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B-2016-2733ra CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2733 10805 N WOLFE RD CUPERTINO, CA 95014-0614 (316 05 056) ACTIVE SIGN CO SAN JOSE, CA 95133 OWNER'S NAME: CUPERTINO VILLAGE LP DATE ISSUED: 09/15/2016 OWNER'S PHONE: 650-301-3000 PHONE NO: (408) 297-6640 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License II Contractor ACTIVE SIGN C DateU1 /31'/201.7. X BLDG _ ELECT _ PLUMB MECH RESIDENT IAL X COMMERCIAL I hereby affirm that I am licensed under the provisions ofChapter 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: STE # 106 - INSTALL N ILLUMINATED WALL SIGN ON FRONT I hereby affirm under penalty of perjury one of the following two declarations: EXTERIOR - LE QUEENA 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 fon 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 this permit is issued. Sq. Ft Floor Area: Valuation: $1000.00 APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 316 05 056 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. Signature' 4 Date 09!15/2016 Issued by: PAUL O'SULLIVAN Date: 09/15/2016 OWNER-BUILDER DECLARATION Ihere n affirm th 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 r foRowg twoons 1. 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: 09/15/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS Tp BE CLASS "A" OR BETTER t. 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. HAZARDOUS MATERIALS DISCLOSURE 2. 1 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 maintain compliance with the Cupertino-Municipal Code, Chapter 9.12 and the permit is issued. 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 subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of. California. If, alter 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 25505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION bate: 09/15/2016 I certify that I have read this application and state that the above information is I hereby affirm that there is 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 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, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,, the applicant understands ARCHITECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 09/15/2016 Professional SIGN PERMIT APPLICATION Pa6 -33:33, COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408)1777-3228 - FAX (408) 777-3333 build ing(cDcupertino.org PROJECT ADDRESS eY 90 W OLP F ft .: I R50 14-1 APN # 3 I W OWNER NAME(:�U5EgT1` 10 l00`L , �•� PHONE i_�� ry ,t�®�d� L -MAIL STREET ADDRESS CITY, STATE, ZIP -) � * �`.�y° a (A• U „` `� , `@� FAX /_ 19 � e^s/ - 33io CONTACT NAME X15 ` PHONE4.K L E-MAIL' .0 STREET ADDRESS MS+f^ �J�! �!❑I CITY, STATE, ZIP 6 �� c�w/� j cA r soso HARCHITECT FAX /,,4& ®y pj p Orr/ -z4_ `❑$ C�❑1 ❑ OWNER ❑ OWNER -BUILDER OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑� ❑'EENNGINEER DEVELOPER TENANT CONTRACTORNAMENAACI LICENSE NUMBER 7 LICENSE TYPE Cyd BUS. LIC # 6 COMPANY NAME-TK� � ACTLVM S E-MAIL FAX/,��Z�,1 1 43 Wil' STREET ADDRESS CITY, STATE, ZIP SAM CA- PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LTC # COMPANYN.AME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK l �® Saar RA W jL1UAArs�I ALL ( y o#t`oviA-w b ��F-b J. C_ K6 /d1J'E- L LEJ W l- .Ld *11 DAPI �i))••01A.4- MORf37E/' F .p o USE OF ❑ SED or Duplex ❑ Multi -Family STRUCTURE: Commercial ,ILLUMINATED (Y /N) SIGN TYPE (CODE) NO. OF SIGNS SIGN AREA (SQ. FT.) VALUATION M SIGN TYPE CODES: 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 RECEIVED BY:O AL ' ON By my signature below, I certify to eagh of the following: I am the property owner or authorized agent to act on the property owner's behalf. I I have read this application and the information I have proviorrect. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local a � Ing cons ctioB. thorize rep entatives of Cupertino to eater the above -identified property for inspection purposes. ordinances and state laws relating to b Simatu e of Applicant/Agent: y^ Date: 73Au SUPPLEMENTAL INFORMATION REQUIRED Site Plan _ Elevation n Details - including UL listing(s) applicable Sign Structural Calculations (if applicable) _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. OFFICE USE ONLY AN CHECK TYPE ROU NG SLIP OVER-THE-COLINTER ❑ EXPRESS ❑ STANDARD ❑ LARGE ❑ hlAaoR BUILDIN WLE IESi �1 rLANNINGEVIrw ❑ OTHER: Si,gnApp_2011.doc revised 03131111 TISConstruction 8& Active Signs 1365 E. Taylor Street, San Jose, CA 95133 Tel: 408-297-6640 Fax: 