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B-2017-0080
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0080 10080 N WOLFE RD STE SW3-301 CUPERTINO, CA 95014-2518 (316 20 086) CORPORATE SIGN SYSTEMS INC SANTA CLARA, CA 95050 OWNER'S NAME: I&G DIRECT REAL ESTATE 27 LP DATE ISSUED: 01/18/2017 OWNER'S PHONE: 408-982-8404 PHONE NO: (408) 292-1600 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C45 Lic. #765078 Contractor CORPORATE SIGN SYSTEMS INC Date 06/30/2017 X BLDG _ELECT _ PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing MECH RESIDENTIAL X COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: WOLFE SQUARE - REMOVE/REPLACE 1 ILLUMINATED I hereby affirm under penalty of perjury one of the following two declarations: MONUMENT SIGN; REPLACE FACING ON 2 (E) ILLUMINATED i. I have and will maintain a certificate of consent to self -insure for Worker's MONUMENT SIGNS (3 SIGNS TOTAL) 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 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: $24000.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 316 20 086 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. Additionally, the applicant understands and will comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations perth Cupertino"Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 01/18/2017 Issue _ Date: 01/18/2017 OWNER -BUILDER DECLARATION _ 1 I hereby affirm that I am exempt from the Contractor's License Law for one of the S -.- following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 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 (See.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: 01/18/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. 1 have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 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 shall not employ any person in any manner so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous Ar contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino M�cipaI Code, `Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of"the the Health & Safety Code, Seed ns 5 , 25533 nd 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked., Owner or authorized agent: r ", APPLICANT CERTIFICATION Date: 01/18/2017 1 certify that 1 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 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 01/18/2017 Professional s SIGN PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT •BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (4408) 777-3228 • FAX (408) 777-3333 • buildingP—cupertino.org �Zc>1-0086 PROJECT ADDRESS 10080 Wolfe Rd. 3 . ?�. p ! APN # 316-20-086 OWNERNAME I&G Direct Real Estate 27 LP PHONE 408-982-8404 E -MAH, martery@riverrockreg.com STREET ADDRESS 10050 Wolfe Rd Road CITY, STATE, ZIP Cupertino, CA 95014 FAX CONTACT NAME Corporate Sign Systems Joe DiChoso PHONE 408-292-1600 E-MAIL joe@corporatesigns.com STREET ADDRESS 2464 De La Cruz Blvd. CITY, STATE, ZIP Santa Clara, CA 95050 FAX 408-292-1673 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME Danny Moran LICENSE NUMBER 765078 LICENSE TYPE c45 BUS. LIC# 22804 COMPANYNAME Corporate Sign Systems E-MAIL joe@corporatesigns.com FAX 408.292.1673 sTREET ADDREss 2464 de la cruz blvd. CITY, STATE, ZIP santa clara, ca 95050 PHONE 408-292-1673 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK - refurbish 2 existing street signs, replace courtyard directory sign 01- 5ao USE OF ❑ SFD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial ILLUMINATED (Y / N) SIGN TYPE NO. OF (CODE) SIGNS SIGN AREA (SQ. FT.) VALUATION (s) 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 y In 1 121.7 s.f. 12,000 y m 1 27 s.f. 5,000 y In 1 13 s.f. _ 7,000 _ TOTAL VALUATION: 24k By my signature below, I certify to each of the following: I am the property o ent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I 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 construction. /�I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: �� L%�%(�1[.rlQd Date: 1/17/17 SUPPLEMENTAL INFORMATION REQUIRED Site Plan Elevations Sign Details - including UL listing(s) applicable Structural Calculations (if applicable) _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. OFFICE USE ONLY PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ EXPRESS ❑ STANDARD ❑ LARGE ❑ MAJOR ❑ BUILDING PLAN REVIEW ❑ PLANNING PLAN REVIEW ❑ OTHER: SignApp_2011.doc revised 03/31/11 corpor,',pte- CUPERTINO ui ding Department Rev --w _}' SEAN A _ _ , Date- 0111 if W 0 L F E S Q U A R E RiverRock Real Estate Group 10080 N. Wolfe Road Suite SW3-301A Cupertino, CA 95014 PERMIT SET Form + Function. 