BSIG2018-001478-495.CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype: SIGN/
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BSIG2018-0014
Property Address:
79660 HIGHWAY 111 STE 103
APN:
600030016
Application Description:
PALM TREE PALACE / ONE (1) CHANNEL LETTER -LED SIGN
Property Zoning:
Application Valuation:
$5,000.00
VOICE (760).777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
DUNES BUSINESS PARK
P O BOX 1216
HERMOSA BEACH, CA 922S3
Date: 7/23/2018
Applicant: / \ Contractor:
88 SIGN CORP DACK LEE / 88 SIGN CORP
1906 DOREEN AVENUE I 1906 DOREEN AVENUE
SOUTH EL MONTE, CA 91733 JUL 2 320 �$ SOUTH EL MONTE, CA 91733
(626)442-8033
CITY0FLAQUINTA Llc. No.: 702474
COMMUNITY DEVELOPMENT DEPARTMENT
---------------------------------------------------------------------------------------------
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.
License Class: License No.: 702474.
�Dasie: (.rf2,v Cont do
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division .
3 of the Business and Professions Code) or that he or she is exempt therefrom and the <
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(_) 1, as owner of the property, or my employees with wages as their sole
compensation, will do the work,�and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that
he or she did not build or improve for the purpose of sale.).
(_) 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 Address:
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: EXEMPT Policy Number: I
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Daie1,(IZ3 � 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 Zcioter upon the
above -mentioned property for inspection purposes.
Gat-,., Sigmas Hato e(Applicant or Agent):
r
Date: 7/23/2018
Application Nu.mber;,,
BSIG2018-0014
Owner:
Property ddress.-"
79660`HIGHWAY 111 STE 103
DUNES BUSINESS PARK
APN:
600030016
P 0 BOX 1216
Application Description:
PALM TREE PALACE / ONE (1) CHANNEL LETTER LED SIGN
HERMOSA BEACH, CA 92253
. Property Zoning:
Application Valuation:
$5,000.00
Applicant:
Contractor:
88 SIGN CORP
DACK LEE / 88 SIGN CORP
1906 DOREEN AVENUE
1906 DOREEN AVENUE
SOUTH EL MONTE, CA 91733
SOUTH EL MONTE, CA 91733
(626)442-8033
---------------------------------------------------------------------------------------------
Llc. No.: 702474
Detail: ONE (1) CHANNEL
LETTER LED SIGN [PALM TREE PALACE] SIGN PERMIT N0. 2017-0033 [CHFL] 2016 CALIFORNIA BUILDING CODES.
DESCRIPTION
BSAS SB1473 FEE
INFORMATION
ACCOUNT QTY. AMOUNT
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DEVICES, FIRST 20
.101-0000-42403
0
$26.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$26.01
Total Paid for ELECTRICAL: $52.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: • $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/AWNING SIGN, FIRST .
101-0000-42404
0
$26.53
DESCRIPTION
ACCOUNT
`CITY
AMOUNT
WALL/AWNING SIGN, FIRST PC
101-0000-42600
0
$93.62
Total Paid for SIGN: $120.15
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT -FEE: $5.00
TOTALS:
3
"I"k, DESERT
PERMIT # oot
PLAN LOCATION:
Project Address: / &Y
U
tO
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech I
APN #:
7 --
&,J S1e4
Applicant Name:
.Address:
U
City, ST, Zip:
K92
Telephone:
Email:
Valuation of Project $
Contractor Name:
:.
.<_Z�24)
New SFD Construction:
Address:
Conditioned Space SF
City, St, Zip.,.
Garage SF
Telephone g�
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: City Bus Lie:
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Telephone:.
Bedrooms:
Stories:.
#]nits:
Email:
State Lie: City Bus Lie:
-
Property Owner's Name:
New Commercial / Tenant Improvements:
Address:
Total Building.. SF
—ity, ST, Zip
Construction .Type: Occupancy:
Telephone:
J
Email:
/64y5 CALLL IAMNICU
LA QUINTA, CA 92253*
760-777'-7000
88'SIGN
1906 .DOREEN AVE
SOUTH EL MONTE, CA 91733
PH: 626-442 8033
6-21-2018
Dear whom may concern
I,Dan Han,. Luong (88 SIGN ,STATE LIC. #702474) hereby authorized
uDIAGK Z-EE to pull the pemits for One Job only.
