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06-2623 (SIGN)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 0.6,0.0.002623 Owner: Property Address: 78995 HIGHWAY 111 STE 6 WASHINGTON 111 LTD APN: 643-020-999-6 -30903 - C/O JACK TARR Application description: SIGN 30240 RANCHO VIEJO RD. Property Zoning: REGIONAL COMMERCIAL SAN JUAN CAPISTRANO, C. Application valuation: 5000 Contractor: Applicant: Architect or Engineer: EVER-GLO ELECTRIC SIGN 2128 SO. GROVE AVENUE, ONTARIO, CA 91761 (900)555-9027 Lic. No.: 696762 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: C45 License No.: 696762 Date:_ 7 r ContractoY.`:I � 1..,=�j • [j 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 _ 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/11/06 STE. B 92675 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 STATE FUND Policy Number 1880791 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 b me sub' ct to the wor rs' compensation laws of California, and agree that, if I should be subi to the orke c pensation provisions of Section 3. 000_of the Labor Code, I s fort compl wit provisions. Date; WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO OVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND L FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000) IN ADDITION TO THE COST OF OMPENSATION, 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 i ati n ' correct. I agree to comply with all city and county ordinances and state laws relating to building c trio nd hereby authorize representatives of%th'i�s�countyto a t►/,er upon the above-mentioned property for ' cii n ur s. Dvte:f �••/�'�Signat�u rCe•IA�plicant or Agent): Application Number . . . . . 06-00002623 Permit . . ELEC-ELECTRICAL SIGN Additional desc . Permit Fee . . . . 33.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/07/07 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. TWO INTERNALLY ILLUMINATED CHANNEL LETTER SIGNS PER SA06-1913. Fee summary Charged Paid Credited ------------------------------------- Due -------------------- Permit Fee Total 33.00 .00 .00 33.00 Plan Check Total .00 .00 .00 .00 Grand Total 33.00 .00 .00 33.00 J 3 LQPERMIT - ,• Bin # City of La Quinta Building 8T Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # ( ?j� �b Project Address: 79795 Hwy i C,� Owner's Name: A. P. Number: Address: 7 Legal Description: Contractor: O City, ST, Zip: C a Telephone: P e. Address:,� C'ju !� e C. Project Descripti on: 11 } City, ST, Zip: On ><o C 9 l �7�) � � �..} Telephone: P o e. 9 � q a State Lic. # : (p City Lic. #; Tj pT c Arch., Engr., Designer: Address: City, ST, Zip: Telephone: hone: Construction on T Type: cc Panc Occupancy: Y•• State to Lic. #• Project ct tYPe �car cle o ne : New Add'n Alter Re air Demo o Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: 44 APPLICANT: DO NOT WRITE BELOW THIS LINE tv # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance Title 24 Cafes. 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 CERTIFICATE OF COMPLIANCE (Part 1 of 2) OLTGA -C PROJEC NAME a n rc,-SS(D DA//TE �W PROJECT ADDRESS Either LTG -1-C or OLTG-I-C may be used for signs as follows: 78 c/ Buildina Permit PRINCIPAL DESIGNER -LIGHTING V � d G1 TELEP ONE 6-1200 DOCUMENTATION AUTHOR V TELEPHONE Checked bv/Da7e— V ❑ OLTG-3-C oZ C i 1 Enforcement Agency Use GENERAL INFORMATION signs. DATE OF PLANS OUTDOOR LIGHTING ZONE (✓ One) ❑ LZ ❑ LZ2 1:1LZ3 ❑ LZ4 FUNCTION TYPE ❑ OUTDOOR LIGHTING OUTDOOR SIGNS ❑ INDOOR SIGNS PHASE OF CONSTRUCTION ❑ NEW CONSTRUCTION ❑ ADDITIONS ❑ ALTERATIONS STATEMENT OF COMPLIANCE Thi. rorfifi­#. -f r`....,..r.,..,.,, I{..._ - 11 I:_I -- _ -- .1. _ .. . . • -- ----- ------ ..a••••••�-;••••-''' ..p....•••..�..,v 11— — w 11piy ­L11I luc LY, rClLb 2112 o UT Ine Lanrorma uoae of Kegulations. This certificate applies only to building lighting requirements. The documentation preparer hereby certifies that the documentation is accurate and complete. DOCU ENTATION AUTHOR SIGNATUK DATE O G� T46 Q r The Principal Lighting Designer hereby certifies that the Dr000sed outdoor liahtino and Binns dPsinn r,-nra,,ntGri in fhi..of of ;-- a __._ :_ 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: ❑ I hereby affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code to sign this document as the person responsible for its preparation; and that I am licensed in the State of California as a civil engineer or electrical engineer, or I am a licensed architect. I affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code by section 5537.2 or 6737.3 to sign this document as the person responsible for its