07-2979 (SIGN)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA CALIFORNIA 92253 • BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Dater 11/19/07
Application Number:
07-00002979
Property Address:
46660 WASHINGTON ST STE 5
APN:
643-020-999-3 -30503--
3 90
Application description: •
Application
SIGN
Property Zoning:
REGIONAL- COMMERCIAL
Application valuation:
3400
Owner:
WASHINGTON 111 LTD
C/O JACK TARR
30240 RANCHO.VIEJO RD- STE. B
SAN JUAN CAPISTRANO, CA 92675
U a QContractor:
Applicant: Architect or Engineer. _ SIGN ARAMA
41945 BOARDWALK, L.. V 19 2nn
PALM�DESERT, . CA' 92211 vv1
(760)776-9907 �11yoF
Lic. No. 830.131Qulll
r--------------------------------"—
LICENSED CONTRACTOR'S DECLARATION_ -• --: WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that'l am licensed under provisions of Chapter 9 (commencing with. Ihereby affirm under penalty of perjury one of the following declarations: -
SectiJI
000) of Division 3 of the Business an �Fr�si6nal� nd.my license is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
'licen1 s: D42 - .: 830131 for by Section 3700 of the Labor Code,'for the performance of the work for which this permit is
issued.
Datehave 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 -
- /essio,ns
R -BUILDER DECLARATION - - insurance carrier and policy number are: - -
I.hereby affirm under penalty of perjury that I pt from the Contractor's State License Law for the Carrier 'WAUSAU INS I .'Policy Number WCJZ91442878017 -
following reason (Sec. 7031 .5, Business and PCode: -Any city or county that requires a permit to _ I certify that, in the performance. of the workfor. ich this permit is issued, I shall not employ any
construct; alter, improve, demolish, or repair ature, prior to its issuance, also requires the applicant for the . - - _ person in.any manner so as to bec a sub' o the workers' compensation laws of California, -
• - permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if 1 should com ub' t the work ' compensation provisions of Section
Licensee Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cod or ' _ 3700 of the Labor Code, 1 all f with those provisions.,
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 rry 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 WARNING: FAILURE TO SECURE WORKERS'- MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS IS 100,000): IN ADDITION TO T E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN ,
improvements are not intended or, offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, IN EREST, AND. ATTORNEY'S FEES.
- 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.). - APPLICANT ACKNOWLEDGEMENT '
(_ 1 1, as owner of the property, am exclusively contracting with licensed contractorsto construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for -
pursuant to the Contractors' State License Law.). - whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason 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.' -
Date: Owner:. 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
CONSTRUCTION LENDING AGENCY - permit to cancellation.. -
- I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that 1 have read this application and state that the abov infor is correct. I agree to comply with, all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating t0 building nstr and hereb representatives
' - of this county to enter upon the above-mentioned prope io S.
Lender's Name:
�Signaturree (1 ant or Agent):
Lender's Address: -
LQPERMIT .. .. .
" Application Number. 07-00002979
Permit . . . ELEC-ELECTRICAL SIGN `
' Additional desc ..
Permit Fee: . . . . 33.00.
. Plan Check Fee
.00
Issue Date"
Valuation . . .
. 0
<' Expiration Date'. 5/17/08
Qty Unit Charge Per
Extension
BASE
FEE
15.00
.1.00 15.0000 EA ELEC
SIGN 1ST CIRCUIT
15.00
1.00 3.0000 EA ELEC
SIGN ADDITIONAL CIRUITS
3.00
----------------------------------------------------------------------------
Special'Notes and Comments
INTERNALLY -ILLUMINATED CHANNEL LETTER
SIGN (2) CIRCUITS SA.2003-682
"MONTECITO MENSWEAR"
Fee summary. Charged
Paid._ Credited
Due
------ - - - - ----
Permit' Fee Total 33.00
-- ---------- - - - --- ----------
00 .00
33.00
Plan Check Total .00
.00 '- .00
.00
Grand Total 33.00
.00 .00
33.00
l
LQPERMIT
CERTIFICATE
OF COMPLIANCE
(Part 1 of 2)
OLTG-1-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.
