13-0084 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000084
Property Address:
79150 HIGHWAY 111 STE 101
APN:
649-820-999- - -
Application description:
SIGN
Property Zoning:
REGIONAL COMMERCIAL
Application valuation:
2500
c&h
j� 4 4 Qum&
Applicant: Architect or Engineer:
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.
LicenseClasss: C10—C45 License Io.: 898078
S-Date:51 'Z81 3 Contractor.
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 1$500).:
(_ 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 contractors) 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 (160) 777-7153
Date: 1/28/13
Owner:
COSTCO WHOLESALE CORP
989 LAKE DRIVE
LA QUINTA, CA 92253
(760)613-3783
Contractor: JAN 28 2013
MEGAHERTZ ELECTRIC SIGNS & LI
112 W. ELM COURT C/
BURBANK, CA 91502F AAJC Q'JINTq
(818)566-1850 E�EpT
Lic. No.: 898078
-----------------------------------------------
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 PACIFIC INS Policy Number WA00011500
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 the workers' compensation provisions of Section
3700 of the Lab ode, I shal rth ' o I ifh those provisions.
Date: 1A� i-1 i Applic t
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 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 and state laws relatin building cons coon, and hay authorize representatives
of this county to enter upon the above-mentioned pr erty for i p ti n pos
Date: 2J ' Signature (Applicant or gent):
• t r i
v Application Number . . . . . 13-00000084
Permit . . . ELEC-ELECTRICAL SIGN
Additional desc .
Permit Fee . . . . 30.00 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
0
Expiration Date 7/27/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT
15.00
----------------------------------------------------------------------------
Special Notes and Comments
(1)permenatly - illuminated sign per
S.P.A 2012-1673 "Famous Footwear" 2010
codes.
---------------------- ------------------------------------------------------
Other Fees . . . . . . . ... BLDG STDS ADMIN (SB1473),
1.00
Fee summary Charged Paid Credited
----------------------------------------------- ----------
Due
Permit Fee Total 30.00 .00 .00
30.00
Plan Check Total .00- .00 .00
.00
Other Fee Total 1.00 .00 .00
1.00
Grand Total 31.00 .00 .00
31.00
Bin. #
City of La Quinta
UklZng 8t Safety Dirisfon
P.O. Box 1504,78-495 Cape Tampico
La.Quinta, CA 92253 • (760) 777-7012
Building Permit Application and Tracldn Sheet
7 � g
OwncesName:. CCO W�06
Permit #
Project Addtess:
A. P. Number y�
t -
Legal Description:
City. ST, Zip: ISS 0. WA a
L
Contractor. Z �ev-`ylti
Telephone:
Address: 2—- E m'V11-00
Project Description:
City,ST.zip: vv�wv�yL Cq 15o
Telephone:( 7- Z)
State Lia #: Q Qj City Lic. k:
At&, Ettgr., Designer:
Address:
City, ST. Zip:
Telephone:
State Lta tl.
Name of Contact Person: J
T
Construction Type: • Occatpancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft,: # Stories: k Units:
Estimated value of Project: 2.5 cx) . CD
Telephone Y of Contact Person: 14 _].-1-12
APPLICANT:
p Submittal Req'd mtec'd .
DO NOT WRITE BELOW THIS UNE
TRACKING PERMIT FEES
Pian Sets
Plan Check submitted
Item Amount
Strtldaiai Calces
Reviewed, ready for corrections
Plan Cb'c& Deposit. .
Truss Cala.
Called Contact Pcrson
Plan Cheek Balance-
'nde 24 Calc ,
Plans picked up
Construction'
Flood plain plan
Plans resubmitted. .
Mechanical
Grading plan
2" Review, ready for eorrectionsfissue
Electrical
Subeontaetor Fist
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
IL04 Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Revtew, ready for correctionslume
Developer impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fen
To tat Permit Fees
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
January 24, 2013
Mr. Dennis Stout
504 E. Palmyra Avenue
Orange, CA 92866
SUBJECT: SIGN PERMIT APPLICATION 2012-1673
FAMOUS FOOTWEAR
Dear Mr. Stout:
(760) 777-7000
FAX (760) 777-7101
The Community Development Department has reviewed and approved your request for
permanently mounted business identification signs on the southern building elevation of
Famous Footwear at 79-150 Highway 1 1 1, Suite 101. The approval is subject to the
following` Conditions of Approval:
1. This sign permit grants one permanent internally -illuminated main identification sign
and one permanent ,blade sign.
The'total square footage of the primary Famous Footwear sign shall be no greater
than 43.04 square feet.
The blade sign shall be no, greater than 3.00 square feet, and is mounted at the
approved location.
The materials for the sign are per the approved plans on file with the Community
Development Department.
2. A building permit shall be obtained prior to any work on the signs being started.
3. The signs shall, conform to the approved sign program for The Pavilion.
Should you have any questions or need additional information, please feel free to contact
me at (760) 7/7-7125.
, . Sincerely,
A'ss6ciate Planner
C: -Building &=Safety. Dep rtment
Certificate of Compliance
(Sign Lighting)
(Page 1 of 4) SLTGIC
Project Name:
��1��L�
!
��a [ 51 .-�
�c�j
Date: t — 2V —1
Project Address:
l �l,y-J ilt J�1�
Location of Sign
<121 Outdoor Signs ❑ Indoor Signs
Phase of Sign Construction
ANew Signs ❑ Sign Alterations
Type of Lighting Control
❑ New Lighting Controls WReplaced 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 maybe a CI 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.
f� 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, Parts 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 pe k application.
Name:
_r.
-r
Sig atur
r
N
.
