B-2016-1278PA
CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1278
10594 S DE ANZA BLVD CUPERTINO, CA 95014-445 (369 38 037)
( PHOENIX SIGNS LLC)
SAN JOSE, CA 95112
OWNER'S NAME: BYER PROPERTIES LP
DATE ISSUED: 01/28/2016
OWNER'S PHONE: 4085091575
PHONE NO: 408-835-0614
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C45 Lic. #924806
Contractor ( PHOENIX SIGNS LLC ) Date 01/28/2016
X BLDG —ELECT —PLUMB
MECH RESIDENTIAL X COMMERCIAL
I hereby affirm that 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.
JOB DESCRIPTION:
Installation of illuminated channel letter sign for LeapStart.
I hereby affirm under penalty of perjury one of the following two declarations:
i. 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
Sq. Ft Floor Area:
Valuation: $0.00
this permit is issued.
APPLICANT CERTIFICATION
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
APN Number:
Occupancy Type:
ordinances and state laws relating to building construction, and hereby
369 38 037
A (Tenant Improvements)
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, costs, and
PERMIT EXPIRES IF WORK IS NOT STARTED
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 with all non -point source regulations per the Cupertino Municipal
180 DAYS FROM LAST CALLED INSPECTION.
Code, Section 9.18.
Signature Date 01/28/2016
Issued by: ��e
Date: 01/28/2016
OWNER -BUILDER DECLARATION
RE -ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of the
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
installed without first obtaining an inspection, I agree to remove all new materials for
1. 1, as owner of the property, or my employees with wages as their sole
inspection.
compensation, will do the work, and the structure is not intended or offered
for sale (Sec.7044, Business & Professions Code)
Signature of Applicant:
2. 1, as owner of the property, am exclusively contracting with licensed
Date: 01/28/2016
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
i. 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
HAZARDOUS MATERIALS DISCLOSURE
performance of the work for which this permit is issued.
I have read the hazardous materials requirements under Chapter 6.95 of the
2. I have and will maintain Worker's Compensation Insurance, as provided for
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
by Section 3700 of the Labor Code, for the performance of the work for which
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
this permit is issued.
Health & Safety Code, Section 25532(a) should I store or handle hazardous
3. I certify that in the performance of the work for which this permit is issued, I
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
Worker's Compensation laws of California. If, after making this certificate of
the Health & Safety Code, Sections 25505, 25533, and 25534.
exemption, I become subject to the Worker's Compensation provisions of the
Labor Code, I must forthwith comply with such provisions or this permit shall
yO,wner or authorized agent:
be deemed revoked. A-4!10ate:
01/28/2016
APPLICANT CERTIFICATION
Y CO STRULENDING AGENCY
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
correct. I agree to comply with all city and county ordinances and state laws
of work's for which this permit is issued (Sec. 3097, Civ C.)
relating to building construction, and hereby authorize representatives of this city
Lender's Name
to enter upon the above mentioned property for inspection purposes. (We) agree
to save indemnify and keep harmless the City of Cupertino against liabilities,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant
ARCHITECT'S DECLARATION
understands and will comply with all non -point source regulations per the
I understand my plans shall be used as public records.
Cupertino Municipal Code, Section 9.18.
Licensed
Professional
Signature Date 01/28/2016
11
SIGN PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 85014-3255
CURER (Tt0 (408) 777-3228 - FAX (408) 777-3333 - buildingaOcuDertino.org
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APNr, 369-38-037
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❑ o%%wER I I OWNER.B}BtDER 01VNF7t AGEN17 ❑ coxrmCroR ❑ CONTRACTOR AGENr ARcnrrEcT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
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AFSCRIPTION WORK /i�-s /. /%�j _� �`�i��T1rhCL1�L7 �•j!�%�n�i� !��',j[n � ,P�
USE OF ❑ SFD or Duplex El Multi -Family
STRUCTURE: is Commercial
n.LUMINA'rtiD
• (YIN)
SIGNTYPE
(CODE)
NO. OF
SIGNS,
SIGN AREA
(Sq. PT.)
VALUATION
(s)
SIGNTYPECOD
B - BANNER 51ON M - MONUMENT (GROUND)SrON-
BL - BLA.DESGN P - PROJECTING SIGN
D - DZVELOI MENT ID SIGN SP - SPF.CIALEVENT BANNER
DI - DIRECT} HAL SIGN T - TEMPORARY
F - ELECTRC 131C W WALL SIGN
RFADERI OARD WI - WINDOW SIGN
C'�rS
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RfOFAM BY: `i � /
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By my signatm. below, I certify to each of the following: I am the property owner or authoSed agent to act on the property owner's behalf. I hive read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. 1 authorize representatives of Cupertino to enter the above -identified property for inspecti�onn purposes,
Signature ofA plicant/Agent: N(7Y�`!ox)(C1L _ _ Date: TP_Xt
SUPPLEMEN'1•ALINFORMATIONP QUIRED
_ Site Plan
_Elevatio s
Sign Del ils - including U1, listing(s) applicable
_ Structur, t Calculations (ifapplicable)
Copy of fanning Approval Letter or Meeting with Planning prior to
subinitta ofBuilding Permit application.
