SA 2022-0013BUILDING PERMIT
DESIGN & DEVELOPMENT
DEPARTMENT
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type:
Sign
Permit Number:
SA2022-0013
Property Address:
79070 HIGHWAY 111 STE 102
APN:
600390029
Legal Description
Property Zoning:
Valuation:
$22,000.00
PHONE (760) 777-7125
WWW.LAQUINTACA.GOV
APPLIED DATE: 03/08/2022
ISSUED DATE: 03/14/2022
CALIFOKISIA —
Owner: INLAND AMERICAN LAQUINTA PAV
P O BOX 9271, OAK BROOK, IL 92253
Applicant: Michelle Rose
13580 Fifth Street, Chino, CA 91710
Contractor: NATIONAL SIGN & MARKETING CORP
13580 FIFTH STREET, CHINO, CA 91710
PRIOR TO THE ISSUANCE OF THIS PERMIT FOR CONSTRUCTION, ALTERATION, IMPROVEMENT, DEMOLITION, OR REPAIR THE OWNER, APPLICANT AND/OR
CONTRACTOR UNDER PENALTY OF PERJURY HAVE AFFIRMED WHEN APPLICABLE, THROUGH THE SUBMITTAL OF FORMS OR BY OTHER ELECTRONIC MEANS, THE
FOLLOWING:
LICENSED CONTRACTOR OR OWNER -BUILDER DECLARATION (1 or 2)
1) They are licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professions Code, and the
referenced
License is in full force and effect, or;
2) That they are exempt from the Contractors' State License Law for the
reason(s) indicated by either (2)(a) and/or (2)(b), or (2)(c) where he or
she is exempt from licensure by a valid exemption. [Section 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
Contractors' State License Law (Chapter (commencing with Section 7000)
of Division 3 of the Business and Professions
Code] 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).)
a) As owner of the property, or my employees with wages as their sole
compensation, will do all of or portions of the work, and the structure is
not intended or offered for sale (Section 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an owner of
property who, through employees' or personal effort, builds or improves
the property, 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 it was
not built or improved for the purpose of sale.).
b) As owner of the property, will be exclusively contracting with licensed
c) Are exempt from licensure under the Contractors' State License Law.
As an Owner -Builder, they acknowledge that, except for their personal
residence in which they must have resided in for at least one year prior to
completion of the improvements covered by this permit, they cannot legally
sell a structure built as an owner -builder if it has not been constructed in
its entirety by licensed contractors. It is understood that a copy of the
applicable law, Section 7044 of the Business and Professions Code, is
available upon request when this application was submitted at the
following Web site:
http://www.leginfo.ca.gov/calaw.html.
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY (If
applicable)
A construction lender will be used for completion of the improvements
covered by this permit and the name and information of which is on file for
public inspection during the regular business hours of the public entity.
Failure of the applicant to indicate the construction lender on the
application does not relieve that person of the requirement to give the
construction lender preliminary notice from that duty.
WORKERS' COMPENSATION DECLARATION (1, 2 or 3)
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.
1) Has and will maintain a certificate of consent to self -insure for workers'
compensation, issued by the Director of Industrial Relations as provided for
by Section 3700 of the Labor Code, for the performance of the work for
which this permit is issued.
2) Has 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.
3) Certifies that, in the performance of the work for which this permit is
issued, shall not employ any person in any manner so as to become subject
to the workers' compensation laws of California, and agree that, if should
become subject to the workers' compensation provisions of Section 3700 of
the Labor Code, shall forthwith comply with those provisions.
NOTICE TO APPLICANT (1, 2 and 3)
1) Each person upon whose behalf this application was made, each person
at whose request and for whose benefit work is being 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 360 days from date of issuance of such
permit, or if cessation of work for 180 days will subject permit to
cancellation. On or after January 1, 2019, every permit issued shall become
invalid unless the work on the site authorized by such permit is commenced
within 12 months after its issuance, or if the work authorized on the site by
such permit is suspended or abandoned for a period of 12 months after the
time the work is commenced.
3) Certified that they read the application and state that the information
provided is correct. 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.
IMPORTANT: An Application for Permit was made to the Building Official,
subject to the conditions and restrictions set forth at the time of application,
which is now hereby an Issued Permit. If any part of the information being
supplied on this permit is inaccurate or untrue, please contact the City of La
Quinta at (760) 777-7125 immediately for correction.
