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11-0299 (SIGN)P:O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: D 700000299 Property Address: 79630 HIGHWAY 111 STE 103 APN: 649-020-014-1 -31143 Application description: SIGN Property Zoning: REGIONAL COMMERCIAL Application valuation: 3000 T-4bt - 4 4 Q" Applicant: Architect or Engineer: Cay' BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Cy: C10 License No.: 727552 Date: C6ntractor: -' 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 155001.: (_ 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 contractorls) 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 . 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: HIGHLAND LA QUINTA, LLC 1055 E. COLORADO BLVD. #5178 TENANT: PHO VU PASDENA, CA 91106 Contractor: QRS LIGHTING INC 81211, #2B INDIO BL INDIO, CA 92201 (760)619-6565 LiC. No.: 727552 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/24/11 D ° MAR 2 4 2011 CITY OF LA QUINTA ' FINANCE DEPT. 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 37 0 of the Lab / shall forthwith comp) with those provisions. Date: j Applicant: �// WARN NG: AILURE TO SECURE WORKERS' COMPENSATION 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 ofthis cony n to en r upon the above-mentioned prop or inspection urposes. Ss 7 � Date: J ignature )Applicant or Agent): f LQPERMIT -Application Number . . . . . 11-00000299, Permit ELEC-ELECTRICAL.SIGN Additional desc . Permit Fee . . . 33.00 Plan Check Fee .00 Issue Date . . . Valuation 0 Expiration Date .. 9/20/11 Qty Unit Charge Per Extension BASE FEE.. UIT 1.00 15.0000 EA ELEC SIGN 1ST CIRC15.00 .15.00 1.•00 3.0000 EA ELEC SIGN ADDITIONAL CIRUITS 3.00 Special Notes and Comments. TWO SETS OF INTERIOR ILLUMINATED CHANNEL LETTER SIGNS PER SP 2011-1513. "PHO VU VIETNAMESE RESTAURANT" -------------------------------------------------------------- Other Fees . . . I. . . BLDG STDS ADMIN (SB1473) -------------- 1.00 Fee summary Charged Paid Credited ----- Due ----------------- Permit Fee Total 33.00 .00 .00 33.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1..00 .00 .00 1.00 Grand Total 34.00 .00 .00 34.00 LQPERMIT Bin # City of La Quinta Building 8c Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico �\ IAI\ La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: 79 (,f, ��� v�� �© Owner's Name: A. P. Number: Address: Legal Description: G©I-4X/672 1;0Z ' City, ST, Zip: Total Permit Fees Contractor: /° C„L C, Telephone: Address: Project Description: City, ST, Zip• ,UW/4 �J� . 'O/ .-� Telephone:2� City Lie. #; State Lic. # :=72 7� 5,Z . Arch., Engr., Designer. Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: OO l> d �Z C Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. FL: !,/y( # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project,# 3 cP©O,. ceo APPLICANT: DO NOT WRITE BELOW THIS UNE N Submittal Req'd Recd TRACKMG PERMTr FEES tea° Sets Plan Check submitted Item Amount Structural Gla. Reviewed, ready for corrections Plan Check Deposit Truss Gla. Called Contact Person Plan Check Balance Tide 21 Gla Plana picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'' Review, ready for correctioas/issue Electrical Subcontactor Liat Called Contact Person Plumbing S.M.I Grading Grant Deed Plans picked up H.O.A. Approval Plans resubmitted IN HOUSE:- ''' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit bsue School Fees' Total Permit Fees T _IMyl.la�ua,s�Jaf91�F1�a1, rr �•+fir+^ » PLYWOOD BACKING 2' X 4' SNB 1 STUCCO FAFASCIA�I PH(l\/1 ICL ori,., n Jay- EAManufactuie ❑Repair THIS DESIGN IS THE PLYWOOD BACKING F ALUMINUM RETURN (.04M Oarvanr cnrnrw LrmB V /'1—PRIMARY //�TI O N PROPERTY OF ' - ELECTRICAL SOURCE fI TRN CAP ..