14-0788 (SIGN)V� P.O. BOX 1504 VOICE 760 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/06/14
Application Number: 14-00000788 Owner:
Property Address: 79390 HIGHWAY 111 LAWRENCE HENRY
APN: 600-390-001- - - 79390 HIGHWAY 111
Application description: SIGN LA QUINTA, CA 92253
Property Zoning: REGIONAL COMMERCIAL (760)408-0753
Application valuation: 9500
Contractor:ffG10
Applicant: Architect or Engineer: SIGNARAMA41945 BOARDWALK, "L"PALM DESERT, CA 92211(760)776-9907Lic. No.: 830131 17YJ-OUWiA
rIam6 ,��FP_
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 Class: D42 C45 LicenseNo.: 830131
Date: 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 ($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.).
(_ 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
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:
i
LQPERMIT
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.
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 GRANITE STATE Policy Number WC065256570
_ 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 forthwith comply with those provisions.
Date: Applicant:
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 1$100,0001. 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, indemnity and hold harmless the City
f of La Quinta, its officers, agents and employees for any act or omission related to the work being
t 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 rcertify 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 for inspection purposes.
Date: 10, Signature (Applicant or Agent):
t�
Application Number 14-00000788
Permit ELECTRICAL 2013
Additional desc . .
Permit Fee . . . . 23.83 Plan Check Fee
.00
Issue Date Valuation
0
Expiration Date 12/03/14
Qty Unit Charge Per
Extension
1.00 23.8300 LS ELEC DEVICES, FIRST 20
23.83
----------------------------------------------------------------------------
1.
Special Notes and Comments
SIGN - THREE CHANNEL LETTER SIGNS
[SHADOW ROCK CHURCH]. 2013 CALIFORNIA
BUILDING CODE.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . PLAN CHECK, ELECTRICAL
23.83
PERMIT ISSUANCE M/P/E
90.57
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 23.83 .00 .00
23.83
Plan Check Total .00 .00 .00
.00
Other Fee Total 114.40 .00 .00
114.40
Grand Total 138.23 .00 .00
138.23
" LQPERMIT -
Projeu Nn h� �
42 k417d 1 `
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Phase of Construction
Function T
New Construction O Addition O Alteration
Outdoor Signs O Indoor Signs
Project Address:
Date / G
Dale:
Compliance Method Used O Maximum Allowed
Lighting Power O Alternate Ughting Sources
Documentation Author's Declaration Statement
• 1 certify that this Certificate of Compliance documentation is accurate and complete.
Namc
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Signature
Company
Date / G
Address
If applicab e:
S �c�Prt2A w- Sv t'iE L
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City/State/Lip
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Phone:
460 - -+,Ke - 14 O
Principal Lighting Designer's Declaration Statement
• 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, 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:T>S
Signature
Company:S I oQ 1k 2 or
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Address: ` _ct s
License a O 13
City/State/Zip:
Date
95 �'YLT
Sign Mandatory Measures
Indicate location on building plans of Mandatory Sign Measures Note Block:
Mandatory Sign Lighting Controls
Yes
No
1
§133(a)l. All signs with permanently connected lighting are controlled with an automatic time switch control
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that complies with theapplicable requirements of 119.
§133(a)2. All outdoor signs are controlled with a photo control or outdoor astronomical time switch control.
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2
Exception to §133(x)2. Outdoor signs are in tunnels or large covered area that require illumination during
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9.
daylight hours.
§133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce
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sign power by a minimum of 65 percent during nighttime hours.
Exception 1 to §133(a)3. Signs are illuminated for less than one hour per day during daylight hours.
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3
Exception 2 to §133(a)3. Outdoor signs are in tunnels or large covered areas that require illumination
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during,daylight hours.
Exception 3 to §133(a)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps are used to
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illuminated signs or parts of signs.
§133(x)4. An Electronic Message Center (EMC) having a new connected lighting power load greater than
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N/A
15 kW has a control installed is capable of reducing the lighting power by a minimum of 30 percent when
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receivinga demand response signal that is sent out b the local utility.K
Exception to §133(a)4. The EMC is required by a health or life safety statue, ordinance, or regulation,
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N/
includin but not limited to exit signs and traffic signs.
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2008 Nonresidential Compliance Fornrs August 2009
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P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
June 4, 2014
M
Mr. Bill Sigurdsen
Sign" A" Rama
41945 Boardwalk
Palm Desert, CA 92211
SUBJECT: SIGN PERMIT APPLICATION 2014-1775:
. SHADOW ROCK CHURCH IDENTIFICATION SIGNS
Dear Mr. Sigurdsen:
(760) 777-7000
'FAX (760) '777-7101
The Community Development Department has reviewed and approved your request for three
(3) building -mounted business identification signs for "Shadow Rock Church", located at 79390
Highway 111', within the La Quinta Valley Plaza. The signs have been determined to be
consistent with the provisions of the approved sign program for La Quinta Valley Plaza, and are
approved per the sign exhibits on file subject to the following Conditions:
1. This sign permit grants three (3) building -mounted illuminated business identification
signs, with logo, reading "Shadow Rock Church", one sign each on the building's south,
west and..north elevations above the leasehold space. Each sign shall not exceed 49.0
square feet, and shall be designed and placed in conformance with the sign graphics on
file with this application.
2. The applicant is.required to obtain a building permit prior to the placement of this sign.
.The Building Division can be reached at (760) 777-7012.
Should you have any questions or need additional information please feel free to contact me at
(760) 777-7125.
Sincerely,,
Wallace Nesbit
Principal Planner
c: Building_Di'ision
Code Compliance
1 4
Bin #
City of La Quinta
Building Sz Safety Division
P.O. Box 1504,.78-4 95 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:1CJ 3Rb W J
Owner's Name: 9C4 C-14 ry 1
A. P. Number:
Address: 7q :7 96 `Ojy /11
Legal Description:
City, ST, Zip: Lq U
Contractor: S /J
G �/
telephone: ��1� — 0 6 �
�'•'>':�� 'r
` +.~
Address: " / C? �
Project Description: �,«, G L
City, ST, Zip: A. Z yY1
Telephone: '%
State Lic. # : 63d 13'1
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
.:#'t::?
;f^:::::::
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add, n Alter Repair Demo
Name of Contact Person: y.L t� f� J
Sq. Ft:
# Stories:
# Units:
Telephone # of Contact Person: %i "C) J 9- g 6 l 3
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Reyiew, 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