Loading...
15090077guo!ssaJoad pasu331-1 •spjooaj 3ggnd se pasn aq Reqs sueld Am puelslapun I NOI.LVHV'133a S,J33JLIHJHV ssa.1ppv s,.Iapua-I awgN s,.iapua•I ('O A!O `L60£ •3aS) panss! s! 1!uuad s!tp g314m JoJ s,)Iaom Jo aaueuugl,ad oql joJ A3uoSe Sulpuaj uo!ponnsuo3 a si 2jay1 legl wjgJe Ag0j04 I AJN39V 9NIQN31 NOUXIH.LSN03 •r£Ssz Png'f£SSZ •IIS i �opaa a!/e7Xw�$ T yllvjg 041 Pug ZI.6 aaldvgJ'apo.) lvdlalunW out► , i , 1!m aauv!ldtaw ulvlulvw ll!m I 13u3s!4 luawaSvuvl� -U!Ivn0 a!V vaaV Avg ail Aq paugap ss slueulwgluoa i!e snop.iezvy 11wa yalym saa!Aap ao luawdlnba asn I pinoys'AI!vuo!llppV •Im!aalvw snopavzmq alpuvq to aaols I pinoys (v)Z£SSZ uoll33s ,.PoJ kines y11eJH 041 Pus Z1'6 aaldgy) •apoJ lgdl3lunlN oul).jadnj aql ql!m aauv!Idwo3 ulglulum ll!m l •t£SSz Puv'£fSSZ `SOSSz suoll3aS `aPOJ A43J13S a9 41183H g!uaoJ!lvJ ail Jo S6.9 aaldv40 aapun sluawa.t!nbaj slv!jalew snopiezvy aql pgaa aney I 3HIIS0'1JS14 S7VIH3.LVW SIlO4HVZVH H3.LL39 HO .. V„ SSYD 39 01 SJNI113AO3 400H '11V :0113] :luvogddV Jo ainmuSlS •uo!laadsu! aoJ s113u01eut mau Ile anowaJ 0130/221 `uopoadsu! us Swu!elgo 1sig 1noy1!m pallelstu s! Joo1 vjj •pallelsu! Su!aq Ieualew Sugool Aue of loud p2l3adsw aq llegs s;oo1 IIV :MOOR -3H l- J. mvQ panssl INOI.LaUSAII QII'I'Iva .LSvrl NI02I3 SAVQ 081 HO II3INIVfISSI J.IMHd 30 SAVG 081 I\IIHJ:IM QII.LHV LS J ONI SI Xm0tA Al S:lHldxa . imad I :adAjL Aauvdnaa0 go,gg T gZg}6, .iagwnN NdV 009S$:11096nlyA1 :c.�.i� .iool.I 1.1 bti '81'6 uol13OS `OpoO ludl3!unW oulliadnJ a41 iod suollelnsai aatnos 1ulod-uou Ile 41!m Aldwo3 ll!m pus spuslsiopun lue3!Idde Otp `Aj jvuo!1!ppV 'uuuod slap Jo Sm1uuiS 041 Jo monbosuo3 u! Ap!O p!es 1sule2e atu33e AM g3!gm sosuadx0 pug `s1so3 `sluowSpnf `sa!1!I!ge!I 1sulese ou!laadnO Jo Allo atp ssoluuwq dawl pus AJ!uwapui apes of aajSv (aM) •sasodmd uonoodsm joJ Altadad pauolluaw OAoge aql uodn jalua of Al!3 slglJo saA!leluasaidoj azuoglnv Agaioq pus `uoilonnsuo3 Sulpl!nq of Sullelai smel a1131s pus sommulpio A4uno3 pus Al!3 IPi qp!m Aldwo3 of a0i2m I -joomo3 Sl u0!113uu0Ju! anoqu atil letp alels pug uo!lga!Idde sl41 peOJ DAey 111341 AJ!y00 I NOI LVJI31.LH3J .LNVJI IddV •pa)lonaJ pawaap aq lleys 1!uuod s!41 Jo suols!Aad vans 41!m Aldwo3 tp!mquoJ lsnw I `apoO joqu-I oql Jo suo!s!Aoid uo!lesuadwo0 s,jojioM a p o1 laafgns otumq I `uo!ldwaxo Jo oleag!liaa slgl Sunlew jage :lI elwgj!jvD Jo smvj uopvsuadtuo3 s,jojjoM 041 o1 laafgns awoaaq of se os jauuvw Aum u! uosiod Aum Aoldwa lou pmt's I `panss! s! 1!uuad sltp g3!4m joJ Tom a p Jo aaueuugl,ad aql u! lmgl Ajpjao I .E •panssi si ptuiad slgl gO!gm aoJ Tom O41 Jo 03uetwqj.iod a41 joJ `opoJ joge-1041 JoOOL£ uo!laaS Aq joJ pap!Aoad se `mvinstq uopusuodwoO s,iailjoM utiqulmw ll!m pug aney I z •panssi si ptuiad s!til 4314m aoJ )Ijom oq1 Jo ootmuuoJjad a41 aoJ 'opoO joge-I aql Jo OOL£ uoll32S Aq joJ pop!Aoad se 'uogusuadwoO s,ja4ioM joJ amsui Jlas