13-0645 (SIGN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
13-00000645
79710 HIGHWAY 111 STE 103
649-020-014-3 -31143 -
SIGN
REGIONAL COMMERCIAL
3360
Architect
or Engineer:
1J o
e4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
HIGHLAND LA QUINTA, LLC
1055 E. COLORADO BLVD. 45178
PASDENA, CA 91106 FADr-
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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. 42 C45 Lic e No.: 830131
Da� T� � Contra��
/ 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 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 contractorls) 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: filij
I,QPERAIIT
Contractor:
SIGNARAMA
41945 BOARDWALK, "L"
PALM DESERT, CA 92211
(760)776-9907'
Lic. No.: 830131
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/21/13
u
MAY 21201371 j
LA
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
ued.
Z&I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance cf the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier GRANITE STATE Policy Number WC065256570
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
�/00 of the Labor Code,1 shall forthwith comply with those provisions.
Dai1 , / `� % Applicant:. 1A
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 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 and state laws relating to building construction, and hereby authorize representatives
of thi(sscco my to nter upon the above-mentioned property for inspection purposes.
Date! Signature (Applicant or Agent):
l
Application Number . . . . . 13-00000645
Permit . . . . . ELECTRICAL 2013
Additional desc .
Permit Fee 35.75 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 11/17/13
Qty Unit Charge Per
Extension
1.00 35.7500 EA ELEC SIGNS
35.75
----------------------------------------------------------------------------
Special Notes and Comments
ONE PERMANENTLY MOUNTED SIGN FOR " PAPER
DOLL INTERIORS" SA13-1696 ILLUMINATED.
2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, ELECTRICAL
47.67
PERMIT ISSUANCE M/P/E
90.57
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
' Permit Fee Total 35.75 .00 .00
35.75
Plan Check Total .00 .00 .00
.00
Other Fee Total 139.24 .00 .00
139.24
Grand Total 174.99 .00 .00
174.99
r
LQPERMIT
Bin. #
City of.La Quinta
Buildhy 8T Safety Division
P.O. Box 1504,78-495 Calle Tampico
14 QLdnta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: —79 %l 0A7 Z
Owner's Name:. GJ1.1 G
A. P. Number. /03 /6 4t. -
Address: 9 7 0. I -IN %
Legal Description:
City, ST, Zip: Z 64 J e.�) Z
i
Contractor.
Telephone:
Address:
Project Description: 7, N
City, ST, Zip:
Telephone: §
MIN ym
State Lic. # : City Lic. #;
Arch., Engr., Designer.
2I
CL
Address:
City., ST, Zip:
Telephon -- o -7-7.4-— 29-6-7
State Lie. #: 9-3o p ) 3 7Project
Name of Contact Person: L L, u. �t
Construction Type:. Occupancy:
type (circle one): New Add'n Alter Repair Demo
Sq. FL: # Ston7s: # Units:
Telephone # of Contact Petso 67(, O
Estimated Value of Project 3 b
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Reed
TRACKING
PERMITFEES
Plan Sets
Plan Check submitted
Item Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss C21cs•
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted..
Mechakilcal
Giading plan
2'` Review, ready for correctionstissue
Electrical
Subcontactor List
Called CoutactPerson
Plumblog
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
1N ROUSE:-
'^' Review; ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
AJ-P.P.
Pub. Wks. Appr '
Date of permit issue
School Fees
Total Permit Fees
:Certificate of. CompBance (Sig6 Lighting) (Page 1; of 2) . SLTG-1C
Project Nam .
Phase of Construction ❑ New Construction ❑ Addition ❑ Alteration
r QOLL �N 1. t ort S
Function Type JILOutdoor Signs 13 Indoor Signs
Project Address :- -7
Date:
Compliance Method Used [3Maximum Allowed
/ 2
!e. D
Lighting Power [3Alternate Lighting Sources
Documentation Author's Declaration Statement
• 1 certify that this Certificate of Compliance documentation is accurate and complete.
