B-2016-2077CITY OF CU
ERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-2077
19449 STEVENS CREEK BLVD CUPERTINO, CA 95014 (316 20 112)
THAI BUI
SAN JOSE, CA 95112
OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LTC
DATE ISSUED: 06/06/2016
OWNER'S PHONE: 408-896-6601
PHONE NO: (408) 298-9153
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C-45 Lic. # 69
X BLDG
Contractor THAI BU Date 06/30/2017
_ELECT _PLUMB
MECH RESIDENTIAL X COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9
icommencing
with Section 7000) of Division 3 of the Business & Professions Code and
that my
license is in full force and effect.
JOB DESCRIPTION:
INSTALL (l) ILLUMINATED SIGN - CAPEZIO
I hereby affirm under penalty of perjury one of the following two dec
arations:
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
ode, for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, al
provided for by
' Section 3700 of the Labor Code, for the performance of thework
for which this
Sq. Ft Floor Area:
Valuation: $1200.00
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
APN Number:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
316 20112
representatives of this city to enter upon the above mentioned proRerty
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,
Additionally, the applicant understands and will comply with all non
permit.
point
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations per the Cupertino Munldp tion 9.181.
180 DAYS FROM LAST CALLED INSPECTION.
'Signature Date 6/1 612
0 M6
Issued by: Abby Ayende (9n_o
Date: 06/06/2016 Cum
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law
for one of the
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
1. I, as owner of the property, or my employees with wages as th
it 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 (See.7044, Business & Professions Code)
z. I'as owner of the property am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (See.7044, Business & Pro
f essions Code).
Date: 6/16/2016
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-insurel
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
2. I have and will maintain Worker's Compensation Insurance, aprovided
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 thew
rk 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
3.I certify that in the performance of the work for which this permit
(
is issued, I
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become s
bject to the
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making
is certificate of
will maintain compliance with the Cupertino Municipal Code ha 9.12 and
exemption, I become subject to the Worker's Compensation p
ovisions of the
the Health & Safety Code, Sections 255 5 34.
Labor Code, I must forthwith comply with such provisions or
's permit shall
be deemed revoked.
fr.
Owner orauthorized agent:
APPLICANT CERTIFICATION
Date: 6/16/2016
I certify that I have read this application and state that the above inrormation
is
CONSTRUCTION LENDING AGENCY
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 s�,
relating to building construction, and hereby authorize representatives
ate laws
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 agains�
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 6116/2016
Professional
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STATE OFCAUFOFNA
SIGN LIGHnNG
CERTIRCATE OF CXXVPUANCE
NROC-LTS-01E
'Sign Lighting
(Page lof 5)
Prcdect Narm
Project
-for tif�, sign I liohdn4&r;6ols, then the owner qfthsign,
`gener?�l contractor,` or an3rrtelct shall tie response le to'halre file sign lighting coritrois iiutalled. ' • '
3.- responsible person shall prepare and sign a'Ceritiffica'te of
..Project Address:
the person .with chief responsibility for aonstnrcti�on shall ph are and sign the. Certifibqe.o C :)n St6t&rert
Location of Sin qUdoor Slgnsr❑indoor _qgns
'is
Phase of Sign Construction _VWisjgn
, . 541t�n Alteratior
Type of Lighting Control 0 New lighting Cont n:A5j
pr,,.;:[3 Replaced U&ting:CbritroK .'-10,—NotiristallihgUghtirgControls :.,..-,;
fi oflariceinduciesthefbiloWrtgcommrerits(checkall#iatapply)
,.:-.,',-,....'�.',,,,
ng SP ea rces.