of luasuo0 Jo almogivoo m u!elu!mw II!m pue aney I t :suollg.tvlaap aaayl $ulmo11oJ aql Jo auo A.mfiad Jo A1lvuad iapun w tt-Ily Agaaay I •(apoO suo!ssa;oid V ssoulsng `y CMOS) loafoid a4113nusuo3 01 sJol3enu03 POSn2311 41!m Sn113enUO3 AIaAlsnj3xa um `AUOdad of pJo iaumo se `I z (opoJ suo!ssa;ad 7p ssatusng ` 7VOL'33S) ales aoJ pajogo jo papualw lou si amlatuls otp pug `Tom otp op p!m `uoiwsuadwo3 Ojos rayl se sOsem 4l!m soa,Coldwa Aw io `A>Jadoad atp Jo taumo se `I :suosva.t oml SulmopoJ ail Jo auo aoJ mea asuaarl s,.iol3v.tluoJ ail woiJ ldwaxa ws I lvyl waljjv Aga.taq I NOI.LVHV'IJ34 NMI I lfl-M3NAAO ❑ JI •' 1�• als amleuS!S '81'6 u01130S `apoO ledla! IN ou adnO ay suo el md-uou lie qp!m Aldwo3 ll!m pue spuelsla un 1 jddu atp ` u uuad snp J ulluslS atp Jo 03uanbasuo3 to 3311A11w 43!4masua sdxa pue `slso3 `sluautspnf `soq!I!qu!j 1sumse owlladnO Jo A3!O a41 ssoluueq doa7l pus AJ!uwopu! Ones 01 aaJSm (aM) •sasodlnd uo!13adsu! 1oJ Auadad pouolluaw anoge a p uodn JOpuO 01 Al!3 sltll Jo saAguluosaldal azuoglns Agalaq pus `uo!13nnsuo3 sulpl!nq of Su►lelai smel olmis pug somump10 Apunoa pus AI!3 pe 41!m Aldut03 of aa1211 I •102=3 St uollguUoJu! anoge 0411e41 alels pug uo!le3gdde stip peal OAe4 I wtp 4J!v23 I NOI.LVJI3I.LH3J .LNVJ1'1ddV •panssi si ptuiad sl4143►ym 1oJ Tom ail Jo a3ueuuopod a4p 1oJ `opoJ 1ogv j ail J0 OOL£ U01130S Aq JoJ pap!Aoid se `a3uelnsuj uoumsuadwoO s,103j1oM ul131utvw Ipm pus aney I� •panssi si uuuad s"P 4314m JoJ Tom otp Jo aoumuoJlad 041 MOND Jogm-1 atp J0 OOL£ 130113oS Aq ioJ pap►Aad su `uo!pesuadwoO s,1a)j1oM 1oJ amsu!;las of luasuoo Jo Olvog!yao v u!e1ulew ll!m pug aney I t :suollvavl3ap oml Su!mo1loJ ail Jo auo A.tnfaad jo Allvuad aapun wjWv Agajaq I •laapa pus aa.ioJ pnJ ut s! asuaa!1 Aw lvgl pus apo,3 suolss3Jold I? ssaulsng ail Jo f uo!s!A!4 Jo (OOOL 1301133S y)!m sul3uautwo3) 6 aaldv40 Jo suo!s!Aoad ail aapun pasuaall we I lvgl wall,Iv Agalaq I 3113](C+"4; vol" 1013enuoO OE „IOO2o —24e. ".LNVN31 3oSNQ SN()IS •1IVM L bZ, # 3!3 "% W/o 17 ssg10 2su231-1 ]3.LVNIM 111( SW-IVJnUZ)9'13 TlV.LSNI-11OMMOU NOI.LVHVI334 S.HO13VdJX03 G3SN30I'l ❑ ❑ 7VIJH3NINIOJ ❑-JVI.LN3QIS3H :NOI.LdlH3S34 HOf I IZ6Z-lb6(60Z) :ON 3N011d I 9OZ56 VO NO.L)IOOJ.S I 969ZZSZS017 :3NOHd S6113NMO 9IOZ/11/60 :U3f1SSI 33.\ (I I is Q'IVNOH 9 ££ZI OTI 'I"IVNI DNIdd0HS 03TIVA :3N!VN SMNM0 LL006051 :ON.LIWHHd SNJIS 330.E VNIW :HO.LJVH.LNOJ / X r 3LS "aa 3d'IOM N £ZI01 :SS3HQQV `JNId'll ltl J.IWHHd OAIIQ'IIflfl CINU MIJ 30 AID SIGN PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • bulldingacuoorlino.orcT 5D� �}O % 7 S PROSECT ADDRESS 10123 N. Wolfe Road #200 APN 4 /�GLLl� i?FG c 7 cJN.r LL (� ST FFI ODRFSC p �3 CITl STATF 71P 7 7�G v FAA CONTACT NA\IF Mike Behnke Pll � �9) 941-2921 E MAIL mike.behnke@mina-Ireesigns.cam sTRFIT AnnRfss 1233 E. Ronald Street CIT) " CT�TEd n, Califomia 95205 E69) 941-2651 .::: ❑ OWNER ❑ OwNER•mHLnER 0 Ow -SFR AGINT ❑ rMTRACTOR ❑ ro%1RAMCIR AGFSI ❑ ARCIIIITFCT ❑ FSGINFER ❑ DEVELOPER ❑ TENASr CONftRACTOR NA.