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15040109CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10497 S DE ANZA BLVD CONTRACTOR:_JZ144,� BE PERMIT NO: 15040109 D OWNER'S NAME: BDC HAYWARD LP S SAlean DATE ISSUED: 04/15/2015 OWNER'S PHONE: 3232913333 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ALL THAT BARBECUE- INSTALL (2) ILLUMINATED SIGN Class Lic. # q (F q9 License It S.. in Date fY Contractor I hereby affirm th t I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. 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. Sq. Ft Floor Area: Valuation: $4000 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 35917019 10497 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF W IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITIIIN 180 DAY P T ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, 180 DAYS ALLED INS ECTION. costs, and expenses which may accrue against said City in consequence of the Issued b Date: Y' granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section ROOFS: 9 18. Signature ' � Date /—/ All roofs shall be inspected prior to y roofing material being installed. If a roof is any r installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and 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 thisOwner the Health & Safety Code, Sections 25505, 25533, and 25534. ( / Date: or authorized agent: permit is issued. 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 Worker's CONSTRUCTION LENDING AGENCY 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 must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 918. Signature Date CUPERTI"tNO SIGN PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingacupertino.orct (\ q6j PROJECT ADDRESS IEN(A. �� APN # 3s 9 1 0 I �. �. OWNER NAME PHONE �y39 _ 3 333 / E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME r C,\ Vl PHONE r 3 �3\ �Q !� 1 / f— ` J 4 V .7�}J E-MAIL ��55 S ( V ' v `% STREET ADDRESS ao s A- CITY, STATE, ZIP r`,� L FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT y/e E CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME � LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME r j Qom,^' &-;b• 1 E-MAIL /yy� ^ j \ ei%� � l�-� �i �' 1 � 1/1� � FAX C 3�3 aq IoLl ' STREET ADDRESS2� �, Sial AVe , CITY, STATE, ZIP L-A , cmc)4`1 PHONE (3Z3) I _) q —3 ARCHITECT/ENGINEER NAME 7 LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CrrY, STATE, ZIP PHONE DESCRIPTION OF WORK r atn USE OF ❑j SSFD or Duplex ❑ Multi -Family 9 II-LUMINATED SIGN TYPE NO. OF SIGN AREA VALUATION STRUCTURE: commercial (Y) N) (CODE) SIGNS (SQ. FT.) (S) SIGN TYPE CODES: V) B - BANNER SIGN M - MONUMENT (GROUND) SIGN BL - BLADE SIGN P - PROJECTING SIGN D - DEVELOPMENT ID SIGN SP - SPECIAL EVENT BANNER DI - DIRECTIONAL SIGN T - TEMPORARY E - ELECTRONIC W - WALL SIGN READERBOARD WI - WINDOW SIGN _ !' TOTAL W N: II By my signature below, I certify to each of the following: I am the property owner or authorized a nt t on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work an verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building cons ion. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Appl icant/Agent: Date: SUPPLEMENTAL INFORMATI RE UIRED Q Si•��a�'_-'�� ;� }s+�`,}},`S '.ak �:tw+,.C� USI"i .