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08-0503 (SIGN)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tit* 11.. 4.40" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number.08-060 00 J— Property Address: C:6-6WASHINGTON S STE 10 APN: 643-020-999-3 -3 903 - Application description: SIGN Property Zoning:. REGIONAL COMMERCIAL Application valuation: 3000 Applicant: Architect or Engineer: Owner: WASHINGTON 11 C/O JACK TARF 30240 RANCHO SAN JUAN CAPI Contractor: BLAKE SIGN CC 11661 SEABOAF STANTON, CA 5 (714)891-5682 Lio. No.: 506422 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 3/25/08. LICENSED CONTRACTOR'S DECLARATION - -WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with 1 hereby affirm under penalty of perjury one of the following declarations: �. Section 7000) of Division 3 of the Business and Professionals Code, and 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 License ass: C45 License No.:. 506422 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is - � - /Date: ntractor: .. - �! issued. I have and will maintain workers' compensation insurance, as required by Section 3700of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: . 1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1581808 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I.certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the .person in any manner so as to become subject to 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 I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3100 of the Labor I shall forthwith comply 'efri`ose 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).: b/s'/ ate: 5) / plicant: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and T__T the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 PENALTIES 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.($100,000). IN ADDITION TO THE 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, INTEREST, 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, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety fora.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, (_) I am exempt under Sec. , BAP.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 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.I. _ Lender's Name: Lender's'Address: LQPERMIT 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 I.have read this application and state that the above information is correct. I agree to comply with all �6�tyand county ordinances and ate laws relating to building construction, and hereby authorize representatives ouytonterupoeabove-mentioned proper ins echo pose 6 ignature (Applicant or. Agent): J, Application Number . . . . 08-00000503 ^ Permit . . . .. . •ELEC-ELECTRICAL SIGN Additional desc". Permit Fee .'. . . 30.00 Plan Check Fee .00 Issue Date Valuation '. 0 Expiration Date 9/21/08 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 INTERNALLY ILLUMINATED CHANNEL LETTER SIGN, PER SIGN AP # 2008-1243, "BLISS DENTISTRY" . Fee summary Charged Paid Due •"Credited Permit Fee Total 30.00 .00 00 30.00 Plan Check`Total .00, .00 .00 :00 Grand Total 30.00 .00" .00 30.00 LQPERNIIT - Bin # City of La Quinta Building g Safety Division Permitfl P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Trarkinor thppr Project Address: A. P. Number: Contractor: Address: City, ST, zip., A, 0 Telephon/O?� State Lie. # : S`04 2� City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: rName te Lic. #: of Contact Person: f� ephone # of Contact Perso . 79 R_ 9Y # Submittal Plan Sets Structural Calcs. Truss Calcs. Energy Calcs. Flood plain plan . Grading. plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees APPLICANT: DO NOI I Recd Plan Check submitte Reviewed, ready for Called Contact Perso Plans picked up Plans resubmitted 21" Review, ready for Called Contact Perso Plans picked up Plans resubmitted Review, ready for 4 Called Contact Persoi Date of permit issue Owner's Name: Address: City, ST, Zip: Telephone:. Project Description: CXI.44 fK& Gl Construction Type: Occupancy: Project tpe (circle one): New Add 'n Alter Repair Demo Sq. Ft.: # Stories:. # Units: Estimated Value of Project• (� 'WRITE BELOW THIS LINE RACHING _ PERMIT FEES' 1 Item Amount orrections Plan Check Deposit Plan Check Balance Construction Mechanical . correctionsrissue Electrical Plumbing S.M.I. Grading orrections/issue Developer Impact Fee A.I.P.P. Total Permit Fees 03-25-2008 16:25 BLAKESIGNCOMPANY 7148913078 PAGE4 This certificate applies only to building lighting requirements. The documentation preparer hereby certifies that the documentetion is accurate and complete. D QU% ON AU ` f SIGNATOR �C` DATEX_VrZ�� The Principal Lighting Designer hereby certifies that the prCiposed 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 lighting requirements contained in the applicable parts of Sections 110, 119,130 through 132, 146, and 149 of Title 24, Pan 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. L7 I affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code by section 5537.2 or 8737.3 to sign this document as the person responsible for its preparation; and that I am a licensed contractor performing this work. ❑ 1 affirm that 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, These sections of the Business and Professions C de are printed 'W6119the Nonresidential Manual. PRINCIPE LIGHTING DESIGNER -NAME SIGN T E DATE LIC. rl /" (a c-, s, I &,—. 1 3 2-_57 .57*Yz Z__ INSTRUCTIONS TO APPLICANT OUTDOOR LIGHTING COMPLIANCE S WORKSHEETS (✓ box If workehaet Is Included) For detailed instructions on the use of (his 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-I-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-1-C If the roiect consists of outdoor lighting. and indoor or outdoor signs, but no other indoor li htin ❑ 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. LTG -C SIGN LIGHTING COMPLIANCE. Required for all intemally and externally illuminated signs, for both indoor and outdoor signs. 2005 Nonn ickliandel Compliance Farms March 2005 03-25-2008 16:26 BLAKESIGNCOMPANY 7148913078 PAGES CERTIFICATE OF COMPLIANCE (Part 2 of 2) OLTG-1-C PROJECT NAME Llghtlna Schedules on Plans Show that Outdoor Llbhtlng 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 0 Not Applicable � - ❑ Lighting power allowances for vehicle service station canopies on OLTG-2-C Part 4 of 4 ❑ Not Applicable 6/sign lighting compliance on OLTGA-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 § t 3o(c)l ❑ Not Applicable _ ❑ All permanently installed luminaires with lamps rated over 100 watts either have a lamp efficacy of at least 80 lumens per watt or are Controlled by a motion sensor § 132(a) , ❑ Not Applicable ❑ 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) ❑ Not Applicable ❑ All permanently installed outdoor lighting meets the Control Requirements of § 132(c)l ❑ 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 AUTOMATIC CONTROLS - - CONTROL LOCATION CONTROL IDENTIFICATION CONTROL TYPE uto Time SwItchWhotO r, etc AREA CONTROLLED NOTE TO FIELD .1 .....c_CAe e, K 2005 NonrasrdarWal Compllence Forms March 2005 IGHTING COMPLIANCE OLTG-4-C S!�!M�- PROrj' ss li! � �e•,,�-t•� S�-� HATE 3 - Z - 08 Alternative 1 — lighting Power Allowances Aftemative2 - For Signs that ONLY use one at more of the technologies listed in M through S Check all that avplVj A B C D E F G H I J K L M N 1 O P O R S `e g O oA CX ., O< Description or tACatlOn Allotted Watts Lamp i Ballast Design Watts to m 3 � 3� n m mai s c0 0 z m � 0 n m `} m 3 m� 08 A iv a' V 5 o nC1 3 3wR w .. m a 9 � c' m 0» (p05 E m w R 9 �o g o c� zmm 2yy— O C y. c F _ m N °' 3 Q 3_ ao a0i�-- m o iii A D N S '0 n�1ia N� l•••• D a ->c `= H 3 v rn 0 Z 3 r 3 a o w M c 3 Cr 0 _ � mU--' H w Ci cn b a. m� m w a to <� 2 w i F' For Allotted LPD use 12 watts/square foot for Internally Illuminated Signs, and us 2.3 wattslftZfor Externally Illuminated Signs Note: If an Internally Illuminated or Externally Illuminated sign contains light sources and ballasts other than those included in columns (All) 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_ m m 2M NaveresiRenOai Compliance Forms March 2005