11010093 i
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CITY OF CUPERTINO BUILDING PERMIT j
BUILDING ADDRESS: 20380 STEVENS CREEK BLVD CONTRACTOR: !PERMIT NO: 11010093
OWNER'S NAME: PROMETHEUS RE GROUP ,.� DATE ISSUED:01/18/2011
OWNER'S PHONE: 6509313400 , ® PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATIONr—
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class f2+ < Lic.# 711Y&-S:'
MECH r RESIDENTIAL f— COMMERCIAL r
�t-
Contractor ..! 1tI`'Q-Z"c,K Ic- Date L i t$i 1
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:FRONT OF BLDG BY MAIN ENTRANCE-INSTALL A
(commencing with Section 7000)of Division 3 of the Business&Professions BLADE
Code and that my license is in full force and effect. SIGN ON BUILDING&INSTALL ADDRESS NUMERALS
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
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 Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$1800
permit is issued.
APPLICANT CERTIFICATION APN Number:36901026.00 Occupancy Type:
I certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
Issued by: Date:
Sia � ®--�- -'�� Date tta
❑
OWNER-BUILDERDECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for.sale(Sec.7044,
Business&Professions Code) Signature of Applicant: Date:
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
I have and will maintain a Certificate of Consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Safety Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this
Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I ust own e nfl ager '
forthwith comply with such provisions or this permit shall be deemed revoked. Date:
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. I understand my plans shall be used as public records.
Signature Date Licensed Professional
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CITY OF
ILI] CITY OF CUPERTINO
GENERAL BUILDING
C U P E T I OPERMITA I'LICATI FORM
APN# �. � � � Date:
Building Address:
3 2
Mailing Address (if differe fro M ' ad(gess):
Are Hazardous Materials being used as part of this project? Yes ❑ No 51
HOA: Exterior work only) Yes 2 No ❑ If yes, provide letter from HOA A T Oc ti 0
Owner's Name: Phone#:/d S-b) y,;'I ,Q�'o 0
(earn tr t ,,-a 5 `0 3 y ua
Contractor: Phone: Ccs b) q 1-7 C>J 1e1,V(a, P_ C;.Apt+iC-S, C Fax: (6,Sb
Contractor License#: rJ J/V,6 5
Cupertino Business License#:
Contact: Phone: &;V_)
I� 1 c�t.��2 uL. �. ✓z -z, Fax: f b sn) 5'-71- 663a
Residential 10 Commercial ❑
Job Description:
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Building Permit Info:
Bldg Elect Plumb ❑ Mech ❑
Type of Construction(Usage Class): Occupancy Type:
1-A5 1-B ❑ II/IWV-A ❑ II/III B,IV-HT,V-B IV-`
Valuation: j( Square Footage:
Project Size: Express Standard ❑ Lar e ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist& attach it
to the application or if applicable,include in plan set& the sheet index.
Points Achieved:
For help, contact Build it Green at www.tl!ilditi$aee z,ar
Revised 07/14/09
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CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 20380 stevens crk blvd. DATE: 01/18/2011 REVIEWED BY: bobs.
APN: BP#: *VALUATION: 1$1,800
,'PERMIT TYPE: Building Permit PLO''C1lECA
PRIMARY Si PENTAMATION
Sign 10EAP5
USE: g PERMIT TYPE:
WORK install externally illuminated sign/address for existing R-1 complex.
SCOPE
SIGN TYPE FEE ID QTY SIGN FEE
Other Sign 1SIGNOTHER 1 $317
TOTALS: 1 $317.00
Xfe di. Flan Check 1'/111116. Plan Check #Branch Circuits 1 $42.00
lifecb. pel,mi!Fee: Phunb, powlir Tee: IESIGN Elec.Permit Fee: IEPERMIT
011ie)•Afech, hasp. Othe1 Plulnb hisp. Other Elec,Insp. 0.0 $42.00
,ilech, limp,Fee: I phnub, filsp, f ea: Elec.hasp.Fee:
NOTE: These ees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info,
FEE ITEMS (Fee Resolittion 09-051 E . 7/1/10) FEE QTY/FEE MISC ITEMS
Plata Cltec%hen.