preparation; and that I am a licensed contractor performing this work. ❑ 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. These sections of the Business and Professions ode ace printed in full in a Nonresidential Manual. PRINCIPAL 41GHT G DESIGNER -NAME SIG R DATE LIC. # 1 C a I 401;2ejwl 62676a 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 Califomia Energy Commission. ❑ OLTG-I-C Certificate of Compliance. Required on plans for all submittals for outdoor lighting. Part 2 of 2 may be incorporated in schedules on the plans. Either LTG -1-C or OLTG-I-C may be used for signs as follows: 1. Use LTG -1-C if the project consists solely of indoor signs 2. Use LTG -1-C if the project consists of indoor lighting, and outdoor or indoor signs, but no other outdoor lighting. 3. Use OLTG-I-C if the project consists solely of outdoor signs 4. Use OLTG-1-C if the project consists of outdoor lighting, and indoor or outdoor signs, but no other indoor lighting ❑ 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. OLTG-4-C SIGN LIGHTING COMPLIANCE. Required for all internally and externally illuminated signs, for both indoor and outdoor signs. zuuo rvonresraentral compliance Fors March 2005 CERTIFICATE OF COMPLIANCE (Part 2 of 2) OLTG-1-C PROJECT NAME Lighting Schedules on Plans Show that Outdoor Lighting Meets Allowed Lighting Power ❑ Lighting power allowances for general site illumination.on OLTG-2-C Part 1 of 4 Not Applicable ❑ Lighting power allowances for local ordinances or for security multipliers on OLTG-2-C Part 2 of 4 [� Not Applicable ❑ Lighting power allowances for specific applications, other than vehicle service stations with canopies on OLTG-2-C Part 3 of 4 Not Applicable ❑ Lighting power allowances for vehicle service station canopies on OLTG-2-C Part 4 of 4 Not Applicable Sign lighting compliance on OLTG-4-C ❑ Not Applicable Mandatory Measures on Plans Show that Outdoor Lighting Meets Outdoor Lighting Controls and Equipment Indicate location on plans of Note Block for Mandatory Measure ❑ Installed lighting power has been determined in accordance with § 130(c)1 Not Applicable [],All permanently installed luminaires with lamps rated over 100 watts either have a lamp efficacy of at least 60 lumens per watt or are controlled by a motion sensor § 132(a) Not Applicable ❑ All Luminaires with lamps rated greater than 175 watts in hardscape areas, including parking lots, building entrances, canopies, and all outdoor sales areas meet the Cutoff Requirements of § 132(b) Not Applicable ❑ All permanently installed outdoor lighting meets the Control Requirements of § 132(c)l Not Applicable ❑ Building facades, parking lots, garages, canopies, and outdoor sales areas meet the Multi-Level Lighting Requirements of § 132(c)2 Not Applicable MANDATORY AUTOMATIC CONTROLS CONTROL LOCATION CONTROL IDENTIFICATION CONTROL TYPE Auto Time Switch/Photosensor, etc AREA CONTROLLED NOTE TO FIELD wOc to zva5 Nonresidential Compliance Forms March 2005 N � a U N � N C O N 0 vi •- c rn 'N Ca c N E Cn C U 7 _rn N m 2 3 C U = C Cn r > CU c c m i f0 C N � N W O Q s O 0 a o N C: V% C N (6 O- N 3 Ea C cU N cc U) � Zn N. U a j c y 0 'cn m a� 0 E E U) = c O }, 'gyp �• N C C }U,^ 7 E U n o O U L C iii O -2 in O E . a� - E U_ y L T N O Zn cc N -0C N NC 7 W O v, O � N a m ZZ V — E 2: G 0 N>' c a. m O- m E J E E c o o c Q) z Q of O a `p — a c ay, U- Qj O .O `e O U 0 U. Z .0 h Electronic Ballasts with V ° Output Frequency of 0 20kHz or more 1 E ami CFLs not containing o Medium Screw Base Sockets J z Barrier Coat Fluorescent O O d Lamps (includes most T5 and T8 lamps) W g a Light Emitting Diode o c (LED) _ o ° W h O Neon and Cold Cathode m N (n - = Z Pulse Start or Ceramic o u Metal Halide r � High Pressure Sodium J Is G Smaller than K? 3 Y/N c Y n Total Designed d O Sign Input watts h Number of Ballasts U In Signs M N 1p Number of OR _ m Lineal Feet of Lamps Q CD 3 a° _ Lamp Type rn c r .rn Allotted Watts �- (D X F) a� Allotted LPD `m U ea (12 or 2.3) Q 13 (W / ft2) 'W v Z W C Internally (1) OR Externally a (E) Q Illuminated J IL Sign Area (ft µ � O U O O O� O o? Z " a.� P � AW — N J W r � T V M Quantity of Signs z V U W d♦Z 0 Q Sign Symbol or Code a N � a U N � N C O N 0 vi •- c rn 'N Ca c N E Cn C U 7 _rn N m 2 3 C U = C Cn r > CU c c m i f0 C N � N W O Q s O 0 a o N C: V% C N (6 O- N 3 Ea C cU N cc U) � Zn N. U a j c y 0 'cn m a� 0 E E U) = c O }, 'gyp �• N C C }U,^ 7 E U n o O U L C iii O -2 in O E . a� - E U_ y L T N O Zn cc N -0C N NC 7 W O v, O � N a m ZZ V — E 2: G 0 N>' c a. m O- m E J E E c o o c Q) z Q of O a `p — a c ay, U- Qj O .O `e O U 0 U. Z .0 h