08-1763 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
08-00001763
Property Address:
79245 CORPORATE
APN:
649 -820 -017 -
Application description:
SIGN
Property Zoning:
COMMERCIAL PARK
Application valuation:
2200
T4ht 4 XP "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
CENTRE DR # 100 111 VENTURE LLC
- - 327 E 18TH ST
TENANT / ELITE HEALTH
COSTA MESA,,CA 92627
Applicant: Architect or Engineer:
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: C45 License No.: 779255
I Date:Lh 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 70001 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, 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
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:
r
LQPERMIT
Contractor:
INLAND SIGNS D
10783 BELL CT
RANCHO CUCAMONGA, C
(909)581-0699
Lic. No.: 779255 J
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
730
OCT 24 2008
CITY of �c QUINTA
_ FINA1u�+
Date: 10/23/08
------------------------------------
WORKER'S
------------------------------ 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.
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: 1,
Carrier STATE FUND Policy Number 1739710
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 becomesubs* the workers' compensation provisions of Section
�� ),, ,, 3700 of the Labor Code, I sh �k rt�hwith comply with those provisions.
DateAD/'W_P_1& 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$100,000). 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 1 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 ins es.
Date: �� Signature (Applicant or Agent): r /
Application Number . . . 08-00001763
Permit . . . ELEC-ELECTRICAL SIGN
Additional desc .
Permit Fee . . . . 30.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date 4/21/09
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 15.0000 EA ELEC SIGN
1ST CIRCUIT
15.00
----------------------------------------------------------------------------
Special Notes and Comments
(1) MOUNTED INTERNALLY - ILLUMINATED
OPAQUE CHANNEL LETTER SIGN PER SA
2008-1270 "ELITE HEALTH & WELLNESS "
Fee summary Charged Paid
---------------------------
Credited
Due
----------
Permit Fee Total 30.00
----------
.00
----------
.00
30.00
Plan Check Total .00
.00
.00
.00
Grand Total 30.00
.00
.00
30.00
LQPERMIT
I CERTIFICATE OF COMPLIANCE (Part 1 • of 2) OLTGA -SJ
PROTECT NAME
For detailed instructions on the use of this and all Energy Efficiency Standards compliance -forms, please refer to the Nonresidential
DATE
OLTG-I-C '
Certificate of Compliance. Required on plans for all submittals for outdoor. lighting. Part 2 of 2. may be
PROJECT ADDRE
:...... . . ....
1. Use LTG -1-C if the project consists solely of indoor signs
PRI IPAL SIG -LI(41TING
TELEPHONE
9uildifid Permit
MENTTIO OR
HONE
_................:... _ _ ....
EFifoFceinerit;Ag eRcy;Use;
GENERAL INFO ON
❑ OLTG-2-C
LIGHTING COMPLIANCE SUMMARY. Applicable Parts required for ALL outdoor lighting allowances (Except for
DATE OK PLANS
OUTDOOR LIGHTING ZONE (✓ One) ❑ LZt. ❑ LZ2
❑ LZ3 ❑ L7-4
FUNCTION TYPE
❑ OUTDOOR LIGHTING OUTDOOR SIGNS
❑ INDOOR SIGNS
PHASE OF CONSTRUCTION
NEW CONSTRUCTION ❑ ADDITIONS
❑ ALTERATIONS
'STATEAAENT OF COMPLIANCE
rrns 1 erancare or r.ompliance lists outdoor lighting system specifications need to comply with Title 24, Parts 4 and 6 of the California Code of
Regulations. This certificate applies only to building fightingrequirements.
and complete.
The Principal Lighting Designer hereby certifies that the proposed outdoor lighting and signs design represented in this set of construction documents
is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with this permit
application. The proposed building has been designed to meet the righting requirements containedin 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
11"
0 I affirm that'l 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 I -am a licensed contractor performing this work.
❑ 1 affirm that 1 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 pursu.ant.to Business and Professions Code Sections 5537,5538 and 6737.1.
