08-1605 (SIGN)P.O.-BOX 1504
.78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 08-00001605
Property Address: 79174 HIGHWAY 111 STE 103
APN: 649-820-999- -
Application description: SIGN
Property Zoning: REGIONAL COMMERCIAL
Application valuation: 6500
Applicant: Architect or Engineer:
( 0;V+P1__A ` /v/3 -
4 4Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/22/08
Owner:
FOURTH QUARTER PROPERTIES
45 ANSLEY DR
"CALIFORNIA PATIO" / TEN,A
1 NEWNAN, GA 30263
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�C.11aas_s: /C455 D42se No 37739
Date: Contractor: r
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).:
(_) 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 orimprovement 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 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:'
LQPERMIT
Contractor: (p
PARAGON SIGNS Fi�3
77650 ENFIELD LANE
PALM DESERT, CA 9221
(760)345-3340 'f'V-
Lic. No.: 637739 QG 07
--------------------------- -------------
WORKER'S COMPENSATION DE ION
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 1735081-2008
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
3700 of the Labor Code, I shall ith comply iM tai provisions.
Date: �� Applicant:
WARNING: FAILURE TO SECURE WORKERS' OMPENSATION 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 Ouinta, 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
of this county to enter upon the above-mentioned property ffor//irt/sy�coon pu s.
Date: / G aiSignature (Applicant or Agent): ,�///
Application Number . . . . .' 08-00001605
Permit . . . SIGN PERMIT
Additional desc . .
Permit Fee . . . 90.00
Plan Check
Fee
.00
Issue Date
Valuation
. . .
. 6500
Expiration Date 3/21/09
Qty Unit Charge Per
Extension
BASE
FEE
45.00
5.00 9.0000 THOU. BLDG
--------------------------------------------------------------7-------------
2,001-25,000
45.00
Permit . . . SIGN PERMIT
Additional desc .
Permit Fee . . . . 90.00
Plan Check.Fee
00
Issue Date . . .
Valuation
. . .
. 6500
Expiration Date 3/21/09
Qty Unit Charge Per
Extension
BASE
FEE
45.00
5.00 9.0000 THOU BLDG
2,001-25,000
45.00
----------------------------------------------------------------------------
Special Notes and Comments
(2) INTERNALLY -ILLUMINATED CHANNEL
LETTER SIGN PER SA 2008-1279 "CALIFORNIA
PATIO"
Fee summary Charged
---------- ----------
Paid Credited
--------- ----------
Due
-----------------
Permit Fee Total 180.00
.00
.00
180.00
Plan Check Total .00
.00
.00
.00
Grand Total 180.00
.00
.00
180.00
LQPERMIT
CERTIFICATE OF COMPLIANCE (Part 1 of 2) OLTG-1-C
PROJECT NAME
C4164ed',CA'A
Pa o
Manual published by the California Energy Commission.
DATE
PROJECT ADDRESS
incorporate in schedules on the plans.
Building Permit
AI., ` eby/DateD
::Enforcement Agency Use
PRINCIPAL DESIGNER -LIGHTING
PARAGON SIGNS
TELEPHONE
760-345-3340
DOCUMENTATION AUTHOR
DON SWINDEL
TELEPHONE
760-345-3340
GENERAL INFORMATION
3. Use OLTG-1-C if the project consists solely of outdoor signs
DATE OF PLANS
OUTDOOR LIGHTING ZONE ✓ One ❑ LZ1 '❑ LZ2 ❑ LZ3
❑ LZ4
FUNCTION TYPE
❑ OUTDOOR LIGHTING
OUTDOOR SIGNS ❑ INDOOR SIGNS
PHASE OF CONSTRUCTION
NEW CONSTRUCTION
❑ ADDITIONS ❑ ALTERATIONS
STATEMENT OF COMPLIANCE
outdoor signs.
I his cemncate of compliance lists outdoor lighting system specifications need to comply with Title 24, Parts 1 and 6 of the Calitomia Code 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
D. SWINDEL I % 8/
The Principal Lighting Designer hereby certifies that the propo outdoor.lightinq and siqns 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. 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:
❑ 1 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 Code are Drinted in full in the Nonresidential Manual.)
PRINCIPAL LIGHTING DESIGNER -NAME SIGNATURE DATE LIC. #
D. SWINDELj>js�� jtp 637739
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 California Energy Commission.
❑ OLTG-I-C
Certificate of Compliance. Required on plans for all submittals for outdoor lighting. Part 2 of 2 may be
incorporate in schedules on the plans.
Either LTG -1-C or OLTG-1-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-1-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.
2005 Nonresidential Compliance Forms April 2005
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