11-0784 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 11-00000784_ Owner:
Property Address: 78995 -HIGHWAY _111 STE 6 WASHINGTON 111 LTD
APN: 643-020-056-. - - PO BOX 1623
Application description: SIGN PALM DESERT, CA 92261
Property Zoning: REGIONAL COMMERCIAL
Application valuation: 4000
Contractor:
Applicant: Architect or Engineer: AD ELECTRICAL ADVERTISING
9437 VALLEY BLVD
ROSEMEAD, CA 91770
(626)448-1166
pip
LiC. No.: 927951
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/26/11
-------------------------------------------------------------------------------------------------
i 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
License Clas : C45 License No.: 927951
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/Date: tractor:
Issued.
V-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 o erjury that I am exempt from the Contractor's State License Law for the
Carrier CENTURY SURETY Policy Number 2010010121541Z
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ 1 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 becomj� 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 C�Isforthwith 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).:
te: plicant:
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 Coder The
WARNING: FAILURE TO SE E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
_
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER T 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.).
APPLICANT ACKNOWLEDGEMENT '
1 _ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec..
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.)•
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
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
oft>p county to enter upon the above-mentioned property for in pection purposes.
d'
te: 2��( ,nature (Applicant or Agent): .
Application Number . . . . . 11-00000784
PermitELEC-ELECTRICAL
SIGN
Additional'desc .
Permit Fee . . . . 33.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 1/22/12
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 BUILDING MOUNTED INTERNALLY
ILLUMINATED CHANNEL LETTER SIGNS,
PER
SA#2011-1538. "SAWA SUSHI". 2010
CODES.
----------------------------------------------------------------------------
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•
Certificate of Compliance
(Sign Lighting)
(Page 1 of 2) SLTG-1C
PPrroject Name: t
Signature
Ae_��
Phase of Construction
❑ New Construction 13 Addition 13 Alteration
>
Address
Function Type
IKQutdoor Signs ❑ Indoor Signs
Project Address:
1 v
Date:
Compliance Method Used ❑ Maximum Allowed
,�° /
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Lighting Power ❑ Alternate Lighting Sources
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate and complete.
Name'.A
/
Signature
Ae_��
Company t�
Date
Address
If applicable:
1
(� /
a Q
CEA #
1 v
CEPE #
City/State/Zi
a 04 qi %O
Phone:
6 0-1/
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 permit application.
Name: (
Signature
COMPAY All
Phone 66- . Qr 10i
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e/
Address: Tr tie
License#
City/State/Zip: r
C6Date
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❑
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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
that complies with the applicable requirements of § 119.
❑
§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.
e/
Exception 1 to §133(a)3. Signs are illuminated for less than one hour per day during daylight hours.
0,
❑
3
Exception 2 to §133(a)3. Outdoor signs are in tunnels or large covered areas that require illumination
during daylight 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 by the local utility.
❑
❑
Exception to §133(a)4. The EMC is required by a health or life safety statue, ordinance, or regulation,
YN
N/
including but not limited to exit signs and traffic signs.
❑
❑
2008 Nonresidential Compliance Forms August 2009
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�SAWA SUSHI
Proposing: Internally illuminated LED channel letter sign.
• Faces: 3/16" thk red acrylic face .
• Trim Cap: 3/4" white trim cap.
• Letter Returns: 5" deep .063 aluminum, painted white.
Channel letter installation shall be does with the use
of a mechanical lift. NO LADDERS are to be leaned up
against stucco.
Landlord must be notified no less than 72 -hours of the
sign being installed. Notice shall be made to Bill
Sanchez at 760-485-5308 or at
gsanchez@gsanchezgroup.com
21' -7"
� " ID.'
SIGNS Landlord Signature:
This sign is intended to be installed in accordance with the requirements of Article 600 of the National Electrical Code and/or other applicable local codes. This includes proper grounding and bonding of the sign.
JOB LOCATION APPROVED 11
9437 VALLEY BL., ROSEMEAD, CA 91770 DEPAR NT
TEL: 626-448-1166 FAX: 626-448-1111 78995 Highway 111, suite 6, La Quinta, CA I BY SATE
EXHIBIT
CASE NO.�: lh 1,0Ll
5• �
TRIM -TO -PAN
� WALL
PAN -TO -WALL FASTENER
FASTENER-MIN.3
ANCHORMG (#10 S-)
TRIM CAP
1/4"X1' TO 3", MIN. OPCS.
GTO WIRING AND FLEX
CONDUfT
LED tk-n•tm
TRANSFORMER
ENCLOSURE
MER
SWITCH
HIN SIGHT
jKjCT
LETTER FACE
--PRIMARY
ELECTRICAL
1/2 SPACE
WALL TYPE
DRYWALL/STUDS WOODSCREW 3IP X"X2"T04"
CONCRETE ANCHOIMAG 31V TO%'X 2 -TO 4"
STUCCO/E-EETROCK ANCHORILAG 3/S"TOWX2"TOO"
STEEL BEAMS MACH /ANCH. 3/8" TO X" X 2° TO 4•
All assembly and electrical components to be U.L. listed and labeled.
Channel letter installation shall be does with the use
of a mechanical lift. NO LADDERS are to be leaned up
against stucco.
Landlord must be notified no less than 72 -hours of the
sign being installed. Notice shall be made to Bill
Sanchez at 760-485-5308 or at
gsanchez@gsanchezgroup.com
21' -7"
� " ID.'
SIGNS Landlord Signature:
This sign is intended to be installed in accordance with the requirements of Article 600 of the National Electrical Code and/or other applicable local codes. This includes proper grounding and bonding of the sign.
JOB LOCATION APPROVED 11
9437 VALLEY BL., ROSEMEAD, CA 91770 DEPAR NT
TEL: 626-448-1166 FAX: 626-448-1111 78995 Highway 111, suite 6, La Quinta, CA I BY SATE
EXHIBIT
CASE NO.�: lh 1,0Ll
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