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BSIG2019-001278-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: ce-d4t 4 *P Q"A& DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT SIGN/ BSIG2019-0012 79440 HIGHWAY 111 STE 105 600390004 CARING FOR WOMEN / (1) CHANNEL LETTER SIGN $3,585.00 Applicant: BILL SIGURDSEN - PD GROUP DBA SIGNARAMA 41945 BOARDWALK SUITE L PALM DESERT, CA 92211 D �A AUG 11 2019 CITY OF :AQIIJINTA DESIGN & 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 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: 4 45 License No.: 830131 Date: F ;� i bri Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_) I, as owner ofthe property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Addre! VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/21/2019 Owner: EMILY REKUC D 0, INC. 79440 HIGHWAY 111 STE # 105 LA QUINTA, CA 92253 Contractor: PD GROUP DBA SIGNARAMA 41945 BOARDWALK SUITE L PALM DESERT, CA 92211 (760)776-9907 Llc. No.: 830131 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 ofthe �ork for which this permit is issued. wu 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: ACE AMERICAN INSURANCE COMPANY Policy Number: RWCC65199567 _ 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 ovisions. Date: ) ) If 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 mperty for inspection purposes. Date: i 1Signature (Applicant or Agent): 2 Date: 8/21/2019 Application Number: BSIG2019-0012 Property Address: 79440 HIGHWAY 111 STE 105 APN: 600390004 Application Description: CARING FOR WOMEN / (1) CHANNEL LETTER SIGN Property Zoning: Application Valuation: $3,585.00 Applicant: BILL SIGURDSEN - PD GROUP DBA SIGNARAMA 41945 BOARDWALK SUITE L PALM DESERT, CA 92211 Owner: EMILY REKUC D 0, INC. 79440 HIGHWAY 111 STE # 105 LA QUINTA, CA 92253 Contractor: PD GROUP DBA SIGNARAMA 41945 BOARDWALK SUITE L PALM DESERT, CA 92211 (760)776-9907 Llc. No.: 830131 Detail: (1) CHANNEL LETTER LED SIGNS [CARING FOR WOMEN] LOCATED ON THE WEST SIDE OF BUILDING AT ENTRY LOCATION. SIGN PERMIT NO. 2019- 0023 [ PLANNER NAME ] 2016 CALIFORNIA BUILDING CODES. FINANCIAL INFORMATION DESCRIPTION ACCOUNT CITY AMOUNT BSAS SB1473 FEE 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 $26.68 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $26.68 Total Paid for ELECTRICAL: $53.36 DESCRIPTION ACCOUNT QTY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT QTY AMOUNT WALL/AWNING SIGN, FIRST 101-0000-42404 0 $27.22 DESCRIPTION ACCOUNT QTY AMOUNT WALL/AWNING SIGN, FIRST PC 101-0000-42600 0 $96.06 Total Paid for SIGN: $123.28 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 TOTALS:,4 ta Qw�fra — (ALWORN! l -- Project Address: APN #: PERMIT # ?>J( `-'1 2— (Qj — 00 q0 i -oTE4L Project Description: Z2'0 5�, Applicant Name: ,LL bs ! Address: City, ST, Zip: Telephone: Email: 91 C' T � 7 r_J Valuation of Project $._ IrpJ{J Architect/Engineer Name: Construction Occupancy: Address: Grading: City, St, Zip Telephone: Bedrooms: Stories: # Units: Email: State Lic: City Bus Lic: 4r,-`r Property Owner's Name: ��,�� New Commercial / Tenant Improvements: Address: Total Building SF City, ST, Zip Construction Type: Occupancy: Telephon '70 c � n bra-D7>< 16 E m a i 1: o, v-cN� Yv1 aL ��x e w L 1W` - 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 r' SECTION B - APPLICANT/OWNER INFORMATION A licant Certification I certify that / have read this application packet in its entirety and have read and understand the City's sign regulations (LQMC 9.160) along with any City approved property specific sign program applicable to the proposed location. I further certify that each application item submitted is consistent with the requirements listed in the following Section C and all proposed temporary and permanent improvements included in this application are proposed in compliance with all applicable regulations. I understand and agree that if during the processing of the application, it is determined the information submitted does not strictly meet such standards or contains errors or omissions, clarification and/or supplemental information may be required which will delay the processing of this application. Applicant's Signature - Print Name: Property Owner Certification Date: I certify under the penalty of the laws of the State of California that I am the property owner of the property that is the subject matter of this application and I am authorizing and hereby do consent to the filing of this application and acknowledge that the final approval by the City of La Quinta, if any, may result