06-3540 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4 4Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
STAMKO DEV CO
C/O PROVIDENT FINANCIAL MGMT
10345 W OLYMPIC BLVD 2 FL
LOS ANGELES, CA 90064
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/04/06
�e
Contractor: -
Applicant: Architect or Engineer: SIGNARAMA -
41945 BOARDWALK, "L" OCT O 1006
PALM DESERT, CA 92211 C U
(760)776=9907
Lic. No.: 830131/88410 CITY®FLAQUINTA
FINANCE 99M.—i
Q
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lice sed nder prov' ' ns of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business an rof ssi als C nd my License is in full force and effect. -
License Class: D42 C45 n o.:-3-3-0131/884104 .
Date: �Contractor:
OWN UILDER DECLARATION
I hereby affirm under penalty of perjury that I am ex pt 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 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
I 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
WORKER'S COMPENSATION DECLARATION
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 WAUSAU INS CO Policy Number WCJZ91442878016
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 1 should o e bject o the workers' compensation provisions of Section
a r he Labor Code, fo h those provisions.
Date: Ib Applicant:
WARNING: FAILURE TO SECURE WORKERS' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO TFtt 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 abo infor ion is correct. I agree to comply with all
city and county ordinances and state laws relating to building nstr on, and hereby a representatives
ofthis c`ou/}tLy enter upon the above-mentioned property f n n urpose
Date: Logy Signature (Applicant or Agent):
Application Number:f
06-00003540
Property Address:
79255 HIGHWAY`111
STE
APN:
649-030-999-8
-30420
Application description:
SIGN
Property Zoning:
REGIONAL COMMERCIAL
Application valuation:
6800
4 4Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
STAMKO DEV CO
C/O PROVIDENT FINANCIAL MGMT
10345 W OLYMPIC BLVD 2 FL
LOS ANGELES, CA 90064
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/04/06
�e
Contractor: -
Applicant: Architect or Engineer: SIGNARAMA -
41945 BOARDWALK, "L" OCT O 1006
PALM DESERT, CA 92211 C U
(760)776=9907
Lic. No.: 830131/88410 CITY®FLAQUINTA
FINANCE 99M.—i
Q
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lice sed nder prov' ' ns of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business an rof ssi als C nd my License is in full force and effect. -
License Class: D42 C45 n o.:-3-3-0131/884104 .
Date: �Contractor:
OWN UILDER DECLARATION
I hereby affirm under penalty of perjury that I am ex pt 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 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
I 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
WORKER'S COMPENSATION DECLARATION
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 WAUSAU INS CO Policy Number WCJZ91442878016
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 1 should o e bject o the workers' compensation provisions of Section
a r he Labor Code, fo h those provisions.
Date: Ib Applicant:
WARNING: FAILURE TO SECURE WORKERS' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO TFtt 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 abo infor ion is correct. I agree to comply with all
city and county ordinances and state laws relating to building nstr on, and hereby a representatives
ofthis c`ou/}tLy enter upon the above-mentioned property f n n urpose
Date: Logy Signature (Applicant or Agent):
Application Number 06=00003540
- Permit . . . ELEC-ELECTRICAL SIGN
Additional desc .
Permit Fee 33.00 Plan Check Fee
.00
�.. Issue Date . . . . Valuation
0
Expiration Date 4/02/07
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 SETS INTERNALLY ILLUMINATED CHANNEL
LETTER SIGNS FOR "DIPPIN DOTS" PER SA
'06-1036
_
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
J
TF
LQPERMIT
Bin ff"CitY
of La Quinta
.Building U 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: 1
Owner's Name: v eT
A. P. Number:
Address: 75N 0 Cc Fes" 64a d o
Legal Description:
City, ST, Zip: L
Contractor: IIQ ti. � 1 Rctncq
Telephone: �%
/
Project Description:
Address: A
City, ST, Zip: tY � 1-kat
S �IU t
Telephone: G -910
n /
State Lie. # : DqWo4
City Lic. #:
1
Arch., Engr., Designer:
Address:
City,; ST, Zip:
Telephone: q t
'-
ConstructionType: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #:
Name of Contact Person:Nod U to 401
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 776 -9961.
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd _
Rec'd
TRACKING .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
,Truss Calcs.
Called Contact Person
Plan Check Balance
Energy .Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading,plan
tad 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 HOUSE:-
Review, ready for corrections/issue
Developer Impact Fee.. ;
Planning Approval
Called Contact Person
A.I P.P.
Pub. Wks. Appr
Date of permit issue_
School Fees
.. ,
Total Permit Fees ,...
,.,.