\IE Mike BehnkeLtC12�E�L�1111.R `E "98, Lyfb, C61 TICS. LIC R COMP \Nl NAME Mina -Tree Signs, Inc. SL\IL Mike. behnke@mina—treebsigns-coni F�b9-941-2651 STREET \DDRF.SS 1233 E. Ronald Street "" Sslt bWn, califomia 95205 PI 8-941-2921 \RCHITECr ENGINEER NAME LICENSE NU\IRFR HCS. LIC o NIA COMP \NY NAME EMAIL FAX STREET \DDRESS CIT) ST %TI:. zir PHONE DISCKIPTK)N OF UORK Install two (2) illuminated signs on inside of bowling alley Sign #1: 30" letters 'BOWL" Sign#2: 21" x 6' Arrow VSF OF ❑ SFD or Duplex ❑ Multi -Family ILL'. \II\ \TED SIGN Tl PE NO OF SIGN \RF \ %ALUAT1ON SIRLCIURL Coouncrcial 11 \1 ICOW , SIGNS ISO FTI IS SIG\ n Pr r»nrs Y w 2 36.75 5,500 H HAN\FRSIGN NI MONUMENT IGROUNn) SIGN HI HI ADE SIGN P PROTEC-TING SIG\ D DLVEI.OMIENT ID SIGN SP SPECIAL F.\TNT BANNER tN DIRECTIO\ \L SIGN T TE.\IPOR,\RY E ELECTRONIC U k% ALL SIGN READERHO %RD l\ I \I INDOU SIGN RECEItFD BY / IUTA \, LAIIIJy By my signature betow, I ecrllf aeI of the following I am the w ionzed aglrm to act on Clic property owner's behalf I have read this application and the infnrmTlinn I has pml vid s L L vc rr d the Des n tin_ of \ ark and verify it is accunte t agree Io comply with all applicable local ordinances and stale laws relating to . ng a in c rrprrs to srs of uperuno Io enter the above -identified property fur inspection urposo Signature of Applicant'Agcnl _ _ _ Date �• 2� • � "�+ SUPPLEMENTAL INFORMATION REQUIRED OFFICE USEON41 PLAN CHECK TYPE ROUTING SLIP Site Plan � O\ ER -THE -COUNTER UILDING PL\N RE\ HEM Elc\•ations Sign Dclwls Including UL listing(s) applicable ❑ t.xrRF:SS �:&­%WNINGPUN REYIE\\ Structural Calculations (ifapplicahlc) ❑ W,\\D.\R0 ❑ OTIIER: copy Of Planning Approval Letter or Meeting with Planning pear 111 ❑ L\RGE submittal of Building Permit upphcatiun ❑ \I.WR Sign 1pp '0/ 1 rfoc ret ised 03 3/ 11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION APPLIANCE / EQUIP TYPE ADDRESS: 10123 N WOLFE RD #20 DATE: 09/11/2015 REVIEWED BY: SEAN UNITS APN: BP#: 'VALUATION: 1$5,500 'PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: $48 PENTAMATION 1REAP10 I PERMIT TYPE: WORK - INSTALL ELECTRICAL FOR 2 ILLUMINATED WALL SIGNS INSIDE TENANT. [PLOWLMOR SCOPE APPLIANCE / EQUIP TYPE FEE ID Phrnrh. Plor, Check QTY UNITS BP FEES Elec. Permit Fee: 1EPERMIT Recep/Switch/Outlets 1BREMRECEP Other Elec. Insp. 0.0 hrs $48.00 2 # $48 I'Llratil Frye': hop FCC, PME Unit Fee: $48.00 PME Permit Fee: $48.00 Cuttvtr-uctintt loo. Administrative Fee: IADMHN $45.00 Work Without Permit? O Yes 0 No $0.00 I (h,unced Planning; F,, TOTALS: Travel Documentation Fee: 1TRA VDOC $48.00 $48.00 $0.72 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). Thesefees are based on the preliminary information available and are only