INSTRUCTIONS—To—APPLICANT OUTDOOR LIGHTING COMPLIANCE & WORKSHEETS"(" box H worksheet is Included)
For detailed instructions on the use of this and all Energy Efficiency Standards compliance -forms, please refer to the Nonresidential
Manual published 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-1-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.
dOLTG� C
SIGN LIGHTING G.OMPLIANCE. Required'.for allintemally and external illuminated, signs, for•both indoor and
"nS':-
outdoor•si
2005. Nonresidential Compliance Forms April 2005
CERTIFICATE OF COMPLIANCE (Part 2 of 2). OUG=1-C
PROJECT NAME .
Lighting htin Schedules on Plans Show that Outdoor Lighting Meets Allowed Lighting Power
❑ Lighting power allowances for general site illumination on O_ LTG -2-C Part 1 of 4
❑ Not Applicable
❑ Lighting power allowances for local ordinances or for security multipliers on OLTG-2-C Part 2 of 4
❑ 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
❑ No Applicable
Sign lighfing compliance on 0LTG-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
❑ Installed lighting power has been determined in accordance with § 130(c)1
❑ 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)
LZ Not Applicable
❑ All Luminaires with lamps rated greater than 175watts in hardscape areas, including parking lots; building entrances, canopies, and
all outdoor sales areas meet the Cutoff Requirements of § 132(b)
Not Applicable
(; All permanently installed outdoor lighting meets the Control Requirements of § 132(c)1
❑ Not Applicable
❑ Building facades, parking lots, garages, canopies, and outdoor sales areas meet the Multi -Level Lighting Requirements of § 132(c)2
Not.Applicable
MANDATORY AOTOMATIC CONTROLS
CONTROL -LOCATION
CONTROL
IDENTIFICATION
CONTROL TYPE
Auto Time SwltchlPhotosensor, etc
AREA CONTROLLED NOTE. TO,
FIELD
2005 Nonresidential Compliance Forms April 2005
SIGN LIGHTING COMPLIANCE . OLTG-4-C
PROJECT NAME
DATE
•
Alternative 1 — Lighting Power Allowances
Alternative 2 — For Signs that ONLY use one or more of the
technologies listed In M"through S
Check all that ap IV.)
A
B
C
D E F O
H I J
K L
M
N
O
P
Q
R
S
co
3
0
f7
°a
fD
o
cn
�'
Description or
Location
Allotted Watts
Larnp ./
Ballast '
Design
Watts
chi
d
°1�
m m
0 3•
CD C)
i1
sni
a
!D
3
`c
? 4
m
v� CD
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N C
moi
3 S1
-�
fil
3
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Vl (D �O
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. 7
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=';
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C�r Wd
F For Allotted LPD use 12 watts/square foot for Internally Illuminated Signs, and us 2.3 watts/ft for Externally Illuminated Signs.
Note: If an Internally Illuminated or Externally Illuminated sign contains light sources and ballasts other than those included in columns (M) through (S), such
as incandescent lamps, medium base sockets; magnetic ballasts, etc, then the sign must comply under Alternative 1. However, unfiltered signs, and
unfiltered Portions of Internal) and External) illuminated si ns are not re wired to meet these Standards.
2005 Nonresidential Compliance Forms Apol 2005
" Bin #
Permit # A! 010
Project Address:
A. P. Number:
Legal Description:
Contractor:
Address:
City, ST, Zip:
State Lic. # : -j'1C 2-55
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Teleahone # of Contact Person:
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name: U
Address:
City, ST, Zip:Ila QiUlpar.
I
Telephone: h LPO
Project Description: O
z
Lic. #:
Construction Type: IV46A(- . Occupancy:
Project type (circle one) Ne Add'n Alter Repair Demo
Sq. Ft.:# Stories: :� # Units:
,31 01
co
Estimated Value of Project: Zpp
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
i
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:-
''" Review, 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
O
r
!Y
Q
V
C�
Z
I—
Ln
X
W
CITY OF LA QUINTA
BUILDING & 3AFM DEPT.
APPROVED
DAYS 3/12 O 13Y ACCESSIBLE PATH
OF TRAVEL
79-245 CORPORATE CENTRE DRIVE
LA QUINTA, CALIFORNIA