408-297-0743 Lic, No. 622,021 CIU, +C45, B September 12, 20,16 To whom: it may concern, I, Nancy Bae give my permission to Thomas Quick to work as my agent for obtaining a city permit from the City of Cupertino. Should you have any questions or concerns, please feel free to contact me. Sincerely, Nancy. T. Bae -' 7 Lic. #622021 -30ft— STORE FRONTAGE DAY TIME VIEW 113" �— o— o Ip 1411 NIGHT TIME VIEW Li — — — — — — — — — — — 14" 11" 16" UEENA Sign Area = 14.528 ft2 2" J\'I�A1975 Drawing No.: 4003 n: Tom Quick ELECTRIC SIGNS OF ALL KINDS SFile Name.: dd-LeQueena 4003 DIgRL(jWEVrOIteGODE COMPLIANCE File Path: e:/Cal-Neon Jobs/LeQueena 17Aporiaved By:SEAN HATC H I Date: ENT DEPARTMENT — CUPERTINO IVED IST be kept at the job make any changes or from, without approval cial. tions SHALL NOT be held to permit or to be an approval of the violation of any provision of any City Ordinance or State Law. BY SEAN HATCH DATE 09/16/16 PERMIT NO B-2016-2733 113" 0 0 1411 I L---OQ,--U 11/4" Stand-offs Sign Area = 14.528 ft' 1 Elevation view Scale:'/z"=1' Qty. 1 "Le.Queena": Aluminum halo -lit reverse -pan channel letters internally illuminated with LED lighting system. Faces and returns to be painted Black. Logo Box ("crown"): Aluminum face -lit/ halo -lit channel logo internally illuminated with LED lighting system. Face is White acrylic with Gold translucent vinyl graphics and Black trim -cap. Black returns. i I = 21.05 SgFt -f _� No.: 4003 Tom Quick im 3° 1 a Side view ELECTRIC SIGNS OF ALL KINGS SINCE 1975 File Name.: dd-LeQueena 4003 D�� IiW.EIVFF*80W9E COMPLIANCE File Path: e:/Cal-Neon Jobs/LeQueena A09yi d By: SEAN HA TLTa H Date: 3/8" Blue screw with 1 1/2' embed. Min. 3 per letter Aluminum reverse -pan 3/16" thick acrylic backer channel letter Shut-off switch Waterproof transformer box White LED illumination Waterproof low voltage cable connected to back of letter through wal I and to each letter and to low voltage transformer behind wall To power by others at" Weep hole All components @ approved A Electrical/Attachment Detail - Channel Letters Scale: NTS Approx. weight: 2 lbs per letter Note: This sign is intended to be installed in accordance with the requirements of Article 600 of the National Electrical Code and/or other applicable local codes. This includes proper grounding and bonding of the sign. � , yr RK40 # ■f 1! �Lilkle L • �iL '� - i f Homestead Rdhk { A,; z P_ o y� -din mom { a - ;AM At a 5 M0IJ=?J0101s GL INSOKI Drawn for: Le.Queena -10805 N. Wolfe Rr �' ert p,r C4 46014 Suite 106 st•ras 4003 �� nTom Q Date: 5/25/16 Sheet 3 of 3 COPYRIGHT NOTICE: THIS IS AN ORIGINAL UNPUBLISHED DRAWING SUBMITTED FOR USE IN CONNECTION WITH A PROJECT PLANNED BY CAL -NEON SIGNS. IT IS NOT TO BE SHOWN TO ANYONE OUTSIDE File Name.: d . Q a 003 R i Er� , O ; _WDE COMPLIANCE File Path: e:/Cal-Neon Jobs/LeQueena ,'' . �• 1. ®� 0�� p��0�� YOUR ORGANIZATION, NOR IS IT TO BE COPIED, REPRODUCED, OR EXHIBITED IN ANY FASHION WITHOUT THE WRITTEN PERMISSION OF AN AUTHORIZED OFFICIAL OF CAL -NEON SIGNS. STATE OF CALIFORNIA SIGN LIGHTING ""er CEG-NRCC-LTS-01-E(Revised 08/15) CALIFORNIA ENERGY COMMISSION 'Fmw CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 1 of 5) Project Name: Le.Queena Date Prepared: 22 -AUG -2016 A. General Information Project Address: 10805 N. Wolfe Rd, Cupertino, CA 95014 Location of Signa❑ 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 ® Specific Lighting Sources 1. Mandatory Sign Lighting Controls NOTES: 1. The some responsible person may install both the sign lighting power and the sign lighting controls, or a different responsible person may install the sign lighting controls than the responsible person installing the sign lighting power. 2. The Mandatory Measures (sign lighting controls) are required for compliance with the sign lighting Standards. If the person responsible for installing the sign lighting power is not also responsible for the sign lighting controls, then the owner of the sign, general contractor, or architect shall be responsible to have the sign lighting controls installed. 3. If more than one person has responsibility for compliance, each responsible person shall prepare and sign a Certificate of Compliance and an Installation Certificate applicable to the portion of construction for which they are responsible; alternatively, the person with chief responsibility for construction shall prepare and sign the Certificate of Compliance Declaration Statement for the entire construction. 