10-0812 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: /10-00000812%
Property Address: 79410 HIGHWAY 111 STE 112
APN: 649-820-006- - -
Application description: SIGN
Property Zoning: , •REGIONAL COMMERCIAL
Application valuation: 2000
T-it!t'4'XPQ"
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.
license Class: C45 License No.: 698638
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)•:
(_) 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.).
I I am exempt under Sec. B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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
Owner:
E & DD
2114 ARI LN
LOS ANGELES, CA 90049
VOICE'(760) 777-7612'
FAX (760) 777 -7011 -
INSPECTIONS (760) 777-7153
Date: 8/27/10
Contractor:
COST SIGN
1800 W. ADAMS BLVD AUG 2 r 20
LOS ANGELES, CA 90018 '
(323)733-1177 CI
Lic. No.: 698638 RLVAJL.-- QUffU7.
--------------- - - -
WORKER'S COMPENSATION DECLARATION
1 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 EXEMPT Policy Number EXEMPT
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
j37700 of the Labor shall forthwith comply with those provisions.
Date: -�T Applica R
WARNING: FAILURE TO SECURE WORKERS' COMPE OVERAGE 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 relating to building construction, and hereby authorize representatives
�(
of this county to enter upon the above-mentioned prop 'section purposes.
$Gate: /d Signature (Applicant or Agent). _
Application Number 10-00000812
Permit ` ELEC-ELECTRICAL SIGN
Additional desc
Permit Fee . . . . 30.00 Plan Check Fee .0.0
Issue Date . . :Valuation . . . . 0
Expiration Date 2/23/11
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT. 15.00
Permit SIGN PERMIT
Additional desc
Permit Fee . . . . 45.00 Plan Check Fee 29.25
Issue Date . . Valuation 2000
Expiration Date 2/23/11
Qty Unit Charge Per Extension
BASE FEE 15.00
15.00 2.0000 HND BLDG 501-2,000 30.00
--------=-------------------------------------------------------------------
Special Notes and Comments
LED ILLUMINATED SIGN [O'SUSHI & BAR]
2007/2008 CALIFORNIA BUILDING CODES.
August 27, 2010 12:06:50 PM AORTEGA
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 75.00 .00 .00 75.00
Plan Check Total 29.25 .00 .00 29.25
Grand Total 104.25 .00 .00 .104.25
LQPERMIT
tL
Certificate of Compliance Si n Li titin(Page 1 of 2 SLTG-1C
Project Name: Phase of Constriction 0 New Construction O Addition O Alteration
BQ Function Ty XOutdoor Si s O indoor Si ns ,
Project Address i;n $
Date' Compliance Method Used ❑ Maximum Allowed
(v (� �W ►4Y ( I Z �� Z
��;I:D Lighting Power ❑ Alternate Lighting Sources
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate and complete.
Name � � `
S
Company �V
C'C9T st6�
Address
If applicable:
CEA #
CEPE #
LQS +4 AO—r—S� el ` g001ig (3' 8)1733 11,20
Principal Lighting Designer's Declaration Statement
• 1 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, ;1culafio plans and specifications submitted to the
enforcement agency for approval withthis building permit applica
Name —
Company
�6 s(.6 A \o' pWdhe
Address: -:0253,V,33-//">"
City/StatetZip:D o6 ��
LA Gr9 ytv v 7WA,,9,b
Sign Mandatory Measures
Indicate location on building plans of Mandatory Sign M utas BI k �8
mandatory Sign Lighting Controls
1 §133(a)1. All signs with permanently connected lighting are controlled with an automatic time switch control
that complies with the applicable requirements of § 119. +
Yes
, ®
No
❑
§133(a)2. All outdoor signs are controlled with a photo control or outdoor astronomical time switch control.
❑
a
2 Exception to §133(x)2. Outdoor signs are in tunnels or large covered areas that require illumination during
daylict rt hours.
11
§133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce
sin ower b a minimum of 65 percent during nighttime hours.
❑
=g
Exception 1 to §133(a)3. Signs are illuminated for less than one hour per day during daylight hours.
®
❑
3
Exception 2 to §133(a)3. Outdoor signs are in tunnels or large covered areas that require illumination
Buring daylight hours.
❑
t!r-
Exception,3 to §133(a)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps are used to
illuminated si s or arts of signs.
❑
-a
4
i §133(a)4. An Electronic Message Center (EMC) having a new connected lighting power load greater than
15 kW has a control installed is capable of reducing the lighting power by a minimum of 30 percent when
receiving a demand r -,sponse signal that is sent out by the local utility.
Y
❑
N
❑
N/A
ag
Exception to §133(a)4. The EMC is required by a health or life safety statue, ordinance, or regulation,
including but not limited to exit signs and traffic signs.
Y
❑
N
❑
N/A
ia
2008 Nonresidential Compliance Forms August 2009
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Bin #
City of La Quinta
Building &r 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: _lf�O
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Owner's Name: W n/I
A. P. Number:
Address:
Legal Description: (�
Contractor:n
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Address: pv �� AD,4 OqS BL/0
City, ST, Zip:
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Telephone: °A' `: <
Project Description: TN { �;I c
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City, ST, Zip: 4A CA
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Telephone:;323r/j?--t/q,7
;MaLic.
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S( NstateLic.#:
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Arch., Engr., Designer-
esignerAddress:
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person: �1
Construction Type: f5•1 Occupancy:
Project type (circle one): ew Add'n Alter Repair
Demo
Sq. Ft.: 'a 3
#Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: L - �—
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
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
Title 24 Calcs.
Pians picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
'Grading plan
2i0 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:-
''d Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
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