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1504003220080 STEVENS CREEK BLVD 15040032 F 1 :1 Oki X-C-1 0-511ttme SCANNED BOX #573 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20080 STEVENS CREEK BLVD CONTRACTOR- -'� @ y PERMIT NO: 15040032 G4/ d f<Zi�s OWNER'S NAME: PREG BILTMORE DATE ISSUED: 04/06/2015 OWNER'S PHONE: 4088750121 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL �] * *FRESH PIX ** SUITE 106 - INSTALL 2 WALL SIGNS & 1 License Classl, Lic.. t MONUMENT SIGN Contractor�%�Wf�( 7 Date I hereby affirm that I am licensed under the provisio s of thapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: otlae 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 Sq. Ft Floor Area: Valuation: $5500 performance of the work for which this permit is issued. I 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 APN Number: 36903009.20080 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN ERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save AYS F ALLED INSPECT ON. indemnify and keep harmless the City of Cupertino against liabilities, judg costs, and expenses which may a rue against said City in consequence of a granting of this permit. Additi ly, the applicant understands and will comply s Date: with all non -point source regl1yons per the Cupertino Municipal Code, Section 9.1 %. //� Z/ RE- ROOFS: Sig Lure Date !O All roofs shall 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. ❑ OWNER- BUILDER DECLARATION Signature of Applicant: Date: 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self - insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Ar Air Quality Management District 1 performance of the work for which this permit is issued. will maintain compliance with the Cuper Municipal Code, Chapter 912 apil I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25 25533, and 25534 Section 3700 of the Labor Code, for the performance of the work for which this / permit is issued. Owner or authorized ag Date: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's 41 Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LE AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally,.the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date F"--7,0 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION SIGN TYPE ADDRESS: 20080 STEVENS CREEK BLVD DATE: 04/0612015 REVIEWED BY: MELISSA ;tPeclr. Permit Fee' APN: 369 05 009 BP #: / *VALUATION: 1$5,500 *PERMIT TYPE: Building Permit WAN CllkCK TYPE: PRIMARY Sin USE: $572 PENTAMATION 1 CEAPS PERMIT TYPE: WORK " "FRESH PIX ** INSTALL 2 WALL SIGNS & 1 MONUMENT SIGN SCOPE 1 SIGN TYPE FEE ID Plumb. Murr Check QTY ;tPeclr. Permit Fee' SIGN FEE IESIGN Elec. Permit Fee: IEPERMIT Wall Sign, Electric 1SIGNWELEC Other Elea Insp. 0.0 $48.00 2 Plur+rl?, Insp. Fee: $572 Permit Fee: Ground Sign, Alteration 1SIGNREWRK 0,0 hrs 1 $359 $48.00 PME Permit Fee: $48.00 Construction Tax: Ad1YLIt17S'tl "pll:'i %E': Work Without Permit? 0 Yes (F) No $0.00 Sign Master Plan: 0 Yes 0 No $0.00 TOTALS: Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICO $931.00 Select an Administrative Item NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the nreliminary information available and are onlv an estimate Contact the Dent for addn7 info. FEE ITEMS (Fee Resolution I1 -053 g 711113) Mech. Plan Check Plumb. Murr Check # Branch Circuits 1 $48.00 ;tPeclr. Permit Fee' Plurnh. Permit Fee: IESIGN Elec. Permit Fee: IEPERMIT Other ilcch. Ing.? 01/101- Plumb Imp, Other Elea Insp. 0.0 $48.00 gdar.(r. lush. !tae: Plur+rl?, Insp. Fee: Elec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the nreliminary information available and are onlv an estimate Contact the Dent for addn7 info. FEE ITEMS (Fee Resolution I1 -053 g 711113) FEE QTY/FEE MISC ITEMS Plan Cheek Fee: Suppl. PC Fee: 0 Reg. ®OT 0.0 hrs $0.00 Plunab. i11lec7t. /Flee: Permit Fee: $931.00 Suppl. Insp. Fee:Q Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $48.00 PME Permit Fee: $48.00 Construction Tax: Ad1YLIt17S'tl "pll:'i %E': Work Without Permit? 0 Yes (F) No $0.00 Sign Master Plan: 0 Yes 0 No $0.00 A Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICO $1.54 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $1,077.54 $0.00 1 TOTAL FEE: $1,077.54 Revised: 02114/2015 C UPERTINO SIGN PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISIO 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 ^ FAX (408) 777 -3333 - buildingur7.cupertino.org INE' Vs PROJECT ADDRESS /J ZOO ® 5T d K&4 5 (?,Zte t..v+ 6L I O(p ytJ APN # ,J OWNER NAME PLC) �I-U0s Cz"0(' PH9N�E.,. 'mss•8Z3. ®12.1 E -MAIL Cr�oasterC� Paoru �.t�samt. - STREET ADDRESS 0 _ g,�4l�n SID a Srr�vrer�s ({lC, i+V CITY, STATE, ZIP F c.0 pff_ r.-n cA- 91,5e)(4 . 