• �JUNCTION BOX WITH •(' KING LOT PREMIER SIGN SOLUTIONS 1 DISCONNECT SWITCH ACRYLIC FACE IT IS FOR THE SOLE DISCRETION L POWER SUPPLY 021-277 VAC) LED STRIP T 18 AWG JUMPER WIRE MOUNTING BRACKET . ;; 5118' X Y LAG BOLT (deft. MIN.) �I ANY DUPLICATION ISOPROHIBITED 1 '--- CONNECTION STRIP WIPOWER LEAD 114' DRAIN HOLE BY LAW. ADDRESS: rrur�^IIA'IPNgIagNAt!`.ia�la'aaa�lftl �u+I�ue auuwmmdY+ntawr T Specifications: OAI— LIPI—OMDO c/lant Approval: Drawing No_ 2rinstallation FIService Authentic Vietnamese Restaurant PH(l\/1 ICL ori,., n Jay- EAManufactuie ❑Repair THIS DESIGN IS THE 16„ Oarvanr cnrnrw LrmB PROPERTY OF PREMIER SIGN SOLUTIONS IT IS FOR THE SOLE DISCRETION L 12071 OF THE ANY DUPLICATION ISOPROHIBITED BY LAW. ADDRESS: PRONE: FAX: EMAIL: JOB ADDRESS: O �/LJ �0 o ",.^•Av '11 m LA QUITVr , CA 92255 phovurestaurantPyahoo.com .Hca 92 Mmt.ez 02 / 02 / 1 1f—��/ Specifications: OAI— LIPI—OMDO c/lant Approval: Drawing No_ 2rinstallation FIService OVhyl OF.C.O. Laft— PH(l\/1 ICL ori,., n Jay- EAManufactuie ❑Repair ❑MI+• -;•^•I 1:1B"""' Landlord Approval: Oarvanr cnrnrw LrmB rl 951®330.0770 951.402961 O MANUFACTURE • REPAIR 01 .'-- ERVICE • 1 NSTAI_!_ATIC3N Z� o� w � APPROVED BY PLANNING DEPARTMENT w B DATE x ? 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'� ap�,'O co+ N M Certificate of Compliance and Field Ins ection Energy Checklist Sin Lighting) (Page 2 oft SLTGIC Project Name: Date: Compliance Method Maximum Allowed Lighting Power A B C D E F G H 1 J K Description or location and plan location Allowed Watts Design Watts' Complies? Y/N Light Source Field Ins ector2 '`' conua o LU c,, i a �, aka p II it ¢ G 6 � p UI �•y Vf c3 0 'O w W w ❑ ❑ D D ❑ O D ❑ ❑ ❑ ❑ o Total Sign Area: ' i 1, Design Watts = total connected lighting load installed in the sign, including power used by lamps, ballasts, transformers, power supplies, etc. 2. 1 Fail then describe on Page 2 o the Inspection Checklist Form and take appropriate action to correct. Vert buildingplans if necessa .Use additional sheets if necess The sins identified above; use only one or more of the following technologies: Oist all applicable numbers that apply in column I above 1 High pressure sodium lamps 2 Pulse start or ceramic metal halide lamps served by a ballast with >_ 88% efficiency 3 Pulse start metal halide lamps that are <_ 320 watts, are not 250 watt or 175 watt lams and are served by a ballast with >_ 80% efficiency 4 Neon or cold cathode lams with transformer or Power OPply e tcienc >_ 75% with rated output current < 50 mA 5 Neon or cold cathode lamps with trans o er or power ngWl efficiency?: 68% with rated output current?: 50 mA 6 Fluorescent lamps with a minimum color rendering index CRl of 80 7 Light emitting diodes LEDs with a ers 1 with ? 80% efficiency 8 Single voltage LED external power supplies designed to convert 120 volt AC input into lower voltage DC or AC output, having a namFplate output power less than or equal to 250 watts, and certified to the Energy Commission as com l in with the applicable requirements o the A-ppliance Efflciency Regulations the 20 9 Compocifluorescent lamps that do not contain a medium screw base sockets VIE26 10 Electronic ballasts with a undamerual ou ut a uen >_ 20 kHz Field Inspector Notes or Discrepancies 2006 Nonresidential Compliance Forms August 2009