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BSIGN2014-101078-495 CALLE TAMPICO LA QUINTA, CALIFORNIA Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: CERTIFIED SIGN 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 4. *aw COMM UNITY' DEVELOPMENT DEPARTMENT BUILDING PERMIT - _ r BSIG2014-1010 78850 HIGHWAY 111 643080049 (1) LED ILLUMINATED WALL SIGN $4,600.00 LICENSED CONTRACTOR'S DECLARATION SEP 2 4 2014 CITY COMMUNITY DEVELOPMENT LA NtM-OE M N7 I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 {commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: License No.::LIC-0005300 Date: Contractor: OWNER -BUILDER DECLARATION Lhereby 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 7006) 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.). (_J 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 Lender's Add VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/24/2014 Owner: MCS HHG LLC 71-084 TAMARISK LANE RANCHO MIRAGE, CA 92270 Contractor: CERTIFIED SIGN 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 (951)928-2480 Llc. No.::LIC-0005300 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: _ Policy Number: 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.1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: 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 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 this city to enter upon the above - mentioned property for inspection purposes. Date: Signature (Applicant or Agent) ON 5§ 4_ *tt .cps h �x. :. � _ �DESCRIPTIQN •� • k.:A?`,i ,-:a;x_+; �..A. 's E ; <k ;.•. ,N� '�3 TY., �. i��,. ACCOU T.�xOU �.,Pp —My rbiRhr `Tbe ,..a4': F *v>`..'• ID.�.. ... ..>ssr.' 'I', ' xPAIDDATE. BSAS SB1473 FEE 101 0000'-20306 ' 0- `$1.00 : 3d`xxe RS "�< ; -= � c!,+,•=.t: "` ,. .'`�'. '{,,,;.a<Pf i PAID BY� . ;.:� r_u.xctssr„:v'.k'tt-..c?a..c..+,`.-t.9-..r�-I''s�., €'§G`}"'`'Fc -:. E : ' =« .!,:< ,,, v METHODa r'4i;J?•;,'Gs' ".is -<rr:' �.. 7., '; o i' i.: 1 b''..` RECEIPT(#:,.: ."T,s. -�v�.6''..' C , ,CHECK #, .:F.k.}3�<�`. CLTDBY ✓<A8<�,-,4a.°.fE:v.°.it'`� CERTIFIED SIGN _ CHECK R1422 16045 MFA-:'' Total Paid forBUIL61NG STANDARDS ADMINISTRATION BSA,_ $1.00 $1:00 .:T ' 'f9' SCRIPION� Gtiy :e^v°Jk R '�ri�,�ACCOUNT�} $ OVNI MFOUN '`q��7��`��'i ::. >Pz'PAIJ<'D`a DA;T4h.E€ WALL/AWNING SIGN; FIRST • 101-00 00-42404 0. . $24.31 . $2431 9/24/14 ..e . fig'. ,:✓' n'T$q .fir. `2�Y+�Y4 .xYff4'7:�iXJ:Yi.'%Y �y:^ ..;s SYS: di3Q Seg-.2-rtt+,ST-::1^�< : 4xiX3' 45fe _ - n z 'E �.4-i��c "t�.. § METHOD y Z"czi..:4o-.,..r"t d` :.:mow'-. < 4 �"oi�i�€i`` ... RECEI-PTx# �ie«,�r �tr-rrk3,«dfr.> 'iF<"1 n 'n,t..g-�..agl CHECK #.,.. �4�<��€._K�i: CLTQ BV: CERTIFIED SIGN _ .. CHECK `. Via. R1422 16045.:. MFA W 'i°' -. s: may:. p t ..., - - : ai °„+`fix ,p- .� . - '�h='r Sig`- ACCOUNTS' A..,e + .. ....:�`. Q TY,AMOUNTn 3 sw.. , ti. "$,:?^Xi : <Ar.< a ,�, ., .'t ` a:r. .- e K.Y t .,i«. +, a�$g qv ;_ ;:c `� _.,A ' ` P I < A DADATE i&A.91Wi:Y WALL/AWNING SIGN, FIRST PC 101-0000426001.. 0 " $85.80' : $85.80; 9/24/14 ., :§:. " (�'`Y Sr, k .� ar.,-PAID BYE° n. ',. :.nr .,s�"si 'yes. .;. uqy..< 6 M' ; METHODn '.?:r_,'aiS� s.�. ,:'x�_.a_.�:.: . s�.s.YYwz<f�.. ' .< .._-.:8 -"}`s�`�n_a.L"r,4 _tn.f:; �Y 3 ;S t Eg ?, �: RECEIPTS#:..� r`. . .:,: ^k�a'e's:+�<S4k zsn4: F.':s`fl u 3 CHECK-#.. ..!! ."m'S"q 1§�:i u# CLTD.BY i`: Ru. „`` CERTIFIED SIGN CHECK' 111422 16045 MFA' Total Paid'forSIGN: ;.$110.11 $110.11 .;. Description: (1) LED ILLUMINATED WALL SIGN Type: SIGN Subtype: Status: APPROVED Applied: 9/2/2014 KHE Approved: 9/23/2014 KHE Parcel No: 643080049 Site Address: 78850 HIGHWAY 111 LA QUINTA,CA 92253 Subdivision: PM 25865 Block: Lot: 4 Issued: Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $4,600.