�,:.1: �F..:?".�«,�t�'."v3Z "e-. � , a�'..p ^''°CI`i.`"$� , .§R'LPEr r. _.. -F. ROUINGSLIk.-_ _ Site PlanI Elevations � �imN REVIEW. Sign Details -including UL listing(s) applicable Structural Calculations (if applicable) _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. £ SignApp_2011.doe revised 03/16/11 �� CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10497 s de anza blvd DATE: 04/15/20157REVIEWED BY: Mendez APN: BP#: *VALUATION: 1$4,000 *PERMIT TYPE: Building Permit 11::<2 {:;111:£:'li T11'1:': PRIMARY PENTAMATION 1 CEAP5 USE. Sign PERMIT TYPE: wORK all that barbecue- install 2 illuminated sign SCOPE :Wec hf /'kin ('heck Lk,, -h, 1'gsr•rnit Fee O"her 'I ;.f,. '' lei h. jnsl . 1'z`e 1'duwb, frit: ('heek I'r'iiwb. Permit Fee: Other Phio?b Irsr;. I'IEe, w), Inv), Fee: # Branch Circuits 1 1 $48.00 IESIGN Elec. Permit Fee: IEPERMIT Other Elec. Insp. 0.0 1 $48.00 /anti,>;. Fee" NOTE: This estimate does not include fees due to other uepartments (ie. rianning, ruouc rrorKs, metre, atutstuty .3cwvl ..tom......, —.t..... District, etc). These fiTs are based on the prelimina information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 1.1-053.Eff. 7/1/.13) FEE QTY/FEE MISC ITEMS 1 hin t.'heek flee: Suppl. PC Fee: IS Reg. ® OT 0.0 hrs $0.00 Permit Fee: $572.00 Suppl. Insp. Feer Reg. ® OT 0,0 hrs $0.00 PME Unit Fee: $48.00 Permit Fee: PW Per $48.00 d% (_'ra�t. iruc�t;w? x Work Without Permit? 0 Yes (E) No $0.00 Sign Master Plan: ® Yes (E) No $0.00 Travel Documentation Fee: ITRA VDOC $48.00 Strong Motion Fee: 1BSEISMICO $1.12 Select an Administrative Item IBCBSC $1.00 $718.12 $0.00 EE. $718.12 Revised: 04/01/2015 t T'.:'. _� C t 1720 W.-SLAUSON AVE LOS.ANGELES, CA 90047 1323.291.3333 z-.:..,.. F. 323:291.3704.. expresssign1720@hotmail.com LIC #643841 Representative: Frank Bang Drawn by: Simon Jeong Revisions: ��.t5l�BQ- .4d,noLN(0'1-23-15) ❑2 All That BBQ - Cupertino PLAN (R_04-07-15) ❑3 - ® - Project: ALL THAT BARBECUE . K - Job sae :10497 South De Anza Blvd. Cupe In Approved by (client): W U SIGN & NEON COMPANY U.L:—LISTM$ETM97 —`° m Approved by (landlord): Date: THIS IS AN ORIGINAL UNPUBLISHED DESIGN CREATED BY EXPRESS SIGN & NEON. IT IS NOT TO BE SHOWN OR EXHIBITED TO ANYONE OUTSIDE YOUR ORGANIZATION. REPRODUCTION OR CONSTRUCTION OF DISPLAYS BASED ON THIS DESIGN IS SUBJECT TO COPYRIGHT LAWS AND SUBJECT TO LEGAL ACTION. CUPEWPNe 70'-0" 8"iiding Department 40 EXPRESS 18'-0" SIGN TO HAVE NO VISIBLE RACEWAYS SIGN ILLUMINATION NOT TO EXCEED 250FT-LAMBERTS 1720 W. SLAUSON AVE. LOS ANGELES, CA 90047 T. 323.291.3333 F. 323.291.3704 expresssignl720@hotmail.com STATE LIC. #643841 Representative: Frank Bang Drawn by: Simon Jeong Revisions: 01 All That BBQ - Cupertino PLAN (02-23-15) VC 3'-0" WALL SIGN 1. Internally Illuminated Channel Letters � I T-0" 4'-0" 9'-6" EAST ELEVATION SCALE :1/8"= V-0" 3MTm ScotchcalTm Translucent Graphic Film Ivory 3630-005 (Matte Finish) ■3MTm ScotchcalTm Translucent Graphic Film Red 3630-33 (Matte Finish) INDIVIDUAL ALUMINUM CHANNEL LETTERS INTERNALLY ILLUMINATED BY WHITE L.E.D. MODULES 3116° ACRYLIC FACE w/ TRANSLUCENT VINYL OVERLAY SIGN DETAIL BLACK TRIM -CAP & BLACK ALUMINUM RETURNS SCALE: 3/8"= V-10" ❑2 All That BBQ - Cupertino PLAN (R_04-07-15) Project: ALL THAT BARBECUE Job site :10497 