10-1226 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: r10-00001226
Property Address: 46520 WASHINGTON ST STE 3
APN: 643-020-058- - -
Application description: SIGN
Property Zoning: REGIONAL COMMERCIAL
Application valuation: 3200
AppIi
rnt: Architect or
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am I' ed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and f sio s de, and my License is in full force and effect.
License Class: D42 C45 se o.: 830131
Date:J!13_�Q Contractor:
OWNER/C-0,M--:1
R DECLARATION
I hereby affirm under penalty of perjury that I am exemthe Contractor's State License Law for the
following reason fSec. 7031.5, Business and Profession 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, 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. , BAP.C. forlhis 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:
LQPERA1fT
Owner:
WASHINGTON 111 LTD
PO BOX 1623
TENANT: LEGACY THAI CU
PALM DESERT, CA 92261
Contractor:
SIGNARAMA
41945 BOARDWALK,
PALM DESERT, CA 92211
(760)776-9907
Lic. No.: 830131
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/09/10
NOV 0 -5 2010
WY OF LA QUINTA
FINARCE DEPT.
-----------------------------------------------
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:
Carrier STATE FUND Policy Number 1938607
_ 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 should ome ubject th wor rs' compensation provisions of Section
3700 of the Labor Cod a thwit om y those provisions.
Date: Applicant: AIV 1/0
WARNING: FAILURE TO SECURE WORKERS' COM ENS ON COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES A CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,000). IN ADDITION TO THE COST COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, A D 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 Quima, 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, cessa n of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above rma is cor t. I ee to comply with all
city and county ordinances and state laws relating to buildin tru , and he orize representatives
of this ��nter upon the above-mentioned property spe ' purpos
Date:Signature (Applicant or Agent):
Application Number
Permit . .
Additional desc .
Permit Fee . . .
Issue Date . . .
Expiration Date .
. . . . 10-00001226
ELEC-ELECTRICAL SIGN
30.00 Plan Check Fee .
Valuation . . .
S/08/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 15.0000 EA ELEC SIGN 1ST
CIRCUIT
15.00
----------------------------------------------------------------------------
Special Notes and Comments
ONE ILLUMINATED BUILDING -SIGN APPROVED
PER SA -2010-1488. "LEGACY THAI CUISINE".
----------------------------------------------------------------------------
Other Fees .. . . . . . . . . BLDG STDS
ADMIN (SB1473)
1.00
Fee summary Charged Paid
------------------
Credited
Due
--------------------
Permit Fee Total 30.00 .00
--------------------
.00
30.00
Plan Check Total .00 .00
.00
.00
Other Fee Total 1.00 .00
.00
1.00
Grand Total 31.00 .00
.00
31.00
LQPERMIT
Certificate of Compliance
(Sign Lighting)
(Page 1 of 2) SLTG-1C
Pr
'ect Name:
e
))
Phase of Construction
❑ New Construction Cl Addition ❑ Alteration
that complies with theapplicable requirements of 119.
CEA #
ix
Function Type
Outdoor Signs ❑ Indoor Signs
Project A ess:
z
Date:
Compliance Method Used Maximum Allowed
S
design.
11 9I
Lighting Power 13Altirnate Lighting Sources
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurst and mplet
Nam
Signa
Company,
e
))
Address V
If applicable:
that complies with theapplicable requirements of 119.
CEA #
ix
CEPE #
City/S Zi
Phone:
z
_7 74?:Fd
Principal Lighting Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the lighting
design.
• 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 to document
provided
this design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the
enforcement agency for approval with this building permit licati
i
Name:
Signature
Company:
Phone
❑
Addres `
L
License
City/to ip:
n
Date
v
))
Sign Mandatory Measures
Indicate location on building plans of Mandatory Sign Measures Note Block:
Mandatory Sign Lighting Controls
Yes
No
1
§133(a)1. All signs with permanently connected lighting are controlled with an automatic time switch control❑
that complies with theapplicable requirements of 119.