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: INSTALL (1) LED ILLUMINATED WALL SIGN 21 ,i �J Appl�edao Approved'` Printed: Wednesday, September 24, 2014 12:17:46 PM 1 of 2 __ DESCRIPTION ACCOUNT QTY, AMOUNT PAID PAID DATE f RECEIPT # CHECK:# METHOD ,: PAID. -BY CLT.D BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 9/24/14 R1422 16045 CHECK CERTIFIED SIGN MFA Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: WALL/AWNING SIGN, 101-0000-42404 0 $24.31 $24.31 9/24/14 R1422 16045, CHECK CERTIFIED SIGN MFA FIRST WALL/AWNING SIGN, " 101-0000-42606 0 $85.80 $8S.80 9/24/14 R1422 16045 CHECK CERTIFIED SIGN MFA FIRST PC Total Paid forSIGN: $110.11 $110.11 ..PARENT PROJECTS I, Printed: Wednesday, September 24, 2014 12:17:46 PM 2 of 2 lespw ........ Bln.# City Of I.t1 Quintd i Building a Safety Divtslon # S P.O. Box 1504,78-495 Calle Tampico . La.Qulnta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Owner's Name:. Lily (CS . Lily 71 A. P. N.um Address: ql-S 3c> �L "t. S.Z Z,sv Legal cription: ,� City, ST, Zip: PW „, (.r/% 9 0 Contractor. ( n Telephone: (ec) ZZ S 3 `i 3 Address: 0 +, zly -'�� Project Description: City, ST, Zip: J/� L L� Z 5 0 (e Telephoner 15 j I Orn i,"'�l State Lia # : S City Lie'. #, Arch., Rngr Designer Address: s, City, ST, Zip: w (� � 3(AD —7 Telephone: 3 S� �� �v r '`�. State Lic. #: " ' i :"ss% •' , Name of Contact Person: J� o- Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq, Ft : #Stories: # Units: Telephone # of Contact Person: �� . +i Z l " 9 i S`� Estimated Valise of Project: D APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Reed TTtACIMG PERMrrFEES Plan Sets 3 Plan Check submitted,. 4 a Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit. . Truss Cates. Called Contact Person 2 Plan Check Balance Tide 24 Cal& Plans picked up nstraction Flood plain plan Plans resubmitted.. Mechanical Grading plan 2" Review, ready for corrections/issue Electrical 1 Subeontactor List Called Contact Person Plumbing a Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' Review; ready for correctio 11, Developer Impact Fee 2 Planning Approval. Called Contact Person A I.P.P. Pub. Wks. Appr Date of permit issue ov- 1 School Fees Total Permit Fees q � �p0� Ca r&eur �c.ei'�S/ F-ai2MS-.C"�4<< -� �4'l2OSA T� STATE dF CALIFORNIA,' SIGN I IGH`�ING ' Ila CEC-NRCC-LTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 1 of 5) Project Name: ( Date Prepared: Project Address: -7y _ .�, 1+vim Y La C� 4-1. j/%,[ e_ / CA_ Location of Sign ErOutdoor Signs ❑ Indoor Signs Phase of Sign Construction ErNew Signs ❑ Sign Alterations Type of Lighting Control O'New Lighting Controls ❑ Replaced Lighting Controls ❑ Not Installing Lighting Controls This Certificate of Compliance includes the following components (check all that apply) ❑ Mandatory Measures (Lighting Controls) ❑ Maximum Allowed Lighting Power .PfSpecific Lighting Sources 1. Mandatory Sign Lighting Controls NOTES: 1. The some 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 for the entire construction. la. Statements of Responsibility: Any person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E shall complete Part la. Check Yes or No for all of the following statements: 1 1 have responsibility for installing the sign lighting controls ❑ Yes, complete parts 1a and lb of this -form ZNo, complete part la of this form 2 There are no existing sign lighting controls and I will be installing compliant sign lighting controls ❑ Yes EfNo 3 There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls ❑ Yes ffNo There are existing sign lighting controls that do not comply with the