Suppl.PC Fee: ) Reg. 0 OT 0.0 hrs $0.00
A
Phimb l,fech./Elee Pkat (7icck:
Permit Fee: $317.00
Suppl. Insp.Feer Reg. 0 OT 0.0 hrs $0.00
PME Unit Fee: $42.00
PME Permit Fee: $42.00
Convniclion T(/.A-
Sign Master Plan: 0 Yes E) No $0.00
Work Without Permit? 0 Yes E) No $0.00
Plarartitr<; Fees:
Travel Documentation Fee: ITRAVDOC $42.00
Strong Motion Fee: 1BSEISMICO $0.50 Select an Administrative Item
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Bldg Stds Commission Fee: IBCBSC $1.00
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SUBTOTALS: $444.501 $0.00 TOTAL FEE: $444.50
Revised: 01/03/2011
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Building Department
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City Of Cupertino
10300 Torre Avenue )
Cupertino, CA 95014-3255
Telephone: 408-777-3228
CUPERTINO Fax: 408-777-3333
CONTRACTOR SUBCONTRACTOR LIST
JOB ADDRESS: 2 p 380 x Ccc'1c '$C✓,v PERMIT
OWNER'S NAME: 0ti7qWS CalLip PHONE# Lsb•s73•GG32 1G61i4ttl0 140
GENERAL CONTRACTOR: BUSINESS LICENSE#
ADDRESS: 7 C`L (�n,� esfa'k C!, q Vr4-#V CITY/ZIPCODE:
Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRAC'T'OR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring/Carpeting
Linoleum/Wood
Glass/Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting/Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
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Owner Contractor Signatu Date
RESIDENTIAL PROJECT COVER SIIEEET-
Assessor's Parcel Number: ��``0/- 0 6'
Name of owner.
Project address. A03? o { g Uokl5 T pc,F.K rr0 rlDn /' 1 oaAy Cfj�
Contact person. 0 61 _o Phone.
Fax. oA 7 —
Net square footage of lots
Existin.a Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
Are there at least two 10 foot by 20 foot clear spaces inside the garage? .
Is privacy protection planting required for the project?
Build it Green Total Points
On what floor(s) is work being done?
Brief description of work. �L-O V / 6(wt� .
(_Oe7 J r I /+�5 1�l G�"
Code editions:2007 CBC ow N)2007 CFC Y -N)2007 CMC (Y-N)
2007 CPC (Y-N)2007 NEC N)
Effective 1/1/08
,01 Yw
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Plan Review Process Work Book Page-8- Revised 06-15-10
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RESIDENTIAL PROJECT COVED SHEET-
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Assessor's Parcel Number:
Name of owner. I n Yi2,CT;fL-v
Project address. A0-3 t2, j2 a k, \ t,J ,°Ay C
Contact person. 16 Phone. ( ® r �
Fax.
Net square footage of lot. - —
Existing Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
Are there at least two 10 foot by 20 foot clear spaces inside the garage? 1,4
.
Is privacy protection planting required for the project? �' y
Build it Green Total Points17.1
On what floor(s) is work being done?
