B-2017-0211CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: � PERMIT NO: B-2017-0211
20080 STEVENS CREEK BLVD STE 106 CUPERTINO, CA 95014 (369 03 009) MCHALE SIGN CO INC
REDDING, CA 960p2
OWNER'S NAME: PROMETHEUS REAL ESTATE GRP DATE ISSUED: 02/02/2017
OWNER'S PHONE: 408-873-0121 I I PHONE NO: (530) 223-2030
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-45 Lic. #Z03137
Contractor MCHALE SIGN CO INC Date 03/31/2018
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
hereby affirm under penalty of perjury one of the following two declarations:
r. I have and will maintain a certificate of consent to self -insure for Worker's
X BLDG _ ELECT —PLUMB
_ MECH _ R"IDENTLAL X COMMERCIAL
i
JOB DESCRIPTION:
(1) CHANNEL LETTERED SIGN, LED, ILLUMINATED (1); (N)
MONUMENT SIGN (1); (N) BLADE SIGN (1),
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
2. 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: i Valuation: $4000.00
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
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 regulation rthe Cupertino Municipal Code, Section 9.18.
s
Signature
Date 02/02/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. 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)
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:
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.
2. 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.
s. 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 Compensation laws of California. If, 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 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 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.
Signature Date 02/02/2017
03T009 umber: Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS `OF PERMIT ISSUANCE OR
180 DAYS !FROM LAST CALLED INSPECTION.
Issued by: Kim Dunbar
Date: 02/02/2017
All roofs shall be %aspected prior to any roofing material being installed. If a roof is
installed without fust obtaining an inspection, I agree to remove all new materials for
inspection.
i
Signature of Applicant:
Date: 02/02/2017
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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 Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) 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 & Safety Code,,81ctions 25505, 25533, and 25534.
Owner or authorized agent / f
Date: 02/02/2017
GAGENCY
CO
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
Professional
SIGN PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingCrx.cupertino.org
1
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❑ OWNER ❑ OwNER-BUIIAER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ P,RCHErECT ❑ ENGINEER ❑ DEVELOPER XTENANT
CONTRACTOR NAME Me_ WALL <;?e( l�
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ARCHITECT/ENGMEERNAME .
LICENSE NUMBER
BUS. LIC#
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
USE OF ❑ SFD Or Duplex ❑ Multi -Family
ILLUMINATED
SIGN TYPE
NO. OF
SIGN AREA
VALUATION
STRUCTURE: Commercial
(Y / N)
(CODE)
SIGNS
(SQ. FT.)
(S)
SIGN TYPE CODES:
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o cm
p�
15
B - BANNER SIGN M - MONUMENT (GROUND) SIGN
BL - BLADE SIGN P - PROJECTING SIGN
/ e
D - DEVELOPMENT ID SIGN SP - SPECIAL EVENT BANNER
DI - DIRECTIONAL SIGN T - TEMPORARY
r /
f3
_
E - ELECTRONIC W - WALL SIGN
READERBOARD WI - WINDOW SIGN
RECEIVED BY:
TOTAL DATION:
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have ded is corn 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 1 ' g c do . I p thorize reprQszatatives of Cupertino to enter the above -identified prope for inspection purposes.
Signature of Applicant/Agent: / Date: 07
SUPPLEMENTAL INFORMATION REQUIRED
OFFICE USE ONLY
PLAN CHECK TYPE
ROUTING SLIP
_ Site Plan
❑ 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
SignApp_2011.doc revised 03/31/11
STATE OF,CALIFORNIA
SIGN LIGHTING
CEC-NRCC-LTS-01-E(Revised 08116) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 1 of 5)
Project Name:Date Prepared:
l tE f
A. General Information
NOTES:
Project Address:
C
Location of Sign
99 Outdoor Signs ❑ Indoor Signs
Phase of Sign Construction
VTNew Signs ❑ Sign Alterations
Type of Lighting Control
❑ New Lighting Controls ❑ Replaced Lighting Controls Not Installing Lighting Controls
phis Certificate of Compliance includes the folio mg components (check all that apply):
Mandatory Measures (Lighting Controls) e1N Maximum Allowed Lighting Power A Specific Lighting Sources
contractor may complete parts 2a and 2b on a separate compliance document - the Responsible Designer shall submit the two
compliance documents together for the same complete installation).
