B-2016-1365CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO; B-2016-1365
10815 N WOLFE RD STE 100 CUPERTINO, CA 95014 (316 05 056) ( MID - WAY
ENTERPRISE INC)
SANTA CLARA, CA
I OWNER'S NAME- CUPERTINO VILLAGE LP DATE ISSUED: 02/16/2016
I OWNER'S PHONE. 650-946=7503 ( !PHONE NO: 409-982-9646
LICENSED CONTRACTOR'S DECLARATION
Class C=K Lie. #M7M
;or ( MID -WAY ENTERPRISE INC) 02!1612016
I hereby affirm that I am licensed tinder the provisions of Chapter 9 (commencing
wltb Section 7000) of Divislon 3 of the Business & ProfessIons Code and that my
license is in fall force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
1, I have and will nvnintain a certificate of consent to self-lusure, 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 mnintain Worker's Compensation Insurance, as providedfor
0111 by Section 3700 of the Labor Code, for the performance of the work for which
this permit is issued.
API'L ICANT CERTIFICATION
I certify that I have read this application and state that the above
information is correct,! agree to comply with all city and county
ordinances and state laws relating to building construction, and hereby
authorize representatives of this city to enter upon the above mentioned
property for inspection purposes. (We) agree to save Indemnify and keep
harmless the City of Cupertino against liabilities, judgments, costs, and
expenses which may accrue against said City in consequence of the
granting of this permit, Additionally, the applicant understands and will
comply with all non -paint source regulations per the Cupertino Municipal
Code, Section 9.18. A
I hereby affirm that I am exempt from the Contractor's License Law for one of tate
following two reasons:
a. I, as owner of ilre property, or tiny employees with wages as their sole
compensation, wilt do the work, and the structure is not intended or offered
for sale (See.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code),
I hereby affirm under penalty of perjury one of the following three declarations:
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.
a. 1 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,
s, I certify that in the performance of the work for which tris permit is issued, I
shall not employ any person in any manner so as to become subject to the
Worker's Compensation laws of California, lf, after making this certificate of
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
be deemed revoked.
APPLICANT t EWrIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws
relating to building construction, and hereby authorize representatives of this city
to enter upon the above mentioned property for Inspection purposes. (We) agree
to save indemnify and keep harmless the City of Cupertino against liabilities,
Judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant
understands and will comply with all non -point source regulations per the
Cupertino Municipal Code, Section 9.18.
Date 02/16/2016
PERibIIT INI0:
X .BLDG _ ELECT ^ PLUMB
_ MECH _ RESIDENTIAL X COMMERCIAL
JOB DESCRIPTION:
I{EXYPOINT - INSTALL 3 (N) ILLUMINATED WALL SIGNS
Sq. Ft Floor Area Valuation: $ t 0000.00
APN Number: Occupancy Type;
316 05 056
PERMIT EXPIRES IF WORD IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LASTXA-t"[+'~ SPECTIUN,
Issued by:
REt ROOFS:
All roofs sball be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection,
Signature of Applrcautt
Date: 02116/201 6
ALL ROOF COVERINGS TO BE CLASS "A" OR
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6,95 of the
California health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Codc, Chapter 9.12 and the
Health & Safety Code, Section 25532(x) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
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
the Health & Safe a, Sectio its 25505, 25533, and 25534.
Owner or authorized age
Date: 0211 6/2 01 6
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is Issued (Sec. 3087, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be us'hd as public records,
License
Profession6t.
SIGN PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
cupwrINO (408) 777-3228 - FAX (408) 777-3333 - buildinclAcuperfinQ.om
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PROJECT ADDRE�� a 4J
OWNERNAMRA
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-MAIL
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STREET ADDRESS CITY, STATE 7ZIP
FAX
CONTACT NAME
STREET ADD
❑ OWNER ❑ OWNER -BUILDER, 0 OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT 13 ARCHITECT Cl ENGINEER EJ DEVISLOPER. l TENANT
Cot?IMIT
LICENSE
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BUS. Lie #
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CIT�ATH, P
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ARC141 ECTISNGIHERR NAME
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LICENSE NUMBER
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COMPANY
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FAX
STREET ADDRESS
CITY, STATE, ZIP
'PMQNP-
DESCRIPTION OF WORK
51Q4 K
USE OF E] SFD or Duplex F-1 Multi -Fancily
ILLUMINATED SIGN TYPE NO. OF sioN AREA
VALUATION
STRUCTURE: Q Commercial
(YIN) (CODE) SIGNS (SQ. FT-)
(S)
Slow TYPE CODES;
B - BANNER SIGN M - MONUMENT (GRdUM) SIGN
BL - BLADE SIGN P - PROJECTING SIGN
D - DEVELOPMENT,ID SIGN SP - SPECIAL EVENT BANNER
DI - DIRBCTICNALSIGN T - TEMPORARY
E - ELECTRONIC w - WALLS;GN
READERBOARD WI - WINDOW SIGN
a
By my signature below, I certify to each of tate following: I am the property owner or authorize the pro owner's h4slf.'l have read this
it is accurate. I agree ply with all applicable local
t15�
application and the information I have provided is qprrect, I have read the Des r=Y
ordinances and state, laws`uildin onst I oil. I authorize reezScotatives of Cupertino to enter the above-Venti for inspection purposes.