Printed: 5/9/25 10:49 am Page 1 of 3
BUILDING PERMIT
Permit Type: Sign
Permit Number: SA2022-0013
Property Address: 79070 HIGHWAY 111 STE 102
JAMBA / [11 ILLUMINATED SIGN — JAMBA / (1) ILLUMINATED WALL MOUNTED SIGN PER 2019 CALIFORNIA BUILDING CODES
Location on premises Sign Illuminated? No Number of Wall / 1
Awning Signs w/
Electrical
Type Group Sq Ft Value
Invoice No. Fee
PERMIT-SA2022-0013 WALL/AWNING SIGN. FIRST
I:I.yFY.y:TiCl/LH���
WALL/AWNING SIGN, FIRST PC
RECORDS MANAGEMENT FEE
TECHNOLOGY ENHANCEMENT FEE
Workflow Step / Action Name
Inspections v.1
FINAL** v.1
Fee Amount
Amount Paid
$28.34
$28.34
$1.00
$1.00
$368.00
$368.00
$100.04
$100.04
$11.00
$11.00
$5.00
$5.00
Total for Invoice PERMIT-SA2022-0013 $513.38 $513.38
Grand Total for Permit
Action Type
Inspection
$513.38 $513.38
Start Date End Date
03/08/2022 0:00
Construction or work for which a permit is required shall be subject to inspection by the building official and such construction or work
shall remain visible and able to be accessed for inspection purposes until approved. Approval as a result of an inspection shall not be
construed to be an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Inspections
presuming to give authority to violate or cancel the provisions of the applicable code and other ordinances of the jurisdiction shall not be
valid. It shall be the duty of the owner or the owner's authorized agent to cause the work to remain visible and able to be accessed for
inspection purposes. Neither the building official nor the jurisdiction shall be liable for expense entailed in the removal or replacement of
any material required to allow inspection.
It shall be the duty of the holder of the building permit or their duly authorized agent to notify the building official when work is ready for
inspection. It shall be the duty of the permit holder to provide access to and means for inspections of such work that are required by this
code.
A building or structure shall not be used or occupied in whole or in part, and a change of occupancy of a building or structure or portion
thereof shall not be made, until the building official has issued a certificate of occupancy therefor as provided herein. Issuance of a
certificate of occupancy shall not be construed as an approval of a violation of the provisions of the applicable code and other ordinances
of the jurisdiction. Certificates presuming to give authority to violate or cancel the provisions of this code or other ordinances of the
jurisdiction shall not be valid.
Printed: 5/9/25 10:49 am Page 2 of 3
BUILDING PERMIT
Permit Type: Sign
Permit Number: SA2022-0013
Property Address: 79070 HIGHWAY 111 STE 102
A person shall not make connections from a utility, a source of energy, fuel, or power, or a water system or sewer system to any building
or system that is regulated by the applicable code and other ordinances of the jurisdiction for which a permit is required, until approved by
the buildina official.
Printed: 5/9/25 10:49 am Page 3 of 3
SA2022-0013 / 79070 HIGHWAY 111 STE 102
CITY OF LA QUINTA
BUILDING DIVISION
REVIEWED FOR
CODE
COMPLIANCE
03/11/2022 . A*1 H
JAMBA / (1) ILLUMINATED
WALL MOUNTED SIGN PER
2019 CALIFORNIA BUILDING
CODES
0 d
J
PRESENTED TO
PLANNING APPROVAL
ADMINISTRATIVE
CASE # SA2022-0013
EXHIBIT #
INITIAL: SFE
DATE : 03/09/22
smoothies • juicese bowls
Jamba Juice - La Ouinta, CA
79079-B Hwy 111 92253
ELECTRONIC SIGNS
DRAWING # 21111R2
13580 5th Street • Chino, CA 91710 • Tel: 909.591.4742 • FAX: 909.591.9792 • Toll Free: 877.877.NSMC
SCOPE OF WORK---------------------------L---T-f: -;
�
NEW ILLUM. FACE LIT, FACE & HALO CHANNEL LETTERS
AND SELF-CONTAINED CABINET WITH PUSH-THU COPY CITY OF LA QUINTF' PLANNING APPROVAL L�......r-.O
BUILDING DIVISION ADMINISTRATIVE 1'0
REVIEWED FOR CASE # SA2022-0013 '
CODE EXHIBIT #
COMPLIANCE INITIAL: SFE rQO
A DATE : 03/09/22 r :. •,Q 0 r
r ` r
r r
r r
r r
r r
lu'� VICINITY MAP
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Note:
ALL NEW SIGNAGE TO CONNECT
TO CLIENT PROVIDED ELECTRICAL
CIRCUITS
OR
Nataonal Sign
1 M.W..7 r. GA91I97
Tels9e.s9r.a�44 ra«9ca.sal.s�sz
Lida ]44
Project Name:
Jamba Juice
La Quinta
Address:
7"73-8 Hwy 111'2253
La QuiIn CA
pcccuntMgr.
