06-3160 (SIGN)P.O. BOX 15'04
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
06-00003160
79050 HIGHWAY 111
649 -820 -999 -
SIGN
REGIONAL COMMERCIAL
5000
T4b-t 4. XP "-
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
� IA -
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.
Licen lass: C45 D42 License No.: 637739
Date: ��� aE tractor:
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.).
(_ 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: 1�
LQPERMIT
Owner:
FOURTH QUARTER PROPERTIES
45 ANSLEY DR
NEWNAN, GA 30263
(760)613-3783
Contractor: D
PARAGON SIGNS
77650 ENFIELD LANE
PALM DESERT, CA 92
(760) 345-3340
Lic. No.: 637739
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
e
AU6 go 2006
CITY
Date: 8/30/06
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 STATE FUND Policy Number 1735081
_ 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
v y/ 37700 of the Labor Code, I shall fo v0ith comply with thos provisions.
2%te: u nim A scant: ,
WARNING: FAIL E TO SECURE WORKERS' PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 0100,000). 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 is correct. I agree to comply with all
city and county ordinances ands to laws relating to building construction, and hereby authorize representatives
of this count t6 enter upon above-mentioned property for inspe en purpos
Dat �D Gd, ' nature (Applicant or Agent):
1-1
L
Bin k
I
rmit # 1 �O
01
J� Project Address:
A. P. Number:
City of La Quinta
Building at Safery Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777.7012
Building Permit Application and Tracking Sheet
/4 Owner's Name:
Address: 79 -oro ,�� �•�
X Contractor: ��R�roo+✓ S% y f
Address: -27_C p ,CNF/E4,P
X
City, ST. Zip: ,o /,,t �SeS�•CT Z2�/
Telephone:
SYS 3iYo . -.
State Lic. a : 377 City Lic. #:,2 91
Arch., Engr., Designer:
Address:
Ci, ST Z'
Cin•. ST. Zip:
;Telephone:
XL
Project Description: ^�,�,�n
1=i
r"
h. tp.
Telephone:;
Construction Type: Occupancy:
Project type (circle one): New
Name of Contact Person: Add'n Alter Repair Demo
1C 6 Sw •,.dCL Sq. Ft.: p Stories: aY
Units:
i� Telephone 11 of Contact Person: GO — 4/0
s f•r
aA,car
vGL
X 1 Submittal
Plan Sets
Structural Cates.
Truss Calcs.
Energy Cates.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE:.
Planning Approval
Pub. Wks. Appr
School Fees
Req'd
APPLICANT:
Recd
sttmated Value of Proiect: .5066 "
DO NOT WRITE BELOW THIS LINE
TRACKING PERMIT FEES
Plan Check submitted Item Amount
Reviewed. ready for corrections Plan Check Deposit
Called Contact Person Plan Check Balance
Plans picked up Construction
Plans resubmitted
Mechanical
2- Review, read), for corrections/issue Electrical
Called Contact Person
Plumbing
Plans picked up S.M.1.
Plans resubmitted
Grading
Review, ready for corrections/issue Developer Impact Fee
Called Contact Person
A.I.P. P.
Date of permit issue
Total Permit Fees
s
�- Application Number . . . . . 06-00003160
Permit . . . ELEC-ELECTRICAL SIGN
Additional desc .
` Permit Fee . . . . 33.00
Plan Check Fee
.00
Issue Date'
Valuation . . .
.
0
Expiration Date 2/26/07
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
2 INTERNALLY ILLUMINATED CHANNEL
LETTER
SIGNS & 2 MONUMENT SIGNS, PER SA
2005-878. "HENRY'S MARKET"
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
• R
LQPERMIT
CERTIFICATE OF COMPLIANCF (Part i ^f n r)i Tr -__4 _r-
-- - -- - --- -.-•-••• -r ................... 11- N bWjllply Willi Inge [9, r-ans l ano 0 or fne t.alllornla k:ooe of
Regulations. This certificate applies only to building lighting requirements.
The documentation preparer hereby certifies that the documentation is accurate and complete.
DOCUMENTATION AUTHOR SIGNATURE DATE
The Principal Lighting Designer hereby certifies that the propos oor lighting and signs design represented In this set of construction documents
Is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with this permit
application. Tire 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 Slate of California as a civil engineer or electrical engineer, or I am a licensed
architect.
®' 1 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 typo of work described as exemp nt to Business and Professions Code Sections 5537,5538 and 6737.1.
(These sections of the Business and Profe ra nrW-1 in 1..11 1n u.e K1A_ .._1A_ :_.
r --1
-. 1.. .......... V�]..r,IV,C, 1 nAxE, i LIC.#
G3773 9
INSTRUCTIONS TO APPLICANT ournnnR 1 1G41TIAlr_ fInKAnl
For detailed instructions on lho use of this and all Energy Efficiency Standards conrpliance•fom7s, please refer to the Nonresidential
Manual published by the California Energy Commission.
® OLTG-I-C
Certificate of Compliance. Required on plans for all submittals for outdoor lighting. Part 2 of 2 may be
PRn.lr-r.T AIA\IC
incorporated in schedules on the plans,
1A/6C 7-
DATE
VKQJECT ADDRESS -
2. Use LTG -1 -C if the project consists of indoor lighting, and outdoor or indoor signs, but no. other outdoor lighting.
