07-1363 (ELEC)"-P.O. BOX 1504
X78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
07-00001363
Property Address:
50777 SANTA ROSA'PLAZA.
APN:
770-020-031-6 -000000-
Application description:
ELECTRICAL
Property Zoning;
GOLF COURSE
Application valuation:
35000
Applicant: Architect or Engineer:
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
_ .UCENSEDCONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencingw_ ith
Section 7000) of Division 3 of the Business and -Professionals Code, and rny'Licerise is.in,full(force' and effect.
License Class: C45 9� / License No.: %795630`"
Date. ontractor: �}i'Ad lel
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractoi'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 provisionsof the Contract'or's State -
.License Law (Chapter 9 (commencing with Section-7000).of Division 3 of the Business and Professions Code) or
.thathe.or she isexempt 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 dojjars ($500).:
(_ I 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 hot apply to an owner of property.who'ouilds 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 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:
V It
LQPER1111T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/16/07
Owner:
SANTA ROSA PLAZA
7902 S. DEPEW STE 120 D
LITTLETON, CO 80121 6
Contractor:
MAY 161007
BRADLEY SIGN ADVERTIS G
9450 7TH STREET, STE C�OFLA.QVI�TA
RANCHO CUCAMONGA, CA 91730 FIMq CE®EPt
(909)048-7232
Lit. No.: 795630
WORKER'S. COMPENSATION DECLARATION
Lhereby affirm under penalty of perjury oneofthe; 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 ofthe .work for which this permit is issued. My workers' compensation
insurance carrier and policy. number are:
Carrier STATE FUND Policy Number 15781542007
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.
�te�
NING: F flE TOSECURE WORKER ACOMPENSATION COVERAGE IS UNLAWFUL,'AND SHALL
SUBJECT AN EMPLOYER TO'CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (S100,000). IN ADDITION TO 7HE 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 dateof issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have rea this appticati and state that the above information is correct. I agree to comply with all
.city and county ord antes and st Taws relating to building construction, and hereby authorize representatives
of this county / mer upon t above-mentioned property
yffor
inins.,pee/c//tion purposes.
Date: ! �J ' ature (Applicant or Agentl: ��
Application Number . . . . . 07-00001363
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . . .90.00 Plan Check
Fee
22.50
Issue Date . . . . Valuation
. . .
. 0
Expiration Date . . 11/12/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
5.00 15.0000 EA ELEC SIGN 1ST CIRCUIT
75.00
------------------------------------------------------------
Special Notes and Comments
-----------------
INSTALL 5 ELECTRIC SIGNS (3 ON EXISTING
MONUMENTS AND 2 ON EXISTING WALLS, PER
APPROVED SA #2007-1122, AND APPROVED
ENERGY CALLS.
Fee summary Charged Paid' Credited
-----------------
Due
------------------------------
Permit Fee Total 90.00 .00
----------
.00
90.00
Plan Check Total 22.50 .00
.00
22.50
Grand Total 112.50 .00
.00
112.50
LQPERMIT
This Certificate of Compliand6 lists outdoor light irig �syste m
This certificate applies only to buildin 1 - I spkificatjbnsi
glighting reqbi rements.
H:�;eby certifies that
the, docum nt ' i$ p-
d:*
Princifial.Lighting Designer hereby certifi6s-.t the proposed outdoor lighting and signs design represented in this set of cons tructio(documents
c-nsistent with the other compliance forms: el (works he ets, with the specifications, and with any other calcul6tions'submitted with this permit
;mcalion. The proposed building has been de'sig6ed to'm'ee't the lighting requirements contained in the applicableparts ,
Q2. 146, and 149 of Title 24, Part 6. F�Iea"Se v' one: of Sections 110, 119,130
I hefeby affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code to sigh this, document as the person
resp�iisible for its preparation; and thaQ.,am, licensed in the -State of California as a civil engineer or electrical engineer, or I am a licensed
I affirm that 13m eligible under the provisioiis of Division 3 of the -Business and Professions Code by section 5537.2 or 6737.3 to sign this
document as ne person responsible to;* its preparation; and that I 'am a licensed contractor performing this work.
affirm that :im eligible under the proYisi?ns:bf 94
!sion 3 of the�80�uslgss and Professions Code to sign this document because it pertains to a
xemp, p B
structure or type of work described as e It ail! to t si fessions Code Sections 5537,5538 and 6737.1.
Bu I
(These sections of the Rimina—
FR;NCIPAL LIGHTING E:
INSTRUCTIONS TO APPLICANT
ZIA
OfidkTINeCdM_P'LIA'NCE`
&,WORKSHEI
(✓'bok: If worksheet is in'-cl-u'd-ed)
For detailed instructions on the use of
........ !*.. o_thisbhdall, Energy Effciency fojms please"refer
to the Nonresidential.
