12-0878 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12- 00DO087
Property Address:7_8.1.-10- "CALL_ ESTADO
APN: 770 -151 -004 -
Application description: SIGN
Property Zoning: VILLAGE COMMERCIAL
Application valuation: 800
T4ht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ROBERTS REAL
PO BOX 1144
LA QUINTA, CA
ESTATE INVEST
92247
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/07/12
Contractor:
Applicant: Architect or Engineer: SIGNARAMA rftl;Tj�YO
��41945 BOARDWALK, r'L'r
PALM DESERT, CA 92211(760)776-99072012 ! iLiC. No.: 830131 UINTA14CE DFPT.
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Cla s: _ 42 C45 License No.: 830131
/Date: 7 ontractor:
OWNER -BUILDER DECLARATION
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
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_) 1, 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.l.
(_) 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: �TPi
LQPERMIT
WORKER'S COMPENSATION DECLARATION
1 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 HARTFORD' CO Policy Number 198607
_ 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 I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
aD te,f 2 plicant: /,eS.Q n
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND .
DOLLARS ($100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND 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 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 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
city and county ordinances nd state laws relating to building construction, and hereby authorize representatives
o/f/tf�(s co nt to enter n the above-mentioned property for inspection purposes.
Dat Signature (Applicant or Agent):
Application Number . . . . . 12-00000878
Permit ELEC-ELECTRICAL SIGN
Additional desc .
Permit Fee . . . . 30.00
Plan Check Fee
.00
Issue Date
Valuation . . .
. 0
Expiration Date 2/03/13
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 SA # 2012-1622 "TEDDY'S
RESTAURANT". 2010 CODES.
----------------------------------------------------------------------------
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
sln.#
City. Of la Quinta
Bulk0og ar Safety Division
P.O. Box 1504,-78-495 Calle Tampfco
1.a.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
ProjectAddress-
2L a�
wrs Ne:.�Y1.
A. P. Number.
`0
Address: 7? _ i / O Co, LLLa— s'I a 6 O
Legal Description:
City, ST, Zip: � „� 1�, �- c' srL Ir 3
Contractor. 5/ Ls _ P—a M
Telephone ry J 7 i i� ��
Address: �� - �j Zj S` o a (N4,L jL L
Project Description: �.. (. (��
City, ST, Zip: : Q (rt1 t S U+-� �
Telephon :76>?'7 6 — 99d i
State Lia # : O % .3 City Lic. #:�i76c f`/ 7 /
Arch., EW., Designer
Address:
City., ST, Zip.
Telephone:
State Lia #:
Name of Contact Person: , L L / G t,t 217 S E'P-)
Construction Type:. Occupancy:
Project type (circle obeeN Add'n Alter Repair Demo
Sq. Ft.:
# Stories: # Unitx:
Telephone # of Contact Person 760 ,�7g 63 i_5
Estimated Value of Project: �'�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACMG PERMIT FEES
Plan Sets
Pian Check submitted"
Item Amount
Strodural Ca1cs.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Cheek Balance
Tide 24 Cates.
Plans picked up
Construction
Inood plain plan
Plans resubmitted.'.
Mechanical
Grading plan
2" Review, ready for correctiousfissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
S3LL
H.O.A. Approval
Plans resubmitted
Grading
IIY ROUSE:-
''d Review, ready for eormctionslissae
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CHANNEL LETTER SECTION
INTERNALLY ILLUMINATED WITH NEON
EACH LETTER FASTENED BY A
OF 4 #10 SCREWS WALL
CO APPROVED
L 2161 LISTED
ELF ENCLOSED
NEON TRANSFORMER
O
a.........
B.......
DISCONNECT
SWITCH
G.
MINIMUM
WITH STUC
ANCHORS
ALUMINUM
RETURNS
---- TRIMCAP
U
S
1 /2 "CONDUIT
5".040
ACRYLIC FACES
NE
G
ON TUBE
LASS STAND
ELECTROBIT
EN D CAP
T.O.-1
INTEGRAL SLEEVED WIRE
12GAUGE COPPER
ONDING WIRE
8 SHEET METAL SCREW
ALL WALL PENETRATIONS TO BE SEALED WITH UL LISTED SILICONE SEALANT
THIS SIGN IS INTENDED TO BE INSTALLED IN ACCORDANCE WITH THE REQUIREMENTS
OF ARTICLE 6000F THE NATIONAL ELECTRICAL CODE AND/OR OTHER APPLICABLE LOCAL CODES.
THIS INCLUDES PROPER BONDING OF THE SIGN.
CHANNEL LETTER CONNECTION DETAIL
TRANSFORMER
MOUNTIN9HANNEL
STUCTURE
LETTER CHANNEL LETTER HANNEL LETTER HANNEL LETTER HANNEL LETTER
U.L. LISTED AND LABELED
COMPLIES WITH 2010 CA ELECTRIC CODE; ARTICLE 600
Certificate of Compliance (Sign Lighting)
Pae i of 4 SLTG-I-C
Project Name: S
,..