,J•,
Outdoor Lighting Forms Compliance
CERTIFICATE OF COMPLIANCE (Part 1 of 2)
OLTG-1-C
PROJECT NAME
DATE
Dippin' Dots
10/04/2006
PROJECT ADDRESS
79255 Highway 111 Suite 5, La Quinta, CA 92253
Building Permit
PRINCIPAL DESIGNER -LIGHTING
Sign*A*Rama
TELEPHONE
760-776-9907
DOCUMENTATION AUTHOR
Grady
TELEPHONE
Checkedby/Date
Enforcement Agency Use
,Jeff
760-776-9907
^„- __ _ _ __I OUTDOOR LIGHTING ZONE ( One) ❑ LZ1 ❑ LZ2 ❑ LZ3 ❑ LZ4
STATEMENT OF CWCIARE ❑ NEW CONSTRUCTION ❑ ADDITIONS ❑ ALTERATIONS
This Certificate of Compliance lists outdoor lighting system specifications need to comply with Title 24, Parts 1 and 6 of the
California Code of Regulations. This certificate applies only to building lighting requirements.
The documentation preparer hereby certifies that the documentation is accurate and complete.
Jeff Grady
The Principal Lighting Designer hereby certifies that the proposed oirt!door 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. 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:
❑ 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 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.
hese sections of the Business and Professions Code are ted in full in theonresidential Manual.
PRINCIPAL LIGHTING DESIGNER -NAME SIGNATURE
Jeff Gradv 01f AA °�n lU �l M.�
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 Nonresidentia
Manual published by the California Energy Commission.
❑ OLTG-1-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 LTG71-C if the project consists of. indoor lighting, and outdoor or indoor signs, but no other outdoor
lighting.
r .< .::_. ::•,� :'» , = .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
�_�:: ^!..•',.,. .1.1C';4.IT:1�I/;.;R„LI�ADI IAAIr`f~•.C1 �11�AADV,.,•Annlinahlc Dorrc,rcnisirurl fnr All nn4rinnr linF�4inn �Iln�u�nrcc /Gvrcn4 fn .
CERTIFICATE OF COMPLIANCE (Part 2 of 2)
OLTG-1-C
PROJECT NAME
Lighting Schedules on Plans Show that Outdoor Lighting Meets AllowedLighting Power
❑ Lighting power allowances for general site illumination on OLTG-2-C Part 1 of 4
❑ 0 Not Applicable
❑ Lighting power allowances for local ordinances or for security multipliers. on OLTG-2-C Part 2 of 4
❑ 0 XNot Applicable
❑ighting power allowances for specific applications, other than vehicle service stations with canopies on OLTG-2-C Part 3 of 4
❑ 0 Not Applicable
❑ Lighting power allowances for vehicle service station canopies on OLTG-2-C Part 4 of 4
110 Not Applicable
❑ 0 Sign lighting compliance on OLTG-4-C
❑ Not Applicable
Mandatory Measures on Plans Show that Outdoor Lighting Meets Outdoor Lighting Controls an qulpmen
Indicate location on plans of Note Block for Mandatory Measure
❑ Installed lighting power has been determined in accordance with a 130(c)1
❑ 0 Not Applicable
❑ All permanently installed luminaires with lamps rated over 100 watts either have a lamp efficacy of at least 60 lumens. per watt o
are controlled by a motion sensor B 132(a)
❑ 0 Not Applicable
❑ All Luminaires with lamps rated greater than 175 wafts in hardscape areas, including parking lots, building entrances, canopies,
and all outdoor sales areas meet the Cutoff Requirements of a 132(b) .
1:10 Not Applicable
❑ .All permanently installed outdoor lighting meets the Control Requirements of a 132(c)1
110 Not Applicable
110 Building facades, parking lots, garages, canopies, and outdoor sales areas meet the Multi -Level Lighting Requirements of f -
132(c)2
❑ Not Applicable
MANDATORY AUTOMATIC CONTROLS
CONTROL LOCATION
CONTROL
IDENTIFICATION
CONTROL TYPE
Auto Time Switch/Photosensor, etc
AREA CONTROLLED
NOTE Ti
FIELD
Electrical Room
Sign Timer
Auto time Switch
Elevation
RV
SPr%
1
SIGN LIGHTING COMPLIANCE ®LTG -C
PROJECT NAME - OATE
Alternative 2– For Signs that ONLY use one or more of the
Altemattve t – Lighting Power Allowances technologies listed In M through S
ck all that anDNI
A ® C 0 E —F -Fr I G H t J K L h}`: N -O P Q R S
Allotted Watts tam I Ballast Oesl n Wath
LEO �
AL
H$
allr �$
n N w. i ter' st a e-0 5
$ Oesciiptitin or v ro >< V o ; < X s g s @ m 3 g a
t.008110n ..:"' �`!� O a a: A �+a a. v. � Z � . 3 ®�� � .. �.� ..�'^., vi ? Fn ffi d3
kawrT
Am
For Allotted LPD use 12 watts/square fvot:for Intemaly Illuminated. Signs, and us 2.3 watts/fe for Externally Illuminated Signs
Mote: If an Intemally Illuminated or Externally Illuminated sign conlatns fight sources and ballasts other than those included in columns (M) through (S), such as
Incandescent lamps, medium base sockets, magnetic ballasts, etc, then 166 sign must comply -under Alternative 1. However, unfiltered signs, and unfiltered
portions of Internally and Externally illuminated, signs, are not required to meet these Standards.
2005 Nonresidential Compliance Forms Metal 2005
Sep,19 06 12:46p Stamko Development Co.
I
760-777-7687
p.2
a
r
tD
as