:L'wbrKbtor'y Sign UgMij d6mrte;
I The some M-5 person May install bom the sign lighting pomr and sign lighting colfitrols or a d
on irstalfinj the�ljh Ljjd
person maytristall the sign fighting PO
_qhdng erson
2. The Nbndctay hbasures (sign'll mfth -the -sLcjr0ig&Ui� Siandh�.`Ij'M�'p
-for tif�, sign I liohdn4&r;6ols, then the owner qfthsign,
`gener?�l contractor,` or an3rrtelct shall tie response le to'halre file sign lighting coritrois iiutalled. ' • '
3.- responsible person shall prepare and sign a'Ceritiffica'te of
Compliance arrd an Installation -Cert ante"app/i le to the 'cf which they are iiespnnsihle;'vlternatively,
the person .with chief responsibility for aonstnrcti�on shall ph are and sign the. Certifibqe.o C :)n St6t&rert
anth&entire corisirii*i6&
Ia. SUUmmntsafRmpoieibilky.Any person sighiiiii-idGeibfi6ai6ofGDri-oliano"e'Ddd-6'r'a'ti"d'h'Si'�at
onjhisNRdC-LTS4bI-E
shall complete Part Ia. Check Yes or'N&for`6111 of the ,6116
virjjst6it
I fo%f4t-espomibililiyf&ii-isWI[ititii4sign lightQ666661
O,Yes, complete parts Ia and 1b,of.tWis.fbrm_-.
No, completepant la of his'f
-There,are no e)dsting sign lighting controls and I
ll be installing compliant sign lighting controls
2
'El Yes
jn—No
Thpri5are no existing sign lighting controls and
meone,else will be responsible�tc, install -compliant sign lighting controls
11 Yes
0 No
There are eAsting 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
0 Yes
111'No
There are e)dsdng sign lighting controls that do ri
o comply with the applicable provision of §110.9 and §130.3 and someone
5
else will be responsible to install compliant sign lightingdrols
0 Yes
No
CA Wilding Energy Effidery-yStandards -2013 NonresidentiallCorrpliance June 2014
STA7EOFCAUFOFWA
SIGN UGHTING
CEC4*?Cr—LTS;01-ERlu 05/14) - :, C-AUFCFWA ENUM.00MSSON
CEFMFICATE OF CCfVPUANCE NROC-LTS-01-E
Sign lighting (Page 2 of, 5)
Pn4ect mm Date Prepared:
1b. Mandatory Sign Lighting Cmb-ds
If the person signing the Certificate of Compliance Declaration Statement on this NROC-US-01-Fisresponsible for corqplyirg.with ,_
the sign lighting control requirements, that person shall answer all of the following questions:
If there are construction documents,-incricate:W-k-mon.the building plans the
mandatory measures (sign lighting control) note block can be located: -
1
rig
§0113(a)L Al indoor sign -light! ;' iscontrblledvAthah-'a�Uton-idbetin-L—svuit�h'c6kmiorastoh6n-icEil�ii��
Y
'N]
NA
switch control.
0
13
D
§M%a)2&'AI) bUWb&sjjfi lightinig is o5ntroll ed -With -a pl-iatocofitrol'ih additi6rito affa ffirne--.�
2
switch control,
-oran-astrorxxTical,tirnem:sWtch control.-
Aj
El
0
EKCEMON to Section 330,.3 (a)2A. Outdoor signs: in tunnels, and signs in large pen �ntly covered outdoor
Y,
NA
continuously 4
areas that are irrtenclecl,ioi contih y lit,'2_ �'hours per day aril 46 days per year.
q130.3(a)2B. All outdcior'sign lighting that is ON . bothday and ,nii tiscontrolledWthadii 'that proyid es
gh77w
. r
the abilitvtoautomaticallyreducesii lighting during nighttime hours.
Va minimum of 65 perc".quri
Y
R
NA
Signs that are illuirrinated at night and for ftprethaq , i cluring,dayfight,houFs,shall, be cbnsid6rL-d ON both
[1
0
0
3
clay and night.
P,(CEPn0N to Section 33063(p)2M, Outdoor. signs in tunnels arid.lar * ge compa�� are intended to be'
Y
NA
.
illurninated both day and.night.
0
0
-
§M3(a)3. Dernand Responshfe Sectranic Nlessage Center Contird. An Electronic Message Center,,(EM9
'haVing
Y
WA
htingpowe Tload g-pater-_
a nciew o5hnected,lig,.convol installed that -is capable -of -
15'kwhas a
-
4
".. ; , . , 'thAn
'
reducing the lighting power by a rninimum4kp6wnt'vAi5en receivinga'de'ma'n'd response signaI , .. ..
- 0
., El
0
. !
EKCEPnONto Section 230.3(a)3- Ughting for EMCs that is not perinitted by, 6 health ze life t", statute,,. •
Y,,,:
NA
ordinance, or regulation to be reduced. by 30 percent.