81:5. ©! 2r CONTACT NAME Piww to der lRl�sP g t � PHONE �i driO, 4 52.74-4b E -MAIL S - CO STREET ADDRES �11 -d, CITY, STATE, ZlP FAX pprr'� ❑ OWNER ❑ OWNER- BUILDER ❑ OWNERAGENT FrCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMP LICE NSENtJ BEER�� LICENSEnTY 9 rock BUS. LIC# FA (o COMPANY NAME E -MAIL tAe- M-r scE'wS . 1�C _ @ AI &WtRT05t bans. Wl nW STREET ADDRBss 41, I .� i�t i.�� d -9� �!�' 1�- CITQ A, S�TAT �%TV, O ql PH i �O . ARCHITECT /ENGINEER NAME LICENSE�NCU"MBBERR BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK I 0 51tt _A Tb n ! ®r- Est v CJE 6Ci47L ► t.t,t,Wt r dJ M�=>J W tT�F Ehf7E C1� I s 4J(1Y!- It..t. WiAj X28 T5 ( U%-1 -10(1 A OD Void v►'tilW-C e, bWc t USE OF ❑ SFD or Duplex ❑ Multi- Family ILLUMINATED SIGN TYPE NO. OF SIGN AREA VALUATION STRUCTURE: Commercial (Y / N) (CODE) SIGNS (SQ. FP.) (s) SIGN TYPE CODES: B �•5 5 • w 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 ECEIV' VAL TI N: B By my signature below, I certify to each of the followi : I am the property owner or authorized agent to act on the property owner's behalf 1 have read this application and the information 1 have provided is co ct. l have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building const ti iae yep esentatives of Cupertino to enter the above -iden / led p perry for inspection purposes. — Signature of Applicant/A ---- -� Date: 3 SUPPLEMENTA TION REQUIRED OFFICE USE ONLY PLAN CHECK TYPE ROUTING SLIP Site Plan IN ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW Elevations Sign Details - including UL listing(s) applicable ❑ EXPRESS ❑ PLANNING PLAN REVIEW Structural Calculations (if applicable) ❑ STANDARD ❑ OTHER: _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ LARGE submittal of Building Permit application. ❑ MAJOR Created using 10A-k easyPDF Ar nttelr CITY OF CUPERTINO C-&D &4�D .511 f" Temporary Sign Permit 10300 Torre Avenue Cupertino, CA 95014 408.777.3308 www.cui)ertino.org Name of Business: /5K4Y,( A/K x - Business Address: 7-66& J7P-41AFIV5 Off-OfK � / ��� eU�i c✓�,c�d Contact Person: �7L0��/N �/A-T� iii /S Phone /Cell: / Contact E -Mail: Fax: Contact Address(ifdifferent than above) : City /Zip: Lj Type of Sign: �, Banner co ❑ Project Announcement cy ) ❑ Free Standing J,:) ❑ Special Event Sign cy) (check all that apply) (e.g. A- frame /Sandwich board) ❑ Flag ❑ Other Description of Special Event /Sign: eeww/ 500y )ate to be Installed: Date to be Removed: AT V=A&I=A h 0/— Please attach the following exhibits: 1. Site Plan showing location of special event and/or sign on property (dimensioned or scaled). 2. Elevation drawing showing sign content, dimensions, colors, and materials. 3. Letter of description /justification. Conditions: Each business may have the use of temporary signs for a maximum of one hundred twenty days in a period of 360 days. The applicant agrees to hold the City, its officers, agents, employees, and volunteers harmless from all damages, costs, or expe es in law or equity that may at any time arise or be asserted because of damage to property or ersonal injury received by any reason of or in the course of displaying a sign or other display obje 3/ Applicant's Signatur Date: Date Received: C4 ((o loo /,5 Planner: � 'ermit Fee: $ 11 Expiration Date? ❑ No Yes x p 4J 6 (2-016 Sticker Issued ?/tilly/ ❑ R Deposit Required? No ❑ Yes $ STATE OF CALIFORNIA MGR- LIGHTING CERTIFICATE OF COMPLIANCE Sign Lighting 1 Project Address: �%r7 �./ /�1if % S CALIFORNIA ENERGY COMMISSION NRCC - LTS -01 -E (Page 1 of 5) Location of Sign F.putdoor 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 ASpecific Lighting Sources 1. Mandatory Sign Lighting Controls (VOTES: 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. 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: 1 I have responsibility for installing the sign lighting controls 'PAro dku- es, complete parts la and lb of this form ❑ No, complete part la of this form There are no existing sign lighting controls and I will be installing compliant sign lighting controls es ❑ No There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls ❑ Yes o 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 o are existing sign lighting controls that do not comply with the applicable provision of §110.9 and §130.3 and someone LThere else will be responsible to install compliant sign lighting controls ❑ Yes o CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA BMW LOGHTNG CEC- NRCC - LTS -01 -E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC - LTS -01 -E Sign Lighting / (Page 2 of 5) 1b. Mandatory Sign lighting Controls If the person signing the Certificate of Compliance Declaration Statement on this NRCC - LTS -01 -E is