Date:
Project Address: /
L %�
�-CL X12 f
Location of Sign 17L�yytdoor Signs
O Indoor Signs
Phase of Sign Construction 1,7�1t1e Signs
O Sign Alterations
Type of Lighting Control ew;Lijhting Controls
O Replaced Lighting Controls O Not Installinit Lighting Controls.
This Certificate of Compliance includes�the following components (check all that apply)
0 Mandatory Measures (Lighting Controls) 0 Maximum Allowed Lighting Power O Specific Lighting Sources
1. Certificate of Compliance Declaration Statement (this may be a Cto. C45 or other eligible person)
a 1 certify under penalty of perjury, under the laws of the State of California. the information provided on this form is true and
comet.
a 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the lighting design.
a This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with
Title 24, Parts I and 6 of the Califotnia Code of Regulations.
a The design features represented on.this Certificate of Compliance are consistent with the information provided to document
this design on the other applicable compliance forms, worksheets. calculations, plans and specifications submitted to the
enforcement agency for approval with this building permit applic
Name: --r Vt'2�f Signature
Company: / n Phone
�n � H - PA, �
Address: v i/ Lice number may be coq t0�'s, lie #)
9-7-
2. Installation Certificate to be;si ned by msponsibleperson after installation)
Permit timber Chetlrod %MWe
A Uss Enfbvoemeot A Use
Installation Declaration statement
a I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and
correct.
a I am 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.
1 certify that the installed features, materials, components, or manufactured devices identified on this certificate conforms to a
applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the
enforcement agency.
a I certify that the requirements detailed on this Certificate of Compliance have been met.
1 will ensure that a completed, sigrjed copy of this Installation Certificate shall be posted, or made available with the building
permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections., t understand
that a signed copy of this installation Certificate is required to be included with the documentation the builder pmvidct`to the
building owner at occupancy.
Company Name:
Person's
Respons
number (may be contractor's lie #) Date Signed: Position With Cotnoanv.
ill
2008 Nonrvei./o,.,:,,,
- �•••••••�r turns
rldy 20/0
U. '
Certificate of Com li nae CSi n Li htin (Page 2 of 4 SLTGiC
Project Name:
Data ;� \^��
/
3. Mandatory Sign Lipghtfnj Controls
7-773.-
VTES:1. The il-landutory Measures (sign lighting controls) are required for compliance with the sign lighting Standards. The same
1.
responsible person ►nay install both rite sign and the sign lighting controls, or u different responsible person mgvviydiu the
.sign lighting controls than the responsible person installing the sign.
1. /f'the person responsible for installing the sign 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. /j inure than one person has responsibility for compliance, each person shall prepare and sign a Certificate of Compliance
and an installation Certificate applicuble to the portion of construction for which they are responsible; alternatively,. rhe
person with chief responsibility for cumvniction shall prepare and sign the Certificute of Compliance Declaration Statement
or the entire eonstntetion. -
3a. Statements of Responsibility:
Theperson signing the Certificate of Com fiance Declaration Statement shall check Yes or No for all of the following statements:
1
I have responsibility for installing the sign lighting controls . ,.!:u j._
3a of this form - _'
❑ Yes, complete arts 3a and 3b of this form o. complete _
Y
There are no existing sign lighting controls and I will be installing compliant sign lighting controls
2
❑ Yes PNNO
3
There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls.
.II
O Yes KNo
These are existing sign lighting controls that do not comply with the applicable provision of § 119 and § 133 and t will be
4
installing compliant sign lighting controls--,-, '
❑ Yes KNO
❑
There are existing sign lighting controls that do not comply with the applicable provision of §119 and §133 and sotneor a else '
S
will be responsible to install compliant sign lighting controls
Y
❑ Yes o
3b. Mandatory Sign Lighting Controls
The person signing the Certificate of Compliance Declaration Statement shall answer all of the following questions if they ale
responsible for complying with the sign likhting control requirements. .• ':.,.1:
If there are construction documents, indicate where on the building plans the
mandatory measures(sign lighting control note block can be located:
1
§133(2)1. All indoor sign lighting is controlled with an automatic time switch control that complies with the
Y
N
N
applicable requirements of § 119.
0
; (�:
§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 § 11.9.
.II
❑
Exception to §133(a)2. Outdoor sign`s in tunnels or large covered areas that require illumination during
Y
NA
daylight hours.
❑
§133(x)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 t to §133(x)3. Signs illuminated for less than one hour per day during daylight flours.
Y
N`
3
Exception 2 to §133(a)3. Outdoor signs in tunnels or large covered areas that require illumination duringY
—§L -
NA
daylight hours.
❑
16,
Exception 3 to §133(2)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps used for
Y"
NA
illuminating signs or parts of signs.
�
.CI
§133(9)4. An Electronic Message Center (EMC) having a new connected lighting power load greater than
IS 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.
0- ..
A
Exception to §133(a)4. EMC required by a health or life safety statue, ordinance, or regulation. including Y NA
but not limited to exit signs and traffic si ns.
