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BSIG2016-001978-495 CALLE TAMPICO . LA QUINTA, CALIFORNIA 92253 DESIGN ODENT D ARTMENT Application Number: BSIG2016-0019 Property Address: 78370 HIGHWAY 111 STE 140 APN: 604050068 Application Description: MIRACLE EAR/ SIGNS Property Zoning: Application Valuation: $4,900.00 Applicant: PD GROUP DBA SIGNARAMA 41945 BOARDWALK SUITE L PALM DESERT, CA 92211 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Nps, 0 n DFS+o IT APPY REALTY "N C�IY ?0j6` 6 ILSHIRE BLV STE 410 vyP,0�' F44 B LY HILLS, CA 92253 Fp�9r'841p Contractor: PD GROUP DBA SIGNARAMA 41945 BOARDWALK SUITE L PALM DESERT, CA 92211 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 Professions Code, and my License is in full force and effect. CLic��ense Clas . D42 C45 License No.: 8301 1 `Date'�l /0 CContractor: AA 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).: (_) 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.). (_) 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: C (760)776-9907 Llc. No.: 830131 Date: 11/10/2016 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' :ompensation, 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 s issued. My workers' compensation insurance carrier and policy number are: Carrier: STATE COMPENSATION INSURANCE FUND Policy Number: 9111087 _ 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' :ompensation 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 :omply /with thos provisions. Date: lD 11 Applicant: 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 ($100,000). 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 Building Official 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 ssued 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 and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above -me 7tnedpropertyforinspectionpurposes. Date: h0 16 Signature (Applicant or Agent): Application Number: BSIG2016-0019 Property Address: 78370 HIGHWAY 111 STE 140 APN: 604050068 Application Description: MIRACLE EAR/ SIGNS Property Zoning: (760)776-9907 Application Valuation: $4,900.00 1 Owner: POINT HAPPY REALTY 8665 WILSHIRE BLV STE 410 BEVERLY HILLS, CA 92253 . Date: 11/10/2016 Applicant: Contractor: PD GROUP DBA SIGNARAMA PD GROUP DBA SIGNARAMA 41945 BOARDWALK SUITE L 41945 BOARDWALK SUITE L PALM DESERT, CA 92211 PALM DESERT, CA 92211 (760)776-9907 ------------------------------------- ---------------------------------------------- LIc. No.: 830131 Detail: (2) ILLUMINATED CHANNEL LETTER SIGNS FOR "MIRACLE EAR" PER 2013 CALIFORNIA BUILDING CODE. t I Total Paid for SIGN: $168.72 FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $25.33 DESCRIPTION ACCOUNT CITY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $25.33 Total Paid for ELECTRICAL: $50.66 DESCRIPTION ACCOUNT CITY AMOUNT WALL/AWNING SIGN, EA ADDITIONAL 101-0000-42404 0 $25.84 DESCRIPTION _ ACCOUNT CITY AMOUNT WALL/AWNING SIGN, EA ADDITIONAL PC 101-0000-42600 0 $25.84 DESCRIPTION ACCOUNT CITY AMOUNT WALL/AWNING SIGN, FIRST 101-0000-42404 0 $25.84 DESCRIPTION ACCOUNT CITY AMOUNT WALL/AWNING SIGN, FIRST PC 101-0000-42600 0 $91.20 Total Paid for SIGN: $168.72 i4z6i6 0066 Bin #1 rrp�tt City of La Quinta Vy� Building &r Safety Division Permit #i t> i 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-701,2 �J r Building Permit Application and Tracking Sheet Project Address: D Owner's Name: A. P. Number: Address:666 L�/cIL� jj Legal Description: t�l N "'i L,.L`t,� S r,5 City, ST, Zip: ti e SLS ^ �� �DZti j Contractor: — oL, 'LTele h ne- Address: li B x VJ. L", Project Description: _ S t NS City, ST, zip: L 2L 1 1 C(., f l�' Te le h ne- p o c 7 6-2 a / ' State Lic. # : d 3O 13. 1 City Lic. #1 y Arch.,!Engr., Designer: Address: City, ST, Zip: hone: :Tele Con aneY structi n Type: Occupancy: t a ,. Sto Lic. # • Pr Ject r Demo type (circle one): New Add'n Alter Repairai of Contact Person: Sq. Ft.: #tories: s:Name Telephone # of Contact Person: 'Q g � �� S Estimated Value of Project: ( D APPLICANT: DO NOT WRITE BELOW THIS LINE th Submittal Req'd Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance. Title 24 Cafes. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2a° Review, ready for corrcctions/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. 1-I.O.A. Approval Plans resubmitted Grading IN IiOUSE:- 1rd ReyiW, ready for corrcctions/issue Developer Impact Fee Planning Aliproval Called Contact Person A.I.P.P. Pub. \Vks. Appr Date of permit issue School Fees, Total Permit Fees ;ECi;.kd!t;rs�/i/1 �.► Gni! ^ , f/ '�O % b ((/✓}� fr —� �+ eA :ation of .'•;;gm Outdoor Signs O Indoor Signs ase of Sign Construction ,KNew Signs O Sign Alterations )e of Lighting Controlc.ro CCU O. New Lighting Uontrols O Replaced Lighting Controls O Not Installing Lighting Controls s Certificate of Compliance Includes the following co ponents (check all that,apply) Mandatory Measures (Lighting Controls) O Maxi um Allowed Lighting Power O Specific Lighting Sources Mandatory Sign Lighting Controls OTES: The some responsible person may install bo the sign lighting power and the sign lighting controls, or a different responsible person may install the sign lighting controls t Jdn the responsible person instolling the sign lighting power. The Mandatory Measures (sign -lighting con rots) 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. 