PALM TREE PALACE
CHINESE FOOD
Job address: 79660, hwy 111 ste..#103
La quinta, Ca. 92253
If you have any questions or concerns. please give me..a call at
above phone: number. (626) 487-8869. Thank you.
Regards
Dan Han, Wong
ignature
f
A notary public or other officercompleting this certificate verifies only the identity of the
individual who signed the document to which this certificate is attached,. and not the truthfulness,
accuracy, or validityof that document.
STATE OF (•A 1 I FUfi _
COUNTY OF
On , before me,ZZ,4 %/UG/vG dtVA'1, a Notary Public,; personally
( appeared 0A►J wt, �vQ <� , who proved tome on! the' basis of satisfactory evidence
to be the person(•s) whose name(-,) is/ate subscribed to the within instrument and acknowledged
to. me that he/sue/they executed'the same .in his/Mr/their authorized capacity(i%), and that by
hisAmrkheir signature(,) on the instrument the person(a}, or the entity upon behalf of which the
persons acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of �i4LIf0�l//A that -
the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature of the Notary Public
TRA HUONG PHA
• = Commission No.-2�08235
NOTARY PUBLIC -CAL 4 ORN1A
lOS ANGELES COUNTY
My Comm. Expves JULY 31 2021
N
ta 0aigra - -
- GE\4 ofL& DESERT -
December 12, 2017
Jose Carlos Garcia
79660 Highway 111 Ste 103
La Quinta, CA 92253
SUBJECT: SIGN PERMIT APPLICATION 2017-0033: PALM TREE PALACE
Dear Mr. Garcia:
The Design and Development Department has reviewed and approved your request
for one internally illuminated sign for Palm Tree Palace, located at 79660 Highway
111, Suite 103, within the Dunes Business Park sign program. The sign is approved per
the sign exhibit on file, and subject to the following Conditions:
1. This sign permit grants one 50 s.f. internally illuminated sign to be designed
and located per the approved plan on file (attached).
2. The applicant,is required to obtain a building permit for the illuminated sign
prior to the placement of these signs.
Should you have any questions or need additional information please feel free to
contact me at (760) 777-7067.
Sincerely,
Cheri Flores
Senior Planner
78-495
• • • • • • 760.777.7000
:24.(Y'
.... . . ..... .... ......... ........ ............... 'DETAIL:
LAU
.24' TOTAL:. 50 SQFT.
41'STORE. ,FRONT
.............. .... ...
R�'
0
f I f .", , I I - 11 , 'A
0
d g
NEW WALL SIGN
PS ADDRESS-
-79660 HWY 111 ST68sipnlsbWto�l net E 103
:LA QUINTA, CA 92253'
TEL: :(026) 442-8033 1906 OOREEN WE
FAX*` (626) 350-5343 s. Ea, mONTE CA APPROVED - . , . BY: . .............. . .. . ....... ... ......
STATE L . IC: #702474 U.L. APPROVED GARE:�
St4.2.Gt1- cr33
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raa wry-.� " `��;F r. 1•✓g '! ' x
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4
240"
DETAIL:
�° CPALM TREE PALACE
15
12"�CHINESE CUISINE
1 1
120"
TOTAL: 50 SQFT.
NEW WALL SIGN
----- u 't car JOB ADDRESS
88i[ @abcBloeal.not
TEL: (626) 44 -8033 19" DOREEN /VE-
FAX: (626) 350-5343 S. EL MONTE CA 91733
SCALE
STATE LIC: #702474 I U.L. APPROVED _i
DAT
PROPOSED 4' DEEP CHANNEL LETTERS VrOALL SIGN,
INTERNALLY ILLUMINATED BY (12 V L.E.D. LIGHT)
SIGN FACE: 118' Thick acrylic face with 314' Black trim cap.