applicable provision of §110.9 and §130.3 and I will be 4 installing compliant sign lighting controls ❑ Yes' IffNo There_ are existing sign lighting controls that do not comply with the applicable provision of §110.9 and §130.3 and someone 5 else will be responsible to install compliant sign lighting controls ❑ Yes eNo CITY OF LA QUINTA BUILDING & SAFETY DEPT. 6`.ppROVED CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 z i STATF,OF CALIFORNIA SIGN LIGHTING '4 CEC-NRCC-LTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 2 of 5) Project Name: !_ Date Prepared: ' (] lb. Mandatory Sign Lighting Controls If the person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E 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 mandatory measures (sign lighting control) note block can be located: 1 §130.3(a)1. All indoor sign lighting is controlled with an automatic time -switch control or astronomical time- Y N NA switch control. ❑ ❑ 8' §130.3(a)2A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time- Y N NA 2 switch control, or an astronomical time -switch control. ,®' ❑ ❑ EXCEPTION to Section 130.3(a)2A: Outdoor signs in tunnels, and signs in large permanently covered outdoor Y NA areas that are intended to be continuously lit, 24 hours per day and 365 days per year. ❑ _-a §130.3(a)2B. All outdoor sign lighting that is ON both day and night is controlled with a dimmer that provides the ability to automatically reduce sign lighting power by a minimum of 65 percent during nighttime hours. Y N NA 3 Signs that are illuminated at night and for more than 1 hour during daylight hours shall be considered ON both ❑ ❑ .a day and night. EXCEPTION to Section 130.3(a)2B: Outdoor signs in tunnels and large covered areas that are intended to be Y NA illuminated both day and night. ❑ .2- §130.3(a)3. Demand Responsive Electronic Message Center Control. An Electronic Message Center (EMC) having a new connected lighting power load greater than 15 kW has a control installed that is capable of Y ❑ N ❑ N/A fr" 4 reducing the lighting power by a minimum of 30 percent when receiving a demand response signal. EXCEPTION to Section 130.3(a)3: Lighting for EMCs that is not permitted by a health or life safety statute, Y NA ordinance, or regulation to be reduced by 30 percent. ❑ 2- Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 _ d , STATE OF CALIFORNIA SIGN LIGHTING' CEC-NRCC-LTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION --s-_ CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 4 of S) Project Name: (- Date Prepared: 3. Specific Lighting Source Method of Compliance - Certificate of Compliance and Field Inspection Energy 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 the maximum allowed lighting power method of compliance) A B- C p E OPTIONAL Specific light source used for Field Inspector; ; Symbol ENERGY VERIFIED compliance or Description label Shall include only.lighting Check that Sign .Complies= Code (see instructions technologies listed below - below) List all that apply ��� rIIVM/ne.G�-GoE' I/J�l�� S( /� _ ❑ .n ",.• _ :, ❑ �,. 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 C OPTIONAL - Check this box only if this sign has a permanent, pre-printed, factory -installed ENERGY VERIFIED label, confirming that this sign complies with the Section 140.8 of the California 2013 Title 24, Part 6 Standards, using the Specific Lighting Source Method of Compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized 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 inspection program carried out by a Type A Inspection body in accordance with ISO/IEC 17020. For signs with such 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: c List all applicable numbers (1 through 9) that apply 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 C82.6-2005. 