0
0
'Reld'Intoector Notes:
CA Building Energy Efficiency Standards - 2013 Nonresidential Cbrq%anoe
June 2014:
STATE OF CAUFORNA
S1 GN UGHTING
CEC4,JRCC,LTS-01-EW;Ll%n'sed .06114)'.',', -
:CERTIFICATEOF COMPLIANCE
,Sign LigWing
"ea Name:
cAL1FcF;wAENER3y0wmSscN
'.,,--'NR CC TS -L -01-E:
3 of 5);
Dae Prqnred: - -, ` I
2. MaidmurnAlloviied U"rw Pbvug Method oflance
Certificate of Compliance and Field Inspection Energy
Completethis part if there are signs using the r rodryumaklomled lighting "power method of, compliance. (Complete part3 of
this Certificate of Corripliance if thereare A tisingthe Specific lightiresources method-cifoomplianoe)--.
A
B
C
D >E F G
H
sY
Descriptionafth&Sign
CPTIONAL7!��,.
Verffle�l lm�
Design V&M
compiles
Ilia—
H inspector
Chedc that sign
660&,
1 -
nsmictionsi
YEN
corTplies
0
"g
IU
vi
r -'M
X
40 -
0
E
�J
v/
ve
13
13
113-
1, Ztj
i�reqtiired)
El
A
Symbol or code used on the
plans (when plans and other documents. -
13-
location �i_ on building and -the ocO nents
=A of sign on -the Iqc&tiofi_6f "sign on construction d t
A description of.thp sij�i, or,
OPTIONAL - Check this box only if this sign has a Permanent, pre-printed, factory -installed, ENERGY -VERIFIED that the
,label,conflnIning
_,.Parl:15S-6�rid gthe Wb)drnumAJloviedUghtingP.ovex -
sign corroles with the Section 140.8 of the Iii&Ia,2013TffJe24 ards�u'sir.-
. a;� I , "I 1 1-1, " \/EAFl
�The is reaUvied f&itiii purpose are ENERGY ED.Certiftation 1V6s a4"zed by
rnetl�iod of compliance. only labels
'Iil�American:4' ' '
Underwiters Laboratories (UL) or other Product 9'. accredited to ISO/IEC Guide 65 by National Standards
C
acoon, rwnanoe_-bi/' A6�i�teci c&bfib�tion' "II be n a rg annualinspedd6n
dance with ISO IEC 1701L Su rigol
Institute 6" v -
_41."
'i - "" iiG` 6 i§ AEC 17020. progr,amcame�dAb��ty�e'Ali��&ib6dV�acc,or roe
,, -;�k
ptlonaI m6ihbat - oijijj&�
-columns 'D' through T are not required to be fille out. Note: Using an ENERGY VERIFIED label isan optional
VERIH abel is not nee�t f&, ia L n ce:
iarK,�.AnjNER�dy t6l,
ID
-thb-s" " - in square feet
gn area
E--
List "I" if the sign is internally illuminated: -List "V`j if the sign is -externally illuminated.-
_Afloi��'iiaitspersqimrLefoc;t 'Eni6r 12 ifth4 sigh ii.1lited as ih_�61'umn E' .tnter.2�.9'ifsi�6i�'lis�edas"E"i6c6ibmIn E.:'"-
G
Multiply the square footage in column Qtirriesthe allowedLighting Pone ,&. berisitv in caurrin F.
H-
determned acoo to the applicable provisions of §130(c)'.
Showthe total installed watts in the sign, asrding
I
I - - - G. -
Enter Y if the number in -cblurrn H is less- jLhari or- equal to the hu number -in colurm Oiher;Qs6,jhe sign does not comply.
This page doubles as a field Inspection cheddist
' Field Inspector Notes:
CA Building Energy Efficiency Standards - 2013
.June 2014,
STATE OF CAUFOFHA
c§GNuGHnNG
CWWRCC-I_T&01-E(F�evised 06/14) - CAUFCFRNA ENS:tGY COWS -MON
.CERTIFICATE OF CX)IVPUAIqM NRGC-MmOl-E
Sign Lighthig (Page4of.:S)
"ea NaffL-. Date ftepre&
3. Specific Lina SotBne Method of Compliance Z,
Certificate of Compliance and Reld Inspection Energy Checklist
Complete this part:if there are signs using the Specific lighting source method of-borripliance. (Gornpletapart2 of this Certificate
of Compliance if there are signs uisingthe rnmdrnurn alloved fighting pover method of compliance),
D
OPTIONAL
Specific light source used for
Symbol
ENEkGYVEPJFIED•
'�aM ian6ee '
y
Field Ins
pector�,
or
Shall' indticlewily iiighti
Check that Sign
Cade
see instructions
technologies listed below
Complies
belov4.