Brief description of work. "V tMajel, u n f^c�;c� c),5 6 doine- 61 toe-le
s
C Oft ,)I IL /lel y !it . 'C.," c / G ,i?ec f - C' �'
Code editions:2007 CBC N)2007 CFC Y-N)2007 CMC (Y-N)
2007 CPC (Y-N)2007 NEC ( N)
V
Y �
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Effective 1/1/08
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Plan Review Process Work Book Page-8-
Revised 06-15-10
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SPECIFICATIONS
CONSTRUCTION:Cast aluminum,cast brass or composite Bullet;matching heavy duty cast I I �
aluminum,brass or composite adjustable stvlvel;matching extension collar with lens � @;
LENS:High impact clear tempered convex glass tens tJ CerF«
O•RING:High temperature red silicone
LAMP SUPPLIED:75 watt MR 16 FL(EYC)5000 hours average rating(75w max) LJ Ga t
LAMP OPTION S:We recommend 20v7atlMR16ULTRA 10,000hours average ratin
20 watt MR 16 TITAN 18,000 hours average rating;4w ARROW LED 50,000 average rating
{
SOCKET:High temperature ceramic GU5.3 bi-pin with 250'C silicone lead wires
WIRING:Black 3 foot 18/2 zip cord from base of fixture(I2v.only) 5.25" 3.5"
For 25 foot 16/2 fixture lead wire add-25F to catalog number. 5.25 0.7 3.S" a
CONNECTION:FA-O5 Quick Connector(not supplied)from fixture to main cable '-19n,m
(12/2,10/2 or 8/2 only) o
MOUNTING:FA-03 black 9"ABS stake threaded 112"NPS DL-20-MR16-BRS
FINISH:Alundnum-Black texture polyester powder coat;optional finishes available ' mounted on
Brass-Unfinished brass;optlonal finishes available DL-20-MR16 FA-24-BRS
ORDERING INFORMATION
CATALOG NO, DESCRIPTION LAMP SHIP WEIGHT 5.25" 3,5
DL-20•MR16-BLT Cast aluminum Bullet 75w MR16 FL(EYQ 2.0 lbs. 3725 61rm
3.5"
DL-20d01116•BRS Cast brass Bullet 75viMR16FL(EYC) 3.0 lbs.
CDL.20•MRI6•BLT Composite Bullet 75wMR16FQEYQ 2.0 lbs.
DL-20-AC•h1R16•BLT Cast aluminum Bullet,angle collar 75wMR16FQEYQ 3.0 lbs. -
DL-20-AC-MR16•BRS Cast brass Bullet,angle collar 75v7 MR16 FL(EYQ 5.0 lbs.
CDL-20•AC-MR16-BLT Composite Bullet,angle collar 75wMRI 6FQEYQ 3.0 lbs.
110VO1fG10DElf{YITNIIlEE6RATEDEIElIR011IC7S19AiITRAiIffORI,IERAVAIlABIE.ADD-TTOPARIlIUdDL-20-AC-MR1 618ER
I(OTErlEDll68fBUiSSARIIOT(061P,ITIBIEI9ffN•rNODEIS
MOUNTING ACCESSORIES
2.6S' 2.6'S' 225- 7,
CL 71'
41rrm 5 67 5 6] m I�'I I' -- 7f-m
Sir r D'
FA
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14m J8
_ Op 7°m-s 1L..vJ 03'* 1
I a ee75^ I T1_�J FA-30A FA-3"
IS' ( B.]5' I 7E.r•n 175n.x, FA-24.!.10-C5T,FC/-BRS FA-24-rif)CST7-DRS 09'-l-
rimrn FA 72 CST7•BP5
FA-221-SRS FA•24MRS
rAOIP%FBPS iAO1;BAs FA07LG
FA�YAD
O 26
3' 1' I-'I r FA 2461D•CST-TREE et- 1 FA-111 FA-24- 11'
FA0118R5 7ET.n O]r.-,m Oo, 7r.rm (10"•41`) ,. _)� TREE 351
FA-24-LG-SPUII BRS 15'
3 —
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33
1A,11 33,'-
(q
3, .