in restrictions, limitations and construction obligations being imposed on this real property. Owner/Authorized Agent Signature*: Print Name(s): z 179 1 Date: a,/J1_ *An authorized agent for the ownler must attach a notarized letter of authorization from the legal property owner. SECTION C - APPLICATION SUBMITTAL REQUIREMENTS ` APPLICATION SUBMITTAL REQUIREMENTS TO BE COMPLETED BY CITY STAFF V Each .of the following items is required for submittal unless a waiver is granted by City Staff. All plans shall # of FDF Waiver be legible, accurately scaled, representatively colored paper mat ion CD- OK'd by with identified dimensions and presented on 8q"x11" or copies ROM) (initials) 11"x17" sheets ❑ ❑ Filing Fees Receipt ($100) 1 NA ❑ NA Application 1 NA NA ❑ NA Site Plan (showing location of each proposed and existing sign to 5 NA NA remain) ❑ NA Building Elevations (showing location of each sign on entire side 5 NA NA of building as proposed) Sign Construction Detail (identifying size, colors, construction 5 p NA materials, and lighting components for each varying portion of the NA NA sign) Sign Permit Application - Permanent Page 2 of 2 City of La Quinta - Planning Department - 760.777.7125 08.30.10 PAApplication Submittal Forms\Applications\SA\SA-P Application - 08.30.10.doc Bill Sigurdsen From: Dan Saldana <Dan@haven-management.net> Sent: Tuesday, August 06, 2019 3:49 PM To: Bill Sigurdsen Subject: RE: Building Signage for Caring For Women Attachments: 97066 copy city of proof.pdf.pdf Please see the attached Dan Saldana Haven Management, LLC 9201 Archibald Avenue Rancho Cucamonga, CA 91730 909 948 0777 ext 101 From: Bill Sigurdsen <bill@pdsignarama.com> Sent: Tuesday, August 6, 2019 3:06 PM To: Dan Saldana <Dan@have n-management.net> Subject: RE: Building Signage for Caring For Women Dan, I have attached the city proof for you. If it is OK please sign it so I can take it to the city for the sign permit. Thank You, Bill Sign -a -Rama 760-578-6315 Cell From: Dan Saldana [mailto:Dan@haven-manaeement.net] Sent: Tuesday, August 06, 2019 2:55 PM To: Bill Sigurdsen <bill@pdsignarama,com> Subject: RE: Building Signage for Caring For Women I believe a board member signed it but may have had trouble with the format if you can send over a PDF request _ I will forward over for signature Dan Saldana Haven Management, LLC 9201 Archibald Avenue Rancho Cucamonga, CA 91730 909 948 0777 ext 101 From: Bill Sigurdsen <bill@pdsignarama.com> Sent: Tuesday, August 6, 2019 2:19 PM To: Dan Saldana <Dan haven-management,net> Subject: RE: Building Signage for Caring For Women Dan, I have not seen any signed approval of the signage for Caring for women? Please let me know if I need to do something else to move this forward. Thank you, Bill From: Dan Saldana [mailto:Dan@haven-management. net] Sent: Wednesday, July 31, 2019 1:30 PM To: Bill Sigurdsen <bill@pdsignarama.com> Subject: RE: Building Signage for Caring For Women Board member has signed on link provided Dan Saldana Haven Management, LLC 9201 Archibald Avenue Rancho Cucamonga, CA 91730 909 948 0777 ext 101 From: Bill Sigurdsen <bi�_pdsignarama.com> Sent: Wednesday, July 31, 2019 11:35 AM To: Dan Saldana <Dan@haven-management.net> Subject: Building Signage for Caring For Women Dan, I have attached the proof for the Reverse Channel Letter signage for Caring For Women. They are in the La Quinta Valley Plaza at 79440 Hwy. 111 Ste. 105, La Quinta, Ca. 92253. 1 need the City proof Signed by you so I can go to the City of La Quinta for the Sign Permit. Please let me know if you have any questions. Thank you, Bill Sign -A -Rama 760-578-6315 Cell )TATE OF CALIFORNIA Amk SIGN LIGHTING SEC-NRCC-L tS-01-E(Revised 08118) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 1 of 5) Pmjw Nama; - ,- r DILE unpaid, 8 A. General Information Project Address: Location of Sign Outdoor igns ❑ Indoor Signs Phase of Sign Construction New Signs ❑ Sign Alterations Type of Lighting Control RNew Lighting Controls ❑ Replaced Lighting Controls ❑ Not Installing Lighting Controls This Certificate of Compliance includes the following components (check all that apply): _ j 10 Mandatory Measures (Lighting Controls) ❑ Maximum Allowed Lighting Power ❑ Specific Lighting Sources 1. M 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 thall 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 lb 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 far the some complete installationt I have responsibility for installing the sign lighting controls:!' ' . N 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 la and lb of this compliance document Someone else will complete parts la and lb 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 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 _ ❑ 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 ^A Qnilrlinn C—rn%, CfC,inn. Ct. 4­4a -)nlc STATE OF CALIFORNIA SIGN LIGHTING CEC-NRCC-LTS-01-E Revised 08/16) CERTIFICATE OF COMPLIANCE Sign Lighting W010" W ­- D%14 Preparkd: e- 1 i J J ' r: AISSiON * RCC-LTS-01-E (Page 2 of 5) 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 wit. 