01/13/2017 DE EE -OP W DEPAa MN GDIVISON_CU3_�?tInO ARO-- V AM ri cched m«6qT4 CD `d°:.: . :. mems .ez a, s eo \ \CD Awec, wm z«w> G y J . « w n fyzxuinderseas 0 eID «r »mom u : amm\ , : w \y& - sunken eme CURES WO Building Department nems e!COD_ C v « » mSEAN =gin = m,«z w:real estate group PROJECT ee<= financial center 10050-10080 w« w: mama = DRAWING REVISION DATE 2 �\ C:)� 0 \\ \ \ V u on � m � LA < � ¢ ■ � e z\a3 & f?a : if �� \2 ° � ^ _ %:�,/^ \ \§ E »- :: . �. _ V : :<�\u��:�.�kd}\ , _ _ :,: :\,< < � ¢ ■ � lim LALA 0 U � N U I Pt ,T.,, IIA... o GI) o Y/ W�N W r ajO L C N - N J ,L 2 c N ¢ a U L u� JJJJJJJ�// I U C o N O O UIJI�� •� u N Y N F _- ,,, _ 4St •.. o JO �ooci�ai s r o0 0 7 u, _ o�ID i v _- __ :TNM 9 �� - V ui tiLLli �2_�ori aYa � � u � o u u s v N lim LALA 0 U � N U I Pt ,T.,, IIA... 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's" UJI ®. 0.67 'iu II g z u) G O C=z J ® fa V N T 6 U t a-, a N )J U 3 II V 4 O > CD � N ry'Y 'iivl d O u V 0 u - N O v o , O x m0 1z w rnp - ih 6'o IA V a u o n p ix, xr a LFY nr I c „Z'r" I. 's" UJI ®. 0.67 'iu II g z u) Q O C=z C5'Y ® fa V N �� �� 1 I N )J U 3 II V > CD � N ry'Y 'iivl d O u 0 ix, xr a LFY nr I c „Z'r" I. 's" UJI ®. 0.67 'iu II g z � Q z C=z C5'Y ® �� We V N �� �� 1 ax N MM Z< K ix, xr a LFY nr I c „Z'r" I. 's" O 1Ln m ply I UJI aLY 0.67 'iu II r � <x:r C � C5'Y vti V N O 1Ln m ply I N o II r � M C � C5'Y vti v ax N — o a3i �> r � II � ti vti v ax — ver, �\ oi/ CDO CL A" 0 V � � � O nil oil sh lilt a In � � STATE OF CALIFORNIA SIGN LIGHTING CEC-NRCC-LTS-01-E(Reviseci 08/16) UALIFUHNIA ENLHUY UUMM1661UN CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 1 of 5) Project Name; Wolfe Square Signage Date Prepared; 1/18/2017 A. General Information Project Address: 10080 Wolfe Rd. Suite 301 Location of Sign Outdoor Signs El Indoor Signs Phase of Sign Construction New Signs [D Sign Alterations Type of Lighting Control ❑ New Lighting Controls El Replaced Lighting Controls El Not Installing Lighting Controls This Certificate of Compliance includes the following cornponents (check all that apply): El Mandatory Measures (Lighting Controls) [D Maximum Allowed Lighting Power El Specific Lighting Sources 1. Mandatary 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 (e.g. a C-10 contractor may complete parts lo and lb on one compliance document and a C-45 contractor may complete parts 20 and 2b on a separate compliance document — the Responsible Designer shall submit the two compliance documents together for the same complete installation). I have responsibility for installing the sign lighting controls: 0 Yes, I have responsibility for the sign lighting controls, and will [E] No, I do not have responsibility for installing the sign lighting controls. complete parts la and lb of this compliance document Someone else will complete parts la and lb of this compliance document. la. Check Yes or No for all of the following statements: There are existing sign lighting controls that comply with the applicable provisions of §110.9 and §130.3 1 El Yes [E] No There are no existing sign lighting controls and I will be installing sign lighting controls that comply with the applicable 2 provisions of §110.9 and §130.3 El Yes [E] No There are existing sign lighting controls that do not comply with the applicable provisions of §110.9 and §130.3 and I will be 3 installing sign lighting controls that comply with the applicable provisions of §110.9 and §130.3 El Yes E] No CU1111EIRTINO Bufldhng Department CA Building Energy Efficiency Standards - 2016 Nonresld'enil'al`C ompli—a,n'c'e---,- August 2016 Reviewed By� \46 1Issa ',Janies DatE�1/18/17 STATE OF CALIFORNIA SIGN LIGHTING CEC-NRCC-LTS-01-E(Revised 08/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 2 of 5) ProjedWi: Wolfe Square Signage Wte Prep d: 1/18/2017 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: §13O.3(a)1. All indoor sign lighting is controlled with an automatic time -switch control or astronomical time- Y N NA 1 switch control. 0 0 G) §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. G 0 0 2 EXCEPTION to Section 3.30.3(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. 0 1 G) §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% during nighttime hours. Signs that Y N NA are illuminated at night and for more than 1 hour during daylight hours shall be considered ON both day and 0 0 0 3 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. 0 0 §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 0 0 G) 4 reducing the lighting power by a minimum of 30% 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%. 