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2.65'
67—, 13' 105
J52021rm
�-
FA-I I1,TREE FA-22•YREE FA-24- FA-30 FA-31 FA-32 rA•33 FA-34
FA-24-MD-CST-POSTPURS CIFA-251.261DRS CIFA-26-75VOInts GFA•26-GFIUBRS (10,41`) 110'-41) TREE `u=en,.1'c?gin
„1 <o:.rEdr<«Phn STEM EXTENSIONS
BEAM/GLARE CONTROL ACCESSORIES JOB INFORMATION
FA•OB-OG Round 1/4"Hex Cell Louver
Type: Date:
FA-10-20 BLUE Blue Tempered Glass Lens Jeb Name:
FA-10.20-GREEN Green Tempered Glass Lens
FA-94 6"Extra-Long Extension Shield(aluminum only) Cat,rto:
FA-98.20 Linear Spread-FemperedGlass Lens '...
FA-104.20 Wide Spread Tempered Glass Lens Softener Lamp(s):
specifier.
Contractor;
Noses:
FOCUS RIDUSTRIESINC, vrvnv.focusinduslries.com
25301 COMMERCENTRE DRIVE sales fo4usl nduslrles.com
:ANE FOREST CA 92630 (949)130 1350 I FAX(949)830 3390
O,de,ing Code -131r -ATV -QRT -CAM •WPX -HTX -RST -WIR -WDR -SYU -RQV -CPR -PRC
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Certificate of Compliance (Sign Lighting) (Page 1 of 2) SLTG-1C
APro ect Name: Phase of Construction 13 New Construction 11 Addition ❑Alteration
4" cW> o R44 Function Type 9'0rutdoor Signs ❑Indoor Signs
Project Address: n Date/: Compliance Method Used❑Maximum Allowed
F_ 5 f ,(.K Po
) v h 17 I Lighting Power 1:1Alternate Lighting Sources
Do mentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate and complete.
Name re
Company Date
.JRNb. 2 o(CS, G t
Address If applicable:
7 CEA#
CEPE#
City/State/Zip Phone:
hps .At' �i e 44 � 72 V-0
Principal Lighting Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the lighting
design.
• This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with
Title 24,Pages 1 and 6 of the California Code of Regulations.
• The design features represented on this Certificate of Compliance are consistent with the information provided to document
this design on the other applicable compliance forms,worksheets,calculations,plans and specifications submitted to the
enforcement agency for approval with this building permit application.
Name: Signature
Company: !! P one
✓I C C- 2--9c)
Address: J� Liee�nyse#
X,3-3.3 c l U� c. c I C. `5 0 �>5C9
City/Stat /Zip: Date
�r r,"' c') C-1 0 / /� " z 0 r/
Sign Ma tory Measures
Indicate location on building plans of Mandatory Sign Measures Note Block:
Mandatory Sign Lighting Controls Yes No
1 §133(a)1.All signs with permanently connected lighting are controlled with an automatic time switch control ❑ ❑
that com lies with the applicable requirements of§119.
§133(a)2. All outdoor signs are controlled with a photo control or outdoor astronomical time switch control. 0, ❑
2 Exception to§133(a)2. Outdoor signs are in tunnels or large covered areas that require illumination during
daylight hours. ❑ ❑
§133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce ❑ ❑
sign power by a minimum of 65 percent during nighttime hours.
Exception 1 to§133(a)3. Signs are illuminated for less than one hour per day during daylight hours. ❑ ❑
3 Exception 2 to§133(a)3. Outdoor signs are in tunnels or large covered areas that require illumination 0 11
during daylight hours.
Exception 3 to§133(a)3. Only metal halide,high pressure sodium,cold cathode,or neon lamps are used to ❑ ❑
illuminated signs or parts of signs.
§133(a)4. An Electronic Message Center(EMC)having a new connected lighting power load greater than Y N N/A
15 kW has a control installed is capable of reducing the lighting power by a minimum of 30 percent when ❑ ❑ ❑
4 receiving a demand response signal that is sent out by the local utility.
Exception to§133(a)4.The EMC is required by a health or life safety statue,ordinance,or regulation, Y N N/A
including but not limited to exit signs and traffic signs. ❑ ❑ ❑
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2008 Nonresidential Compliance Forms August 2009