"'f^
3. Use OLTG-I-C if the project consists solely of outdoor signs
6tiildiriq'P.emiit
PRINCIPAL DESIGNER-LIGHTIN =- TELEPHONE
DOCUMENTATION AMOrRTELFPHCf4Ee
❑ OLTG-2-C
LIGHTING COMPLIANCE SUMMARY. Applicable Parts required for ALL outdoor lighting allowances (Except for
aN J!....d Z L
�yS�3f�
e v a c
ifoenl''Agency;Usc
Errecm
GENERAL INFORMATION
® OLTG4-C
SIGN LIGHTING COMPLIANCE, Required for all internally and externally illuminated signs, for both indoor and
DATE OF PLANS
OUTDOOR LIGHTING
ONE (✓ One) ❑ LZ1 ❑ LZ2 ❑ LZ3
LZ4
FUNCTION TYPE ❑ OUTDOOR LIGHTING
® OUTDOOR SIGNS ❑ INDOOR SIGNS
PHASE OF CONSTRUCTION ® NEW CONSTRUCTION
❑ ADDITIONS ❑ -ALTERATIONS
-STATEMENT OF COMPLIANCE
This CCrtlficate of Cmm�lianrn Gere r. a,�...., r..l.r..... _
-- - -- - --- -.-•-••• -r ................... 11- N bWjllply Willi Inge [9, r-ans l ano 0 or fne t.alllornla k:ooe of
Regulations. This certificate applies only to building lighting requirements.
The documentation preparer hereby certifies that the documentation is accurate and complete.
DOCUMENTATION AUTHOR SIGNATURE DATE
The Principal Lighting Designer hereby certifies that the propos oor lighting and signs design represented In this set of construction documents
Is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with this permit
application. Tire 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 Slate of California as a civil engineer or electrical engineer, or I am a licensed
architect.
®' 1 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 typo of work described as exemp nt to Business and Professions Code Sections 5537,5538 and 6737.1.
(These sections of the Business and Profe ra nrW-1 in 1..11 1n u.e K1A_ .._1A_ :_.
r --1
-. 1.. .......... V�]..r,IV,C, 1 nAxE, i LIC.#
G3773 9
INSTRUCTIONS TO APPLICANT ournnnR 1 1G41TIAlr_ fInKAnl
For detailed instructions on lho use of this and all Energy Efficiency Standards conrpliance•fom7s, please refer to the Nonresidential
Manual published by the California 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
li htin
❑ OLTG-2-C
LIGHTING COMPLIANCE SUMMARY. Applicable Parts required for ALL outdoor lighting allowances (Except for
Si ns
❑ OLTG-3-C
AREA CALCULATIONS WORKSHEETS. Applicable parts required for all outdoor area calculations.
® OLTG4-C
SIGN LIGHTING COMPLIANCE, Required for all internally and externally illuminated signs, for both indoor and
outdoor signs.
2005 Nonresidential Compliaoce Forrns
April 2005
l:tK I IFICATE OF COMPLIANCE (Part 2 of 2) OLTG-1-C
PROJECT NAME
Co�lonwealth Financial Network
Li htin 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
Q'Not Applicable
❑ Lighting power allowances for local ordinances or for security multipliers on OLTG-2-C Part 2 of 4
rNot Applicable
❑Lighting power allowances for specific applications, other than vehicle service stations with canopies on OLTG-2-C Part 3 of 4
l Not Applicable
❑ Lighting power allowances for vehicle service station canopies on OLTG-2-C Part 4 of 4
Not Applicable
L Sign lighting compliance on OLTG-4-C
❑ Not Applicable
Mandatory Measures on Plans Show that Outdoor Llghting Meets Outdoor Lighting Controls and Equipment
Indicate location on plans of Note Block for Mandatory Measure
0 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
rcoont�rolled by a motion sensor § 132(a)
L� 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)
`V' Not Applicable
All permanently installed outdoor lighting meets the Control Requirements of § 132(c)1
❑ Not Applicable
❑/Building facades, parking lots, garages, ' noples, and outdoor sales areas meet the Multi -Level Lighting Requirements of § 132(c)2
Le Not Applicable
MANDATORY AUTOMATIC CONTROLS
CONTROL LOCATION CONTROL CONTROL TYPE AREA CONTROLLED NOTE TO
IDENTIFICATION Auto Time Switch/Photosensor, etc FIELD
Interior Wall
behind S gn:, _ sign
2005 Nonresidential Compliance Forms
April 2005
I
0
0
N
Q
N
Electronic Ballasts with
U
°
Output Frequency of
o
20kHz or more
y
E
CFLs not containing
0
v c
o
Medium Screw Base
rn
t•..
Sockets
o c
rn
0
�i to
z0
Barrier Coat Fluorescent
N
r
0
Lamps (includes most T5
and T8 lamps)
w
e M
a
Light Emitting Diode
E c
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c_
(LED)
U
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LL (U
rn •� N
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Neon and Cold Cathode
I_
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'rn A
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a Z
Z
Pulse Start or Ceramic
M o Y
Metal Halide
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Is O Smaller than K7
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3
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Total Designed
t i
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Sign Input watts
o a
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—'
Number of Ballasts
In Signs
m c
a 0
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Number of OR
--Q°
m
Lineal Feet of Lamps
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Type
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Allotted Watts
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)
(12 or 2.313
= y •'
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Internally (I)OR
c
c c
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Externally (E)•
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Illuminated
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Sign Area (ft)
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Quantity of Signs
o c a
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/n
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Sign Symbol or Code
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