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BSIG2015-00037£-495 CALLE TAMPICO - LA Q�1NTA, CALIFORNIA Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BSIG2015-0003 46480 WASHINGTON ST -2 & 3 643020068 TWO CHANNEL LETTER SIGNS $8,000.00 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS ('760) 777-7153 Owner: GERRY WASHACK ' 75130 MEDITERRA AVE PALM DESERT, CA Date: 1/21/2015 ', JAN 2 1 2015 Applicant: Contractor: SIGNARAMA SIGNARAMA CITY OF LA QUINTA COMMUNITY DEVELOPMENT DEPARTMENT OUTSIDE CITY LIMITS OUTSIDE CITY LIMITS LA QUINTA, CA 92253 LA QUINTA, CA 92253 (760)776-9910 LIc. No.: :LIC -0004466 ----------------------------------------------------------------------------- ----------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter' I hereby affirm under penalty of perjury one of the following declarations: 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, I have and will maintain a certificate of consent to self -insure for workers' and my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance License Clas : License No.: :LIC -0004466 of the work for which this permit is issued. _ I have and will maintain workers' compensation insurance, as required by Cghtractor: } 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: OWNER -BUILDER DECLARATION Carrier: _ Policy Number: _ I hereby affirm under penalty of perjury that I am exempt from the Contractor's State I certify that in the performance of the work for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree that, if I should become subject to the any structure, prior to its issuance, also requires the applicant for the permit to file a workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith 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 3of the Business and Professions Code) or that he or she is exempt therefrom and the Appli nt:basis EEKE for the alleged exemption. Any violation of Section 7031.5 by any applicant for apermit subjects the applicant to a civil penalty of not more than five hundred dollars WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO (_) 1, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to within one year of completion; the owner -builder will have the burden of proving that the conditions and restrictions set forth on this application. he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose (_) I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued as a result of this application , the owner, and the applicant, each agrees to, and State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or the Contractors' State License Law.). following issuance of this permit. (_) I am exempt under Sec. B.&P.C. for this reason 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. 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: 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 city to enter upon the above• mentioned propert for inspection purposes. Da Signature Applicant or Agent): DESCRIPTION FINANCIAL INFORMATION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 1/21/15 PAID BY METHOD RECEIPT# CHECK# CLTD BY SIGNARAMA CHECK R3456 3638 MFA Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/AWNING SIGN, EA ADDITIONAL 101-0000-42404 0 $24.66 $24.66 1/21/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY SIGNARAMA CHECK R3456 3638 MFA DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/AWNING SIGN, EA ADDITIONAL PC 101-0000-42600 0 $24.66 $24.66 1/21/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY SIGNARAMA CHECK R3456 3638 MFA DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/AWNING SIGN, FIRST 101-0000-42404 0 $24.66 $24.66 1/21/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY SIGNARAMA CHECK R3456 3638 MFA DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/AWNING SIGN, FIRST PC 101-0000-42600 0 $87.02 $87.02 1/21/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY SIGNARAMA CHECK R3456 3638 MFA Total Paid forSIGN: $161.00 $161.00 00 $162.00 Description: TWO CHANNEL LETTER SIGNS Process Summary Type: SIGN Subtype: Status: APPROVED Applied: 1/21/2015 MFA Parcel No: 643020068 Site Address: 46480 WASHINGTON ST 2 & 3 LA QUINTA,CA 92253 Approved: 1/21/2015 MFA r Subdivision: TR 32683 Block: Lot: 2 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $8,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 (Details: (2) CHANNEL LETTER LED SIGNS [NEXT LEVEL FITNESS] SIGN PERMIT NO. 2015-0003 MF] 2010 ENERGY, 2013 CALIFORNIA BUILDING CODES. _ j Applied to Approved DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 1/21/15 1 R3456 3638 CHECK SIGNARAMA MFA Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: Printed: Wednesday, January 21, 2015 4:43:34 PM 1 of 2 CLTD DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT# CHECK# METHOD PAID BY BY WALL/AWNING SIGN, 101-0000-42404 0 $24.66 $24.66 1/21/15 R3456 3638 CHECK