Steve Rosenbloom
Approved by:
Date:
Drawing Number
29474R2
Revision
Designer: Date:
R. Lune 01/272022
SITE PLAN
Scale:
NTS
roe'equimmeenoffUdeboo Moth
"�
Norenol Rern�ol (ode and/or odle�
oppliohle bolodes.this rn g,spaper
gmunding and hooding of Mis sign.
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ELECTRONIC SIGNS
LEV
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Project Name:
Jamba Juice
La Quinta
Address:
79079-B Hwy 111 92253
CA
pcc
Steve Rosenbloom
d
30 ____��-_—_ ________� 4�8��
SrrWO:Ilied
Approved by:
o ..
- _� • _. -
___________________
Date:
Drawing Number
29474R2
Revision
t
r ,
091
-
Designer: Date:
R. Luna 01/272022
ELEVATION
q NEW ILLUM. FACE LIT,
F"1• AND SELF-CONTAINED
' ; -
CITY OF LA QUINTA
BUILDING DIVISION PLANNING APPROVAL
REVIEWED FOR ADMINISTRATIVE
CODE
CASE # SA2022-0013
COMPLIANCE EXHIBIT#
pA,—� 03/11/2022 5r INITIAL: SFE ?
DATE : 03/09/22 _
_�- -
FACE & HALO CHANNEL LETTERS
CABINET WITH PUSH-THU COPY err
_
-
.+ _ .
-� -
+
•
"
6
F
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Scale:
NTS
THIS S AN ORI 'fNA YUNPUPEHSONED
AL
(T
USE PLANNIN ION WITH A PROJECT
ED CfDNNEOR
YOUBYNSMUTJSNOTTORE
SHOWNEPRODU E%CDPIOANIZATHI NOR
USED REPRODUCED COPIEDORERIZEDIN
IN IoN FASHION UNLESS AUTHORIZED IN
wemgcgragoFncERORNsmC
This"I Intend¢, 11 in ounce 1"
uoraoiiie NofArde60 o ee
°sPliaq bd'booJm of5Ord peR�Ru
;,li s°° s s
SP s O
South Elevation
ELECTRONIC SIGNS
Specifications:
( WHIRL LOGO - FACE LIT
FACES:
.177" WHITE ACRYLIC #7328 WITH 3M TRANSLUCENT VINYL
APPLIED FIRST SURFACE
TRIM CAP:
3/4" JEWELITE - PTM VINYL COLOR
RETURNS:
3" DEEP, .040"ALUMINUM PTM VINYL COLOR
BACKS:
.063" ALUMINUM
MOUNTING:
FLUSH MOUNT
ILLUM.:
2 GOQ M-2WC048-6500 MINI WHITE 6500KELVIN .48
Jwba
V JAMBA- FACE & HALO LIT LETTERS
FACES:
.177" WHITE ACRYLIC #7328 WITH TRANSLUCENT VINYL
APPLIED FIRST SURFACE
TRIM CAP:
1" JEWELITE -PTM VINYL COLOR
RETURNS:
3" DEEP, .040" PRE -FINISHED ALUMINUM BLACK
BACKS:
.177" CLEAR POLYCARBONATE
MOUNTING:
1-1/2" STAND OFF PTM DUNN EDWARDS GRAY WOLF, DE6354,
RL#590
ILLUM.:
3 GOQ 3WC072-6500 WHITE 6500KELVIN .72
CABINET- SELF-CONTAINED W/ PUSH THRU COPY
CABINET:
.080" ROUTED OUTALUMINUM PTM DUNN EDWARDS GRAYWOLF
DE6354, RL#590
RETURNS:
063"ALUMINUM, PTM DUNN EDWARDS GRAY WOLF, DE6354,
RL#590
BACK:
.063" ALUMINUM - FLUSH MOUNT
COPY:
1/2" CLEAR ACRYLIC PUSH THRU COPY WITH TRANSLUCENT
VINYLAPPLIED FIRST SURFACEAND WHITE DIFFUSER SECOND
SURFACE.