OFFICEUSEONLY
PLAN CHEGTCTYPE
ROtrrINGSLIP
ei OVER-TH&C'OUNTER
EXPRESS
❑ STANWARB
❑ LARGE
❑ t+lA.fOR
❑ BUILDING PLAN REVIEW
❑ PLANNING PLAN REvirw
❑ OThER:
SignApp_ 201 Ldac revised 03131111
STATE OF CALIFORNIA
SIGN LIGHTING
CEC-NRCC-LTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 1 of 5)
Pr°'e``"ame: Leapst art After .School .. Date Prepared: 1/27/2016
Project Address:
10594 .De Anza Blvd,. Cupertino; CA. 95014
Location of Sign NOutdoor Signs ❑ Indoor Signs
Phase of Sign Construction XNew Signs 0 Sign Alterations -
Type of Lighting Control XNew 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 XSpecific Lighting Sources
1. Mandatory Sign Lighting Controls
NOTES:.
1.
The same 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 isnot 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:
Lhave responsibility.for installing.the sign lighting controls.
1
❑ Yes, complete parts 1a and 1.b of this form X_No, complete part 1a of this form
..
There are no existing sign lighting controls and I will be installing compliant sign lighting controls
2
❑ Yes D:No
There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls
3
❑ Yes. .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
O Yes No
There are existing sign lighting controls that do P.Gt comply with the, applicable provision of §110.9 and §130.3 and someone
5
else will be responsible to install compliant sign lighting controls
,D[Yes O -No
STATE OF CALIFORNIA
SIGN LIGHTING
CEC-NRCC-LTS-01-E(Revised 06114) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 2 of 5)
Project Name:Leapstart After School Date Prepared: 1/27/2016
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
Signs that are illuminated at night and for more than 1 hour during daylight hours shall be considered ON both
❑
❑
11
3
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
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 3 of 5)
Project Name: Leapstart After School. Date Prepared: 1/2 7 /20,16
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
Or Code
Description of the Sign
OPTIONAL—Energy
Verified Label (see
instructions below)
Allotted Watts
Design Watts
Complies
YEN
Filed Inspector
Check that sign
complies
-
N}}
4,
bo
VI
O
LU
GJ
V
C w
{J N
dCr
'r4 M
_1 N
0
Q G W
:�
N X
D
0
Q
C w
F— 3
V1
N
CL
0
-
❑
-
❑
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.
C
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
Institute in accordance with 150/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).
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.
J
This page doubles as a field inspection checklist.
Field Inspector Notes:
CA Building Energy Efficiency Standards -7 2013 Nonresidential Compliance
June 2014
STATE OF CALIFORNIA
SIGN LIGHTING
GEC-NRCC-LTS-01-E(Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 4 of 5)
Project Name: Leapstart After School Date Prepared: 1/27/2016
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
D8
LED
❑
❑
❑
❑
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-NRCC-LTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 5 of 5)
Project Name: Leapstart After School _ _ Date Prepared: 1/27/2016
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
-'�—°'9'."y°p9 dby"°^9
Documentation Author Name:. Documentation Author Signature: yQaltgl
! HUNG TRAM
Company:
.PHOENIX SIGNS, LLC.
Signature Date:
1/27/2016
Address: I.
HERS Certification Identification (if applicable):
446 QUEENS
City/State/Zip:
SAN JOSE, CA. 95112
Phone:
(408)S7.3-9300
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. I
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 provides to the building owner at occupancy.
Responsible Designer Name: Responsible Designer Signature:
HUNG TRAM
Company : I
PHOENIX SIGNS, LLC.
Date Signed:
1/27/2016
Address:
446 -QUEENS LANE
License:
924806 C-45-
City/State/Zip:
SAN'JOSE, CA. 95112
Phone:
(408) 573-9300
24"
�
000 Or
_�_ LeapstaRt�
1010After School oor
.25"
119"
Sign Frontage 25 Sq Ft
ITEM DESCRIPTION
Leapstart 3/16"Orange Acrylic
Kangaroo 3/16"White Acrylic with
Day/Night Vinyl Overlay
VENDOR SPECIFICATIONS
38"
OMMUNITY D
BUILDING D �.
A.PbNW�
This set of plans and Sr:. Photo Overlay
o site during construction. it,,," e Pr)t 3t th
changes or alterations on sJ unlawful to Make any
/% thersfrcm, without a ame, or to deviafo
�f pproval from the Building Csfi j .
Tha �'t
Katie McLoughlin
Property Manager
Byer Properties
408-509-1575
Camping of this pian and specifications SHA! I i :;T
bF° held to permit or to be an a-
, rovai of
Of any provisions of any Ciry Ordinance or g
BY E,qN
DATE
PER?IIT NO. _ Gl .. , `� 7�c-..___. .,,d • ..
FB (
3476,
LEO
IVA
Installation Detail
— 300"
After School
DATE i
PLANNING DE
CUPERTINO
VON
SIGNS &ADVERTISING
1212 EI Camino Real # 103
Santa Clara 95050
Phone (408) 499-9622
(844) 234-6243
�C'EIVgD
�3y
Designed for
Leapstart Afterschool
10594 De Anza Blvd.
Cupertino, CA 95014
Date: 10/27/15
Sales: Atta Nikkhah
Designer: Amir
This drawing is a representation of colors and
does not accurately depict final color of product.
Always refer to paint chips or material samples
for color referal.
Rev. Date Description
A
B
C
D
E
F
G
H
Customer Approval LU
This is original unpublished drawing
prepareded or you by Ad -Image Signs an
Advertising, in a sign program designed r
business. -
It is not to be shown to anyone outside Qf your
organization nor to be reproduced, cop
exhibited in any fashion. UL
Date:
Print Name:
Signature:
Sheet 1
02016