SIGNARAMA MFA EA ADDITIONAL WALL/AWNING SIGN, 101-0000-42600 0 $24.66 $24.66 1/21/15 R3456 3638 CHECK SIGNARAMA MFA EA ADDITIONAL PC WALL/AWNING SIGN, 101-0000-42404 0 $24.66 $24.66 1/21/15 R3456 3638 CHECK SIGNARAMA MFA FIRST WALL/AWNING SIGN, 101-0000-42600 0 $87.02 $87.02 1/21/15 R3456 3638 CHECK SIGNARAMA MFA FIRST PC Total Paid forSIGN: $161.00 $161.00 TOTALS:0i $162.00 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE FINAL" ATTACHMENTS Printed: Wednesday, January 21, 2015 4:43:34 PM 2 of 2lsrs7�ti,s IC4 CD omme rna�r- N i z m X n o oC� co 0 �° � a n XD� N CD Ncn 1- A j 5 ��r c Z I 00 ag O c Z O o/ J CD C n n co q o 0 O 2mmoZ0 rn =M;D0C) Zonmya c�m<� m,� Armr-mm °���n� � rri <o�z��m -0 co m rioC) -n DO 0 r— C rI� Zl Cl nno�m¢ c) ::; � un n V -{C O Ar-Zz� �nC)�-0Z C') L 3 O 5 CD N. 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Lighting Power O Alternate UgfiNng Sources Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete. Namc S SE Signature 1 Company Date Arz PT Address I f applicable: 4 S S�opo'AQ w pt"z- So I iE i.._ CEA W CEPS � Citylstatelzip ppr izse otr C A Phone: o - 11<0- O Principal Lighting Designer's Declaration Statement • 1 am eligible under Division 3 of the Califomia Business and Professions Code to accept responsibility for the lighting design. i • This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with Title 24, Pages I 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, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Name:S Signature Company: SI t�j Or (z PCr,4 0�- Phone - 444g - 99 o Addr ss:1 License 9 O 3 City/state2ip: Dau Wtk Sign Mandatory Measures Indicate location on building plans of Mandatory Sign Measures Note Block: Mandatory Sign Lighting Controls Yes No All signs with permanently connected lighting are controlled with an automatic time switch control that complies with the applicable requirements of § 119. P(O §133(s)2. All outdoor signs are controlled with a photo control or outdoor astronomical time switch control. O 2 Exception to §133(x)2. Outdoor signs are in tunnels or large covered areas that require illumination during O daylight hours. §133(x)3. All outdoor signs arc controlled with a dimmer that provides the ability to automatically reduce O si power b a minimum of 65 percent duringnighttime hours. Exception Ito §133(a)3. Signs are illuminated for less than one hour per day during daylight hours. ! ;k O 3 Exception 2 to §133(s)3. Outdoor signs are in tunnels or large covered areas that require illumination durin da li t hours. O Exception 3 to §133(a)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps arc used to O k,{ illuminated signs or emu of signs. § 133(s)d. 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 whin Y N N/A 4 rtecivinst a demand response siltrial that is sent out b • the local utility. 1 O O Exception to §133(a)4. The EMC is required by a health or life safety statue, ordinance, or regulation,! Y N N/ including but not limited to exit signs and traffic signs. O O t 2008 Nonresidential Compliance forms I August 2009 2 Maximum Allowed URhtine Power Method of Compliance Certificate of Compliance and Field Inspection Energy Checklist Complete this part if there are signs using the maximum allowed lighting power method of compliance. (Complete part 3 of this Certificate of Compliance if there are signs using the Specific lighting sources method of compliance) A B C D E F G H I 1 Symbol Description of the Sign OPTIONAL — Energy Verified Label (see Allotted Watts Design Watts Complies Y/N Filed Inspector Check that sign Or Code Instructions below) complies I Q a C X33 "ax o C 0o d °r' — o rn LU o o a 3: 3 CL E Q f' u Vol �C IAC' a ❑ �,� ,7 -�? z.N 7-0❑ N�� . ' 62.1 q ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ A Symbol or code used on the plans (when plans are required) and other documents. B A description of the sign, or location of sign on the building; and the location of sign on construction documents. OPTIONAL - Check this box only if this sign has a permanent, pre-printed, factory -Installed, ENERGY VERIFIED label, confirming that the sign complies with the Section 140.8 of the California 2013 Title 24, Part 6 Standards, using the Maximum Allowed Lighting Power method of compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories (UL) or other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards C Institute In accordance with ISO/IEC 17011. Surveillance by the Accredited Certification Body shall be an ongoing annual inspection program carried out by a Type A Inspection body In accordance with ISO/IEC 17020. For signs with such an ENERGY VERIFIED label, columns 'D' through'I' are not required to be filled out. Note: Using an ENERGY VERIFIED label is an optional method to validate compliance. An ENERGY VERIFIED label is not needed for compliance. D The sign area insquare feet. E Ust "I" if the sign is internally illuminated. List "E" if the sign is externally illuminated. F Allowed watts per square foot. Enter 12 if the sign is listed as "1" in column E. Enter 2.3 if sign is listed as "E" in column E. G Multiply the square footage in column D times the allowed Lighting Power Density (LPD = watts) in column F. H Show the total installed watts In the sign, as determined according to the applicable provisions of §130(c). I Enter Y If the number in column H is less than orequal to the number in column G. Otherwise, the sign does not comply. i This page doubles as a field inspection checklist. Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 3. Specific Lightintt Source Method of Compliance Certificaie of Compliance and Field Inspection Energy Checklist ' Complete this part if there are signs using the Specific lighting source method of compliance. (Complete part 2 of this Certificate of Compliance if there are signs using the maximum allowed lighting power method of compliance) A B C D E OPTIONAL Specific light source used for Symbol ENERGY VERIFIED compliance Field Inspector or Description label Shall include only lighting Check that Sign Code (see instructions technologies listed below Complies L1-1 a N S, 7',:) CN��1 vu S below) Last all that apply ❑ o ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ A Symbol or code used on the plans (when plans are required) and other documents. B A narrative description of the sign, or location of sign on the building; and the location of sign on construction documents C OPTIONAL - Check this box only if this sign has a permanent, pre-printed, factory -installed ENERGY VERIFIED label, confirming that this sign complies with the Section 140.8 of, the California 2013 Title 24, Part 6 Standards, using the Specific Lighting Source Method of Compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories (UL) or other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards Institute in accordance with ISO/IEC 17011. Surveillance by the Accredited Certification Body shall be an ongoing annual inspection program carried out by a Type A Inspection body in accordance with ISO/IEC 17020. For signs with such an ENERGY VERIFIED label, column 'D' Is not required to be filled out. Note: Using an ENERGY VERIFIED label is an optional method to validate compliance. An ENERGY VERIFIED label is not needed for compliance. Specific Ught Source Compliance Method. The sign(s) Identified above use only the following lighting technologies: List all applicable numbers 1 through 9) that apply In column 0 above for each row. 1 High pressure sodium lamps Metal halide lamps that are pulse start or ceramic served by a ballast that has a minimum efficiency of 88 percent or 2 greater. Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage when tested according to ANSI C82.6-2005. Metal halide lamps that are pulse start that are 320 watts or smaller, are not 250 watt or 175 watt lamps, and are served by a ballast that has a minimum efficiency of 80 percent. 3 Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage when tested according to ANSI C82.6-2005. Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 75 percent D 4 when the transformer or power supply rated output current is less than 50 mA. The ratio of the output wattage to the input wattage is at 100 percent tubing load. Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 68 percent S when the transformer or power supply rated output current is 50 mA or greater. The ratio of the output wattage to the input wattage is at 100 percent tubing load. 6 Fluorescent lighting systems meeting one of the following requirements: A. Use only lamps with a minimum color rendering Index (CRI) of 80; or B. Use only electronic ballasts with a fundamental output frequency not less than 20 kHz. 7 Light emitting diodes (LEDs) with a power supply having an efficiency of 80 percent or greater; Single voltage external power supplies that are designed to convert 120 volt AC input into lower voltage DC or AC output, and have a 8 nameplate output power less than or equal to 250 watts, shall comply with the applicable requirements of the Appliance Efficiency Regulations(Title 20). 9 Compact fluorescent lamps that do not contain a medium screw base sockets (E24/E26). E This page doubles as a field Inspection checklist. Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance lune 2014 DOCUM-ZNTATION AUTHOR'S DECLARATION STATEMENT : 1. t certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signatur t..►._ S Company: !P VA—*^AV'!`4r Signature Date: � Address: � l9�{S f3olr�pv.1 SufT� CEA/ HERS Certification ldentification (if a plica e): City/State/Zip: PA,,,,DESc`r2T CA. ZZ (1 Phone: 66 -?)