South De Anza Blvd. Cupertino, CA Approved by (client): Date: SIGN & NEON COMPANY I U.L. LISTED #E 141997 I I 0 _ _— I Approved by (landlord): Date: THIS IS AN ORIGINAL UNPUBLISHED DESIGN CREATED BY EXPRESS SIGN & NEON. IT IS NOT TO BE SHOWN OR EXHIBITED TO ANYONE OUTSIDE YOUR ORGANIZATION. REPRODUCTION OR CONSTRUCTION OF DISPLAYS BASED ON THIS DESIGN IS SUBJECT TO COPYRIGHT LAWS AND SUBJECT TO LEGALACTION, NO VISIBLE RACEWAYS 1❑ CHANNEL LETTERS W/ COMPONENTS LISTED AS BELOW Fl -TA -1 3/16" PLEXIGLASS — W/ HIGH PERFORMANCE VINYL EACH MODULE:15,000 mcd (APPROX. 7 LUMEN) 1 B SS LIGHT, 60MA KPL SERIES NOT TO EXCEED 250FT LAMBERT (11 MODULES PER S.F.) LED UNITS 11L = 3.43 lumen / 1 m2 LIT 250f = 857.5 Lumen / 1 m2 = 79.7 lumen / 1 S.F. F1_FC1 18GA PRE -PAINTED 1 Module = 7 lumen WHITE ALUM. BACK Max # modules / 1 S.F. = 11 5751 SEAL ENTRY & EXIT HOLES W/ SILICONE FTFEI 18GA ALUM. RETURNS.— PRE-PAINTED ETURNS-PRE-PAINTED ALUMINUM F1_T_F1 TRIM CAP 171761 1W WEEP HOLES (2 MIN.) ® EXISTING FASCIA 1720 W. SLAUSON AVE. LOS ANGELES, CA 90047 T. 323.291.3333 F. 323.291.3704 expresssign1720@hotmail.com NOT NOTES: 1. This Sign Is Intended To Be Installed In Accordance With The R Of The National Electrical Code And/or Other Applicable Local C Grounding And Bonding Of The Sign. 2. All Penetrations Into Building Walls To Be Sealed & Water Proof. 3. There Will Be No Exposed Fasteners Or Conduit. Representative: Frank Bang Drawn by: Simon Jeong Revisions: �j All That BBO - Cupertino PLAN (02-23-15) ❑2 All That BBQ - Cupertino PLAN (R_04-07-15) WALL SIGN 1. Internally Illuminated Channel Letters (#19)5/16"x3" LAG SCREWS 90 W/ PLASTIC ANCHOR USE MIN. 4 SCREWS PER LETTER POWER SUPPLY OUTPUT LEAD OR EXTENDED > D LEAD USING APPROPRIATE UL LISTED PLTC: Up to 15' = 18AWG / Up to 50' = 14AWG J -BOX W/ DISCONNECT 11 SWITCH MOUNTED TO END OF TRANS. BOX 12VDC 60 WATT 12 POWER SUPPLIES. CONSTANT CURRENT J -BOX POWER TO INDEPENDENT CIRCUIT ELECTRICAL TO USE U.L. LISTED COMPONEM AND SWILL MEET N.E.C. STANDARDS OUnderwriters uL Laboratories Inc. Project: ALL THAT BARBECUE Job site :10497 South De Anza Blvd. Cupertino, CA E X P R E S S STATE LIC. #643841 ® _ Approved by (client): Date: SIGN & NEON COMPANY U.L. LISTED #E 141997 ❑5 _ _ _ _ _ _ _ Approved by (landlord): Date: THIS IS AN ORIGINAL UNPUBLISHED DESIGN CREATED BY EXPRESS SIGN & NEON. R IS NOT TO BE SHOWN OR EXHIBITED TO ANYONE OUTSIDE YOUR ORGANIZATION. REPRODUCTION OR CONSTRUCTION OF DISPLAYS BASED ON THIS DESIGN IS SUBJECT TO COPYRIGHT LAWS AND SUBJECT TO LEGALACTION. 2'-0" WALL SIGN 2. Non -illuminated Channel Letters to EXPRESS 1720 W. SLAUSON AVE. LOS ANGELES, CA 90047 T. 323.291.3333 F. 323.291.3704 expresssign1720@hotmail.com STATE LIC. #643841 SOUTH ELEVATION SCALE :1/8'= V-0" 3MTM ScotchcalT" Translucent Graphic Film Ivory 3630-005 (Matte Finish) ■3MTM ScotchcalTm Translucent Graphic Film Red 3630-33 (Matte Finish) INDIVIDUAL ALUMINUM CHANNEL LETTERS NON -ILLUMINATED �R -, ^SIGN DETAIL BLACKI ALUM NUM RETURNSC FACE TRANSLUCENT VINYL ERLAY NON -ILLUMINATED SIGN �eve`v 8y G� SCALE: 3/8"=1'-0" RIMCAP &BLACK Representative: Frank Bang Drawn by: Simon Jeong Revisions: M1 All That BBQ - Cupertino PLAN (02-23-15) ❑2 All That BBQ - Cupertino PLAN (R_04-07-15) ❑3 - ❑4 Project: ALL THAT BARBECUE Job site :10497 South De Anza Blvd. Cupertino, CA Approved by (client): Date: SIGN & NEON COMPANY I U.L. LISTED #E 141997 I I I Approved by (landlord): Date: THIS IS AN ORIGINAL UNPUBLISHED DESIGN CREATED BY EXPRESS SIGN & NEON. IT IS NOT TO BE SHOWN OR EXHIBITED TO ANYONE OUTSIDE YOUR ORGANIZATION. REPRODUCTION OR CONSTRUCTION OF DISPLAYS BASED ON THIS DESIGN IS SUBJECT TO COPYRIGHT LAWS AND SUBJECT TO LEGALACTION. 