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12-1449 (SIGN)P.O.- BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number. U.4;2 01449 Property Address: 79024 HIGHWAY 111 STE 102 APN: 649-820-999- - - Application description: SIGN Property Zoning: REGIONAL COMMERCIAL Application valuation: 1200 Applicant: Ta!t 4 40" -- Architect or Engineer: d 114 ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Cla. C45 License No.: 951207 Date: 1 ntractor: - e OWNER-BUILDI 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.). (_ 1 1, 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: INLAND AMERICAN RETAIL 2901 BUTTERFIELD ROAD OAK BROOK, IL 60523 (760)613-3783 Contractor: MATTHEWS SIGNS INC 550 W. 6TH AVENUE ESCONDIDO, CA 92025 (858)435-0121 LiC. No.: 951207 MGMT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/19/12 D a l7 Do" 2012 CITY OF LA QUINTA FINANCE DEPT. -----------------------------7----------------- 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. Y 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 GOLDEN EAGLE Policy Number WC3583514 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 r j 3700 of the Lab de, I shall forthwith co ly with those provisions. ate:` `� y plicant: WARNING: FAILURE TO SECURE ORKERS' COMPENSATION VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL F NES 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 incorrect. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of t is coup y toenter upon the above-mentioned pro erty for insp coon purpos dignature (Applicant or Agent): Application Number . . . . . 12-00001449 Permit . . . ELEC-ELECTRICAL SIGN Additional desc . Permit Fee . . . . 33.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/17/13 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 Cdmments INSTALL 2 INTERNALLY ILLUMINATED CHANNEL LETTER SIGNS AT FRONT & REAR ELEVATIONS, PER SA # 2012-1666 "SPORTCLIPS HAIRCUTS". 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 # Crty of LQ Quilltd Bullding 8L Safety Division P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application• and Tracking Sheet Permit # Project Address: '7 -Oa� ��� a. Owncr'sName:.W A. P. Number. . l Address: 7-7,01 1,ef - /� , Legal Description: Contractor: i City, ST, a: ' ll �_ ! ;Telephon Address: SS 0 W Project Description: City, $T, zip: 710 L Tele hon p G (� p 6 �o i35 Q L 21 �,- £`- tt<, . z� r. „✓.<! L0 f ,, State Lic. #: —5 110 City Lia C aOvU Arch., Engr., Designer /V Address: City., ST, Zip: Telephone: Stoic Lic. #: f ;w � » : Construction Type:. Oceupaacy: Project type (circle one): New Add'n Alter Repair Demo Ft.: Z 3 , # Stories: # Units; Name of Contact Person: J-IPASq. Telephone # of Contact Petco Q L Estimated Value of Project Z 0o , --- APPLICANT: DO NOT WRITE BELOW THIS UNE # 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 Cates. Called Contact Person Plan Check Balance Tide 24 Coles. Plans picked up Construction Flood plain plan Plans resubmitted Meclhariicai Grading plan 2`! Review, ready for correctionstissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN ROUSE:- ''d Review; ready for correetionsAssue Developer Impact Fee Planning Approval. Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees CeEr- rtificate of Compliance Si n Li htin (Page 1 of 2) SLTG-1C Project Na Phase of Construction O New Construction ❑ Addition • ❑ Alteration Function Type 0 Outdoor Signs ❑ Indoor Si ns Proiect Address ���� g Date: Compliance Method Used ❑ Maximum Allowed 2-/(i f z, Lighting Power 13 Alternate Lighting Sources Documentation Author's Declaration Statement • 1 certify that this Certificate of Compliance documentation is accurate and complete. Name _ T�( Sign Company Date Address S ©,, W ,, rr if applicable: 'CEA # Ly City/State/ZipCEPE # yo hone. _ Principal Lighting Designer's Declaration Statement • 1 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 Company Phone Address: License # City/State/Zip: Date Sign Mandatory Measures Indicate location on building plans of Mandatory Sign Measures Note Block: Mandatory Sign Lighting Controls 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. Yes ,$� No ❑ ❑ 2 §133(a)2. All outdoor signs are controlled with a photo control or outdoor astronomical time switch control. 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 ni ttime 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 durin da li ht hours. ❑ X Exception 3 to §133(x)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps are used to illuminated sign; or parts of signs. ❑ 4 §133(a)4. An Electronic Message Center (EMC) having anew 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 receiving a demand response signal that is sent out by the local utility. Y ❑ N ❑ Exception to §133(a)4. The EMC is required by a health or life safety statue, ordinance, or regulation, includin but not limited to exit signs and traffic signs.__ Y ❑ N ❑ N/ 2008 ,N ont-esidential Compliance Forms August 2009 12 j b Oo v Q In +:. �—y = p Sign symbol or code D rD Mn� a� CS n 3 _. oo a fi o 3 o a� fi fi 7 a Z 1 R rt C W O O A O a Q EZ 3 o i Ilk fD •� i m p a w n ce '0 7 n II , Q 9 EL 4 rA �. m A s " i m o ft a a l rn a a -� fD o po m` o h p` p O fi 3 3 o In k� _ n A h. h a_ O O 9 ^ O° 3 K �' fh a 3' JQ ; O O C ry n 7 +, Z, q 3 o a• C. IV 3 no IV 4L�.�o yi C AQ 4 O O N p A O• ti z C y p1 A .�.. 'o Q �.: A• �. IV O p W 0 Iv Iv 4 A h o n v m o a D Oq t9 WCNN S .. Sign Area (ft) c� M.. n n N tp "r r. CA o i 3 ` , Internally (I) or > m o ;,, Externally (E) o p Illuminated c n 3 0 0 _ fi a� a Allowed LPD a � o N (I = 12 W/112) a IV ° (E = 2.3 W/ft2) A O oo C MAllowed o 1'(', Watts C" y N �l = C x E Tj _ .. o'13 S ... Total Installed w °Q O O watts for sign H f° _ eo Complies If .�c x 3 G<F ° •J r � 'o 0 y From List o r' °-, o ° Below ? _ NJ 13 0 000 Specia `~ a h 011000 Pass H "� � rA' 0 0 1133 103❑ 1 Fail �n