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 ore responsible, alternatively, the person with chief responsibility for const uction shall prepare and sign the Certificate of Compliance Declaration Statement for the entire construction. t. Statements of Responsibility: Any person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E call complete Part la. Check Yes or No for all of, the following statements: I have responsibility for installing the sign lig iting controls Yes, complete parts'la and lb of this forn O No, complete part la of this form. There are no existing sign lighting controls a id I will be installing compliant sign lighting controls ,9 Yes O No There are no existing sign lighting controls a d someone else will be responsible to install compliant sign lighting controls Yes O No There are existing sign lighting controls that do not comply with the applicable provision of §110.9 and §130.3 and I.will be installing compliant sign lighting controls O Yes �3No There are existing sign lighting controls that do not comply with the applicable provision of §110.9 and §130.3 and someone else will be responsible to install compliant s ign lighting controls O Yes. f Na CO Wilding Energy Efficiency Standards - 2013 Nonresid n COmplitnyel June 2014 2: Z -� H Building Energy Efficiency Standards - 2013 N u �i; e r. ITI C: M Z June 2014 ,. Mandatory Sign lighting Cdntrols the person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E is responsible for complying with e sign lighting control requirements, that person shall answer all of the following questions: there are construction documents, indicate where on the building plans the andatory measures (sign lighting control) note I ilock can be located: §130.3(a)1. All indoor sign lighting is control ed with an automatic time -switch control or astronomical time- Y N NA switch control. ❑ R ❑ §1303(a)2A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time- Y N NA switch control, or an astronomical time -switch control. ❑ ❑ EXCEPTION to Section 130.3(a)2A: Outdoor igns in tunnels, and signs in large permanently covered outdoor Y NA areas that are intended to be continuously I t, 24 hours per day and 365 days per year. ❑ §130.3(a)2B. All outdoor sign lighting that i ON both day and night is controlled with a dimmer that provides the ability to automatically reduce sign lighti g power by a minimum of 65 percent during nighttime hours. Y N NA Signs that are illuminated at night and form re than 1 hour during daylight hours shall be considered ON both ❑ ❑ bQ day and night. EXCEPTION to Section 130.3(a)28: Outdoor igns in tunnels and large covered areas that are intended to be Y NA illuminated both day and night. ❑ §130.3(a)3. Demand Responsive Electronic Message Center Control. An Electronic Message Center (EMC) NO having a new connected lighting power load greater than 15 kW has a control installed that is capable of C1 reducing the lighting power by a minimum of 30 percent when receiving a demand response signal. EXCEPTION to Section 130.3(a)3: Lighting fo EMCs that is not permitted by a health or life safety statute, Y NA ordinance, or regulation to be reduced by 3 percent. ❑ ?Id Inspector Notes: Building Energy Efficiency Standards - 2013 N u �i; e r. ITI C: M Z June 2014 ;lairrum Allowed L)l;hting Power Method of('compliance G �-4z-, — 2 tificate of Compliance ind Field Inspection Energy Checklist Complete this part if there are signs using the maximum allowed lighting power method of compliance. (Complete part 3 of this Certificate of Compliance if there are signs using the Specific lighting sources method of compliance) A B C D E F G H I J ymbol OPTIONAL– Energy Complies Filed Inspector Description of the Sign Verified Label (se . Allotted Watts Deslen Watts Y/N Check that sign ,r Code instructions below) complies — oLu «^ c l7 ut A). a T f0 ro c 3 fr1 LL x ^ o C •- Q c c: .C. c a� 3 N o '" r�i N C 3 _ -; :P, 7n in w Q -- Lu v ✓ ✓ ❑ ❑ ❑ O ❑ ❑ ❑ ❑ A Symbol or code used on the plans (when plans are required) and other documents. B A 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 140.8 of the California 2013 Title 24, Part 6 Standards, using the Maximum Allowed Lighting Power method of compliance. The only labels thal will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories (UL) or other Prc duct Certification Body accredited to ISO/IEC Guide 65 by the American National Standards C Institute in accordance with ISO/IEC 17011. Surveillance by the Accredited Certification Body shall be an ongoing annual 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 a filled out. Note: Using an ENERGY VERIFIED label is an optional method to validate compliance. An ENERGY VERIFIED label is not needed for compliance. D The sign area in square feet. E List "I" if the sign is internally illuminated. I ist "E" if the sign is externally illuminated. F Allowed watts per square foot. Enter 12 if, he 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 0 tir ies the allowed Lighting Power Density (LPD = watts) in column F. H Show the total installed watts in the sign, a determined according to the applicable provisions of §130(c). I Enter Y if the number in column H is