MATERIAL: Channel letters shall be fabricated by 0.04' thick aluminum
and returns w/ powder coated finish in Black color.
ALL ELECTRICAL COMPONENTS ARE TO BE U. L. RATED
3tW TFIM CAP
ACRYLIC FACE Q TRANSFOAMER 130(
w! DISCONFBCTS SWITCH
12 V TRANSFORMER
WHITE COLOR
L.E.D. LIGHT
3116"X3"SCREW
4 - 10 SCREW PER LETTER
W RAIN HOLD
3J4' STAND OFF SPACERS
. e61q
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE? ►0L
124 I
06-t6 b) 1LV.« L,&&44� S 1-40-4
Mot
79660 HWY 111 STE. 103
LA QUINTA, CA 92253 Mires
APPROVED BY.
IT16100 10
i4:rf+�• 'i - I�f�tY'•l'!'�F,rf is i �^i � it"J.t.'..,", �: a s .;�--�,�1�� `��. FTa. � Jt i �.31pv r .�i+� . . ��S . '�" '.
r
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y 1 , - i i 1 t 1, + - i4•f-- :it -
• . - ' �;.,y.+•�, � +'7 rT � _in-` � , �`� ;_,/Y�� : I .�.-,ran .�Y _ ;. � � � � y3r � - �s
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f! trN►Is !- S� i - �:.�^ �l'/' t �: k� �i i^�t. 1. . _
STATE OF CALIFORNIA
C1r%—K1 1 IP_`LJTI\1^
d6
CEC-NRCC-LTS-01-E(Revised 08/16) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting ' (Page 1 of 5)
Project Name: PALM TREE PALACE Date Prepared:
ti-20-2018
A. General Information
Project Address:
.1788 S. SAN GABRIEL BLVD
Location of Sign . Outdoor Signs ❑ Indoor Signs
Phase of Sign Construction 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 []Specific Lighting Sources
1. Mandatory Sign Lighting Controls
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
for the entire construction (e.g. a C-10 contractor may complete parts la and 1b on one compliance document and a C-45
contractor may complete parts 2a and 2b on a separate compliance document — the Responsible Designer shall submit the two
compliance documents together for the some complete installation).
I have responsibility for installing the sign lighting controls:
0 Yes, I have responsibility for the sign lighting controls, and will ❑ No, I do not have responsibility for installing the'sign lighting controls.
complete parts 1a and lb of this compliance document Someone else will complete parts la and 1b of this compliance document.
la. Check Yes or No for all of the following statements:
1
There are existing sign lighting controls that comply with the applicable provisions of §110.9 and §130.3
0 Yes ❑ No
There are no existing sign lighting controls and I will be installing sign lighting controls that comply with the applicable
2
provisions of §110.9 and §130.3
❑ Yes [Z] No
There are existing sign lighting controls that do not comply with the applicable provisions of §110.9 and §130.3 and I will be
3
installing.sign lighting controls that comply with the applicable provisions of §110.9 and §130.3
❑� Yes ❑ No
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE 710 BY
Irk
STATE,QF CALIFORNIA
,SIGN LIGHTING
CEC-NRCC-LTS-01-E(Revised 08/16) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 2 of 5)
Project Name: PALM TREE PALACE Date prepared: 6-20-2018
1b. 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.
Q
0
0
§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.
O
0
0
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.
0
G
§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% during nighttime hours. Signs that
Y
N
NA
3
are illuminated at night and for more!than 1 hour during daylight hours shall be considered ON both day and
0
0
O
night.
EXCEPTION to Section 130.3(a)26: Outdoor signs in tunnels and large covered areas that are intended to be
Y
NA
illuminated both day and night. t
0
Q
§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
4
reducing the lighting power by a minimum of 30% 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%.. .
