06-0270 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
06-00000270
79440 HIGHWAY 111 STE 105
649-820-004- - -
SIGN
REGIONAL COMMERCIAL
5000
Architect or Engineer:
BUILDING PERMIT
4perjuryth
NSED CONTRACTOR'S DECLARATION
I hereby all' under penalty m licensed under provisions of Chapter 9 (commencing with
Section 70 1 of Division 3 od Professionals Code, and my License is in full force and effect.
Licens Cla V_C
C61 License No.: 207136
Date ontraOWNER-BUILDER DECLARATION
I hereby affirm under penalty m 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,
qv 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
1 I 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 �.
Owner:
KLEINE NEIL WAYNE
41910 BOARDWALK A-10
PALM DESERT
PALM DESERT, CA 92211
Contractor:
IMPERIAL SIGN CO,
>6120 CALHOUN
DIO, CA 92201
60)347-3566
LiC. No.: 207136
INC.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/18/06
-------------------------------------- - - - - -—
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
_ 1 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 HRH INS Policy Number 142483705
I certify that, in the perfor nce o he work for which this permit is issued, I shall not employ any
person in any mann so as to be me subject to the workers' compensation laws of California,
and agree that, if I r become ubject to the workers' compensation provisions of Section
—T 1 37p of the Labor e, I all f hwith comply with those provisions.
Date: ('/) Applicant:
WARNING: FAILURE TO SECURE W J K R COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL'- ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 15100,0001. 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, 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 th t I have read this application and state thJavemation is correct. I agreeto comply with all
city and ' my rd' ances and state laws relating totion, and hereby authorize representatives
of this c u t en u n the above-mentioned pron purposes.
Date: mature (Applicant or Agent):
Application Number 06-00000270
J
Permit . . . ELEC-ELECTRICAL SIGN
Additional desc .
Permit Fee . . . . 33.00 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 7/17/06
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
TWO INTERNALLY ILLUMINATED CHANNEL
LETTER SIGNS PER SA -#06-951
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
LQPERMIT
Bin #
City of La Quinta
Building & Safety Division
P.O. Box. 15044 78-495 Calle Tampico
La Quinta, CA'92253 -.(760) 777-.7012
Building Permit Application and TrackinLy Sheet
APPLICANT: DO I
Recd
Plan Check subn
Reviewed, ready
Called Contact I
Plans. picked up
Plans resubmitte
2°' Review, read:
Called Contact P
Plans picked up
Plans resubmitte
3" Review, ready
Called Contact P
Date of permit is:
Permit #
Address:
Project Address:*..
q
A. P. Number:
'
Legal Description:
Contractor: _12
Construction Type:
Address: —
Project type (circle one): New Add'n Alter Repair Demo
city, ST, Zip:
Sq. Ft.: Stories: # Units:
LCA
Estimated Value of Project: �-
Telephone:
TRACM NG .
State Lit. #
pitted
Item
Arch., Engr., Designer:G
for corrections
Plan Check Deposit
c
erson
Address:
Plan Check Balance
City, ST, Zip:
Construction
Telephone:
I
State Lic. #:
for corrections/issue
Name of Contact Person:
Electrical
Telephone # of Contact Person:
#
Submittal
Re,
Plan Sets
1
Grading
Structural Calcs.
for corrections/issue
Developer Impact Fee
Truss Calcs.
,rson
A.I.P.P.
Energy Calcs.
ue
------------
.
Flood plain plan
Total Permit Fees
Grading, plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE:-
OUSE:Planning
PlanningApproval
Pub. Wks. Appr
School Fees
City of La Quinta
Building & Safety Division
P.O. Box. 15044 78-495 Calle Tampico
La Quinta, CA'92253 -.(760) 777-.7012
Building Permit Application and TrackinLy Sheet
APPLICANT: DO I
Recd
Plan Check subn
Reviewed, ready
Called Contact I
Plans. picked up
Plans resubmitte
2°' Review, read:
Called Contact P
Plans picked up
Plans resubmitte
3" Review, ready
Called Contact P
Date of permit is:
Owner's Name:
Address:
City, ST, Zip:
Telephone:
'
Project Description:
Y—,(A I
Construction Type:
Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: Stories: # Units:
Estimated Value of Project: �-
JOT WRITE -BELOW THIS UNE
TRACM NG .