;:....; published by the California Enery�CorJ7lssidn.
-] - G Certificate of -Co 'plans for all
J OL I -1-C mpliance. Required on
submittals for outdoor lighting. -Part 2 of 2 may be
------ — incorporated in schedules on,the plans, . . I . ,
Either LTG-1-CorLTG -1'_trpay 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 prqj6clt consists of indoor lighting, and outdoor or indoor s
3. Use OLTG-1-C if th e p,6ject I consists sole I - y I of outdoor signs igns, but no other outdoor lighting,
4. Use OLTG-1-C if the,project consists outdbor lighting, and indoor or 'but no other indoor
S outdoor sidni,
lighting
-LIGHTING COMPLIANCE SUM—MARY. Applicable Parts required for ALLoutdoor lighting allowances (Except for
Signs)
COJG-3-C I AREA CALCULATIONS-,'WO-RKSHEETS.,Appli'
cable parts required -for all outdoor area calculations.
_)LTG_4 __r, SIGN LIGHTING COMPLIANCE. -Required - internally and externally E. -Required for all*intllI � * , inated signs; for both incloor.ancl -
...... .. outdoor signs. .1.
,
Nonresidential Compliance Forms.
April 2005
RTIFICATE OF COMPLBANCEP
(Part2 of.2) OLTG-1-C
n Sc..hedules on Plans Show that Outdoor-Light'In'g.Meets Allowed Li titin ;Power
;r'.ing power allowances for general site illumination on OLTG-2-C Part 1 of 4
t Applicable
;hting.power-allowances for local ordinances or;for security multipliers"on OLTG-2 C Part 2 of 4:-
P
)I Applicable
Pling power allowances for specific applications, other than vehicle service stations with canopies on OLTG 2-C Part 3 of 4.•'
XApplicabie
31"ing power allowances for vehicle service station canopies on OLTG-2-C Part 4 of 4
)I Applicable
gn lighting compliance on OLTG-4-C "'4S
of Applicable
iatory Measures on Plans Sh 11
a location on plans of Note Block•for that'0utdoor Lighting'�M"eets Outdoor -Lighting ting:Controls and Equipment
Mandato .Measure
stalled lighting power has been determined in accordance with § 130(c)1
'N Applicable
!I permanently installed luminaires with lamps rated over.100 w
)fled by a motion sensor § 132(a)..pits either have.a. lamp effcacy"of'aG least60 lumens per watt or are
rot Applicable 3A
!I Luminaires with lamps rated greater.th'an 175 watts in hardscape areas, includin
-door sales ar eas meet the Cutoff Requir.'ements of. § 132(b) 9 parking lots, building entrances, canopies, and
Applicablr
!I permanern, installed outdoor lighting rneets the Control Requirements of § 132(c)1
Jot Applicabre
.,ilding facades, parking lots, garages; canopies,'and outdoor sales areas meet the Multi -Level Li htih Requirements of 132(c)2
Applicable,
9 9 q §'
:N DATORY AUTOMATIC CONTRpLS
: DNi ROL LOCATION -CONTROL,
--- IDENTIFICATION CONTROL' TYPE AREA CONTROLLED " NOTE TO
Auto Time°Switch%Photosensor; etc7
KlIV1�� �-1:F� Pi �r—i.nr� _ _ _ FIELD
F' For Allc: 'c' q I I I I
J LPD use 12 watts/square uare foot for Internally Illuminated Signs, and us 2:3, watts/ft for Externally Illuminated Signs.
+Le nauy Muminaiea or Extemally Illuminated sign contains light sources and ballasts other than those included in columns (M) through (S), such
as incanc' int lamps, medium base sockets, magnetic ballasts, etc, then the sign must comply under Alternative 1. -However, unfiltered signs, and
unfiltered ;ions of Internally and Externally illuminated signs, are not required to meet these Standards
2005 Nonres;dFr tial Compliance Forms April 2005
C-
SIG(
_ GHTIN COMPLIANCE
r
C7LTG�-;C
PROJECT NA%1c
DATE'
Alternative 1'- Lighting Power Allowances
Alternative 2 -For Signs thatO LY'use one or more of the
technologies"listed'in.M through S
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F' For Allc: 'c' q I I I I
J LPD use 12 watts/square uare foot for Internally Illuminated Signs, and us 2:3, watts/ft for Externally Illuminated Signs.
+Le nauy Muminaiea or Extemally Illuminated sign contains light sources and ballasts other than those included in columns (M) through (S), such
as incanc' int lamps, medium base sockets, magnetic ballasts, etc, then the sign must comply under Alternative 1. -However, unfiltered signs, and
unfiltered ;ions of Internally and Externally illuminated signs, are not required to meet these Standards
2005 Nonres;dFr tial Compliance Forms April 2005