1a. Statements of Responsibility Any person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E shall complete Part 1a. Check Yes or No for all of the following statements: 1 have responsibility for installing the sign lighting controls 1 O Yes, complete parts 1a and 1b of this form 4 No, complete part 1a of this form There are no existing sign lighting controls and I will be installing compliant sign lighting controls 2 O Yes O No 3 There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls O Yes O 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 O 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 O Yes 0 No CUPERTINO Building Department REVIEWED FOR CODE COMPLIANCE CA Building Energy Efficiency Standards - 2013 Non re?ft?�f @Wt n0i August 2015 Date: 09/16/16 STATE OF CALIFORNIA SIGN LIGHTING ""011 CEC-NRCC-LTS-01-E(Revised 08/15) CALIFORNIA ENERGY COMMISSION 'WMW CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 2 of 5) Project Name: Le.Queena Date Prepared: 22 -AUG -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: §130.3(a)1. All indoor sign lighting is controlled with an automatic time -switch control or astronomical time- Y N NA 1 switch control. C C 0 §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. 4 C C 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 C ® O 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. C O §130.3(a)3. Demand Responsive Electronic Message Center Control. An Electronic Message Center (EMC) having a new connected lighting power load greater than 15 kW has a control installed that is capable of Y N NA 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. C G Field Inspector Notes: CUPERTINO Building Department REVIEWED FOR CODE COMPLIANCE CA Building Energy Efficiency Standards - 2013 Non re?ftf�f @Wt not August 2015 Date: 09/16/16 STATE OF CALIFORNIA SIGN LIGHTING ""er CEG-NRCC-LTS-01-E(ReVlsed 08/15) CALIFORNIA ENERGY COMMISSION 'Fmw CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 3 of 5) Project Name: Le.Queena Date Prepared: 22 -AUG -2016 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 Field 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 ^ O Y _ VI > Q c3 N N -a X v n � . O N v N Q1 +'II w II Q .... v p Q O 3 O v ✓ ✓ 1 2'-0" x 9'-5" (Overall) ❑ 14.53 1 12 174.36 150 Yes ❑ Channel Letters+Logo ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ ❑ 0.00 ❑ A Symbol or code used on the plans (when plans are required) and other documents. B A description of the sign, or location of sign on the building; and the location of sign on construction documents. OPTIONAL - Check this box only if this sign has a permanent, pre-printed, factory -installed, ENERGY VERIFIED label, confirming that the sign complies with the Section 140.8 of the California 2013 Title 24, Part 6 Standards, using the Maximum Allowed Lighting Power method of compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories (UL) or other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards C Institute in accordance with ISO/IEC 17011. Surveillance by the Accredited Certification Body shall be an ongoing annual inspection program carried out by a Type A Inspection body in accordance with ISO/IEC 17020. For signs with such an ENERGY VERIFIED label, columns 'D' through 'I' are not required to be filled out. Note: Using an ENERGY VERIFIED label is an optional method to validate compliance. An ENERGY VERIFIED label is not needed for compliance. D The sign area in square feet. E List "I" if the sign is internally illuminated. List "E" if the sign is externally illuminated. F Allowed watts per square foot. Enter 12 if the sign is listed as "I" in column E. Enter 2.3 if sign is listed as "E" in column E. G Multiply the square footage in column D times the allowed Lighting Power Density (LPD = watts) in column F. H Show the total installed watts in the sign, as determined according to the applicable provisions of §130(c). I Enter Y if the number in column H is less than or equal to the number in column G. Otherwise, the sign does not comply. 