§133(a)2. All outdoor signs are controlled with a photo control or outdoor astronomical time switch control.
❑
z
2
Exception to §133(a)2. Outdoor signs are in tunnels or large covered areas that require illumination during
daylight hours.
❑
§133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce
sin ower b a minimum of 65 percent duringnighttime hours.
❑
Exception 1 to §133(a)3. Signs are illuminated for less than one hour per day during daylight hours.
❑
❑
3
Exception 2 to §133(a)3. Outdoor signs are in tunnels or large covered areas that require illumination—
during da li t hours.
❑
Exception 3 to §133(a)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps are used to
illuminated signs or arts of signs.
❑
❑
§133(a)4. 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 when
Y
N
N/,9
4 1
receiving a demand response signal that is sent out by the local utility.
❑
❑
Exception to §133(a)4. The EMC is required by a health or life safety statue, ordinance, or regulation,
Y
N
N/A
including but not limited to exit signs and traffic signs.
❑
❑
el
"Vo "Urue,ruenttut uumpruanee corms August 2009
Certificate of Compliance and Field Inspection Energy Checklist (Sign Li htin age 2 of 2
SLTG-1C
Project Name:
LC—Ie-. U 12%
Date:
1 L
Compliance Method
Maximum Allowed Lighting
Power
A
B
C D E F
G
H
I
J
K
b
U
o..
0
Description or location and plan location
Allowed Watts
Design
Watts'
Complies?
Y/N
Light
Source
Field
Ins ecto?
�- �- b
Q EE
�' S w
V�
c�
aCO 3
c^N c x
¢ v v ¢ II
�,
3
°w
v 0
.14
o"
w 00
0
N
a w
7
7:1
1a
❑
O O
❑
O O
❑
O ❑
❑
❑ O
❑
O ❑
Total Sign Area:
I. Design Watts = total connected lighting load installed in the sign, including power used by lamps, ballasts, transformers, power supplies, etc.
2. If Fail then describe on Pa e 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary, Use additional sheets i necessa .
The sins identified above; use only one or more of the following technologies: list all applicable numbers that apply in column I above
I 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:5 320 watts, are not 250 watt or 175 watt lamps, and are served by a ballast with > 80% efficiency
4 Neon or cold cathode lamps with transformer or power supply efficiency > 75% with rated output current < 50 mA
5 Neon or cold cathode lamps with transformer or ower supply efficiency > 68% with rated output current 2:50 mA
6 Fluorescent lamps with a minimum color rendering index CRI of 80
7 Light emitting diodes LEDs with a ower supply 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 nameplate output power less than or equal to 250 watts, and
certified to the Energy Commission as complying with the applicable requirements of the Appliance Efficiency Regulations (Title 20
9 Com act uorescent lamps that do not contain a medium screw base sockets E24IE26
10 1 Electronic ballasts with afundamental out t re uen > 20 kHz
Field Inspector Notes or Discrepancies
2008 Nonresidential Compliance Forms August 2009
Bin #
City of La Quints
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # n
Project Address: 6530 WOLF,)-wns�bhOwner's
Name:
A. P. Number: .
Address:
Legal Description:
City, ST, Zip: LQ,DZ
Contractor:is
:.
Telephone: _ ;^Y% ;;<,<
Address:
Project Description:
City, ST, Zip:
Telephone: 7c1707
}
L�:..:::w:><ss>
City Lie. #;
State Lic. #: d 1 A
Arch., Engr., Designer:
Address:
City., ST, Zip:
one: <! ;:.::: ;;:•;;>:<> :;;.
State Lie. # •,.;::�<:><>:::<:>:r:?:>r<<«.>;s:<.»<r.•
'- ^• f <:>:"-:'::::
Name of Contact Person:C;X-1Sq.
Construction Type: e: Occupancy:
Pro'
ject type (circle one): New Add'n Alter Repair Demo
Ft: 33, 5
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: o 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god 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