0
O
Field Inspector Notes:.
i
CA Building Energv Efficiencv Standards - 2016 Nonresidential Compliance August 2016
STATE OF CALIFORNIA
SIGN LIGHTING
CEC-NRCC-LTS-01-E(Revised 08/16) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE . NRCC-LTS-01-E
Sign Lighting (Page 3 of 5)
Project Name: PALM TREE PALACE Date Prepared: 6-20-20 18
2. Mandatory Sign Lighting Measures
I have responsibility for installing the sign lighting
❑ Yes, I have responsibility for the sign lighting, and will complete ❑ No, I do not have responsibility for installing the sign lighting. Someone
parts 2a and 2b of this compliance document else will complete parts 2a and 2b of this compliance document.
2a. Maximum Allowed Lighting Power Method of Compliance
Certificate of Compliance and Field Inspection Energy Checklist.
Complete this part if there are signs using the maximum allowed lighting power method of compliance. (Complete part 2b 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
OPTIONAL —
Field
Symbol or
Energy Verified
Design
Complies
Inspector
Code
Description of the Sign
Label (see
Allotted Watts
Watts
Y/N
Check that
instructions.
Sign Complies
below)
CL
v to
vi
41
C
30 N
X
O
C
'C
.
m
Ul
N �"' j
Y X
r1
3
0
a
O
w.1/i
C W
Q W
Q
l--
O
r
WALL SIGN
❑✓
b
1
12
1 '
Yes ❑
❑
0
❑
❑
0
❑
❑
0
❑
❑
0
❑
❑
D
❑
❑
0
❑
❑
0
❑
❑
0
❑
❑
D
❑
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 2016 Title 24, Part 6 Standards, using the Maximum Allowed Lighting
Power method of compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks
C
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, columns 'D' through'I' are 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.
D
The sign area in -square feet.
E
List "I" if the sign is internally illuminated. List "E" if the sign is externally illuminated.
F
Allowed watts per square foot. Enter 12 if the 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 D times the allowed Lighting Power Density (LPD = watts) in column F.
H
Show the total installed watts in the sign, as 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 in column G. Otherwise, the sign does not comply.
J
This page doubles as a field inspection checklist.
Field Inspector Notes:
ra FUiilrlino Fnarmi Fffirianry Ctind;irdr - Jn1A Nnnraciriantial rmmnlinnra AUEi1Gt 2016
STATE OF CALIFORNIA
SIGN LIGHTING
CEC-NRCC-LTS-01-E(Revised 08/16) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 4 of 5)
Project Name: PALM TREE PALACE Date Prepared: 6-20-2018
2b. 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
D
E
OPTIONAL
ENERGY
Specific light source used for
Field Inspector
Symbol
VERIFIED
compliance
Check that Sign
or
Description
label
Shall include only lighting
Complies
Code
(see
technologies listed below
instructions
(List all that apply)
below)
WALL SIGN
❑✓
7
❑
❑
❑
❑
❑
❑
❑
❑
❑
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
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 2016 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
C
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:
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% or greater.
2
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 a ballast that has a minimum efficiency of 80%.
3
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% when
D
4
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%tubing load.
Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 68% when
5
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% 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% 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
This page doubles as a field inspection checklist.
Field Inspector Notes:
CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance August 2016
STATE O'F CALIFORNIA _
SIGN LIGHTING
CEC-NRCC-LTS-01-E(Revised 08/16)AW
CALIFORNIA ENERGY COMMISSION .
CERTIFICATE OF.COMPLIANCE NRCC-LTS-01-E
Sign Lighting _ (Page 5 of 5)
Project Name; PALM TREE PALACE Date Prepared:,
6-20-2018
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: DAN LUONG
Documentation Author Signature:
DAN LUONG .
Company:
88 SIGN CORP. -
Signature Date: 6-20-2018
Address: {
1906 DOREEN AVE
- if applicable):
CEA Certification Identification da 1: -
City/State/Zip:
50. EL MONTE, CA.91733
Ph one:626-442-8033
RESPONSIBLE PERSON'S DECLARATION STATEMENT
i
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 t
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 permits) issued for the
.*made
building, and available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this
t
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:
SAME
DAN LUONG
Company: ,
SAME
Date Signed: 6-20-2018
Address:
SAME y
License:
702474
City/State/Zip:
SAME
- Phone:
SAME
• '
4
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