an estimate Contact the Deptfor addn7 info. FEE ITEMS (Fee Resolution 11-053 l.j1: ' 1 /3) tech. Plan Check Phrnrh. Plor, Check Elec. Plan Check 0.0 hrs $0.00 ; 1', Werk Elec. Permit Fee: 1EPERMIT Lhcr.ifcch. Insp Other Elec. Insp. 0.0 hrs $48.00 PME Plan Check: $0.00 0" h�,l' l r NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). Thesefees are based on the preliminary information available and are only an estimate Contact the Deptfor addn7 info. FEE ITEMS (Fee Resolution 11-053 l.j1: ' 1 /3) FEE QTY/FEE MISC ITEMS l'lun Chcck PME Plan Check: $0.00 I'Llratil Frye': hop FCC, PME Unit Fee: $48.00 PME Permit Fee: $48.00 Cuttvtr-uctintt loo. Administrative Fee: IADMHN $45.00 Work Without Permit? O Yes 0 No $0.00 I (h,unced Planning; F,, Travel Documentation Fee: 1TRA VDOC $48.00 Strong Motion Fee: 1BSEISMICR $0.72 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $190.72 $0.00 TOTAL FEE: $190.72 Revised: 07/02/2015 SIGN LIGHTING r�' CEC-NRCC-LTS-01-E(Revised 05/15) CALIFORNIA ENERGY COMMISSION ''RWP� CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 1 of 5) Protect Name Bowlmor Cupertino Date Prepared 9.11.2 015 A. General Information NOTES: 1. The some responsible person may install both the sign lighting power and the sign lighting controls, or a different responsible Project Address: 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, 10123 N. Wolfe Road, Suite #20, Cupertino, CA. Location of Sign ❑ Outdoor Signs 1XIndoor Signs Phase of Sign Construction ENNew Signs ❑ Sign Alterations Type of Lighting Control ❑ New Lighting Controls ❑ Replaced Lighting Controls ❑ Not Installing Lighting Controls This Certificate of Compliance includes the following components (check all that apply) ❑ Mandatory Measures (Lighting Controls) ❑ Maximum Allowed Lighting Power ❑ 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 la. Check Yes or No for all of the following statements: 1 1 have responsibility for installing the sign lighting controls 13Yes, complete parts la and lb of this form ❑ No, complete part la of this form 2 There are no existing sign lighting controls and I will be installing compliant sign lighting controls ❑ Yes IR No 3 There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls ❑ Yes 13 No 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 12 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 [R No CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 SIGN LIGHTING , CEC-NRCC-LTS-01-E(Revised 05/15) CALIFORNIA ENERGY COMMISSION T CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 2 of 5) Project Name: Bow1mor Cupertino Date Prepared g , 11.2 015 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 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. IN ❑ ❑ §130.3(a)2A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time- Y N NA 2 switch control, or an astronomical time -switch control. [3: ❑ ❑ 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. ❑ ca §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. ❑ 121 §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 Y El N El4 N/A 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 May 2015 SIGN LIGHTING CEC-NRCC-LTS-01-E(Revised 05/15) CALIFORNIA ENERGY COMMISSION Y. CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 3 of 5) Project Name: Date Prepared. Bowlmor Cupertino 9.11.2015 2. 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 3 of this Certificate of Compliance if there are signs using the Specific lighting sources method of compliance) A B C D E F G H I J Symbol OPTIONAL— Energy Filed or Description of the Sign Verified Label (see Allotted Watts Design Complies Inspector Code instructions below) Watts Y/N Check that sign complies Lap M Q c C E 3� ry �° Q a� m °to 1 X ° I u in c W Q — ° Q o° 3 E 0 v ✓ ✓ ❑ ❑ 1 30" 1trs ❑ 26.25 1 12 315 120 Y ❑ 2 21"x72"arrow ❑ 10.5 1 12 126 83.5 Y ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 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 2013 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 authorized by Underwriters Laboratories (UL) or other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards C 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 Density (LPD = watts) in column F. H Show the total installed watts in the sign, as determined according to the applicable provisions of §130(c). I 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. 1 This page doubles as a field inspection checklist. Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 SIGN LIGHTING .1101 /� CEC-NRCC-LTS-01-E Revised 05/15 /,5O O6 2 -2CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 4 of 5) Protect Name. Date Prepared 9.11.2015 Cupertino 9.11.2015 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 1 3011 illum letters ❑ 5 ❑ 2 21" x 72" illum logo ❑ 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 a ballast that has a minimum efficiency of 80 percent. 3 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 This page doubles as a field inspection checklist. Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 SIGN LIGHTING E "I CEC-NRCC-1-TS-01-E(Revised 05/15) CALIFORNIA ENERGY COMMISSION -R1111111" CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 5 of 5) Project Name Date Prepared. Bowlmor Cupertino 9.11.2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Company: Mike Behnke Signature Date: 9.11.2015 Address: CEA Certification Identification (if applicable): Mina -Tree Signs Incorporated City/State/Zip: Stockton, California 95205 Phone: (209) 941-2921 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 applicabl inspections. I nderstand tha co le sl d copy of this Certificate of Compliance is required to be included with the documentatio