13-0050 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: L,,__13-_00.000050 -
Property Address: 47474 WASHINGTON ST
APN: 643=200-005- - -
Application description: SIGN
Property Zoning: COMMUNITY COMMERCIAL
Application valuation: 16000
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
LMLQ PROPERTIES
78100 MAIN ST. -SUITE 203
LA QUINTA, CA 92253
Contractor:
Applicant: Architect or Engineer: SIGNARAMA
41945 BOARDWALK, "L"
PALM DESERT., CA 92211
(760)776-9907
Lic. No.: 830131.
VOICE (760) 777-7012
FAX (760) 777-7011
PECTIONS (760) 777-7153
Date:. 1/16/13.
� DJAN i 6 2Q13
LQPERMIT
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
-
I hereby affirm under penalty of perjury that I m li nsedunder 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 Busines fe sionals e, 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 Class: D42C45cense No.: 830131
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is .
" ate:.111/ i � iContractor: - -
issued. -
K I have and will maintain workers' compensation insurance, as:required by Section 3700 of the Labor
�. ". i-,
r 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: -
I hereby affirm under. penalty of perjury th I am exempt from the Contractor's State License Law for the
Carrier GRANITE STATE Policy Number WC065256570
. 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 wo 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 co s bje 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 b c e c o the workers' compensation provisions of Section
. 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
] 3700 of th labor Code, h comply with those provisions.
6 tt -
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).:
ate: i pplicant:
(_) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
_11
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE.WORKERS' OMPENSATION 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 PE ALTIES 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 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, 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 _ 1 I, 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 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 contractors) 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—) 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 I have read this application and state that the abov formation is correct. I agree to comply with all
- work for which this permit is issued ISec. 3097, Civ. C.).
city and county ordinances and stato laws relating to buildin ,, ru io , and h by authorize representatives
- -
of this county to enter upon the above-mentioned pro fo s io oses.
.
' Lender's Name: - -
r�
Date: l�1-.! .,nature (Applicant or Agen
Lender's Address:
LQPERMIT
r
Application Number 13-00000050
Permit ELEC-ELECTRICAL SIGN
Additional desc
-
Permit Fee 33.00 Plan Check Fee
.00 .
Issue Date . . . Valuation .
. 0
Expiration Date 7/15/13
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
--------------
2 .INTERNALLY ILLUMINATED CHANNEL LETTER
SIGNS PER SA #2013-1677 & CHANGE
EXISTING MONUMENT FACING WASHINGTON ST.
2010 CODES.
------------------------------------.---
Other Fees BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 33.00 .00 .00
33.00
Plan Check Total :00 .00 .00
.00
Other Fee Total. 1.00 .00 .00
1.00
,. Grand Total 34.00. .00 .00
34.00
LQPERMIT -
_ -
.. ry
Bfn
City of La Quints •
Bw7ding ar Safety DhWon
P.O. Box :1504, 78-495 Caffe Tampko
La Qnlnfa, CA 92253 - (760)
77.7-7012 Building Permit Application and Tractdng Sheet
Pew # !„%)
1�
Pioject Address:414-1 14-1 0 'UR in
•
Owner's Name:
Oi v
A. P_ Number:
Address:
.n •�
Legal Description:
Contractor:
City', ST, Zip:. t 3 biJ
Telephone:
Project Description:e
Address: l �a
City, ST, Zip:
Telephone: 61
'
State Lic; # : 1 City Lic. #c
Arch., Env, Designer:,,,r,
Address:
City., ST. Zip: ,
Telephone:
State Lic. #:
Construction D� c 1Ot�P�Y:
Project type (circle one): New Add'n (gqD Rep;a Dmo
Name of Contact Person:
Sq. Ft:
#Stories;
#Units:
Telephone # of Contact Person:
. Estimated Value of Proje ct 606 •
APPLICANT: DO NOT WRITE BELOW THIS' UNE
#
Snbmitml•
Req'd
Reed TRACMG
PERMI`P FEES .
Pian Sets
Plan Cheek submitted
Item
Amount
Structural Coles.
Reviewed, ready for eorreedons
Plan Cheek Deposit
Truss Coles.