Signature ofApplice , rDate;
n�. Q
FP
SUPPLEMENTA I R ATION REQTMD
— 1p_Fm2n
altarGZi
Silo Plan
_N-
Elevations
Sign etails -including UL listing(s) applicable
D
MEW
Structural Calculations (ifapplicable)
Copy of lanning Approval Letter or Meeting with Planning prior to
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submittal of Building Permit application.
SignApp_201 I.doc revised 03116111
77' Le/Le OFFICE copy
This csS of rlgn> rnd sp r (h,T s &g 10815 N. Wolfe
rT
P ,ofd - 13CS
DATE / / /o l'4
PLANNING DEPT
CUPERTINO
757� -P
Y�
All three signs the same size
38' Le7Le
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'XI `�"
. sIaepi-S.
CUPERTINO
i6ilding Department
2616
REVIEWED FOR CdDE�I—' E
01_ NRe
TB
24°
CREDIT UNION
Sign area one to one
HALO
LIT
LETTER
Wall
140 )—(JM&0'CD
1" Spacer
3
a" DEEP Bronze
Cea,lLe
Ilr,
'
ba.1,
Near Lexen backIlk
P
ULLISTED
SECONDARY WIRING
LED white
�o
BONDING JUMPERS WITH
P
' CONNECTION OR FITTING
Colorto be Bronze
i AS REO. ON FLEXIBLE
lace
METALCONDUIT
gF ��
L Noltegel2N
BUSHING RETAINER, 117'
DC
EMT CONNECTOR, 112" EMT
I
CONNECTOR BODY,
.
COMPRESSION NUT,
114" X 1 W STAR NYLON
ANCHOR. 260 TENSILE
".
STRENGTH PER ANCHOR
LISTED DISCONNECT SWITCH
MIN. (4) PER LETTER.
IN PRIMARY
114" DRAIN HOLES (2) TWO
TO PRIMARY ELECTRICAL
MIN. PER LETTER
SOURCE WITH 1/2" CONDUIT
BY OTHERS
12 V disconnect
switch
,Z,'." _i;A&,:W'3290 BASSETT STREET SANTA CLARA CALIF. (408)982-9696 FAX:(408)982-937
OWNER APPROVAL .FOB NAME KEYPOINT DATE: 111-20-15
BY: LOCATION. 10815 N WOLFE RD. SCALE: NONE
PHONE: CITY/ CUOERTINO DRAWN BY: GARY
DATE:
a i A i c yr UHurUKNIA
SIGN, LIGHTING
r
CEC-NRCC-LTS-01-E(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting - (Page 1 of 5)
Projec[Nam---Y�I� � Nate P[e r
A. General Information
NOTES:
Project Address: pO //�$
Ie w L 0-l/
/] y�P
e
k,t -,;�
eJ
Location of Sign Outdoor Signs
❑ Indoor Signs
Phase of Sign Construction 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 -pecific 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.
Ia. 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:
I have responsibility for installing the sign lighting controls
1
❑ Yes, complete parts 1a and 1b of this form 39 No, complete part la of this form
There are no existing sign lighting controls and I will be installing compliant sign lighting controls
2
Yes11No
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
❑ Yes 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 NO
CA Building Energy Efficiency Standards- 2013 Nonresidential Compliance May 2015
J I A I t yr UALIruKrvw
SIGN LIGHTING
>D,
GEC-NKGG-LI6-01-t Kevised Ob115 GALWORNIA tNhHGY GOMMISSICN
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 2 of 5)
Project Na e: Date Pear
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.
❑
❑
❑
§330.3(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
❑
❑
❑
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 May 2015
J [ A I t ur UALIrUKNIA
SIGN LIGHTING
1
CEC-NRCC-LTS-01-E(Revlsed 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 3 of 5)
Project Name: oat. Pre a/d:
SIA)
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
1
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
t7
a
EE
3�N
°1g
�4
='
o
o
0
U
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
Symbol or code used on the plans (when plans are required) and other documents.
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
IB
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,
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
EnterY 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 - 2013 Nonresidential Compliance May 2015
o I M I c ur e A!_Irtittrvw
SIGN LIGHTING
CEC-NRCC-LTS-01-E Revised 05115 GALIEORNIA ENERGY GOMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 4 of 5)
Project Name . e , Date Prep ed:
Iv ♦ '
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
CheckthatSign
Code
(see instructions
technologies listed below
Complies
�
below)
List all that apply
❑
❑
❑
❑
❑
❑'
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 082.6-2005.
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
a I A i t ur UALIrurcry iH
SIGN LIGHTING
CEC-NRCC-LTS-01-E Revised 05115 CALIFORNIA ENERGY COMMISSION -
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 5 of 5)
Project Name: Date Pre r
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Docume tion Auth rN e:
ccume n Author S wA re'
comp an : c
ignatu a Da
/
C
Addre s:
CE Certification Identification (if applicable):
City/State/Zi a-+_
UT
Ph x, Gl ^�
-
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 he 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 t e bAoder provide a uildin5pVner at occupancy.
Respo Ie Designer N e•
espon- signerSign
Compan
Date 5i ed:
Add,
License:
City State 2i
60
P s�
t
C
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015