40 EXPRESS NO VISIBLE RACEWAYS WALL SIGN 2. Non -illuminated Channel Letters 5" (#19)5/16"x3" LAG SCREWS[E W/ PLASTIC ANCHOR 1❑ CHANNEL LETTERS W/ USE MIN. 4 SCREWS PER LETTER COMPONENTS LISTED AS BELOW 1 A 3/16" PLEXIGLASS W/ HIGH PERFORMANCE VINYL I F1_FC1 18GA PRE-PAINTED01 WHITE ALUM. BACK 1 E 18GA ALUM. RETURNS. PRE -PAINTED ALUMINUM FlTIFI TRIM CAP .;r 1 G Ya" WEEP HOLES (2 MIN.) ® EXISTING FASCIA NOT TO SCALE NOTES: 1. This Sign Is Intended To Be Installed In Accordance With The Requirements Of Article6Gt.rea (.cb r Of The National Electrical Code And/or Other Applicable Local Codes. This Includes Proper 8 . Grounding And Bonding Of The Sign. 2. All Penetrations Into Building Walls To Be Sealed & Water Proof. = �" 3. There Will Be No Exposed Fasteners Or Conduit. 1720 W. SLAUSON AVE. LOS ANGELES, CA 90047 T. 323.291.3333 F. 323.29 1 .3704 expresssign1720@hotmail.com STATE LIC. #643841 Representative: Frank Bang Drawn by: Simon Jeong Revisions: Fi All That BBQ - Cupertino PLAN (02-23-15) ❑2 All That BBQ _Cupertino PLAN (R_04-07_15)_ - - ❑3 - — - a Project: ALL THAT BARBECUE Job site :10497 South De Anza Blvd. Cupertino, CA Approved by (client): Date: SIGN & NEON COMPANY I U.L. LISTED #E 141997 I I NI Approved by (landlord): Date: THIS [SAN ORIGINAL UNPUBLISHED DESIGN CREATED BY EXPRESS SIGN & NEON. ITIS NOTTO BE SHOWN OR EXHIBITED TO ANYONE OUTSIDE YOUR ORGANIZATION. REPRODUCTION OR CONSTRUCTION OF DISPLAYS BASED ON THIS DESIGN IS SUBJECT TO COPYRIGHT LAWS AND SUBJECTTO LEGALACTION. STATE OF CALIFORNIA SIGN LIGHTING eEC-NRCC-;LTS-01-E(Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 1 of 5) Project Name: Date Prepared: ALL THAT BA12t3ECUE 3/31/2015 Project Address: IOL M7 $, DE AUZA 13LVID. CUpE2-n140 , CA Location of Sign WCutdoor Signs ❑ Indoor Signs Phase of Sign Construction Ef New Signs ❑ Sign Alterations Type of Lighting Control ❑ New Lighting Controls ❑ Replaced Lighting Controls IKNot Installing Lighting Controls This Certificate of Compliance includes the following components (check all that apply) ML Mandatory Measures (Lighting Controls) ❑ Maximum Allowed Lighting Power I( Specific Lighting Sources 1. Mandatory Sign Lighting Controls NOTES 1. The some 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. 1a. Statements of Responsibility: Any person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E shall complete Part 1a. Check Yes or No for all of the following statements: 1 1 have responsibility for installing the sign lighting controls ❑ Yes, complete parts 1a and 1b of this form 19 No, complete part 1a of this form 2 There are no existing sign lighting controls and I will be installing compliant sign lighting controls ❑ Yes 19 No 3 There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls ❑ Yes QSNo There are existing sign lighting controls that do not comply with the