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B-2016-1873 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1873 10487 S DE ANZA BLVD CUPERTINO,CA 95014-3011(359 17 019) SUCCESS GRAPHIC SIGNS SAN JOSE,CA 95132 OWNER'S NAME: BDC HAYWARD LP DATE ISSUED:05/03/2016 OWNER'S PHONE:925-588-2223 PHONE NO:(408)667-1777 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-45 Lie.#896458 Contractor SUCCESS GRAPHIC SIGNS Date 05/31/2017 X BLDG _ELECT _PLUMB _ I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH RESIDENTIAL X COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: INSTALL ILLUMINATED SIGN-AMY DENTAL I hereby affirm under penalty of perjury one of the following two declarations: 1. 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. 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 permit is issued. Sq.Ft Floor Area: Valuation:$1500.00 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 ordinances PN Number: Occupancy Type: 359 and state laws relating to building construction,and hereby authorize 359 17 019 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 expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Sjg afure Date 5/3/2016 Issued by:Abby Aey nde i Date:05/03/2016 OWNER-136—LD—ER DECLARATION 'd RE-ROOFS: I hereby affirm that I am}exempt from the Contractor's License Law for one of the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is t. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:5/3/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 1 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. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 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 Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 2 25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Or or authorized agent: APPLICANT CERTIFICATION `Gate:5/3/2016 1 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 5/3/2016 Professional SIGN PER�411T APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228 • FAX(408)777-3333•building Wcupertino.org C>�PEl�TriNa PROJECT ADDRESS j ,� -r �7N 4 bt OWNER NAME n/� _ PHONE �7p ,� E-MAIL STREET ADDRESS 9�� e '11�' CITY, TATE,ZIP ���_CJ 2Z'L3 FAX 9 4 CONTACT NAME �Y ,J PHONE I E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME , e ' LICENSE NUMBER �(I U � LICM BUS.LIC# COMPANY NAMELkr� E-IvJAIL FAX ';' STREET ADDRESS i' � �,� llry y� Y,STA ZIP !�� n PHONE ARCHITECTIENGINEER NAME LICENSE 4UGER BUS.LIC 9 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK USE OF ❑ SFD or Duplex ❑ Multi-Family ILLUMINATED SIGN TYPE NO.OF SIGN AREA VALUATION STRUCTURE: ❑ Commercial (YIN) (CODE) SIGNS (SQ.FT.) M SIGN TYPE CODES: v`/ 1 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 VALUATION: By my signature below,I certify to each of the foll I am the property owner or authorized a ent to ct on the property owner's behalf. I have read this application and the information I have prod Is c ect. I have read the Description of Work and verify it is accurate. I agree tp comply with all applicable local ordinances and state laws relating to buildin — authorize representatives of Cupertino to enter the aboMIrWfi inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED PIF _Site Plan PLAIV;CHECI{.TYPE,. .,..,, ROUTING SLIP Elevations ❑ EXPRESS ' ❑ BUILDING PLAN REVIEWx Sign Details-including UL listing(s)applicable ❑ sT�IVDAxD ❑r PLANNINCv PLANREVIEww` Structural CalculationsPP(If applicable) ❑ ❑ bTHEx m� Copy of Planning Approval Letter or Meeting with Planning prior to ❑ 'I�IAaoRk v s s s submittal of Building PP Permit application. a SignApp_2011.doc revised 03/16/11 ' SIdiN LIGHTING 6EC-NRCC-LTS=01-E Revised 05/15 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting AMY (Page 1 of 5) Project Name: AlVl DENTAL Date Prepared: 05-02-16 A. General Information Project Address: Location of Sign PQ Outdoor Signs ❑Indoor Signs Phase of Sign Construction .0 New 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 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 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 I have responsibility for installing the sign lighting controls ❑Yes,complete parts 1a and 1b of this form 15J 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 JK1 No 3 There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls ❑Yes M 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 [X 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 IN No OEM OFrICL'" CUPY CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 SIGN LIGHTING t' CEC-NRCC-LTS-01-E Revised 05115 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting �/ (Page 2 of 5) Project Name: AMY DENTAL Date Prepared: 05-02-16 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. K ❑ ❑ §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. C1 ❑ ❑ 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. ❑ 1 Ix §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 ❑ ❑ [N 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. ❑ 1 M §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 May 2015 STATE_OF CALIFORNIA ., SIGN LIGHTING CEC-NRCC-LTS-01-E Revised 05/15 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 3 of 5) Project Name: AMY DENTAL Date Prepared: 05-02-16 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 Filed Symbol OPTIONAL—Energy Design Complies Inspector or Description of the Sign Verified Label(see Allotted Watts Watts Y/N Check that Code instructions below) sign complies ` v N cu lvi v 0- m — •� _ ai .