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 (sin 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 switch control. , O §130.3(a)2A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time- Y N 2 switch control, or an astronomical time -switch control. 60 EXCEPTION to Section 130.3(a)2A: Outdoor signs in tunnels, and signs in large permanently covered outdoor Y areas that are intended to be continuously lit, 24 hours per day and 365 days per year. O §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 3 are illuminated at night and for more than 1 hour during daylight hours shall be considered ON both day and O O EXCEPTION to Section 130.3(a)2B: Outdoor signs in tunnels and large covered areas that are intended to be illuminated both day and night. §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 4 reducing the lighting power t)y 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, ordinance, or regulation to be reduced by 30%. Field Inspector Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance NA O NA O NA NA Y NA O Y N N/A o O Y NA o 'BI August 2016 STATE OF CALIFORNIA SIGN LIGHTING CEC-NRCC-LTS•41-E Reused =16CALIFORNIA ENERGY COMMISSION -qW' CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (page 3 of 5) Project Nam.: Date Prepared: 2. Mandatory Sign Lighting Measures I have responsibility for installing the sign lighting T^' ❑ Yes, I have responsibility for the sign lighting, and will complete ❑ No, I do not have responsibility for installing the sign lighting. Someone arts 2a and 2b of this compliance document else will complete IDarts 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 si ns using the Specific Lighting Sources method of compliance). A B C D E F G H J OPTIONAL — Energy Verified Field Symbol or Description of the Sign Label (see Allotted Watts Design Complies Inspector Code instructions Watts Y/N Check that below) Sign Complies D"$ y m vt J \ V1 2 r c E E 3 ry "� vox c° w '1 fV 0 3 ra M a 0o to n n o .. V) cwa = cw Q 3 E 0 ✓ U �! r• ❑ �i o —f L� % ❑ ❑ 0 ❑ ❑ 0 ❑ ❑ 0 ❑ ❑ 0 ❑ ❑ 0 ❑ ❑ 0 ❑ ❑ 0 ❑ 0 o ❑ ❑ 0 ❑ 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 Denslty (LPD = watts) in column F. H Show the total installed watts in the sign, as determined according to the applicable provisions of §130(c). 1 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: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance August 2016 STATE OF CALIFORNIA SIGN LIGHTING CEC. r,2w,,t NRCC-LTS-0i-E(Revi5ed 08115 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting ( age 4 of 5) Pr0IWNjme: Date Neyeied: 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 D E OPTIONAL Specific light source used for Symbol ENERGY VERIFIED compliance Field Inspector or Description label Shall include only lighting Check that Sign Code (see instructions technologies listed below Complies below) List all that apply UL LED Lit ❑ UL ❑ ❑ ❑ 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 com liance. 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 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 August 2015 STATE OF CALIFORNIA SIGN LIGHTING CEC. NRCC-LTS-01-E(Revised 08/15) CERTIFICATE OF COMPLIANCE Sign Lighting Prv�rN Nam'; *44M-Iiiiiiiia� t AM- �Hn DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Jeff Grady I]osumentation Author Signature, Company: �(U Slgnarama Signature Catt: % q Address: 41945 Boardwalk Suite L CEA Certirrcalion (dcntirlcatlon (if appiicabfe)- Cily/slate1'21pr Palm Desert, CA 92211 Phone: 760-776-9907 RESPONSIBLE PERSON'S DECLARATION STATEMENT AMISSION 0 NRCC-LTS-01-E (Page 5 of 5) 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. S. i 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 vccupan Responsible Designer Name: Responsible Designer Signature: Company � Signarama Date Signed: '094T + Address: r 41945 Boardwalk Suite L License: 830131 c,tylslatenlp: palm Desert, CA 92211 Phone: 760-776-9907 CA Building Energy Efficiency Standards • 2013 Nonresidential Compliance August 2015