PROJECT InE c b
1. Use LTG -1-C if the project consists solely of indoor signs
DATE
11 0
PROJECT ADDRESS
�' ia0 W
�
3. Use OLTG-1-C if the project consists solely of outdoor signs
Bwldma Permd �`.
ec e v a e . a
'"t Enfiircement Aggncy Use �;
PRINCIFq DESIGNER-LIGH NG
Ick nt
'
TELEPHONE
(1077(y R:
DOCUME ON UTHOR
TELEPHONE
GENERAL INFORMATION
OL G -4-C
SIGN LIGHTING COMPLIANCE. Required for all internally and externally illuminated signs, for both indoor and outdoor
DATE OF PLANS 111 ala
I
OUTDOOR LIGHTING ZONE (v*' One) 1:1LZ1 1:1LZ2 ❑ LZ3
❑ LZ4
FUNCTION TYPE
❑ OUTDOOR LIGHTING OUTDOOR SIGNS ' ❑ INDOOR SIGNS
PHASE OF CONSTRUCTION
❑ NEW CONSTRUCTION ❑ ADDITIONS ❑ ALTERATIONS
STATEMENT OF COMPLIANCE
This.Certificate of Compliance lists outdoor lighting system specifications need to comply with Title 24, Parts 1 and 6 of the California Code of Regulations..
.This certificate applies only to building lighting requirements.
The documentation. preparer hereby certifies that the documentation is a"aie and complete.
The Principal Lighting Desieer hereby certifies that the prcVos d outo"oor 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 lighting Tequirements contained in the applicable parts of Sections 110, 119,130 through 132, 146,
and 149 of Title 24, Part 6. Please -I' 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.
I affirm that I 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.
❑ I affirm that I 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 pursuant to Business and Professions Code Sections 5537,5538 and 6737.1.
INSTRUCTIONS TO APPLICANT OUTDOOR LIGHTING COMPLIANCE & WORKSHEETS (V box if 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 Califomia 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 OLTG-1-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-1-C if the project consists solely of outdoor signs
4. Use OLTG-I-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.
OL G -4-C
SIGN LIGHTING COMPLIANCE. Required for all internally and externally illuminated signs, for both indoor and outdoor
signs.
2005 Nonresidential Comlphance Forms March 2005
l
CERTIFICATE OF COMPLIANCE (Part 2 of 2) OLTG-1-C
PROJECT NAME
Lighting. Schedules on Plans Show that Outdoor Lighting Meets Allowed Lighting Power
❑ Lighting power allowances for general site illumination on OLTG-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
❑ Not Applicable
Sign lighting compliance on OLTG-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)l
❑ 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)
Not Applicable
El"All Luminaires with lamps rated greater than 175 watts in hardscape areas, including parking lots, building entrances, canopies, and all
outdoor sales areas meet the Cutoff. Requirements of § 132(b)
91 Not Applicable
❑ All permanently installed outdoor lighting meets the Control Requirements of § 132(c)i
N�Viof Applicable ,
❑ Building facades, parking lots, garages, canopies, and outdoor sales areas meet the Multi-Level Lighting Requirements of § 132(c)2
Not Applicable
MMEMMMMM
MANDATORY AUTOMATIC CONTROLS
CONTROL LOCATION
CONTROL
IDENTIFICATION
CONTROL TYPE
Auto Time Switch/Photosensor, etc
AREA CONTROLLED
NOTE TO
FIELD
T
2005 Nonresidential Compliance Forms
March 2005
n
J'
March 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 I
A
B
C
D E I F G
H I I J
K L
M
N
O
P
Q
R
S
c_n
cn
`c
Q
O
O
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o
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CD
p
_
.Z
O
N
Descri tion or
Location
Allotted
Watts
Lam / Ballast
Design Watts
=
-
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W .For Allotted LPD -use 12 wafts/square foot for Internally Illuminated Signs, and us 2.3 watts/ft2 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 Internally and Externally illuminated signs, are not required to meet these Standards.
2005 Nonresidential Compliance Forms Manch 2005