List all that apply
CA12eZIC)
13
0
13
0
b
C
A
'Synrili6l or node LiseEf on the plans (when plans are .'required) 'and otherdoairrieiits. _.
B
-A namative description of the sign, or location of sign on the building; and the location of sign on Tx�on documents —
C
OPTIONAL-theckthis.bcxonly ifthis sign.hasa permanent, pre-printed, factory -installed ENERGY.VEPJFIED Ipbel,co n.firryingtiWthis sign
complies with the Section 140.8 of the California 2013 Title 24, Part 6 Standards, using the Specific Lighting Source Method of Gornpli6nce. The
Drily 615els will be ir�ied for the pUrp6setare ENERGY VERIFIED'Certific5tildn" Merldauff'bHzed'by Lkideimet&s Labdratbries N10 or
other Product Body accredited to,ISO/IEC Guide 65bV the Arnerican National-Sta"rds Institute- in accordance with ISO/IEC
17011. Surveillance bVthe Accredited Certification Body shall bean ongoing annual inspectlonrprograrn carried out by a Type A Inspection body
-in -
_'D'
-n- i -s
in accordance with ISO/IEC 17626._ For signs with such an ENERGY VERIFIED label,-iol 6 not requir-edtobe illedout. Note: Usingan
7
ENERGY VERIFIED label is an optional rnethod to validate complibnoe. An EN . ERGY-VERIRED label Is not needed for compliance. , -
--Spedfic.Light Source Corroliance K&-thod. The signi(s)jdentifled above use 6n1y the following I I ightingUtcly4cloes:
List all applicable numbers (I through 9) that apply in oofurrin Dabove for each row
I-
iglfWbs�Ure i�wjurn larrps
Metal; halide lamps that are pulse start or ceramic served by a ballast that has -a minimum efficierw-y of 88 percent or
.great&. Ballast-effidency.,is the rneasurea output -wattage to-the.lamp dirvided.W the measured operating.input vrdftage___,_
when tested.according to ANSI C826_-2005.-.`_,_!_-_
Metal halide lamps that are 326.moftior s�rnaller, . arie'not,250.Wift &175 W& lamps; acid are servecl�.bv_
3
that
`6 ' fi6llaik that has arninimurn efficiercy-of 80"p- euc'ent''
. I - _
.1 I., -
Wilast effider,rcy is the rneasured output wattage to tie lapdvi6dbtheneasredopurating!npmra!!age, tested
according to AN51 CBZ- 6-26k
Neon or, cold cathodejarrps with transforrner or power supply qfflcierc greater reater tha . n or equal to a rninirnurn . efficiencV of 75 percent' -
D
,4
When the tirarisILK rj _or.pq%w supply rated output current• is less,than 50 m4 The ratio of the output wattage to the input wattage is at
100,percenttubirg load.,
Neon or cold cathode lamps with trtransformer or power �Mc' ! greater or equal to a rrinimumefficlency qfl��peroent
_5
W*teh the trangornw-br power supply rated output current is 50 rnkor-greater. The ratio of the output vqattage to" input,wattage is at
100 percent tubing load: -
Fluorescent lighting systems meeting one of the fbll ,o' ." ... � ;!,
.
W,orB.l only elmd,6nicballa�Wt�6'fuManiental'ouW-frequercy riot lessthan20 kH4
7
Light emitting lodes (LEDs), with a p=4 supply having an effic'ier* of So percent or greater;
Single voltage extern61-po%kier iupplie§ that are -designed t6cbrr��-i�O •volt AC input into lox ' �� voltage DC or A I C ou . t , put,'aind have
.8-
oreq. id' 1 .1" p"licablerequire��o'f.the Ap�iancle .. Effic'�&�'cy.
narnepla�o6t�p��r-Fless�thah ualto250metts,'s Y p
I-Regulations (.Title2O)..".---..-.--
Compact fluorescent lamps that doriat contain a niediumscrew.base sockets (E24JE26)..,.
-E
-This page doubles as a field inspection cheddist.