1 This page doubles as a field inspection checklist. Field Inspector Notes: CUPERTINO Building Department REVIEWED FOR CODE COMPLIANCE CA Building Energy Efficiency Standards - 2013 Non re?ftf�f @Wt not August 2015 Date: 09/16/16 STATE OF CALIFORNIA SIGN LIGHTING CEC- _1 NRCC-LTS-01-E(Revised 08/15) CALIFORNIA ENERGY COMMISSION 'wMv CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 4 of 5) Project Name: Le.Queena Date Prepared: 22 -AUG -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 1 2'-0" x 9'-5" (Overall) (Overall) Channel Letters+Logo ❑ 7 -LEDs ❑ ❑ ❑ ❑ ❑ A Symbol or code used on the plans (when plans are required) and other documents. B A narrative description of the sign, or location of sign on the building; and the location of sign on construction documents C OPTIONAL - Check this box only if this sign has a permanent, pre-printed, factory -installed ENERGY VERIFIED label, confirming that this sign complies with the Section 140.8 of the California 2013 Title 24, Part 6 Standards, using the Specific Lighting Source Method of Compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories (UL) or other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards Institute in accordance with ISO/IEC 17011. Surveillance by the Accredited Certification Body shall be an ongoing annual inspection program carried out by a Type A Inspection body in accordance with ISO/IEC 17020. For signs with such an ENERGY VERIFIED label, column 'D' is not required to be filled out. Note: Using an ENERGY VERIFIED label is an optional method to validate compliance. An ENERGY VERIFIED label is not needed for compliance. Specific Light Source Compliance Method. The sign(s) identified above use only the following lighting technologies: List all applicable numbers (1 through 9) that apply in column D above for each row. 1 High pressure sodium lamps Metal halide lamps that are pulse start or ceramic served by a ballast that has a minimum efficiency of 88 percent or 2 greater. Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage when tested according to ANSI C82.6-2005. Metal halide lamps that are pulse start that are 320 watts or smaller, are not 250 watt or 175 watt lamps, and are served by a ballast that has a minimum efficiency of 80 percent. 3 Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage when tested according to ANSI C82.6-2005. Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 75 percent D 4 when the transformer or power supply rated output current is less than 50 mA. The ratio of the output wattage to the input wattage is at 100 percent tubing load. Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 68 percent 5 when the transformer or power supply rated output current is 50 mA or greater. The ratio of the output wattage to the input wattage is at 100 percent tubing load. 6 Fluorescent lighting systems meeting one of the following requirements: A. Use only lamps with a minimum color rendering index (CRI) of 80; or B. Use only electronic ballasts with a fundamental output frequency not less than 20 kHz. 7 Light emitting diodes (LEDs) with a power supply having an efficiency of 80 percent or greater; Single voltage external power supplies that are designed to convert 120 volt AC input into lower voltage DC or AC output, and have a 8 nameplate output power less than or equal to 250 watts, shall comply with the applicable requirements of the Appliance Efficiency Regulations (Title 20). 9 Compact fluorescent lamps that do not contain a medium screw base sockets (E24/E26). E This page doubles as a field inspection checklist. Field Inspector Notes: CUPERTINO Building Department REVIEWED FOR CODE COMPLIANCE CA Building Energy Efficiency Standards - 2013 Non re?ft?�f @Wt ,0i August 2015 Date: 09/16/16 STATE OF CALIFORNIA SIGN LIGHTING CEC- I NRCC-LTS-01-E(Revised 08/15) CALIFORNIA ENERGY COMMISSION 'wmv CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 5 of 5) Project Name: Le.Queena Date Prepared: 22 -AUG -2016 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Thomas Quick Documentation Author Signature: Company: CAL -NEON Signs Signature Date: 22 -AUG -2016 Address: CEA Certification Identification (if applicable): 1005 Martin Ave. City/State/Zip: Santa Clara, CA 95050 Phone: 408-289-1883 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 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. Oigitallysign" by TM1omas Quick Responsible Designer Name: =Thoma, awukn CAL -NEON Sig.%ou=0ffi. Thomas Quick M mail-ioPo�calneno co =D6 Thomas 08.2314:30:33-0]'00'm Digitally signM by Thomas Quick Responsible Designer Signature: DN: cn=rn .ib' ick, ClilEDN fiigna, .-Off- u=o Q Thomas Quick Mana ger, email314 3 045 OT.cam, c=US Date: 3 D16.08.231430'.46 -0)'00' Company: CAL -NEON Signs Date Signed: 22 -AUG -2016 Address: 1005 Martin Ave. License: City/State/Zip: Santa Clara, CA 95050 Phone: 408-289-1883 CUPERTINO Building Department REVIEWED FOR CODE COMPLIANCE CA Building Energy Efficiency Standards - 2013 Nonrek�dvwt not August 2015 Date: 09/16/16