ILLUM.:
GOQ WHITE SPECTRUM 6500K 1.8
0 BACKER PLATE
BACKER:
.090"ALUMINUM BACKER W/ LIGHTTEX-COTE
FINISH PAINTED WHITE
ALL WIRING & COMPONENTS TO MEET U.L. STANDARDS
NEW ILLUM. FACE LIT, FACE & HALO CHANNEL LETTERS
AND SELF-CONTAINED CABINET WITH PUSH-THU COPY
8'-1 Y.."
Ile"
STANDARD WALL PLUG CORD —
--------------------------
CABINET TOP WILL BE CUT TO SHAPE OF LETTERS
smoothies • juices • bowls
PLANNING APPROVAL
ADMINISTRATIVE
CITY OF LA QUINTA CASE# SA2022-0013
BUILDING DIVISION EXHIBIT#
REVIEWED FOR INITIAL: SFE
CODE DATE : 03/09/22
COMPLIANCE
[)AT, 03/11/2022 By —Am #
SIGN TYPE
A
B
C
D
E
SO. FT.
JSJB-CLFH-G-18
V-6"
1'4-71V
4'-7/8"
5"
3"
6.11
JSJB-CLFH-G-21
1'-91,
V-7-314"
4'-9"
5-3/4"
3"
8.31
JSJB-CLFH-G-24
2'-0"
V-10-1/2"
5'-5-1/8"
6.5/8"
3"
10.85
JSJB-CLFH-G-27
2'-3"
2'-1.3/8"
6'-1-114"
7.1/2"
3"
13.73
JSJB-CLFH-G-30
2'-6"
2'-4.1/8"
6'-9-3/8"
8.1/4"
3"
16.95
JSJB-CLFH-G-36
3'.0"
2'-9-3/4"
8'-1-314"
9-718"
3"
24.44
OR
Nataona0.0.l Sign
Te1808W.4 a�tC . 8591.9792
Lida74 ,i
Project Name:
Jamba Juice
La Quints
Address:
7"79-8 Hwy 111'2253
La Quinfa, CA
Account Mgr.
Steve Rosenbloom
Approved by:
Date:
Drawing Number
29474R2
Revision
Designer: Date:
R. Luna 01/272022
FACE/HALO
ILLUMINATED
CHANNEL LETTERS &
PUSH THRU
CABINET
Scale:
he',oquire,onNoffamcIeboodmme "�
Norenol Reoul add end/o, odne,
glimble bml codes. This Audes proper
grounding and bonding of This sign.
Rs O
ELECTRONIC SIGNS
Load: 76.8
Modules: 128
Watts: 92.16W of 120.OW
PS: Mean Well HLG-120H
39 Modules: GOQ Samsung - 2 GOQ M-2WS072-6500 - MINI "SHALLOW" WHITE 6000-7000K 0.72W
98 Modules: GOQ Samsung - 3 GOQ LED LUNA C-2835-3WT072-6500 LED - "SHALLOW" WHITE 6500K 0.72W
89.28 Watts
1 Power Supply: Generic - Mean Well HLG-120H
1.4 Amps
1 - 20 amp circuit 120v
ANNING APPROVAL
ADMINISTRATIVE
# SA2022-0013
IT #
,L: SFE
03/09/22
Push Thm Cabinet
Mod: 30
OR
1.591.4
Nat�on�a0.0.l Sign
Te1aft r. 8591.9792
Lida71 4
Project Name:
Jamba Juice
La Quints
Address:
79079-6 Hwy 111 92253
La Quinfa, CA
pcc9unt Mgr.
Steve Rosenbloom
Approved by:
Date:
Drawing Number
29474R2
Revision
Designer: Date:
R. Luna 01/272022
LED
LAYOUT
Scale:
NTS
he,,oq,ulm noffamcIeboodmme "b
Norenol Rern�ml (nde and/or omen
epplimhIe bcol codes. ibis indudes proper
grounding and bonding of Mis sign.