Company:
r.
c�v r
r
-t� L1
Phone
e' -1 8 - 666 - ( &;O
Address:
2 - COinf
License number (may be contractor's tic #)
R o
City/State/Zip:
3� 6V,� 9"�50�
Date
LU-�
2. Installation Certificate (to be signed by responsible pers after i tallation)
Permit number
i h�clnt hyrDatr
Mnfor[tmcai QCV Use
[EAtOSC�ICII[ EillY U )
Installation Declaration statement
..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 Business and Professions Code to accept responsibility for construction, or an authorized
representative of the person responsible for construction.
1 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.
7 I certify that the requirements detailed on this Certificate of Compliance have been met.
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. l 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:
2008 Nonresidential Compliance Forms October 2010
Certificate of Compliance (Sign Lighting) (Pa e 2 of 4SLTG-IC
Project Name:
�n� s � w u•r Sl
Date: _)
- -A
3. Mandatory Sign Lighting Controls
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 16r the entire construction.
3a. Statements of Responsibility: Any person signing the Certificate of Compliance Declaration Statement on page I 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
0,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
❑ Yes RNo
3
There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls
❑ Yes /JRLNo
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 ❑ 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 iCNo
3b. Mandatory Sign Lighting Controls
If the person signing the Certificate of Compliance Declaration Statement on page I of 4 of this SLTG-1Cis responsible for
complying with the sign lighting control requirements, that persori 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)1. All indoor sign -lighting is controlled with an automatic time switch control that complies with the
Y
N
1
NA
1
a2elicable re uirements of § 119.
ET
❑
❑
§133(a)1 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 § l 19_
Pf-
❑
❑
2
Exception to §133(a)2. Outdoor signs in tunnels or large covered areas that require illumination during
Y
NA
daylight hours.
❑
'®
§133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce I
Y
N
NA
sign power by a minimum of 65 percent durin = nighttime hours.
❑
❑
IR
Exception 1 to §133(a)3. Signs illuminated for less than one hour per day during daylight hours.
Y
NA
3
Exception 2 to §133(a)3. Outdoor signs in tunnels or large covered areas that require illumination during
Y
NA
daylight hours.
❑
0
Exception 3 to §133(a)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps used for
Y
NA
illuminating signs or 2arts of signs.
❑
§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
❑
❑
Ili
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 signs.
❑
Field Inspector Notes:
2008 Nonresidential Compliance Forms October 2010
Certificate of Compliance (Sign Lighting) (Page 3 of 4) SLTG-1C
Project Name: ; Date:
. Maximum AD -owed Lighting -Power Method of Compliance
ti1ic Compliance and Field Inspection Energy Checklist
Complete this part if there are signs using the maximum allowed lighting,4er method of compliance. (Complete part 5
of this Certificate of Compliance if there are signs using the Specific ll-.hting sources method of compliance)
A
B
C
D
E
I F
G
H
I
J
n
Allowed
Watts
Design
Complies?
Watts
Y/N
w o
a>
> a�
�-
0
o
=
o
Y
`
.
Field
�
.i C
Q
a2 � �
� � c'7
�, � �
• �
QJ
Inspector
ci
p N
a X
o II
C3ieok tl tat
O �
r �••'
¢
cC
U-
i
Complies
Description
./
❑
r
I]
❑
ll
❑
❑
❑
1�
A
Symbol or code used on the plans when plans are required) and other documents.
B
A narrative descrt tion of the sign, or location of sign on the building; and the location of sign on construction documents.
OPTIONAL -'Check this box only if this sign has a permanent, pre-printed, factory -installed, ENERGY VERIFIED label, confirming that
the sign complies with the Section 148 of the California 2008 Title 24, Part 6 Standards, using the Maximum Allowed Lighting Power
method ofcompliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized
C
by Underwriters Laboratories (UL) or other Product Certification Body accredited to ISO/IEC Guide 65 by the American National
Staedards Institute in accordance with ISO/IEC 1701 1. 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, columns 'D' through 'I' are not required to be tilled out- Note: Using an ENERGY VERIFIED label is an optional
method to validate compliance. An ENERGY VERIFIED label is not needed for com liance.
D
The sign area insquare feet.
E
List "I" if the sign is internally illuminated. List "E•' if the sign is externally illuminated.
F
Allowed watts per square foot. Enter 12 if the si�n is listed as "I" in column E. Enter 2.3 if sign is listed as "E" in column E.
G
Multiply the square Footage in column D times the allowed Lighting Power Density (LPD = watts) in column F.
H
Show the total installed watts in the sign, as determined according to the applicable provisions of $130 d ore .
I
I Enter Y if the number in column H is less than or equal to the number in column G. Otherwise, the sign does not comply.
J
I This page doubles as a field inspection checklist.
Field Inspector Notes:
2008 Nonresidential Compliance Forms October 20l0
Certificate of Compliance (Sign LiE7hting) (Page 4 of 4) SLTG-1C
Project Name: r Date:
YG(MOU ~f�l Ir �1 2 '1
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 power method of compliance)
A
B
C
D
E
OPTIONAL
ENERGY
�pecific light source used for
Field
lr
Symbol
VERIFIED
compliance
Checktthat
or
Description
label
Shall include only lighting
5>gB
Code
(see instructions
technologies listed below
Complies
below)
List all that apply
r
a
❑
❑
A
S mbol 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 tilled 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 a licable numbers I through 10 that apply in column D above for each row.
/
High ressure sodium lamps
2
Pulse start or ceramic metal halide lamps served by a ballast with > 88% efficient
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% efficient
4
Neon or cold cathode lamps with transformer or power sup2ly 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
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
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