06-1512 (SIGN)P.O. BOX 1504 4 44 Qot,64'
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-0000151.21 +. Owner:
Property Address: 79800 HIGHWAY 111 STE 110 99C ONLY STORES
APN: 649-020-040- - - C/O JEFF GOLD
Application description: SIGN 4000 E UNION PACIFIC AVE
Property Zoning: REGIONAL COMMERCIAL COMMERCE, CA 90023
Application valuation: 4600
Contractor:
Applicant: Architect or Engineer: SIGNARAMA
41945 BOARDWALK, "L"
PALM DESERT, CA 92211
(760)776-9907
Lic. No.: 830131
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am Ii nsed under provisio of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and fessionals C e, a my License is in full force and effect.
License Class:
�D4�2` Lic seN•.: 83 131
Date:7i, ��aibl'fCentracto7:-�^�� /'N
I hereby affirm under penalty of perjury that I am exempt froe Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Cq(J�: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structur 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 _ 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
I—) I am exempt under Sec. , BAP.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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/12/06
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
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 b oma subject to the orkers' ompensation laws of California,
and agree that, if I should bac ebt to t ��ywo ars' c pensation provisions of Section
1 3700 of the Labor Code, I s o h com • th th a provisions.
WARNING: FAILURE TO SECURE WORKERS'COI
COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND C L FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF MPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AN TTORNEY'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 18 days will subject
permit to cancellation.
1 certify that I have read this application and state that the above i ion' corre I a e to mply ith all
city and county ordinances and state laws relating to building c ru t' d her y a ori rep r ntatives
of this county to enter upon the above-mentioned property fo p rpos y
LQPERMIT
Application Number . . . . . 06-00001512
Permit . . . ELEC-ELECTRICAL SIGN
Additional desc . .
Permit Fee . . . . 30.00
Plan Check
Fee
.00
Issue Date . . ..
Valuation
. . .
.. 0
Expiration Date ... 10/09/06
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 15.-0000 EA ELEC
SIGN 1ST CIRCUIT
15.00
------------------------------------------------------------------
Special Notes and Comments
----------
ILLUMINATED CHANNEL LETTER SIGNS
PER
SA -06-975
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
Bin #
City of La Quinta
Building u Safety Division
P:O. Box 1504,78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permitfl
Project Address: 12100 �Wfl)) (t . 1 � bT e. J l 0
caner, s Name:
A. P. Number:
Address: �00 6. L AV
Legal Description:
City, ST, Zip;
ontractor:_ oLQ .
Address:CN6 Q uJGI v. e,
elephone:
Troject Description:
City, ST, Zip: t✓r� e A aal
/
-Te Iephone: M
City Lie. #:
State Lie. # (S
Arch.,. Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle bne): New Add'd Alter Repair Demo
Sq, Ft:
#Stories:
#Units:
Telephone # of Contact Person:
- stimated Value of Projec . 460 0 6 -
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Regld
Recd
TRACIMG
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
Energy Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading.plan,
2ad Review, ready for correctionsrssue
Electrical
Subcontactor List
Called Contact -Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
INHOUSE:-
'`d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
STANDARDAC RYLIC FACED ILLUMINATED CHANNEL LETTERS
24" HIGH, RED FACE, GOLD TRIMCAP, BLACK RETURNS
CG OMEGA BLACK FONT, 22" X 200"= 30.5 SO. FT.
FANCY NAILS APPROVED BY COMMUNITY DEVELOPpAENT DEPARTME`Y
79800 HWY 111 SUITE 110 By �� DATE jj4 "
LA OUINTA, CA 92253
FRONTAGE IS 26 LINEAR FEET EXHIBIT
CASE NO. — _':;P�L—e
Sin AAP (AL-:- WALI nlr:1IONS.
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M:MLII': EN:f -.L � -7 ..'
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L. 5. -1 - 'iETTERSa 1nNlG/"OHLIEN
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- -UI AFPNOVEn
STANDARD ACRYLIC FACED
ILLUMINATED CNANNEL LETTER
,TVPIrAL cot:Sinucfvltj,
S10fif*A *RARA
THE COACHELLA VALLEY'S PULL SERVICE EION CENTER
41-849 8—d—A.. Stn L. P.J. D.Lnt. CA 92811 PR. 760-776-9907
�i
Ap F�ve ; y: I ,
tl it
Customer Signature
Printed Name
t
)perty Owner
nted Name
CERTIFICATE
OF COMPLIANCE (Part 1
of 2)
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.
PROJECT NAM
C
a%
1. Use LTG -1-C if the project consists solely of indoor signs
DATE
)6
PROJECT ADDRESS
-7 - 900
w Y jyj LG C
3. Use OLTG-1-C if the project consists solely of outdoor signs
Buildinq Permit
Checked by/D-afe—
Enforcement Agency Use
PRINCIPAL DESIGNER -LIGHTING
m(70779-7107
TELEP
DOCUMENTAIVION AUTHOR
�Rama-C
TELEPHONE
(766)779-9901
GENERAL INFORMATION
OLTG-4-C
DATE OF PLANS
OUTDOOR LIGHTING ZONE ✓ One ❑ LZ1 ❑ LZ2 ❑ LZ3
❑ LZ4
FUNCTION TYPE
❑ OUTDOOR LIGHTING OUTDOOR SIGNS
❑ INDOOR SIGNS
PHASE OF CONSTRUCTION
❑ NEW CONSTRUCTION ❑ ADDITIONS
❑ ALTERATIONS
STATEMENT OF COMPLIANCE
This Certificate 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 accurate and complete.
DOCUMENTATION AUTHOR SIGNATU DATE
J, a
The Principal Lighting Designer herAy certifies that the proposed outdoor lig h ' and signs design represented in this set of construction documents is
consistent with the other compliance forms and worksheets, with the specifi ions, and with any other calculations submitted with this permit application.
The proposed building has been designed to meet the lighting requiremen s contained in the applicable parts of Sections 110, 119,130 through 132, 146,
and 149 of Title 24, Part 6. Please ✓ one:
❑ 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.
I affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code by section 5537.2 or 6737.3 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.
INSTRUCTIONS TO APPLICANT OUTDOOR LIGHTING COMPLIA E & 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-I-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-1-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 lighting
❑ OLTG-2-C
LIGHTING COMPLIANCE SUMMARY. Applicable Parts required for ALL outdoor lighting allowances (Except for Signs)
❑ OLTG-3-C
AREA CALCULATIONS WORKSHEETS. Applicable parts required for all outdoor area calculations.
OLTG-4-C
SIGN LIGHTING COMPLIANCE. Required for all internally and externally illuminated signs, for both indoor and outdoor
signs.
zuuo Nonresiuential Compliance Forms March 2005
CERTIFICATE OF COMPLIANCE (Part 2 of 2) OLTG-1-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)l
Not Applicable
❑ All permanently installed luminaires with lamps rated over 100 watts either have a lamp efficacy 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)l
Not Applicable
❑ Building facades, parking lots, garages, canopies, and outdoor sales areas meet the Multi-Level Lighting Requirements of § 132(c)2
Not Applicable
MANDATORY AUTOMATIC CONTROLS
CONTROL LOCATION
CONTROL
IDENTIFICATION
CONTROL TYPE .
Auto Time Switch/Photosensor, etc
AREA CONTROLLED
NOTE TO
FIELD
Roo m
v
Au o JA
546e
2005 Nonresidential Compliance Forms March 2005
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