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 3 a ballast that has a minimum efficiency of 80 percent. Ballast efficiency is the measured output 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 transformer or power supply efficiency greater than or equal to a minimum efficiency of.75 percent D 4 when the transformer or power supply rated 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 transformer or power supply efficiency greater than or equal to a minimum efficiency of 68 percent 5 when the transformer or power supply rated output current is 50 mA or greater. The ratio of the output wattage to the input wattage is at 100 percent tubing load. 6 Fluorescent lighting systems meeting one of the following requirements: A. Use only lamps with a minimum color rendering index (CRI) of 80; or B. Use only electronic ballasts with a fundamental 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 are 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 to 250 watts, shall comply with the applicable requirements of the Appliance Efficiency Regulations (Title 20). 9 Compact fluorescent lamps that do not contain a medium screw base sockets (E24/E26). E I This page doubles as a field inspection checklist. Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 A STATE 6F CALIFORNIA SIGN LIGHTING EC-NRCC-LTS-01-E(Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 5 of 5) Project Name: ♦}" �/ ( 'Date Prepared: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: jj��� Joe- IIL.J�ci�— Documentation Author Signature: Company: /► /.n , /) Signature Dale: Z Address: �> OX y� CEA/ HERS Certification Identification (if applicable): City/State/Zip: Phone: 2—r RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 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 (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance 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 included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: �1 Company: r Date Signed: C Address: ,� � - ff G� License: J .City/State/Zip: Phone: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 - `k _ I Certificate of Compliance (SignLightin) (Pagel of 4) SLTG-1C . Project Name: +. Date: Project Address: U Location of Sign O*Dutdoor Signs ❑ Indoor Signs Phase of Sign Construction O'New Signs ❑ Sign Alterations , Type of Lighting Control $New Lighting Controls ❑ Replaced Lighting Controls ❑ Not Installing Lighting Controls This Certificate of Compliance includes the following components (check all that apply) ❑ Mandatory Measures (Lighting Controls) ❑ Maximum Allowed Lighting Power H'Specific Lighting Sources 1. Certificate of Compliance Declaration Statement (this may be a C10, C45 or other eligible person) t I certify under penalty of perjury, under the laws. of the State of California, the information provided on this form is true and ' correct. + I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the lighting design. l� This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with Title 24, Parts 1 and 6 of the Calif6mia'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: ..Signature .. , Company : ^ . Phone 9Sl l Z 1i0 '7' Address: (� p License number (may be contractor's lic #) City/State/Zip: _ _ e b' Z 5' / 2. Installation Certificate (to be signed by responsible person after installation) Permix�tllbs�ax ly�T`* 'ta C',a f�y`'f}"yam ijr rt` t;Checkedby%Datcr�'�Yiy'ihk S� �`c-j �{ I .