06-2492 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number.:
CiL63 00002:4:9:2
" Property Address:
47150 WASHINGTON ST'
APN:
643-200-026- - -`
Application description:
SIGN
Property Zoning:
COMMUNITY COMMERCIAL
' Application valuation:
5212
J
Applicant:
Architect or Engineer
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
{
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lice ed under rovisions of Chapter 9 commencing with
Section 7000) of Division 3 of the Business and Pr ssiona de, and y Lire se ' in full force and effect.
License Cllaajs,.s��'j(D442) � se No.: 3 j 3
(Date: ^ Contra'`c� or
1s fit" '
OWNE -BUILDER D LA TION
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 7000) 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
ri any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500): E
1 _) 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 I, 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 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:
A LQPERMIT _
Owner:
PAUL KOURI
1 REGENCY DR
RANCHO MIRAGE, CA 92270
Contractor:
SIGNARAMA
41.945 BOARDWALK, "L"
PALM DESERT, CA 92211
(760)776-9907
Lic. No-.: 830131
I
- VOICE (760) 777-7012
FAX (760) 777-7011 .
INSPECTIONS (760) 777-7153
Date: 6/23/06
1
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 1640374
_ 1 certify that, -in the performance'oft work for which this permit is issued, Ishall not employ any
person in any manner so as to me subj ct to Xmpensation laws of California,
and agree that, if I should b e su j o the nionprovisions of Section
3700 of the Labor Code, fo mplyi ions. ,
Date: ,4pplicarit:�
WARNING: FAILURE TO SECURE WORKER 'COMPENSA ION RAGE IS UNLAWFUL; AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND Cl ES UP TO ONE HUNDRED THOUSAND '
DOLLARS ($100,000). IN ADDITION TO THE COST OF EN O, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ORNEY'S FEES. .
r
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 an oid if work is not commenced
within 180 days from date of issuance of such permit, or ce ion of rk for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above i an�pose
ract. I ogre com ith all
city and county ordinances and state laws relating to building co coon eby author repr atives
of this county tq enter upon the above-mentioned property fo section �% �•"'
Application Number ', 06-00002492
Permit ELEC-ELECTRICAL SIGN
Additional desc .
Permit Fee. 30.00 Plan Check
Fee
:00
Issue Date Valuation
. . .
. 0
Expiration Date 12/20/06,
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'REVERSE CHANNEL LETTER
SIGN PER SA06-1003. ABILENE ROSE PIT
BBQ.ELECTRICIAN PER SUB -.LIST.
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
CERTIFICATE OF COMPLIANCE (Part 1 of 2) 0LTG-1-C
PROJECT NAME
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.
DATE
PROJECT ADDRES
�i -7 5,0
incorporated in schedules on the plans.
' ,.., . e v a e::...... ,
Enforcement?Agency. Use:, _ .:
PRINCIPAL DESIGNER -LIGHTING
TELEPHONE
6 -
DOCUMENTATION AU I HOR .
TELEPHONE
-76_
GENERAL INFORMATION
3. Use OLTG-I-C if the project consists solely of outdoor signs
DATE OF PLANS
OUTDOOR LIGHTING ZONE l✓ One) ❑ LZ1. ❑ LZ2 ❑ LZ3
❑ LZ4
FUNCTION -TYPE
❑ OUTDOOR LIGHTING
OUTDOOR SIGNS ❑ INDOOR SIGNS.
PHASE OF CONSTRUCTION
❑ NEW CONSTRUCTION
❑ ADDITIONS ❑ 'ALTERATIONS
STATEMENT OF COMPLIANCE
outdoor signs.
I his Gertiticate 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 curate and complete.
The Principal Lighting Designer h4reby certifies that the proposed outd r lighting and signs design represented in this set of construction documents.
is consistent with the other compliance forms and worksheets, wi the specifications, and with any other calculations submitted with this permit
application. The proposed building has been designed to meet t lighting requirements contained in the applicable parts of Sections 110, 119,130
through 132, 146, and 149 of Title 24, Part 6. Please ✓ on
❑ 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.
�l affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code by section 5537.2 or6737.3 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.
(These sections of the Business and Professions Code are Drinted in full in the Nonresidential Manual.)
INSTRUCTIONS TO APPLICANT OUTDOOR LIGHTING COMPLIANCE & WORKSHEETS (✓ 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 California Energy Commission.
❑ 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.
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-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
li htin
❑ OLTG-2-C
LIGHTING COMPLIANCE SUMMARY. Applicable Parts required for ALL outdoor lighting allowances (Except for
Signs)
6LTG-3-C
AREA CALCULATIONS WORKSHEETS. Applicable parts required for all outdoor area calculations.
OLTG13-C
SIGN LIGHTING COMPLIANCE. Required for all internally and externally illuminated signs, for both indoor and
outdoor signs.
2005 Nonresidential Compliance Forms April 2005
U
CERTIFICATE OF COMPLIANCE (Part 2 of 2) OLTGA-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)1
Not Applicable
All permanently installed luminaires with. lamps rated over 100 watts either have a lampefficacy of at least 60 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)1
Not Applicable
❑ Building facades, parking lots, garages, canopies, and outdoor sales areas meet the Multi -Level Lighting Requirements of § 132(c)2
Eg,Not Applicable
MANDATORY AUTOMATIC CONTROLS
CONTROL LOCATION
CONTROL
IDENTIFICATION
CONTROL TYPE
Auto Time Switch/Photosensor, etc
AREA CONTROLLED
NOTE TO.
FIELD
lT. ice!
-T K
/
2005 Nonresidential Compliance Forms April 2005 .
i
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to
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Z
LO
0
04
=
Electronic Ballasts with
rn
Output Frequency of
0
20KHz or more
y
�
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ami
CFLS not containing
C
o
X
Medium Screw Base
rn m
Y
Sockets
o C
_j co
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Barrier Coat Fluorescent
0
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Ci
Lamps (includes most T5
t o
and T8 lamps)
in
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g
Light Emitting Diode
c—
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W
a
in _
a
(LED)
N
U
v
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O
Neon and Cold Cathode
Lm
N
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(>
N L
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a
N
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Z
Pulse Start or Ceramic
2
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Metal Halide
N
U
t
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High Pressure Sodium
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Is G Smaller than K? .
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Total Designed
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Sign Input watts
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Number of Ballasts
E N
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Number of OR
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Lineal Feet of Lamps
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(12 or 2.3)
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(W / ft2)
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Internally (1) OR
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Sign Area (ft2 )
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Sign Symbol or Code
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Bin #
City of La Quints
Building a Safety Division
'P.O. Box 1504, 78-495 Calle Tampico
la Quinta, CA 92253 - (760) 777-7012 "
Building Permit Application and Tracking Sheet
Permit # ".
Project Address:
o
n.
Owner's Name:
Ra Lj OUT
A. P. Number:
Address: y
Legal Description:
Contractor:
Address:"
�.
�.
p
City, ST, Zip:
Telephone: L —60S,5x '
Project Description: --I)]� 1 Gl"
City, ST, Zip: . M
n"
D
`
Telephone: ('76
6 atm.
City Lic. #:
State Lic. # : (o
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
-
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:#Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: Z
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
-.Reed
TRACHING .
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 '
Energy Calcs.
Plans picked up
Construction
Floodplain plan.
Plans resubmitted
Mechanical
Grading. plan
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.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
................