the bu' r pr id tot buildin wner a occupancy. Responsible Designer Name: Responsib De gner ign Mike Behnke Company: Sians Inc. Date SignecrMina-Tree September 11, 2015 Address: License: 1233 E. Ronald St. 299756 City/State/Zip: Phone: Stockton California 95205 (209) 941-2921 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 Basemap Labels Abc Street Names Freeway Basemap 9 Street Centerline County Major Roads County Freeways Right -of -Way Parcels Community Development City Boundary ® Aerials - Sept 2013 - NI � �U�rlJ 1 City of Cupertino ►��° 0° R� r:,MERRITT-DR -•�L,� y1 +-.�✓.�" •� \ t i T 77M rte. _ 1771 AM Gly 'ca nom-= � � . . • , { f„ � ,;; ` �. l-� V -LCO R WX • �� 1. All IGN 10" N SCALE 1 :5,916 500 0 500 1,000 1,500 FEET http://gissvr/cupertinointranet/home/mapFile.aspx Wednesday, September 23, 2015 9:18 AM *0�� -75 r) M�< CD ZY _ 0 cl o cn A o o a N Z N -O 0' •< Q 0 , n cD < N m a SU O CD o N - tn�=moo` 9 < D� CCD O r < < r Z ,:3 O n cD 4 9 Mo A NF m o z C V D m n� c -v z mZ .� Eiri, N D nl T n 0 T O O T r p Nn=nDD-v 0Oz O Z m' T p o� m� p cm' v D n r D p Z S D S 0 �O 07 V Ol V1 A W N r+ m O x 0 7o n 2 1 z O m< m vn m� p 0< O m> p O n rj CD z 2 2 zmo0Nzxm� n O n D p x Z n O z C N O _ -{ T � In A N O m O m m O = p x D <n T� Z� n m S O n.a A p Ul zzDmo= vamv z m E) zoo D> O UN m Z z D c m Q, < D Z m m D N p Gl Cl Z D p R o x c N x Z p> r rn? `� N rn O O N n �O D O �oonz mn m a o � o zaz r p mn (�'z w �� a DI 0-yL1OOn? z o,pom� �� zpovpZ�m00 m 03z m� z �I z o z z c z �om�z zo = n a n? a'a z D r cni vpi Z ' a p Z D D m m� v m.-, m x z O z O z z r m � O ' �D 3 0 O pxx m 02 nnv Ll m70 ti O� O Gl Z p Z N Ommxz p p m p z a z .r. O n O z C v p o �v O O Mn < p z p D '� O 2 LI m Z N v p D D m o � o O m O in O O Gl < z 3 n T c� o r Z cLq z O E6mo c O z z m L° D n m e r��� n p C o rn O z � 12 rn a � m umi fll (A WcD=Om onz,-m L nmox00Oc=z it G1I m p r Nr G m C D I CG � Z Nzn o z z z Ln dJ N N 2 2 m O (m/1 m- m Z O Cpl O D v m o p n O 1 F O O z� D D Z rn 3 n n C rn< p m o p rn Z p N O C m< Z o z z m vm o O P m C D = < oLn mnNm z� tn�pz < n<�m 1 0o T Rpt N m T D O E O m m Z poo z v ti NJ ~r or z C m 3 A H m Z � D �6-4 ov on z n �Z m Z pM or r m -�1 m 12AWG 120V TO MAIN CIRCUIT A o pI r1 -n n O T 0 0� p w�nD>--i Ln z 0Z-1T�O-wi 00 �� Dn P v r D O Z S D. f 2 0 tD OD V pi to A W N �+ rn O x O- n x �- Z O m x D m p 0< O m m O n� d D CO z p S S.. .. .. .. .. .. .. .. .. .. .. z p n Z=m n my v mD zx D Do z CNO p m m to A M m (n o mn0 ^'p OrPxpnmpxpin zGl m to �. < tD MI zI DZmOmDcnp7�o v—clr)o�nZ ap Zpx?ccNxzmzinr- mZQ i mOW N~ 1�c--nOD O O c�oZ mn -4 mnOnopz rprn3 U1Z moi' �i =n C EJ iii w DI O D Gl O O n? Z pOAom� A� z o 0 p p Z m m 0 0 rn .. coz m Z T z 0 z z z c m cn 0 o m < z v D D ;� '> 2 O -0 (') Z O T i z X0 S n n n. � a p r C) � Z I i4 a Z N ,�� ZD Dmm ai= m v: mxDnpZOZ � rp r o O Z 7o v S X o D 6 m n z rn.. v p y p Vl O� O o Z � c m m;0 io :F- p cpi mp z< p z p D O ? I �� m to v n mnzxm �n p m In O o 0< z C7 r a 0� p r- D� p n z C O m O Z n p Z m a m m umi 3 D Rl ��� > Op r�rl �W�DmOO Ocn>Am vin ZAOxOo zzZ ?