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ELECTRONIC SIGNS
.090ALUMINUM BACKER
.090ALUMINUM BACKER 5" 1
OR.040ALUMINUM
RETURNS
.040ALUMINUM RETURNS
BACKER
LED STRIP WIRE FROM "WHIRL" LOGO
314" TRIM C
1"TRIM CA
.090ALUMINUM
COUNTERSINK SCREWS
TO SELF-CONTAINED CABINET
(SEE DETAILS 1)
National Sign
#8X%" PAN HEAD SCREW
#8XW' PAN HEAD SCRE
.063"ALUMINUM RETURNS
el'159�.44�1 . B58L9792
Li 710* '4
1/4"THRU THREADED FAST
LED STRIP
Project Name:
.063" ALUMINUM BACKATTACHMENT
LENGTH AS REQ'D
080"ALUMINUM FACE
Jamba Juice
La Duinta
(4) PER LETTER MINIMUM
LED STRIP WIRE TO
SELF-CONTAINED
(SEE FASTENER SCHEDULE)
ALUMINUM BACK
SUPPLY FROM POWER
Address:
CABINET
.063 —WIRE
SOURCE WITH 1/2" FLEX CONDUIT
DETAIL3
(SEE )
—
3/16"CLEAR
79079-BHwy11192253
La Quinfa, CA
POLYCARBONATE BAC
LED STRIP
3/16" ACRYLIC FACE
Account Ngr.
CLEAR ACRYLIC
PUSH THRU
Steve Rosenbloom
3/16" ACRYLIC FACE
LED STRIP WIRE TO
o
O
SELF-CONTAINED CABINET
(SEE DETAIL 3) k
O 110 VOLT CIRCUIT
Approved by:
1/4" THRU THREADED FASTENE
LED STRIP s
p PROVIDE BY CUSTOMER
ATTACHMENT LENGTH AS REQ'D
(4) PER LETTER MINIMUM
CONDUIT TO DEDICATED
Date:
(SEE FASTENER SCHEDULE)
PRIMARY CIRCUIT (BY OTHERS)
Drawing Number
SEE SELF-CONTAINED
ELECTRICAL TO GLE
1/4" WEEP HOLES W/ COVE
(DETAIL(BTIAIL 3)
DISCONNECT SWIITTCH
29474132
PER U.L. CODE (TYP)
1/4" THRU THREADED FASTENER
STANDOFF SPACER
ATTACHMENT LENGTH AS REQ'D
Revision
(4) PER LETTER MINIMUM
WALL/BLDG. FASCI -
WALL/BLDG. FASCIA
WALL/BLDG. FASCIA
I WHIRL LOGO - FACE LIT
® JAMBA- FACE & HALO LIT LETTERS
� CABINET- SELF-CONTAINED
W/
PUSH THRU COPY
SECTION DETAIL 1
SECTION DETAIL 2
SECTION
DETAIL
3
Note:
' G.0 TO SUPPLY PRIMARY POWER SOURCE
• ALL COMPONENT TO BE U.L. LISTED & APPROVED
• THE LOCATION OF THE DISCONNECT SWITCH
AFTER INSTALLATION SHALL COMPLY WITH
ARTICLE 600.6 (A) (1) OF THE NATIONAL
ELECTRICAL CODE
Designer: Date:
R. Luna 01/272022
SECTION
DETAILS
Scale:
THIS IS AN ORIGINAL UNPUBLISHED
DRAWING CREATED FOR YOUR PERSONAL
USE IN CONNECTION WITH A PROJECT
PLAN NEOFORYOUBYNSMCITISNOTTOBE
SHOWN OUTSIDEYOU R ORGANIZATION NOR
uS nDav EPRODIu EOOCOPIED OR IXNiBn iu
CITY OF LA QUINTA PLANNING APPROVAL
BUILDING DIVISION ADMINISTRATIVE
REVIEWED FOR CASE# SA2022-0013
CODE EXHIBIT #
NEW ILLUM. FACE LIT, FACE & HALO CHANNEL LETTERS COMPLIANCE INITIAL: SFE
AND SELF-CONTAINED CABINET WITH PUSH-THU COPY DATE : 03/09/22
Df,TT 03/11/2022 gy�H
FASTENER SCHEDULE
INSTALLER SHALL VERIFY THAT THE FASTENERS CHOSEN ARE SUITABLE WITH WALL CONDITIONS
#14 SELF TAPPING
TEK FASTENER
FOR USE WITH PLYWOOD BACKED
WOOD, STUCCO, OR EIFS WALL
SYSTEM 1" MIN PENETRATION (EXCL. TIP)
W DIA HILTI HIT ROD
WITH HY150 MAX
ADHESIVE
FOR USE WITH CONCRETE
EMBED AMIN OF 2"
44
W LAG SCREW
FOR USE WITH WOOD OR EIFS WALL
SYSTEMS.