Called Contact Peron
Plan Check Balance
7111c .24 CdcL
Plana picked up
Construction -
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
20! Review, ready for eorrectiowmwe
Electrical
Subcontactor Uqt ..
Caped Contact Person
Plumbing
Gnat Deed
I Plans picked'ap
.&KL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
34 Review, ready for correcdon&%Me
Developer Impact Fee
Planutag Approval
Called Contact Person
A.I.P.P.
Pub. -Wks. Appr
Dateof permit issue
School Fees
Total Permit Fees
V. .. _. � � ^ � • � V � � J "; Y`3 ` 3 - r ih lir
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Certificate of Compliance
r
(Sign Lighting)
(Page I of 4) SLTG-1C -
Project Name: }rte
&I
• 1
Title 24, Parts 1 and 6 of the California Code of Regulations. ,. •' .
Date:
Project Address'
enforcement agency for approval with this building permit applic on:
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1 .� - LN
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Location of Sign
Aoutdoor Signs ❑ Indoor Signs
Addr s:
Phase of Sign Construction
XNew Signs ❑ Sign Alterations
'
-Type of Lighting Control
•
❑ eW Lighting Controls ❑ Replaced Lighting Controls
_
Not Initalling Lighting Controls
This Certificate of Compliance
includes the following components (check all that apply)
r
❑ Mandatory Measures (Lighting Controls) Maximum Allowed Lighting Power
4
❑ Specific Lighting Sources _
1. Certificate of Compliance Declaration Statement (this maybe a CIO, C45 or other eligible person)
0_*1I certify under penalty of perjury, under the laws of the State of California, the information form is true
provided on'this and-
OL
y 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 , w
Title 24, Parts 1 and 6 of the California Code of Regulations. ,. •' .
4 The design features represented on this Certificate of Compliance acre consistent with the information'provided to document `
this design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the ,r
enforcement agency for approval with this building permit applic on:
Namen \
Signature
�� y Q
enforcement agency.
Compariy. r
y/ ,; w
Phone760'71-6490
60 ` 7 7G _ 90
Addr s:
License number (may be contractor's lic #)
' building owner at occupancy. y;
Company Name:
City/S / -
er ,� _
Date h4, 11
ti
s•
2. Installation Certificate (to be signed by responsible person after itistallation)
Permit number' --
Checked by/Date
(Enforcement AgencyUse
(Enforcement A enq Use)',
Installation Declaration statement • ' . R,
; ,
❑, I certify,under penalty of perjury, under the laws of the State of California, the information provided on this form is true and "
:.correct. y
.0 1 a eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized,`
representative of the person responsible for construction.
❑ -I certifythatthe installed features, materials, components, or manufactured devices identified this
ori certificate conforms to all
applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the .'.,
enforcement agency.
❑ I certify that the requirements detailed on this Certificate of Compliance have been met.
�-
❑ . I will ensure that a completed, signed copy of this -Installation' Certificate shallbeposted; or made available wr ith the building
permit(s) issued for the building, and made available to the'enforcement agency for all applicable inspections. I understand ;.
that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides toethe.
' building owner at occupancy. y;
Company Name:
Responsible Person's Name:
Responsible Person's Signature:
1� i'*.
License number (may be contractor's lic #)
Date Signed:
Position With Company: • ;
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• 2008 Nonresidential Compliance Forms October 2010' : -4
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Certificate of Compliance (Sign Lighting) Pa e 2 of 4 SLTG-IC
Project Name-
Date:
L. U
I
3. MandatoEltign Lighting Controls
NOTES:
1. The same 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.
2. The Mandatory Measures (sign lighting controls) are required for compliance with the sign lighting Standards. If the person
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 architect shall be responsible to have the sign lighting controls installed.
3. If more than one person has responsibility for compliance, each responsible person shall prepare and sign a Certificate of
Compliance and an Installation Certificate applicable to the portion of construction for which they are responsible;
alternatively, the person with chief responsibility for construction shall prepare and sign the Certificate of Compliance
Declaration Statement or the entire construction.