}f1 V•t� �fW �SR 7g�R-I - v � '.O-forcement A an Use (-^ ','r4 lv—� '? �`�,Vi F..d�r_-J'. Installation Declaration statement ❑ I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. ❑ 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. ' ❑ I certify that the installed features, materials, components, or manufactured devices identified on this 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 shall be posed, permit(s) issued for the building, and made available to the enforcement agency for a ap l�' T1 n@FotsA nt i 1 A that a signed copy of this Installation Certificate is required to be included with the d c,byilr s tp�tj building 6tt �jt j-' owner at occupancy. Company Name: Responsible Person's Name: Responsible Person's Sign re: License number (may be contractor's lic #) Date Signed:' Position With Company: DATE M p= BY E P 2008 Nonresidential Compliance Forms CI October 2010 a Ol iY (IF Jq M111 ITy info E C�r'r - r ,_N Certificate of Compliance (Sign Lighting) (Page 2 of 4 SLTG-1C Project Name: /r � LLY'XI � Date / g 3. Mandatory Sin Lighting C ntrols 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 ❑ Yes, complete parts 3a and 3b of this form ErNo, complete part 3a of this form 2 There are no existing sign lighting controls and I will be installing compliant sign lighting controls ❑ Yes J'No 3 There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls -Yes -E ❑ No 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 ON ' There are existing sign lighting controls that do not comply with the applicable provision of § 119 and § 133 and someone else 5 will be responsible to install compliant sign lighting controls ❑ Yes 5KO 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 com 1 in .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 re uirements 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 § 119. ❑ ❑ Exception to §133(a)2. Outdoor signs in tunnels or large covered areas that require illumination during Y NA daylight hours. ❑ .a, §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 L3-" NA ❑ 3 Exception 2 to §133(a)3. Outdoor signs in tunnels or large covered areas that require illumination during Y NA daylight hours. ❑ -2� 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. ❑ 0' §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 Y NA but not limited to exit signs and traffic signs. ❑ $ Field Inspector Notes: 2008 Nonresidential Compliance Forms October 2010 • y Certificate ofCompliance (Sign Lighting) (Page 4 of 4 SLTG-1C Project Name: _ 1--b L"(� L'v Dace: zg 5. Specific Liehting Source M hod of Compliance Certificate of Compliance and Field. Inspection Energy Checklist Complete this part if there are signs using the Specific lighting source method of compliance. (Complete part 4 of this Certificate of Compliance if there are signs usin the maximum allowed lighting ower method of compliance) A B C D' E • OPTIONAL Specific light source used for "t Fteld } .Symbol ENERGY Inspector:: VERIFIED compliance •Check that) or Description label Shall include only lighting Code (See instructions technologies listed below ' Complies` below) List all that apply 1 jr e?. ' t❑ ❑ ;sty tf" Wi i� El 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 C . OPTIONAL - Check this box only if this sign has a permanent,'pre-printed; factory -installed ENERGY VERIFIED label, 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. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized 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 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, 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 I through 10 that apply in column D above for each row. 1. High pressure sodium lamps 2 Pulse start or ceramic metal halide, lamps served b a ballast with >_ 88% efficiency 3 Pulse start metal halide lamps that are < 320 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 s upply efficiency>_ 75% with rated output current < 50 mA S Neon or cold cathode lamps with transformer or power supply efficiency>_ 68% with rated output current> 50 mA Fluorescent lamps with a minimum color rendering index (CRI) of 80 6 (Note: when using electronic ballasts for compliance, lamps with a CRI < 80 may be used 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 ' 8 output, having a nameplate output power less than or equal to 250.watts, and certified to the Energy Commission as complying with the applicable requirements of 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 fundamental output frequency > 20 kHz a e doubles as a field ins ection checklist. EeldThis Inspector Notes: ` 2008 Nonresidential Compliance Forms, October 2010 RECEIVED SEP 02 Z014 CITY (,,F LA QUINTA COMMUNITY DEVELOPMENT Upon arrival at the job site, if you find any di between the drawings and the actual physic characteristics of the building which may rec repositioning of the signs, or if someone on site tells you to install the signs in a different than is called for on the drawings, stop immo and call one of the following for authorizatioi Image National, bwffton / 1-800-592-805 Hobby Lobby Store Planning - Larry Hostetfi or Jack Johnston / 405-745-1351; Failure to do so may result in the installer hc- the expense of reinstalling the sign in the co -:R -DED W rerences lire ,ie job position diately ext 223 r / 405-745-1178 to bear position. CITY Off -LA QUINTA UILDING & SAFE T Y DEPT. PLPROED FOR CONSTRUCTION PY 1►M�• El 0- APPRO ON' PLAWNING ®EPAPT ENT BY — DATE o t EXH'ISIT CASS E K'0. LF -E) !E3D W 10 -'3 Upon arrival at the job site, if you find any di erences between the drawings and the actual physic I characteristics of the building which may re ire repositioning of the signs, or if someone on a job site tells you to install the signs in a different position than is called for on the drawings, stop immE diately and call one of the following for authorizatio : Image_Nat ional . won / 1-800-592-805 ext 223 Hobby Lobby Store Planning - Larry Hostetter / 405-745-1178 or Jack Johnston / 405-745-1351; Failure to do so may result in the installer he ving to bear the expense of reinstalling the sign in the co rest position. RECEIVE® JAN 3 0 2014 CITY OF LA QUINTA COMMUNITY DEVELOPMENT Y / 20'-4 3/4rr T-8 5/8" 19'-8 5/8" ED r :—r ED ;. ? Mfg.. & Install,(1) 54" "HOBBY LOBBY" S/C LED Channel Lefler set- • ; . F scale: -3/16"=1'-0" B .*,FACE' IS RETURNS:- ®•ILLUMINATION., _ / MATERIAL:.177 TUF-GLASS -' MATERIAL: PRE -PAINTED .063 ALUM: MATERIAL: GE E t ``' Y - SIZE: 8" -: SIZE: TBD °. ' . , • -, COLOR: #2119ORANGE ' y �' CITY OF LA QUIN jCOLOR: Semi -Gloss Black (Outside) COLOR: Red/orange BUILDING & SAFETY DEFT. - White (Inside) " , O RETAINERS:, - 1 /z G BACKS. Q :ELECYRIC/1L: Y FOR CONSTRUCTION j - = 4 U • 11 : PRE -PAINTED .063 ALUM. TRANSFORMERS:' TBD MATERIAL:t j ^ MATERIAL: RETAINER SYSTEM 1 COLOR: Semi -Gloss White ( Both Sides) r ,DATE _ SY�_ -- ' ON COLOR:. BLACK .TOTAL amps: TBD ED ED . t. t f -' BOXED XED SQUARE FOOTAGE =187.2sf A: 'NOn-Corrrosive Securement - - . _ ..