Name
Signature
Company
Date
Address
` /- fL%SdGG✓Q.�-1
If applicable:
CEA#
CEPE #
City/State/Zip
Phone:
Principal Lighting Designer's Declaration Statement
• 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
Title 24, Pages 1 and 6 of the California Code of Regulations.
• 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 application.
Name: 7
Signature
S
❑
Company:
Pho
Address: s �c�d �� �
License #
City/State/Zip: � L �� r l l
Date
Sign Mandatory Measures
Indicate location on building plans of Mandatory_Sign Measures Note Block:
Mandatory Sign Lighting Controls
Yes
No
1
§133(a)1. All signs with permanently connected lighting are controlled with an automatic time switch control
❑
that complies with the applicable requirements of § 119.
§133(a)2. All outdoor signs are controlled with a photo control or outdoor astronomical time switch control.
❑
2
Exception to §133(a)2. Outdoor signs are in tunnels or large covered areas that require illumination during
❑
daylight hours.
§133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce
❑
S�
sin power by a minimum of 65 percent during nighttime hours.
Exception I to §133(a)3. Signs are illuminated for less than one hour per day during daylight hours.
❑
R
3
Exception 2 to §133(a)3. Outdoor signs are in tunnels or large covered areas that require illumination
❑
15?
during daylight hours.
Exception 3 to §133(a)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps are used to
❑
a
illuminated signs or parts of signs.
§133(a)4. An .Electronic Message Center (EMC) having a new connected lighting power load greater than
Y
N
N/A
15 kW has a control installed is capable of reducing the lighting power by a minimum of 30 percent when
'
❑
❑
tX
4
receiving a demand response signal that is sent out by the local utility.
Exception to §133(a)4. The EMC is required by a health or life safety statue, ordinance, or regulation,
Y
N
N/A
including but not limited to exit signs and traffic signs.
❑
❑
21
2008 Nonresidential Compliance Forms August 2009
Certificate of Compliance and Field Inspection Energy Checklist (Sign Lighting). (Page 2 of 2)
SLTG-IC
Project Name:
Date:
Compliance Method
Maximum Allowed Lighting
Power
A
B
C D E F
G
H
I
J
K
Design
Complies?
Light.
Field
Allowed Watts
Watts'
Y/N
Source
Ins cto?
v
O
U
E
°= ccoo
cd
�'
a
E VI
U
i
O cd
O
U 0
?GO NO
o
t3❑
:
Description or location and fan location
C
Lev tiJ
--5
o
1. 3
❑
❑
Total Sign Area:
1. Design Watts = total connected lighting load installed in the sign, including power used by lamps, ballasts, transformers, power supplies, etc.
2. If Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary, Use additional sheets i necessary.
The sins identified above; use only one or more of the following technologies: list all applicable numbers that apply in column I above
1 High pressure sodium lamps
2 Pulse start or ceramic metal halide lamps served by a ballast with >_ 88% efficiency
3 Pulse start metal halide lamps that are <_ 310 watts, are not 250 watt or 175 watt lamps, and are served by a ballast with > 80% efficiency
4 Neon or cold cathode lamps with transformer or power supply efficiency >_ 75% with rated output current < 50 mA
5 Neon or cold cathode lams with transformer or power supoly efficiency >_ 68% with rated out out current >_ 50 mA
6 Fluorescent lamps with a minimum color rendering index CR! off
7 Light emitting diodes LEDs with a power supply with >_ 80% efficiency
Single voltage LED external power supplies designed to convert 120 volt AC input into lower voltage DC or AC output, having a nameplate output power less than or equal to 250 watts, and
8
certified to the EnerjRy Conu4ssion as complying with the applicable requirements o the Appliance Efficiency Regulations(Title 20
9 Compact fluorescent lamps that do not contain a medium screw base sockets (E24/E26
10 Electronic ballasts with a undamental output frequency >_ 20 kHz
Field Inspector Notes or Discrepancies
2008 Nonresidential Compliance Forms August 2009. •