1%' MIN PENETRATION (EXCL. TIP)
E+"
'/," DIA HILTI HIT ROD
WITH HY20ADHESIVE
FOR USE WITH MASONRYAND BRICK
EMBED A MIN OF 3'/"
W DIA. THREADED
FOR USE WITH WOOD, CONCRETE
Y4" DIA HILTI HIT ROD
FOR USE WITH CONCRETE BLOCK
ROD
BLOCK OR EIFS WALL SYSTEMS.
WITH HY20 ADHESIVE
EMBED A MIN OF 2"
1/4" RED HEAD L.D.T
(LARGE DIAMETER
TOP CON)
FOR USE WITH CONCRETE BLOCK
BRICK OR CONCRETE.
EMBED A MIN OF 2%"
%"DIA HILTI HLC
SLEEVE ANCHOR
FOR USE WITH CONCRETE, MASONRY
AND BRICK
EMBED A MIN OF 3'/e"
Ihesiequiremintended
enb of ANede 600in 'ul the ��
Netianol R:2.I 1'd* omVor "men
opplimhle b[ol [odes. This indudes proper
gmundmg and hunamg of Mis sign.
�sP�s O
ELECTRONIC SIGNS
Sign Lighting �h
`Rcc . Ts f (created) CA, r-OR%IA FNFRGr COMM: SS ON
CFRIII ICATF OF COMPLIANCE NRCC LTS E
This document is used to demonstrate compliance with requirements in, , , , , and for sign lighting scopes usinq the prescriptive path. Exit signs and traffic signs are not required
to comply with prescriptive requirements perexceptions to and do not need to complete this compliance document
Project Name: JAMBA JUICE lReport Page:
Project Address 79079 B CA HWY III Date Preoared
N. GENERAL INFORMATION
01 Prolec t Location (city) LA QUINTA
02 Climate Zone 1�
03 F— Building is a healthcare facility
B. PROJECT SCOPE
Table Instructions: Include any illuminated signs that are within the scope of the permit application and ore demonstrating compliance using the prescriptive path outlined in or
r alterations. Exit signs and traffic signs ore not required to comply with prescriptive requirements per exceptions to and do not need to complete this compliance
document. WARNING: Changing the Compliance Method in this table will result in the deletion of data previously input. If you need to change the compliance method, please
pen a new form or use "Save As".
01
02
03
04
05
Name or
Item Tar
Complete Sign Description
Sign Status'
Sign Type
Compliance Method'
A
ILLUM FACE & HALO CHANNEL
LETTERS
New
Outdoor
ENERGY VERIFIED Label
'FOOINOTF Sign ulterations that increase the connected lighting load, replace and rewire more than 50% of the ballasts, or relocate the sign to a different location must comply
with. See for more details.
`[he ENERGY VFRIFIED Label compliance method is only applicable if the sign has a permanent, factory installed, ENFRGY VERIFIED label certified by Ul or comparable,
confirming the sign complies with. Note that using an ENERGY VLRIFIFD label is an optional compliance path, not a mandatory requirement. See the tool tips for this table for
more details.
C. COMPLIANCE RESULTS
Table Instructions if any cell on this table says "DOES NOI COMPLY" or "COMPLIES with Exceptional Conditions' refer to Table D for guidance,
01
02
03
>
04
0
05
0
06
07
Name or
Sign Description
Total owe
Total Designed
Compliant Light
ENERGY VERIFIED
Item TagComplete
(Watts)
R
Sources
R
Label
Compliance Results
(See Table B)
(See Table B)
(Set! Table F)
(See Iable F)
(See Table G
(See Table H)
A
UM FACE & HALO CHANNFI LET
>
R
0
YES
COMPLIES
Controls Compliance (See Table F/G/H for Details)
COMPI IES
CA Builaing I nergy Efficiency Standards - 2019 Nonresidential Ccmpua-ice
STATL JF CAIIFOPNIA
Sign Lighting
NRCC I E Created) CAL rOP\ A ttiEtiGv CONW11,YON
CERTIFICAIE OF COMPLIANCE NRCC-LTS E
Project Name: 1AMRA JUICF
lReport Page:
Project Address. 79079 B CA HWY 111
loate Prepared:
D. EXCEPTIONAL CONDITIONS
This table is auto -filled with unedrtable comments because of selections made or data entered in tables throughout the form
No exceptional conditions apply to this project
E. ADDITIONAL REMARKS lr�
This table includes remarks made by the permit applicant to the Authority Having Jurisdiction.