❑
Field inspector rotes:
2008 Nonresidential Compliance Forms Jidy 2010
.J
Certificate of Compliance (Sign Lighting) (Page 3 of 4 SL C- C
Project Name:
Dow
4. Maximum 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. (ComWgs �act.5
of this Certificate of Com liance{if there are si ns using the S •ific lighting sources method of comctiliance
A
g
C
D E F G
H
1
J
Allowed Watts
Design
Complies,
Watts
Y / N
_.
..Field
U
O O
o
V,
° w
.�
�'�
A
3
O
vl
Inspector
Check that
o
A
—1 3 3
3
�b
Sign
ts
ry �^
0
I c
'~
3
�_ '"
_
,Complies
"
5
�W�
II II
4�W
O II
Q
t3
a
E
`�
lO
U
at>nra:r.n
Dcscrition
q,q
-
12'
��$,�
,,a
Y
o .
o
a
0
13
o
0
0
0
0
A
Symbol or code used on the plans when' tans
are requiredl and other document -
8
A narrative description of the siLM, or location of sign on the buildinit,• and the location of sijtn on construction documents.
OPTIONAL - Check this box only if this{`.sign has a permanent, pre-printed, factory -installed- label, listed with Underwriters i;.aborator� .
(UL) or other testing laboratory accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) or Intemationai
Standards Organization (ISO) 17025 in ai cordance with ISO/IEC 17011 with the products produced under an ongoing inspection program
C
carried out by a Type A inspection body in accordance with ISO/IEC 17020, 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. For signs with such a
label, columns'D' through '1' are not required to be filled out. Note: Using a label is an optional method to validate compliance. A label is
not needed for compliance.
D
The sign area insquare feet.
E
List "1" if the sign is internally illuminate$. List "E" if the sign is externally illuminated
F
Allowed watts per square foot. Enter 12 if the sign is listed as "1" 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. is determined according to the applicable provisions of §13 d ore .
I
Enter. Y if the number in column H is lesst(han 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:
4 wv 1.vr,rc31Urr/rrur V�omprrance rvrms July 2010
Certificate of Compliance Si n Lighting) Page 4 of 4 SLTG-1C
Date:
Project Name:
5. Specific Lighting- Source Method of Compliance
Certificate of Compliance and Field Inspection Energy Checklist
Complete this part if there are signs rising the Specific lighting source method of compliance. (Complete part 4 of this
nligW- t Nghtino newer method of compliance)
Lernncate
or t,.om Hance a utcic aac, s. na %-11Y..,,� ...0 ........................
__--- _ -- -- ---
p
E
B
C
OrFIONA L
Field -
r
UL
Specific light source uscd for
Inspector
Symbol
or other
compliance
a that
or
Description
label
Shall include only lighting
Sign
-AliA
Code
(`Ce
instructions
technologies listed below
Com 1i4s
below)
List all that apply:
Peon
rOvAte'
p
O
El
p
O
O
I]
A I
Symbol or code used on the plans when' tans arerequired) and other documents.
8
A narrative description of the sign,or location ofsign on the buildin • and the location ofsign on construction documents
C
OPTIONAL - Check this box only if thisfsign has a permanent, pre-printed, factory -installed label. listed with Underwritersd:a3orztor�y
(UL) or other testing laboratory accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) or International
Standards Organization (ISO) 17025 in aiccordance with ISO/IEC 17011 with the products produced under an ongoing inspection program
carried out by a Type A inspection body 'in accordance with 1SOITEC 17020. confirming that this sign complies with the Section 148 of the
California 2008 Title 24. Part 6 Standards. using the Specific Lighting Source Method of Compliance. For signs with such a label; column
D' is not required to be filled out. Note:tUsing a label is an optional method to validate compliance. A label is not needed for compliance.
Specific Light Source Compliance Method. The sign(s) identified above use only the following lighting technologies:
List all applicable numbers I through 10: that apply in column D above for each row.
I Hiltb pressure sodium lamps,'
1 Pulse start or ceramic metal Halide lamps served by a ballast with > 88% efficient
Pulse start metal halide lamps that are <_ 320 watts, are not 250 watt or 175 watt lamps. and are served by a ballast.
3
with >t 80% efficient
4 Neon or cold cathode lamps with transformer owpower supply efficiency >_ 75% with rated output current < 50 mA
5 Neon or cold cathode lamps with transformer or power supply efficiency 2:68% with rated output current >_ 30 mA
D
6 Fluorescent lamps with a midimum color rendering index (CRI) of 80
Note: when using elcctronic ballasts for compliance, lamps with a CR! < 80 may be used
7 Light emitting diodes LEDs `(with a power supply with a 800/o efficiency
Single voltage LED external power supplies designed to convert 120 volt AC input into lower voltage DC of AC
8 output. having a nameplate output power less than or equal to 250 watts, and certified to the Energy Commission as
cum plying with the applicable, requirements of the Appliance Efficiency Regulations Title 20
4 Cum ct fluorescent lamps that do not contain a medium screw base sockets E24/E26
10 Electronic ballasts with a fundamental output frequency > 20 kHz
2008 Nonresidential Compliance Forms July 2010