�T 117 j X GJ f4 C > 'O X G 4— GJ � � C N N M � Q � C ) 7 O f V 30 V am+ fl' h0 LA r- w = Q � w Q 3 0 INTERNALLY CHANNEL LETTER ❑ 21 I 12 252 100 ❑ ❑ ❑ 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 C 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, columns'D'through'1'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 His 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 Buildine Enerev Efficiencv Standards-2013 Nonresidential Comnliance Mav 2015 SIGN LIGHTING CEC-NRCC-LTS-01-E Revised 05115 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 4 of 5) Project Name: AMY DENTAL Date Prepared: 05-02-16 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 Fteld Inspector Cheek thai:Slgn or Description label Shall include only lighting Complies Code (see instructions technologies listed below , below) List all that apply INTERNALLY CHANNEL LETTER 7 ❑ ❑ 't: d 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). g 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 y SIGN LIGHTING CEC-NRCC-LTS-01-E Revised 05/15 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 5 of 5) Project Name: AMY l DENTAL Date Prepared: 05-02-16 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: Signature Date: Address: CEA Certification Identification(if applicable): City/State/Zip: Phone: 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 c pleted signed copy of this Certificate of Compliance is required to be included with the documentation the builder prokdesto the-building owner at occupancy. Responsible Designer Name: SEAN WU Responsible Designer Signature; Company: SUCCESS GRAPHIC SIGNS Date Signed: 05-02-16 Address: 1744 QUEENS CROSSING DRIVE License: 896458 City/State/zip: SAN JOSE CA 95132 Phone: 408.667.1777 CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 FACE LIT CHANNEL LETTER DETAIL DRAWING \E (1),CIRCUIT USED EXISTING Building faces '120xVE}LTI20 AMPSs Raceway 2- 3 inch Primary �- Electrical Source Aluminium (.040) (supplies by Others) 5"-Aluminium Return (.040) Junction Box #10 x 2" - 31/2" Drive Screws Minimum Three (3) per Letters Class 2 Low Voltage or as required per field conditions a' Wiring w/sleeves for stand-off Note: No conduit or flex Rubber Brushing required per class 2 low g voltage wiring guideline Acrylic Face --► Power Supply -- pp Y LED (120-277 vac) � E Trim Cap 3/4" 3/8" Bolt Screws as Required. 1/4" Drain Hole VLSIGNc E3 10 Disconnected Switches SECTION ' 3 ' x V d �, Wr a ' E2 , g xb � JKk Project Location Approval H s 4 ' S r 1744 Queens Crossing Drive-San Jose-CA 95132 I • � 10487 S.De Anza Blvd.,Cupertino T (408) 667-1777 E-mail:swu1966@gmail.com (1)CIRCUIT t Plywood Backing 1120 VOLT/20 AMPS —Primary Electrical Source P LANS C GK (supplies by Others) eL.. 5"Aluminium Return(.040) Junction Box #10 x 2"-3 1/2"Drive Screws DATE Minimum Three(3)per Letters Class 2 Low Voltage ------ -or as required per field conditions�y Wiring PLANNING DEP-'F w/sleeves for stand-off Note: No conduit or flex required p s. Rubber Brushing CT►vt �NI DEVELOPMEN71WRKR6*0 voltage winffg gw NG DIVISION - CUPERTINO ,. Acrylic Face—+ -...._.n. LED �–" I� Power Supply �- (120-277 vac) APPROVED Disconnectfo*g�f pI nsand specifications MUST be kept at the Trim Cap 3/4" 3/8"uo �uri construction. It is unlawful to make any _ as ReyyiR�ges c alterations on same, or to deviate 1/4°Drain Hole a`. therefrom,M thout approval from the Building Official. © E.- The Stampin of this plan and specifications SHALL NOT Kn halri tn ni rmit or to be an approval of the violation of any provi o s of ar; ity Ordinance or State Law. BY ��- vY�Q- 142.11 an DATE 5 b 14 �=RMIT# I'D1(p- 143 CU �� 'TING 1 Bulld;rg Department . 2016 R VIEVVi=D =0RD\t:B COMPLIANCE CC Re: wed By: � Sign Type: (1)Internally illuminated L.E.D individual Channel Letters Sign. Letter Face: 1/8"Thick acrylic face color as shown Letter Returns: 5 Black with.040 Aluminum y Trim Cap: 3/4"white ucce s Project Approval • . 1744 Queens Crossing Drive – San Jose –CA 95132 10487 S.De Anza Blvd.,Cupertino T (408) 667-1777 E-mail: swu1966@gmail.com