3a. Statements of Responsibility: Any person signing the Certificate of Compliance Declaration Statement on page 1 of
4 on this SLTG-1C shall complete Part 3a. Check Yes or No for all of the following statements:
1
I have responsibility for installing the sign lighting controls
N
❑ Yes, complete parts 3a and 3b of this form XNo, complete part 3a of this form
2
There are no existing sign lighting controls and I will be installing compliant sign lighting controls
❑
❑ Yes ANo
3
There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls
Exception to §133(a)2. Outdoor signs in tunnels or large covered areas that require illumination during
❑ Yes ANo
NA
There are existing sign lighting controls that do not comply with the applicable provision of § 119 and § 133 and I will be
4
installing compliant sign lighting controls
❑
❑ Yes ❑ No
§133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce
are existing sign lighting controls that do not comply with the applicable provision of § 119 and § 133 and someone else
LThere
5
will be responsible to install compliant sign lighting controls
❑ Yes ❑ No
3b. Mandatory Sign Lighting Controls
If the person signing the Certificate of Compliance Declaration Statement on page 1 of 4 of this SLTG-1C is responsible for
complying with 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
ma datory measures (sign lighting control note block can be located:
1
§133(a)l. All indoor sign lighting is controlled with an automatic time switch control that complies with the
Y
N
NA
applicable requirements of § 119.
❑
❑
❑
§133(a)l and 2. All outdoor sign lighting is controlled with an automatic time switch control plus a photo
Y
N
NA
2
control, or an outdoor astronomical time switch,that comply with the applicable requirements of § 119.
❑
❑
❑
Exception to §133(a)2. Outdoor signs in tunnels or large covered areas that require illumination during
Y
NA
daylight hours.
❑
❑
§133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce
Y
N
NA
sin power by a minimum of 65 percent during nighttime hours.
❑
❑
❑
Exception 1 to §133(a)3. Signs illuminated for less than one hour per day during daylight hours.
Y
NA
3
❑
❑
Exception 2 to §133(a)3. Outdoor signs in tunnels or large covered areas that require illumination during
Y
NA
daylight hours.
❑
❑
Exception 3 to §133(a)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps used for
Y
NA
illuminating signs or parts 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 capable of reducing the lighting power by a minimum of 30 percent when
Y
N
N/A
4
receiving a demand response signal that is sent out by the local utility.
❑
❑
❑
Exception to §133(a)4. EMC required by a health or life safety statue, ordinance, or regulation, including
YNA
but not limited to exit signs and traffic signs.
El
❑
Field Inspector Notes:
2008 Nonresidential Compliance Forms October 2010
Certificate of Compliance (Sign Lighting) Pa e 3 of 4)' •.SLTG-1C '
Project ame: Date:
13
14.'
Maxi um Allowed'—Lighting 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 5
of this Certificate of Compliance if there are signs usin A the S ecific lighting sources method of com liance
a'
�
C
r. a
�
A
TIJ 4
' 3•
r
_
Allowed Watts
Design.
Complies?
"
w
Certificate of Compliance (Sign Lighting) Pa e 3 of 4)' •.SLTG-1C '
Project ame: Date:
13
14.'
Maxi um Allowed'—Lighting 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 5
of this Certificate of Compliance if there are signs usin A the S ecific lighting sources method of com liance
A
'B
C
D E F G
H
I
TIJ 4
o
Allowed Watts
Design.
Complies?
"
w
Watts
•Y/N
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Check that
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Sign
Description
✓
H
gt
Complies
EMT
14_4' Eniv j gcLvs Lti+
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4
love �adti0
O
a�
a
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.
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 148 of the California 2008 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.
C
.
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 • ,t
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 a
method to validate compliance. An ENERGY VERIFIED label is not needed for compliance. 1
D
The sign area insquare feet.
E
List "I" if the sign is intemally illuminated. List "E" if the sign is externally illuminated'
F
Allowed watts per square foot. Enter 12 if the sign is listed as "I" 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(d ore).
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.
J
This page doubles as a field inspection checklist. '
Field Inspector Notes: t - , • a
2008 Nonresidential Compliance Forms a 4 . • : _ October 2010