� N D cid _ m p Ln �mrm-mz Ofpl O m v g m sd m p n0 C) v_ (n O N f 2I D D p D Znm3vi nc T p m m p x z O C O• ,Q^ Z �I Z Z D O A D � 2 m Lf) p O� Ov m� n T W 4 I �I 1D11 rn OT � Oen>pp 70� � 3< D O z p O p � �7 R1 V V 1 z R U) < p Z m 'a * rr Oc O, r T W D D A m c w c Z m m 3 crn n m X -1 Z A Zx D D G) D D_ D_ C Z --I -n O ZZ N Z m 0 D E5 D � " D { z v < V D�� m n z w p v X �DOpm C m O� p0 D SZ°0c D 0 0� 3 3 ;uv n m O 3 Dw C O m 3 (nr ponmz U D D Oz�nrn 7o c m p x Z n M to m A D O n� D m� Z to m<wn o F, CO c M n m A� X rn 3 N O G) n m 7C O O rn C II Z W p mLf) 2 m z p O --1 m r 3 C = Z � � � 0 c 3 D w m v m z m m m m A o pI r1 -n n O T 0 0� p w�nD>--i Ln z 0Z-1T�O-wi 00 �� Dn P v r D O Z S D. f 2 0 tD OD V pi to A W N �+ rn O x O- n x �- Z O m x D m p 0< O m m O n� d D CO z p S S.. .. .. .. .. .. .. .. .. .. .. z p n Z=m n my v mD zx D Do z CNO p m m to A M m (n o mn0 ^'p OrPxpnmpxpin zGl m to �. < tD MI zI DZmOmDcnp7�o v—clr)o�nZ ap Zpx?ccNxzmzinr- mZQ i mOW N~ 1�c--nOD O O c�oZ mn -4 mnOnopz rprn3 U1Z moi' �i =n C EJ iii w DI O D Gl O O n? Z pOAom� A� z o 0 p p Z m m 0 0 rn .. coz m Z T z 0 z z z c m cn 0 o m < z v D D ;� '> 2 O -0 (') Z O T i z X0 S n n n. � a p r C) � Z I i4 a Z N ,�� ZD Dmm ai= m v: mxDnpZOZ � rp r o O Z 7o v S X o D 6 m n z rn.. v p y p Vl O� O o Z � c m m;0 io :F- p cpi mp z< p z p D O ? I �� m to v n mnzxm �n p m In O o 0< z C7 r a 0� p r- D� p n z C O m O Z n p Z m a m m umi 3 D Rl ��� > Op r�rl �W�DmOO Ocn>Am vin ZAOxOo zzZ ?� N D cid _ m p Ln �mrm-mz Ofpl O m v g m sd m p n0 C) v_ (n O N f 2I D D p D Znm3vi nc T p m m p x z O C O• ,Q^ Z �I Z Z D O A D � 2 m Lf) p O� Ov m� n T W 4 I �I 1D11 rn OT � Oen>pp 70� � 3< D O z p O p � �7 R1 V V 1 z R U) < p Z r oC m 3 m Z p n m m pv on �2 zD �Z m Z pm or I 0 of (lI m n O� m 0 0- r w�nDD -jv,00z o 2=1; p o m T p o D n Fr p m D r D p z 2 D 2 0 �O Co V O� l!1 A W N m O S 0;0 n S Z 0 m< m vai m9 p 0 O� m p n I~I w z •• m = _ .. .. .. .. .. .. .. .. .. .. < zoo. zmm� _ D w D ; = z m T p V1 A m m N O m O m 0 Ll Or x p S Ll D m m ml ZI r) m 2 0 n A A p M zzDmx.u. Im z< F) O p Z to O< D Oc m Z Z D � m O N © 6 < w\ D z m m D to 0 Cz)nZmaZ 70O mx?ci�xZvp(n rm Z� Ln� fT1 p { O N� v � � r) 0 O c�oz_ mn yam>ono-,,>z x cnZ ,��l`) N TI O 0O y z O O n z m mpom�n �m o p0 o Z z ^ o o D W a 70 Z 2 O\ MI ? ? z n c zo omiz x x n a n. `� xv p r n cn Z a Z A Z D Z m Gl pxS=m �: D fZ'1 O D Z m Gi rrn p O 1 I� .i3 O O Lq QI O � p z z to OmT z p on m m x z D Z O Q n -1 c m z z 1 0 .