Field Inspector Notes:-
CABuilcringEnergy Efficiency Standards -2013 Nonresidential Compliance
STATE OF CALJFORNA
Slav uQfnNG
CERTIFICATE OF OONIPUANCE NRCGLTS-01-E
Sign Lighting (Page 5 of 5)
Protea N� i n nam Ii'1 IDate v7klle
DOaNENTATION AUIli S DECLARATION STATEIVU41
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Nacre: �L
Doalme nation Author Sl v�
carpany
�uCl Sc �S
Signature Date:
� z � ( 6
Address:
CEA( HERS Certification identification (if applicable):
QtY/P:
CA- ItSc(2
Phone:
RESPONSIBLE PER ms DECLARATION srA7 A%w
I certify the following under penalty of perjury, under tie laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. I am eligible under Division 3 of the Business and Profusions 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, rrgterials, components, and manufactured devices for the building design or system
design identified on this Certificate of Compliance Mrm to the requirements of Title 24, Part 1 and Part 6 of the California Gode of
Regulations
4. The building design features or system design features identified on this Certificate of Corrpliance are consistent with the infom-otion
provided on other applicable compliance documents, v'ariaheets, 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 Gompl iance is required to be included with the documentation the builder prove es to the building ow w at occupancy.
Responsible Designer Na
Responsible >90
Gornpa„ v:
Date Signed:
/
Address: 0
C r'
T
Ucerse: ecC Q6 -I[U
atv/Stateft:
Sa c2
Phone:
1
CA Building Energy Efficiency Standards - 2013 Nonresidential iCompliance June 2014
CHANNEL LETTERS
PLOT P
a
DATE
OFFICE CO''py
—N N �Nr n�a 7'
P�LA NING DE
CUPERTIN6
MUNITY DEVIHLOPMENT�,Q.EPART.MENT
BUILDING' DIVISION - CUPERTINO
CAPEZ10
1/8" thick white plastic faces 5" deep
w/ color vinyl on surface. White return
& trim cap.
nation by LER"RTI NO
Building Department
- ral-l'
JUN 0 6 2016
REVIEWED FOR CODE COMPLIANCE
Channel letter attach to wall using 2.5"
screws(min 4 ea. letter)
LETTER DETAILS
APPROVED BY-
UL
CAPEZ10
LED
POWER SUPPLY
(60WC*. 12V/5A)
S14MMS OF LUCK
Pho.:(408)298-9163 —:(408)"8-4572
775A 101h St. #180 San Jose CA 05112
LIST be kept a"'f-INe
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i
uri!19 ruction. It i
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ful to make arty
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or to deVJ�ItO
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11, vd (approval from t
'fficfb'l.
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.
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)PIng an and spe6ifi
ns SHALL NOT
SHALL
e th
ope r to be an app
0 f ft-mib lation
of an
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ce,or 8�6t6iaiv.
By
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DATE UJU
PERMIT
CAPEZ10
1/8" thick white plastic faces 5" deep
w/ color vinyl on surface. White return
& trim cap.
nation by LER"RTI NO
Building Department
- ral-l'
JUN 0 6 2016
REVIEWED FOR CODE COMPLIANCE
Channel letter attach to wall using 2.5"
screws(min 4 ea. letter)
LETTER DETAILS
APPROVED BY-
UL
CAPEZ10
LED
POWER SUPPLY
(60WC*. 12V/5A)
S14MMS OF LUCK
Pho.:(408)298-9163 —:(408)"8-4572
775A 101h St. #180 San Jose CA 05112
REM
Ua
0 i� -4
314"VM*
TWCAP
a
We LEC
118=*
RA FNCE
W/Anch
(4 Ea.)
CAPEZ10
1/8" thick white plastic faces 5" deep
w/ color vinyl on surface. White return
& trim cap.
nation by LER"RTI NO
Building Department
- ral-l'
JUN 0 6 2016
REVIEWED FOR CODE COMPLIANCE
Channel letter attach to wall using 2.5"
screws(min 4 ea. letter)
LETTER DETAILS
APPROVED BY-
UL
CAPEZ10
LED
POWER SUPPLY
(60WC*. 12V/5A)
S14MMS OF LUCK
Pho.:(408)298-9163 —:(408)"8-4572
775A 101h St. #180 San Jose CA 05112