PERMIT FEES
pitted
Item
Amount
for corrections
Plan Check Deposit
erson
Plan Check Balance
Construction
I
Mechanical
for corrections/issue
Electrical
erson
Plumbing
1
Grading
for corrections/issue
Developer Impact Fee
,rson
A.I.P.P.
ue
------------
Total Permit Fees
B CERTIFICATE OF COMPLIANCE (Part 1 of 2) OLTG-1-C
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 document Ion is ac to and complete.
DOCUMENTATION AUTHOR SIGNAT DATE
James N. Engle, Jr.. 01-09-06
The Principal Lighting Designer hereby certifies that thepropos outdoo lighting and signs design represented in this set of constriction documents is
consistent with the other compliance forms and worksheets, with trile specIfications, and with any other calculations submitted with this permit application.
The proposed building has been designed to meet the lighting req erne s 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.
L_'1 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 1 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 pursuness and Professions Code Sections 5537,5538 and 6737.1.
hese sections of the Business and Profession 7d.ar:eZted in full in the Nonresidential Manual.
PRINCIPAL LIGHTING DESIGNER -NAME SIGNAIn DATE I LIC. #
James N. Engle, Jr. (11, 01-09-06 207136
.
INSTRUCTIONS TO APPLICANT OUTDOOR LIGHTING CO C & WORKSHEETS (✓ box if worksheet is included)
For detailed instructions on the use of this and al/ Energy kfitiency Standards compliance forms, please refer to the Nonresidential
Manyal ublished 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 incorporated in
schedules on the plans.
Either LTG -1-C or OLTGA-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-I-C if the project consists solely of outdoor signs
4. Use OLTG-I-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 March 2005
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CERTIFICATE OF COMPLIANCE ----.----(Part 2 of 2) OLTG-1-C
PROJECT NAME
123 Fit
Lighting Schedules on Plans Show that Outdoor Li2htinq Meets Allowed Lighting Power
❑ Lighting power allowances for general site illumination on OLTG-2-C Part 1 of 4
ErNot Applicable
❑ Lighting power allowances for local ordinances or for security multipliers on OLTG-2-C Part 2 of 4
l=1 Not Applicable •
❑ Lighting power allowances for specific applications, other than vehicle service stations with canopies on OLTG-2-C Part 3 of 4
Not Applicable
❑ Lighting power allowances for vehicle service station canopies on OLTG-2-C Part 4 of 4
ffNot Applicable
Sign lighting compliance on OLTG-4-C
❑ Not Applicable
Mandatory Measures on Plans Show that Outdoor Lighting Meets Outdoor Lighting Controls and Equipment
Indicate location on plans of Note Block for Mandatory Measure
r❑ Installed lighting power has been determined in accordance with § 130(c)l
t� Not Applicable
❑ All permanently installed luminaires with lamps rated over 100 watts either have a lamp efficacy of at least 60 lumens per watt or are
controlled by a motion sensor § 132(a)
Not Applicable
❑ All Luminaires with lamps rated greater than 175 watts in hardscape areas, including parking lots, building entrances, canopies, and all
out or or sales areas meet the Cutoff Requirements of § 132(b)
IJ Not Applicable
All permanently installed outdoor lighting meets the Control Requirements of § 132(c)l
❑ Not Applicable
7❑ BB ' ing facades, parking lots, garages, canopies, and outdoor sales areas meet the Multi -Level Lighting Requirements of § 132(c)2
L`s Not Applicable
MANDATORY AUTOMATIC CONTROLS
CONTROL LOCATION CONTROL CONTROL TYPE AREA CONTROLLED NOTE TO
IDENTIFICATION Auto Time Switch/Photosensor, etc FIELD
nterior a
INT—T101
Time Switch
Entire Sign
behind sign
2005 Nonresidential Compliance Forms March 2005