- O Ll w 0 ;o Z p D X () I I m g G) z to v pDaxT �N o m n O O�< r Z n r DI D p fp1 pGOmO ZD n z Z m m m (A 3 D fll ''n A+� o wI m Imo D rn rno onDz 03 �Om ;orn v n Z nA o x 0 c x Z Z Z Ln 5� N N 2 N%%f ZI DD� OD zn(^13u one om�pmTmpmmzp �o Oc O ■ ,O//�� 2 �I Z? z W D 0 F z, 4 2 m trail O O A rZri D A n C O W xi �I VDi rn O < 0� D O 0 In 3<> O Z O O O m ni ` RII rn r m Z O m L t z 0 z 3 �. oo A O Q '" - r r n m � Z 3 -ZI 2C D D z D o G) Z - o zD� x ovo r p��� m x X < Z pD pZ-Irn Q' m C m -am C w Ocp3 fpmn 3 Z o = 0 C m p O 3 z m D _ Jnr 3� mz m p f)� z_ m3 r- m mrn 3 p m D .. 7o C, 3� 7o D m (1 W O 0 Z c rN m a 0 v G) co O p { x rn z c N O y r O G) 11 zrn -'p X zC m m 10 m � m p z y p r = D X p D A m I 0 of (lI m n O� m 0 0- r w�nDD -jv,00z o 2=1; p o m T p o D n Fr p m D r D p z 2 D 2 0 �O Co V O� l!1 A W N m O S 0;0 n S Z 0 m< m vai m9 p 0 O� m p n I~I w z •• m = _ .. .. .. .. .. .. .. .. .. .. < zoo. zmm� _ D w D ; = z m T p V1 A m m N O m O m 0 Ll Or x p S Ll D m m ml ZI r) m 2 0 n A A p M zzDmx.u. Im z< F) O p Z to O< D Oc m Z Z D � m O N © 6 < w\ D z m m D to 0 Cz)nZmaZ 70O mx?ci�xZvp(n rm Z� Ln� fT1 p { O N� v � � r) 0 O c�oz_ mn yam>ono-,,>z x cnZ ,��l`) N TI O 0O y z O O n z m mpom�n �m o p0 o Z z ^ o o D W a 70 Z 2 O\ MI ? ? z n c zo omiz x x n a n. `� xv p r n cn Z a Z A Z D Z m Gl pxS=m �: D fZ'1 O D Z m Gi rrn p O 1 I� .i3 O O Lq QI O � p z z to OmT z p on m m x z D Z O Q n -1 c m z z 1 0 .- O Ll w 0 ;o Z p D X () I I m g G) z to v pDaxT �N o m n O O�< r Z n r DI D p fp1 pGOmO ZD n z Z m m m (A 3 D fll ''n A+� o wI m Imo D rn rno onDz 03 �Om ;orn v n Z nA o x 0 c x Z Z Z Ln 5� N N 2 N%%f ZI DD� OD zn(^13u one om�pmTmpmmzp �o Oc O ■ ,O//�� 2 �I Z? z W D 0 F z, 4 2 m trail O O A rZri D A n C O W xi �I VDi rn O < 0� D O 0 In 3<> O Z O O O m ni ` RII rn r m Z O m L t z 0 z O p m m r X rn 7C D rn v n rn 'O p = to N Z A cm m o m Gl A Z° m v ►, v O 2 XA -f o - z m O D m W " cz 7u n (_ H x r - n " n < M O m D O Z z O Z N O W o O� n� m n O� O 0- p m1n D D n o o z o Z� D p O o m T o o �. v D n D r D O Z S D�� S O i0 CO .. .. .. A W.. �+ fTi O= O p n S^ M m O m = m p 0< O� m rt7 p O ri r j �IC� m DI NI X z V) CO S= .. .. .. .. .. .. .. .. .. .. < 0 mno nzmom C) O m= p O m D= p S D N D O z N O m rn T A N= F m m O 1; m P x p O )n r p O D m 0 O In Z C) Z m * �I D z m m D In O O G) n z > 6) p� ? o x z oc �= Ln z v p i^ � m Z_ � U) m a N N py D O pvD A D W v > ZOto>nO O c oz mn n n r.. m3 U1 x A )may ~ �� O D G) O O n Z 000n o> z p m z rn D m f U1 m 7o O m -1 O< O Z y m v O W z O I VI z z z n 3 z Ln z po xnDn?�ci�pZ! D r=GG) (f)) Z F7 a /1 Z ~ O� O Z D 2 X z V1 Omm2Z o'-' -0 p m� O D� m D Z G) m ;d O �. � p O n 'n ? -i c v p --1 O * '� m p Z p Q ,- rnl Z Z m p Dm0 -io V1 0 0 0 C) p D z p 3 n i H T O n m V) m S m N m < r r a C. n y V) A G1 v p D C p z p m v p(A m D T r n xmomo z ? p R1 / G �� W C D=< m O D D O m v n p n p x p� m z m n l0 a c W 2 m rn r m o ommp� Op z p O m j� m n z ■ N F Di Z p O D znmm """ O<pm °pozm o 1 m m O z A D= z0 r om?Lnm p� z z jo o 1 T O V tt ml m T ��z 0 m Ln z 0 z