(a - 2201 RESPONSIBLE PERSON'S DECLARATION STATEMENT - I certify the following under penalty of perjury, under the laws of the State of California: 1. The Information provided on this Certificate of Compliance is true and correct. 2. I am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. S. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy, Responsible Designer Name: Responstbte Designer signature: Company: tj A'.Ir '� Date signed: Q 11-7, Address: �' 9 Y�- 13 G A AA K license: # Gty/state/Zip: PA L^ i�ESE2T era ZZ(I phone; 1c00- 1419 6 - q 9 o June 2014 r Project Address: i?,�(�i v -c. �- r► ►tet Ss Location of`Sign s �2r OutdSig s O Indoor Signs Phase of Sign Construction fZNew Signs O Sign Alterations T of Li htin Control ro EI New Lighting Controls O Re laced LI htin Controls O Not Insta O This Certificate of Compliance includes the following components (check all that apply) Mandatory Measures (Lighting Controls) O Maximum Allowed Lighting Power O Specific Lighting Sources Controls 1. Mandatory Sign Lighting Controls NOTES: 1. The some responsible person may install both the sign lighting power and the sign lighting controls, or a different responsible person may install the sign lighting controls than the responsible person installing the sign lighting power. Measures (sign lighting controls) ore required for-complionce with the sign lighting Stondords. if the person 2. The Mandatory responsible for installing the sign lighting power is not also responsible for the sign lighting controls, then the owner of the sign, general contractor, or architectsholl be responsible to hove the sign lighting controls installed. responsible person shall prepare and sign o Certificate of 3. if. more than one person has responsibility for compliance, each Compliance and on Installation Certificate applicable to the portion of construction for which they ore responsible; alternatively, the person with chief responsibility for construction shall prepare and sign the Certificate of Compliance Declaration Statement 1a. or the entire construction. Statements of Responsibility: Any person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS Ol E shall complete Part la. Check Yes or No for all of the following statements: 1 have responsibility for installing the sign lighting controls-. 1 (Ayes, complete parts la and ib of this form O No, complete part'la of this form There are no existing sign lighting controls and 1 will be installing compliant sign lighting controls 2 Yes O No There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls 3 Yes O No There are existing sign lighting controls that do not comply with the applicable provision of §110.9 and §130.3 and I will be 4 installing compliant sign lighting controls O Yes AN6 There are existing sign lighting controls that do not.comply with the applicable provision of §110.9 and §130.3 and someone 5 else will be responsible to install compliant sign lighting controls No Oyes � - June 2014 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance lune 2014 . Mandatory Slgn Ligfiting Controls Statement on this NRCC-LTS-01-E is responsible for complying with If the person signing the Certificate of Compliance Declaration the sign lighting control requirements, that person shall answer all of the following questions: If there are construction documents, indicate where on the building plans the mandatory measures (sign lighting control) note block can be located: §13O3(a)l. All indoor sign lighting is controlled with an automatic time -switch control or astronomical time- YY NNNOA switch control. §13O3(a)2A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time- Y N NA switch control, or an astronomical time -switch control 0 0 2 EXCEPTION to Section 130.3(a)2A: Outdoor signs in tunnels, and signs in targe permanently covered outdoor Y NA areas that are intended to be continuously lit, 24 hours per day and 365 days per year. 0 §13O3(a)28. All outdoor sign lighting that is ON both day and night is controlled with a dimmer that provides the ability to automatically reduce sign lighting power by a minimum of 65.percent during nighttime hours. be ON both Y N O NA Signs that are illuminated at night and for more than 1 hour during daylight hours shall considered 3 day and night. EXCEPTION to Section 130.3(a)28: Outdoor signs in tunnels and large covered areas that are intended to be Y NA illuminated both day and night. 0 §130.3(a)3. Demand Responsive Electronic Message Center Control. An Electronic Message Center (EMC) y N N/A having a new connected lighting power load greater than 15 kW has a control installed that is capable of 0 0 4 reducing the lighting power by a minimum of 30 percent when receiving a demand response signal. EXCEPTION to Section 130.3(a)3: Lighting for EMCs that is not permitted by a health or life safety statute, Y NA ordinance, or regulation to be reduced by 30 percent. 0 Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance lune 2014