less than or equal to the number..i. column G. Otherwise, the sign does not comply. J This page doubles as afield inspection checklist. Id Inspector Notes: i7 .i!!3. F= w m. I:n u � > 3uilding Energy Efficiency Standards - 2013 Nonresi al Con- f June 2014 C ®. Z MZ �> :Spr f_lfit Lightine Source Method of Compliance ertificate of Compliance -and field Inspection E iergy Checklist Complete this part if there are signs using the Specific lighting source method of compliance. (Complete part 2 of this Certificate of Compliance if there are signs using themaximum allowed lighting power method of compliance) A g C D E OPTIONAL Specific light source used for Field Inspector ymbol' ENERGY VERIFIED compliance Check that Sign or Description label Shall include only lighting Complies Code (see instructions technologies listed below below) List all that apply ❑ ❑ ❑ ❑ ❑ ❑ Symbol or code used on the plans (when plans are required) and other documents. 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 rmanent, pre-printed, factory -installed ENERGY VERIFIED label, confirming that this sign complies with the Section 140.8 of the California 013 Title 24, Part 6 Standards, using the Specific lighting Source Method of Compliance. The only labels that will be recognized for this purpos are ENERGY VERIFIED Certification Marks authorized by Underwriters laboratories (UL) or other Product Certification Body accredited to ISC IEC Guide 65 by the American National Standards Institute in accordance with ISO/IEC 17011. Surveillance by the Accredited Certificatio Body shall bean ongoing annual inspection program carried out by a Type A Inspection body in accordance with ISO/IEC 17020. For signs with uch an ENERGY VERIFIED label, column 'D' is not required to be filled out. Note: Using an ENERGY VERIFIED label is an optional method to validate compliance. An ENERGY VERIFIED 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 (1 through 9) that app in column D above for each row. 1 High pressure sodium lamps Metal halide lamps that are pulse start or ceramic served by a ballast that has a minimum efficiency of 88 percent or 2 greater. Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage when tested according to ANSI C82.6 -2C 05. Metal halide lamps that are pulse start that are 320 watts or smaller, are not 250 watt or 175 watt lamps, and are served by a ballast that has a minimum efficiencyof 80 percent. 3 Ballast efficiency is the measured outpu wattage to the lamp divided by the measured operating input wattage when tested according to ANSI C82.6-2005. Neon or cold cathode lamps with transform r or power supply efficiency greater than or equal to a minimum efficiency of 75 percent 4 when the transformer or power sunniv ratec output current is less than 50 mA. The ratio of the output wattage to the input wattage is at 100 percent tubing load. Neon or cold cathode lamps with transform r or power supply efficiency greater than or equal to a minimum efficiency of 68 percent -5 when the transformer or power supply ratec output current is SO mA or greater. The ratio of the output wattage to the input wattage is at 100 percent tubing load. Fluorescent lighting systems meeting one of the following requirements: A. Use only lamps with a minimum color rendering Index (CRI) of 6 80; or B. Use only electronic ballasts with a f indamental output frequency not less than 20 kHz. 7 Light emitting diodes (LEDs) with a power supply having an efficiency of 80 percent or greater; Single voltage external power supplies that i re designed to convert 120 volt AC input into lower voltage DC or AC output, and have a 8 nameplate output power less than or equal I o 250 watts, shall comply with the applicable requirements of the Appliance Efficiency Regulations (Title 20). 9 Compact fluorescent lamps that do not cont in a medium screw base socke s (E24/E26). This page doubles as a field inspection checklist. j m .� ield Inspector Notes: °)`► r=- Z k Building Energy Efficiency Standards - 2013 Non �<�C) �M C Z MZ June 2014 . )C`CLM:,NTATIOIU AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance Jocumentation is accurate and complete. )ocumentadon Author Name: Documentation Author Signature: :ompany: /^� n '^ _^n .�1.. tV t r R- 0 � `i ` Signature Date: /� may} ) L /X T / �(/ i,dd,ess: 4 n(45 BQA-i2.C,,3AA-� Sv 1- �.- CEA/ HERS Certification ldenrification (ir a plicable): :ity/State/Zip: '��� DC -560-1 CA. 7- Phone: 1&0 -71 RESPONSIBLE PERSON'S DECLARATION STAT�MEN I certify the following under penalty of perjury, nder the laws of the State of California: 7. The information provided on this Certificate of ompliance is true and correct. 2. I am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (res 3ontible designer). 3. The energy features and performance specifica ions, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Complia ce conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be incIL ded with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Zo��rz Jc, i = Responsible Designer Signature: Company: Date Signed: U t J Address:license: �il9yS" 130AP-I'D SUI L tt-83CG . citty/State/Zip: PAi�K �ESE2r �►4 Z (I Phone: 1 iso - 12>- l=l yG --q qu 177 71 (" _ z 0 n 901 i milling tnergy tmciency Standards - 2013' Nonres June 2014