responsible for complying with the sign lighting control requirements, that person shall answer all of the following questions: if there are construction documents, indicate where on the building plans the mandatory measures (sign lighting control) note block can be located: 1 $130.3(a)1. All indoor sign lighting is controlled with an automatic time - switch control or astronomical time- Y N NA switch control. ❑ ❑ $130.3(a)2A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time- Y N NA switch control, or an astronomical time - switch control. ❑ ❑ 2 EXCEPTION to Section 130.3(a)2A: Outdoor signs in tunnels, and signs in large permanently covered outdoor Y NA areas that are intended to be continuously lit, 24 hours per day and 365 days per year. ❑ $130.3(a)20. 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 3 Signs that are illuminated at night and for more than 1 hour during daylight hours shall be considered ON both ❑ ❑ day and night. EXCEPTION to Section 130.3(a)ZB: Outdoor signs in tunnels and large covered areas that are intended to be Y A illuminated both day and night. ❑ $130.3(x)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(x)3: Lighting for EMCs that is not permitted by a health or life safety statute, Y NA ordinance, or regulation to be reduced by 30 percent. ❑ Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA MGN LIGHTING 0 CEC- NRCC - LTS -o1 -E Revised 06!14 CERTIFICATE OF COMPLIANCE Sign Lighting ERGY COMMISSION N RCC- LTS -01 -E (Page 3 of 5) g. Maximum Allowed Lighting Power Method of Compliance Certificate of Compliance and Field Inspection Energy Checklist Complete this part if there are signs using the maximum allowed lighting power method of compliance. (Complete part 3 of this Certificate of Compliance if there are signs using the Specific lighting sources method of compliance) A B C D E F G H I J Symbol Or Code Description of the Sign OPTIONAL — Energy Verified Label (see instructions below) Allotted Watts Design Watts Complies y�N Filed Inspector Check that sign complies ro m aj �, = N _w— CL J ^\ y\ �?, i a�i N m 0 o 'I ° Q_.� �o i LL x a o a c SP N •O c w :° 3 l7 w a 0 U ❑ ❑ ❑ ❑ A Symbol or code used on the plans (when plans are required) and other documents. B A description of the sign, or location of sign on the building; and the location of sign on construction documents. C OPTIONAL - Check this box only if this sign has a permanent, pre - printed, factory - installed, ENERGY VERIFIED label, confirming that the sign complies with the Section 140.8 of the California 2013 Title 24, Part 6 Standards, using the Maximum Allowed Lighting Power method of compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories (UL) or other Product Certification Body accredited to ISO /IEC Guide 65 by the American National Standards Institute in accordance with 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 I Show the total installed watts in the sign, as determined according to the applicable provisions of §130(c). Enter Y if the number in column H is less than or equal to the number in column G. Otherwise, the sign does not comply. J This page doubles as a field inspection checklist. Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA SIGN LIGHTING CEC- NRCC - LTS- 01- E(Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC - LTS -_01-E Sign Lighting r (Page 4 of 5) 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) c4 B C D E t OPTIONAL Specific light source used for Symbol ENERGY VERIFIED compliance or Description label Shall include only lighting (o Gx{ Code (see instructions technologies listed below A below) List all that apply - } ❑ o A Symbol or code used on the plans (when plans are required) and other documents. B A narrative description of the sign, or location of sign on the building; and the location of sign on construction documents C OPTIONAL- Check this box only if this sign has a permanent, pre - printed, factory- installed ENERGY VERIFIED label, confirming that this sign complies with the Section 140.8 of the California 2013 Title 24, Part 6 Standards, using the Specific Lighting Source Method of Compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories (UL) or other Product Certification Body accredited to ISO /IEC Guide 65 by the American National Standards Institute in accordance with ISO /IEC 17011. Surveillance by the Accredited Certification Body shall be an ongoing annual inspection program carried out by a Type A Inspection body in accordance with ISO /IEC 17020. For signs with such an ENERGY VERIFIED label, column 'D' is not required to be filled out. Note: Using an ENERGY VERIFIED label is an optional method to validate compliance. An ENERGY VERIFIED label is not needed for compliance. Specific Light Source Compliance Method. The sign(s) identified above use only the following lighting technologies: List all applicable numbers (1 through 9) that apply in column D above for each row. 1 High pressure sodium lamps Metal halide lamps that are pulse start or ceramic served by a ballast that has a minimum efficiency of 88 percent or 2 greater. Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage when tested according to ANSI C82.6 -2005. Metal halide lamps that are pulse start that are 320 watts or smaller, are not 250 watt or 175 watt lamps, and are served by 3 a ballast that has a minimum efficiency of 80 percent. Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage when tested according to ANSI C82.6 -2005. Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 75 percent D 4 when the transformer or power supply rated output current is less than 50 mA. The ratio of the output wattage to the input wattage is at 100 percent tubing load. Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 68 percent 5 when the transformer or power supply rated output current is 50 mA or greater. The ratio of the output wattage to the input wattage is at 100 percent tubing load. 6 Fluorescent lighting systems meeting one of the following requirements: A. Use only lamps with a minimum color rendering index (CRI) of 80; or B. Use only electronic ballasts with a fundamental output frequency not less than 20 kHz. 7 Light emitting diodes (LEDs) with a power supply having an efficiency of 80 percent or greater; Single voltage external power supplies that are designed to convert 120 volt AC input into lower voltage DC or AC output, and have a 8 nameplate output power less than or equal to 250 watts, shall comply with the applicable requirements of the Appliance Efficiency Regulations (Title 20). 9 Compact fluorescent lamps that do not contain a medium screw base sockets (E24/E26). E This page doubles as a field inspection checklist. Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA SIIGH LIGHTNG CEC- NRCC- LTS -01 -E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-01-01 -E Sign Lighting / (Page 5 of 5) DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 0 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author ame: Documentation Author Sign CompanyY,� � � ®� �o Signature Date. �` /` Address: pp ®0 0®° CEA/ HERS Certification Identification (if plica e): City /StateMp: n� (v Phone: eag/ Arg: k Q9 e 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 maJavailabl with the building permit s) issued for the building, and made available to the enforcement agency for all applicable inspections. that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the build the building owner at occupancy. ResponSible Designer Narne� �� OA� �� Responsib i nerSigna Compan Date Signed: Address: A� License: �& �® rily/ S ta ip: d Phone: vb CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 (} / \� � zE 10 g t E, 4t -0 ro 0 cc -.V m Lr) < > V, C) 00 ru Q 0 —i a IA C) 12 ID In Q Z < > c O 0 0 E E Z 0 O CG O O O i = y zi fl t/j N z 0 O ON x CD 00 C) CL N LL to In Q Z < > c O 0 0 E E Z 0 O CG O O O i = y zi fl t/j N z 0 O ON x CD 00 C) CL N LL MD] R o o A E \ \\ V Y E� � z yas V tF � qgg® u? � 1] rn V Y T- � z h w c7O �Qb? z 5 v F p O LU cc - - w 7i o �p 1w_- 1 x QO J ' G .5 > z ¢ CV T_ 14in 9,in L S/S MONUMENT SIGN PANEL ALUMINUM REVERSE PAN 1.75" DEEP WHITE - MP27386 VERIZON WHITE HIGH GLOSS '/2' CLEAR "PUSH THROUGH' PLEX COPY WITH TRANSLUCENT VINYL OVERLAY VINYL COLORS -GREEN -'BRILLIANT GREEN-- 3M 3630-106, Pantone 376C RED -'LIGHT TOMATO RED" - 3M 3630-43 YELLOW - 3M 3630-3787 - PMS 1300 WA�hti� oj�, t,LD 2-5i APR 0 fi 20f THE ABOVE COLORS ARE FOR REPRESENTATION ONLY. ACTUAL PRODUCTION COLORS COULD VARY. Project: Fresh Pixx 3/2015 Wall Notes, through wall installation is assumed to be normal stucco, wood or soft brick facing. If unusual circumstances inside wall are discovered by installer, buyer, if available, will be notified. In any event, buyer Location: 20080 Stevens Creak Road #106 Mont. Sign shall be billed for special labor on a time and material basis, J`_ +; CA QCMA S/S General Notes Customer to provided electrical service as noted contractor connects only. All electrical components to be U.L. approved. Manufacturer's label and U.L. label shall be placed on sign according to building and city codes. -Sign contractor shall verify all conditions and dimensions prior to manufacture ofshitmage. This —.691-1 d­i,,qbyPadficW-Siq,,s. in connection with a p,rf- being planned for you by PINS It IS not to be reproduced, copied,orexhibited In any faShiOn without thewriKen permission of PaCiflc Wese Signs,