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 (e.g. a C-10 contractor may complete parts 1a and 1b on one compliance document and a C-45
contractor may complete parts 2a 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:
❑ Yes, I have responsibility for the sign lighting controls, and will No, I do not have responsibility for installing the sign lighting controls.
complete parts 1a and Sb of this compliance document omeone else will complete parts 1a and 1b of this compliance document.
1a. 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
❑ Yes 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
❑ Yes No
There are existing sign lighting controls that do not comp y 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
❑ Yes r No
CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance August 1U1b
I
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)
Project Name; ,r.-� (" � Date Prepared:
i
lb. 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
JA
switch control.
§130.3(a)2A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time-
Y
N
LIA
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% 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
p
py
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
OD
§130.3(a)3. Demand Responsive Electronic Message Center Control. An Electronic Message Center (EMC)
Y
N
N/A
having anew 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% 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
ordinance, or regulation to be reduced by 30%.
0
Field Inspector Notes:
CA Building Energy Efficiency Standards 7 2016 Nonresidential Compliance August 2016
STATE OF CALIFORNIA
SIGN LIGHTING
CEC-NRCC-LTS-01-E(Revised 08116) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF.COMPLIANCE
NRCC-LTS-01-E
Sign Lighting
, (Page 3 of S)
Project Name: C
Date Prepared:
2a. Maximum Allowed Lighting Power Method of Compliance
t
2. Mandatory Sign Lighting Measures
I have responsibility for installing the sign lighting
❑ Yes, I have responsibility for the sign lighting, and will complete ❑ No, I do not have responsibility
for installing the sign lighting. Someone
parts 2a and 2b of this compliance document else will complete 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
Description of the Sign
Energy Verified
Label (see
Allotted Watts
Design
Complies
Inspector
Code
instructions
Watts
Y/N
Check that
below)
Sign Complies
$ = a) a d'
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a"+
m _
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in
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@ C W N M
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WA
❑
0
❑
s
❑
0
❑
❑
0
❑
❑
0
❑
❑
0
❑
❑
0
❑
❑
0
❑
❑
0
❑
❑
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 61 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 EJ 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.
J
This page doubles as a field inspection checklist.
Field Inspector Notes:
1
CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance August 2016
STATE OF CALIFORNIA
SIGN LIGHTING
CEC-NRCC-LTS-0 1 -E(Revised 08/16) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 4 of 5)
Project Name:;--. Date Prepared:
Pn '1. 1 r 1 AV_I e --Q tj ?--I, Ak I est 1
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
1 compliance
Field Inspector
or
Description
label
Sall include only lighting
Check that Sign
Code
(see
technologies listed below
Complies
instructions
i (List all that apply)
below)
j
❑
❑
❑
❑
❑
❑
❑
❑
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
(UL) or other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards Institute in accordance with
C
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 fallowing 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
3
served by a ballast that has a minimum efficiency of 80%. r
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.
Fluorescent lighting systems meeting one of the following requirements: A.) Use only lamps with a minimum color rendering index
6
(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% 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 - 2016 Nonresidential Compliance August 2016
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 5 of 5)
Project Name: Cl. _ _ , , _ I Date Prepared: n
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: /j `
Documentation Atjt r si a e:
Company:
i t ---
Signature D
Address:O
l�iY
CEA Certification Identification (if applicable):
c
City/State/Zip: n
Phone: /
6 — �°—t Es�9 *�
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 responsibilifiy 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 provid t the building ow er at occupancy.
Responsible Designer Name:
Responsible Designer
' nat
Company:
Date signed:
-
v y�
Address: Pr ^^
License:
City/State/Zip:
a
Phone:
n—
CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance August 2016