� _ q t -� - -- - _ --- - -- �` - ----- -- -- -- - 1, _ ED ED LTR w/'Rivet Nut & All- Thread Attachment _ y,' _ 1, O'ED O ED or #14 X 3". Screws ° .. --- -- -- - ----------=' _ -- -- --- - -----_ -' 87.1 sf 84.2 sf B:'/2 lexible Conduit Whip to 120v Power i _ SPLIT BOX SQUARE FOOTAGE=171.3sf D. (1) 20-amp 120v Circuit Required 6 A (supplied.by others than Image National) - - - ' . "' • - � E. Disconnect Switch Required in• EA. LTR INDIVIDUAL BOXED LETTER AREA =152.6sf • (Supplied tiy.lmage National) riff the Intent and purpose of this color rendering to provide a basic color representation bf your stgn finish and color. However, digital media end printed colors will vary from actual palm finish an— d ccoolor� _ r - a.Ps, •_r _ .'' - �: --, Existing painted -surfaces will have a perceptible difference in shade and sheen from your sign fmish'Providing a sample,of the paint you wish to match or a Matthew_ s paint color formula will minimize the differences,, 16265 Star Road Nam a ID 83687 toll free: ' 800.592.80" fete: 208.345.4020 fax: 208.336.9886 , www.imagenational.com . _ ^� P PBOJEBf iIIlE: ti EOfNIOH: BATE: •• DRAWN BY: page # ` �~ 00.00.2012 S. Carico • • 0 � 111 COMPUTER fla. I i� O B B u L ®' B Washington St. HL LaQuinta-C • i%s� • • • ` p,. ACCOUNT fMEEL flEWSON: �► .� 1*;t > - 4 La Quinta, CA 92253 R. Paulson. R13 01.17.2014 ii sdfe C, th r t the nii' fifi dev b o e transfer r f wn i i' on display a design "" thR ` n i' distr bate ro es o e ns e a o a sh d d d s ' ©2013 image national si ns. This design is an original work of authorship b image Notional Inc (image) which owns the co ri ht rotedion b them rt ht law of the United Stoles title 17 U.S. Code). All tights are reserved b ima a and, until the use of this dash n is authorized ima a in vrtittin , ima a owns the exclusive rights to: a) reproduce this design in copies, in graphic form or as s sign; b) prepare derivdfive works bused upon a devg ,) p A Y P, ) _ P Y A publicly. _ r A 8 A_ P Y A i A) PY,A P Y PY A _ ( ) A Y 9, „ A b<'- 9 .A 9 _ 8 ,_Y s a , CHANNEL' LETTER SIDE DETAIL scale: KIS A. Non-Corrrosive-Securement 3/8" Rivet Nut w/ All-Thread'Attachment (or 3" x #12 Screws) � r 1 a bask color rep" n shade and sheei 22t_8 ttCM , i t - O.FACE: ; ©.RETURNS: © TRIMCAP: Q BACKS: f f MATERIAL: 1/8" ACRYLIC - MATERIAL:.111 JEWELITE TRIMCAP MATERIAL: PRE -PAINTED .063 ALUM. 'MATERIAL: P + 'MATRE-PAINTED .040 ALUM. ' COLOR: 2648 or COMPARABLE '_ SIZE: 5' COLOR: BLACK COLOR: Semi -Gloss White (Both Sides) COLOR: Semi -Gloss Black (Outside) �. ' White (Inside) ' id color. However, digital media and printed colors will vary from adual paint finish and color. ng a sample of thepand you wish to meta, ors Matthews paint color formula wrp minimize the_d t(erences. 16265 Star Road Nalm a'ID 83687 , toll free: 800.592.8058 . telei 208.345.4020 ' Sfax: - 208.336.9886 www.lMa enationel.com - J' . . r .. jnt .. . _ ...,. u P INDIVIDUALBOXED LETTER AREA•=38.2sf . 141-411 Nr i i i 1� L ram_ INDIVIDUAL- BOXED LETTER AREA=26.8sf 101-3 • E 2 7 a' ' N \ . N i t' INDIVIDUAL BOXED LETTER AREA=19.9sf ` . INDIVIDUAL BOXED LETTER -AREA, = , _Mfg.. &Install (1 EA.)*_24" Non -illuminated Channel Letters scale:•1/41t=1,_0;t - , SIGN SIZES & SQUARE FOOTAGE GRAFT'S: 019.9sf SEASONAL: • HOME ACCENTS: FLORAL: ®1-8.6sf I e VPyNUJECEEIiIE: - EOEAIION: OAE: 00.00.2012 DRAWN BT: $. Carico r 4 111' • • + HO�� , ®� �� Washington St. SU.: . COMPUTER FILE: HL-LaQuinta-.0 ' La Quinta, CA 92253• , ACCOUNT ENEC. R. Paulson REVRION: . R13 01.17:2014 Page # c n the de i n- t i ti ate i6 i' of`' desi n sale ar other transfer of ownership; and display.th d n publicly. 02013imagenationalsigns.ThisdesignisanoriginalworkofauthorshipbyImageNational,Inc(image) which owns the copyrightpmtedionbythecopyrightlowoftheUnitedStates(title17,U.S.Code). All tights are reserved by image and, o)reproducethisdesignincopies,ingraphicfarmmosasign,b)preparedeavativewarksbusedupo sg, )dub pas g by ershp,o�d) a design a 242 $' — E0. 49.1 Cr E0. _ E0. 10.6' E0. 14'4• E0: E0. 