applicable provision of §110.9 and §130.3 and I will be 4 installing compliant sign lighting controls ❑ Yes 0 No There are existing sign lighting controls that do not comply with the applicable provision of §110.9 and §130.3 and someone 5 else will be responsible to install compliant sign lighting controls ❑ Yes 19 No CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA SIGN LIGHTING mgmrlm GEC-NRCC,LTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting l}� �(Page 2 of 5) Project Name: ALL THAT QARBECVG Date Prepared: 3/3Il2OI^ ! 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. ❑ ❑ ❑ §130.3(a)2A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time- Y N NA switch control, or an astronomical time -switch control. ❑ ❑ ❑ 2 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. ❑ ❑ §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 percent during nighttime hours. Y N NA 3 Signs that are illuminated at night and for more than 1 hour during daylight hours shall be considered ON both ❑ ❑ ❑ day and night. EXCEPTION to Section 130.3(a)2B: Outdoor signs in tunnels and large covered areas that are intended to be Y NA illuminated both day and night. ❑ ❑ §130.3(a)3. Demand Responsive Electronic Message Center Control. An Electronic Message Center (EMC) Y N N/A having a new connected lighting power load greater than 15 kW has a control installed that is capable of ❑ ❑ ❑ 4 reducing the lighting power by a minimum of 30 percent 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 percent. ❑ ❑ Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA SIGN LIGHTING CEC-NRCC-LTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION 1 CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 4 of 5) Project Name: A LL 1'444^ r 13 a n c Date Prepared: 3 I 2 0 1 S 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 I(1) LIT, CAANNEL I.OrEfLS ❑ -7 >F a ❑ Z CI LII CHAVNIEL L6Trm5 ❑ 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 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 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 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 1 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 - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA SIGN LIGHTING CEC-NRCG,LTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION 11 CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 5 of 5) Project Name: AirL THAT GAn Date Prepared: 3 1&0 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate. of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Autho 'g tur EVISAa ACEI (UN0 Company: EXplLE5S SIGN 4 uEON Signature Date: :3/V 017 Address: CEA/ HERS Certification Identification (if applicable): 1720 W. S to U30M AVE. City/State/Zip: LDS AAF ELL -S CA J10(9117 Phone: (32 2 q l 3 3 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 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. 5. 1 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 p vi es to the building owner at occupancy. Responsible Designer Name: Responsible Designe E ,oAa ACEITWO Company: E2E S S/6u 1, l=0 Date Signed: 39t 20/�- Address: 1 2 N AVE. License: 6 84 City/State/Zip: LOS 806 LE3CA gV0A17 Phone: (32'>) 2A 6.3333 CA Building Energy Efficiency Standards 2013 Nonresidential Compliance June 2014