0 0 Field Inspector Notes: F CU1111EIRTINO Bufldhng Department CA Building Energy Efficiency Standards - 2016 Nonresidential CoTIP li a rmeI IIssa ',Jan�ies August 2016 Rewewe( 3y: DatE�P N/18/1 7 STATE OF CALIFORNIA SIGN LIGHTING RM CEC-NRCC-LTS-01-E(Revised 08/16) CALIFORNIA ENERGY COMM1661UN CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 3 of 5) Project Narne: Wolfe Square Signage Date P,epwed: 1/18/2017 2. Mandatory Sign Lighting Measures I have responsibility for installing the sign lighting 0 Yes, I have responsibility for the sign lighting, and will complete El No, I do not have responsibility for installing the sign lighting. Someone parts 2a and 2b of this compliance document else will cornplete parts 2a and 2b of this compliance document. — 2a. 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 2b 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 OPTIONAL— Field Symbol or Energy Verified Design Complies Inspector Code Description of the Sign Label (see Allotted Watts Watts Y/N Check that instructions Sign Complies below) (D v] Z7, 0 E ?: E< r,4 ro =3 0 H V, W i7n W X = 11 11 1Z LLJ .2 0 E 0 U Primary Monument 12 1460.4 182.55 Yes El Secondary Monument El 27 1 12 324 40.5 Yes El Courtyard Monument El 13.33 1 12 159.96 19.99 Yes El 1:1 0 El El 0 1:1 El 0 El El 0 El El 0 El El 0 El El 0 ❑ 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 2016 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 C 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 tirnes 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. J This page doubles as a field inspection checklist. Field Inspector Notes: M Cul"I.EERTINO Buildiing Department CA Building Energy Efficiency Standards - 2016 Nonre's�i8evn'tiailv�"oi"n'pli'�a�"n'cegy�"- �'Ilv H LJMIV� August 2016 Rev�ewed l3y� \46 Ilssa ',Jan"ies DatE„P N/18/17 STATE OF CALIFORNIA SIGN LIGHTING ra CEC-NRCC-L I S-01-E(Revised 08/16) CALIFORNIA ENERGY COMMISSION wMW' CERTIFICATE OF COMPLIANCE NRCC-LTS-0 -E Sign Lighting (Page 4 of 5) Pwpd Nm : Wolfe Square Signage Me N�p&. 1/18/2017 2b. 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 ENERGY Specific light source used for Symbol VERIFIED compliance Field Inspector or Description label Shall include only lighting Check that Sign Code (see technologies listed below Complies instructions (List all that apply) below) 3 monument signs with internal push-thru ilium. ❑ (7) LED ❑ ❑ El El ❑ 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 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 2016 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 C (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 he 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% or greater. 2 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%, 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% when D 4 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% tubing load. Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 68% when 5 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% 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 ernitting diodes (LEDs) with a power supply having an efficiency of 80% 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 no medium screw base sockets (E24/E26). E This page doubles as a field inspection ched Field Inspector Notes: Ego -hII VIII 71(1T . III 'IP CA Building Energy Efficiency Standards - 2016 Nonresidential C I' August 2016 Rewewff.�Y'Tohssa ',Jan�ies D a tE„P N/1 ti/1 STATE OF CALIFORNIA SIGN LIGHTING RR CEC-NRCC-LTS-01-E(Revised 08/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 5 of 5) Project Name: 2017 Date Prepared: 1 18 Wolfe Square Signage / / DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. ; Documentation Author Name: Joe DiChoso Documentation Author Signature: Company: Corporate Sign Systems signature Date: 1/18/17 Address: 2464 De La Cruz Blvd. CEA Certification Identification (if applicable): City/State/Zip: Santa Clara, CA 95050 Phone: 408-292-1600 x308 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 systern 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 buildin ner,�at occupancy. Responsible Designer Name: Joe DiChoso Responsible Designer Signature: q Company: Corporate Sign Systems Date Signed: 1/18/17 Address: 2464 De La Cruz Blvd License: 765078(C45) City/State/Zip: Santa Clara, CA 95050 Phone: 408-292-1600 X308 CU1111EIRTINO Bufldhng Department CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance ' �August 2016t� 0Ili IS")f1 IL DatE< P l/18/17