BP 11-0213P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-00000213
Property Address: 50991 WASHINGTON ST STE 1
APN: 770-020-021- - -
Application description: SIGN
Property Zoning: NEIGHBORHOOD COMMERCIAL
Application valuation: 4000
Applicant:
/V
T-4ht 4 4 Q"
Architect or Engineer:
M14
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Professionals Code, and my License is in full force and effect.
License Class: C45 U se No.: 271598
Deli
at %� Con1 acWr-
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 Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/02/11
Owner:
TFG LQV
3857 BIRCH ST. 4496
TENANT:US BANK
NEWPORT BEACH, CA 92660
Contractor:
SUPERIOR ELECTRICL ADVRTSNGPNIMAR 4 2011
1700 W. ANAHEIM
LONG BEACH, CA 90813
(562)495-3808 CM�01Ft T
Lic. No.: 2715981—
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 TRAVELERS INDEM Policy Number PJUB2772NOGA10
_ 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 Labo Code, hall forthwith cgrs ly with those provisions.
Date111 Applicant: I
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to
enter upon the above-mentioned property f inspection urp
Dater Signature {Applicant or Agent).
Application Number . . . . . 11-00000213
Permit . . . ELEC-ELECTRICAL SIGN
Additional desc . .
Permit Fee . . . . 33.00 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 8/29/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 15.0000 EA ELEC SIGN 1ST CIRCUIT
15.00
1.00 3.0000 EA ELEC SIGN ADDITIONAL CIRUITS
----------------------------------------------------------------------------
3.00
Special Notes and Comments
THREE (3) SINGLE FACE INTERNALLY -
ILLUMINATED SUSPENDED CABINET SIGNS.PER
SP 2011-1510 "US BANK".
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
-----------------
Due
----------------------------------------
Permit Fee Total 33.00 .00 .00
33.00
Plan Check Total .00 .00 .00
.00
Other Fee Total 1.00 .00 .00
1.00
Grand Total 34.00 .00 .00
34.00
LQPERMIT
1E T% l el 1- ELEV Tf0N
APPROVED BY PLANNING DEPARTMENT
BY t C DATE
EXHIBIT
CASE NO. _5L
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S/F SIGN CABINET:
CABINET: 12" deep aluminum extrusion w/ 1-1/2" retainers
painted Frazee #5695-A Bourbon as required
BACK: .050 Pre -painted Frazee #5695-A Bourbon aluminum
FACE: 'I7" thick high density foam background w/routed
out graphics painted Matthews Blue - opaque
GRAPHICS: Routed from HDU foam face and backed w/white
acrylic- shield to have Red vinyl overlay
ILLUMINATION: HO fluorescent lamps powered by rapid start,
cold weather ballast
MOUNTING: Alum. wall plate secured from archway using toggles
or equivalent: (2) two 1-1/2" square mounting tubes
welded to plates
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UOT€CE': PRINTSARE THE EXCL USIVE PROPERTYOF "MC SIGN COMPAWANY UN -AUTHORIZED USE OR OUPLICATIO9N WILL RESULT IN A20%CHARGE PER OCCURRENCE PER THE VALUE Of THE OISPLAY® MC SIGN CO. 1998
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SOUTH/REAR ELEVATION
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S/F SIGN CABINET:
CABINET. 12" deep aluminum extrusion w/ 1-1/2" retainers
painted Frazee #5695-a Bourbon as required
BACK: .050 Pre -painted Frazee #5695-A Bourbon aluminum
FACE: Y2" thick high density foam background w/routed
out graphics painted Matthews Blue opaque
GRAPHICS: Routed from HDU foam face and backed w/white
acrylic- shield to have Red vinyl overlay
ILLUMINATION: HO fluorescent lamps powered by rapid start,
cold weather ballast
MOUNTING: Alum. wall plate secured from archway using toggles
or equivalent; (2) two 1-1/2" square mounting tubes
welded to plates
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NOR a H/FRONT ELEVATION
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PROPOSED RORTWFRONT ELEVATION
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S/F SIGN CABINET:
CABINET: 12" deep aluminum extrusion w/ 1-1/2" retainers
painted Frazee #5695-a Bourbon as required
BACK: .050 Pre -painted Frazee #5695-A Bourbon aluminum
FACE: Yz"thick high density foam background w/routed
out graphics painted to match opaque Matthews Blue
GRAPHICS: Routed from HDU foam face and backed w/white
acrylic- shield to have Red vinyl overlay
ILLUMINATION: HO fluorescent lamps powered by rapid start,
cold weather ballast
MOUNTING: Alum. wall plate secured from archway using toggles
or equivalent; (2) two 1-1/2" square mounting tubes
welded to plates
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Certificate of Compliance and Field Inspection Energy Checklist (Sign Lighting) (Page 2 of 2) SLTG-1 C
Project Name: Date:
C1l�r vkuk 1 ;g::�-- Fti*—
2011
Fill-in Columns A and B for all signs. Fill-in Columns C through H only if
Compliance Method
using the Maximum Allowed Lighting Power compliance method. Fill-in
Maximum Allowed Lighting Power
Alt. Light
Column I only if using the Alternate Light Source compliance method.
Source
A
B
C D E F
G
H
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Design
Complies?
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Field
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Watts
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1. Design Watts = total connected lighting load installed in the sign, including power used by lamps, ballasts, transformers, power supplies, etc.
2. If Fail then describe on Pae 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. Use additional sheets i neeessar .
Alternate Light Source Compliance Method:
The sign(s) identified above; use only one or more of the following technologies: list all applicable numbers that apply in column I above
1 High pressure sodium lamps
2 Pulse start or ceramic metal halide lamps served by a ballast with > 88% efficiency
3 Pulse start metal halide lamps that are < 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 supply 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
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7 Light emitting diodes LEDs with a power supply with > 80% efficiency
8 Single voltage LED external power supplies designed to convert 120 volt AC input into lower voltage DC or AC output, having a nameplate output power less than or equal
to 250 watts, and 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 fre uenc > 20 kHz
Field Inspector Notes or Discrepancies
2008 Nonresidential Compliance Forms January 2010
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