10-3• E0. 2?4r E0. 35'4' ' W S 28'-8- f r" ` 242-3" _ z r EQ. 43,_10" EQ.. _ EQ. 101-6° EQ. 14'4° . En. trv_a° cn ' W .� •N--------------.------_- ---- _ _ ---- " ��' B`�` 0 ��wf��l���(+�,�11>=�wsw�wewwal�►�if�Vl����C�.� 43ao d 3 10 6" 14'4° 21y-43/4• - - 7.85!8'- . O M. LOB �; M r INDIVIDUAL BOXED LETTER AREA=19.9sf. . INDMDUAL BOXED LETTER AREA=26.85f �LJJ U u J 22'.8° ®Mfg. III Install (1) 54" "HOBBY LOBBY° SIC LED Channel Letter set Alt scale: 3/32"=1'-0"' " N u : �, L�11 ALJ�9 • N Pr n INDIVIDUAL BOXED LETTER AREA =38.2sf INDIVIDUAL BOXED LETTER AREA=18.6sf EM Wj. & Install (1EA.) 24" Non-IOuminated Channel Letters SIZES & FOOTAGE SQUARESIGN :: :: 51' 1 4" x 0-10" 171.3sf ' . 24" x 10 4' '18.6sf 24" x 22'-8" 38.2sf ' 24" x 10'-6" 19.90 ° 1 24" x 14'-4" 26.8sf 274.8sf C i 1 k Is the Intent and purpose of this color rendering to provide a basic color representation of your sign finish 'and color. However, digital media and primed colors willmytrom acttel paint finish and color. Existing painted surfaces will have a perceptible difference in shade and sheen from your sign finish., Providing a sample of the paint you wish to match or a Matthews paint color formula wig minimize the differences. — 16265 Star Road Nampa, ID 83687 toll free: 800.592.8058 tale: 208.345.4020 fax:. 208.336.9886 "www.imagenatlonal.com TI . , . RATE: AW - a:`, _ o• • • - OJECf IlE' ' • LOCATION: : RR N BY. 00.00 2012 S. Carico® I I page # . • . 0 . • L r 111, B.R.: COMPUTER flu: o o�- Washington St. L HL-LaQuinta-C I A 92 RM La Qu'rita, C 253 - Acca E>�c REVISIRN z -- - R. Paulson R13 01.17.2014 • - - o e notional signs. Th . . _ -... _ :_ . . _...,.. -,,..w - �02013im gadesignisanongmolvrodcofauthmshipbylmageNahonal,Inc.Qmage)ssfiidfownslheropynghtprotedmnbythecopytightlawaflheUnitedStates(ullel7,U.5.Code). Ninghtsarereservedhyimogeand,unhltheuseoflhisdesignisauthonzedbyimagemwntlmg,imageownstheezduyvenghtsta: a)repraducethisdeugnmcopies,mgraphiefaimmasosign;b)preparedervahvevroikshoseduponlhedevgn;c)disfnhutecopiesaEthedevgnhysalearotherhans(erofov+nership;and d)display, the design puhlidy. ORO= scue / / = �� 8 8 6tr `kdP �►CITY OF LA QUIRITA ,g. BUILDING &SAFETY DEPT. /�, Ar {�'• °' , ,. FOR C'flf4STRU3T10N .. do DATE 8Y .711.i,• 'ram �� g CMMMWM awmame 4j�J/ r y _ It is the intent and purpose of this eolor rendering to provide a basic color representetlan of your sign finish and color. However, digital media and printed colors will vary from actual paint finish and color. r ... Existing painted surfaces will have a perceptible difference In shade and sheen from your sign finish. Providing a sample of the paint you wish to match or a Matthews paint color will minimize the differences. 16265 Star Road Nampa, ID 83687 toll free:.800.592.8058 tale: 208.34 .4 f 208.336.9886 www.ima enationaLcom _ p , 5 020 fax: 9 t Paid ma: IOtA➢BN: DATE: DRAWN BY: F 00.00.2012 S. Calico page • • _ 0 = II Il ®tl..� ILA If LOBBY 111 b0.: CDNPDTfH flu: of Washington St. HL-LaQuinta-C R. Paulson R13 01.17.2014 La Quinta, CA 92253 ACCOUNT UK REVISION: - �; - , image notional signs. © 2013 ns. This lest n is an original work of authorship Image National Inc. (image) which owns the copyright mtection h the Cade � ' " ""' ' ` ' •" "�-"' "' �"" 9 9 9P by g ( 9)p ylaw of the United Stoles (fide] U.S. ). AN rights are reserved by image and, until the use of this design is authorized by image m wnhmg, image owns the ettlustve rights to: a) reproduce this design m metes, m graphic form or us a sign; b) prepare denvohve works bused upon the devgn; c) datnbute copies of the design by sole m other transfer of ownership; and d) display the design publicly.