F. MAXIMUM ALLOWED LIGHTING POWER AND CONTROLS VL*
This Section Does Not Apply
G. LIGHT SOURCES AND CONTROLS rA
Ihis Section Does Nut Apply
H. ENERGY VERIFIED LABELED SIGNS AND CONTROLS
[able Instructions Complete this table to demonstrate compliance with mandatory controls requirements from for illuminated signs using the ENERGY VERIFIFD label
compliance method per as rndicoted on Table 6 of this compliance document. Complete this table only if sign has a permanent, pre-printed, factory installed, FNE RGY VERIFIED
label confirming that the sign complies with the Section of the California 2019 Title 14, Part 6 Standards
01
02
03
04
Name or
Item TagComplete
Sign Description
Mandatory Controls
Field Inspector
Shut Off
Dimming
Demand Response'
Pass
Fail
A
ILLUM FACE & HALO CHANNFL LLi IERS
Auto Timer + Photocon;rol
Pwr reduced 65%+
NA
l
L—
'NOTE. Selections with a ' require a note in the space below explaining how compliance is achieved.
FX Sign within tunnel illuminated day & night; EXCEPTION to.
7OOTNOTE: Demand response controls are only required for an Electronic Message Center having a new connected lighting power load greater than 15 kW
Reset
per
CA Building Erergy F`ficienry Standards 2019 NonreS dentin' Comp ,ante:
STATE OF CALIFORNIA
Sign Lighting
NRCC LTS E Cleated
CERTIFICATE OF COMPLIANCE
Project Name. JAMBA JUICE
Project Address 79079-8 CA HWY 111
I. DECLARATION OF REQUIRED CERTIFICATES OF INSTALLATION Cf
Table Instructions. Selections have been made based on information provided in previous tables of this document. If any selection needs to be changed, please explain why in
Table E. Additional Remarks. These documents must be provided to the building inspector during construction and can be found online at
YES
NO
Form/Title
Field Inspector
Pass
Fail
NRCI-LTS-01-E - Must be submitted for ail buildings
EJ
J. DECLARATION OF REQUIRED CERTIFICATES OF ACCEPTANCE
There are no Certificates of Acceptance applicable to sign lighting requirements.
CA Building Energy Effic envy Standard,, 2019 Nonresideniial Compliance
S-ATE OF CAt FORMA
Sign Lighting
NRCC LT, [(Created)
CAt'=OHh A t V HVY COMM S,
CFRTIFICATF OF COMPLIANCF NRCC-LIS-E
Project Name. JAMBA JUICF JRepo,t Page:
Project Address 79079-8 CA HWY 111 Date Prepared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT rAl
I certify that this Certificate of Compliance documentation is accurate and complete
Docurrentation Author Name: MICHELLE ROSE
Documentation Author Signature MICHELLE ROSF
Company: NATIONAL SIGN AND MARKFTING
Signature Date 3/8/22
Address: 135880 FIFTH SIREET
CEA/ HERS Certification Identification (if applicable):
City/State/Zip: CHINO, CA 91710
Phone: 9092034423
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 Divisior 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Cert ficate of
Compliarce (resoons ble designer)
3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on tnis Certificate
of Compliance confo•m to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 0
4. The building design features or system design features identified on tnis Certificate of Compliance are consistent with the rnformat on provided on other applicable
comoiiance docu nerts, worksheets, calculations, plars and specifications submitted to the enforcement agency for approval with this ouilding permit appl-catior.
S. 1 will ensure that a completed signed copy of this Cert ficate of Compliance shall be made available with the bu Iding permit(s) issued for the building, and made ava lable to
the enforcement agency for all applicable inspections. I understard 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. w�
Responsible Designer Name:
Responsible Designer Signature:
Company ;
Date Sigred;
Address:
License.
City/State/Zip:
Phone:
CA Build ng Energy 1`16nency Standards 2019 Non,esidentia Compliance: