - 90.19' Ai/we✓ca z n Y fq7 ♦7 d ? C� <4 L 175.63. 9S'Auerr S, 9�Oti // sT"9T,f� vd79'J0, �JBZp, JZ`l6• \�'*¢Rf4 9 15'EASEMENT FOR SLOPE PURPOSES v ` C yy TO THE STATE OF CALIFORNl4 ZB\ ♦ 'QoZ �`� V, 3ti °C RECORDED OCTOBER 9, 1967 AS 49 •'QoZ v 470 p° �y aei +'t' �o g�• ' INSTRUMENT NO. 88602. O.R. ` b 'OO• 4� tt P ,c3'� 00 0>- �� in• N al 4 I I �w W I ,N a 6,qb J. °?JOB BJ�04 2 / ��ql a Y o hl �o ? • . 0 JZ) °B7t. J� ?9 0 Z f ci SSZ9f m$ mJJ z� n h �S °a � ry� ID. - 1. 0.0. I.P. TAGGED R.C.E. 862. ON. 1.5' NO REF. JOB N0. 0.09W. k 0.22" SO. 41f 258658.O 41