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B-2017-0449
CITY OF CUPERTINO BUILDING PERMIT BUH,DINGADDRESS: CONTRACTOR: PERMIT NO: B-2017-0449 19459 STEVENS CREEK BLVD STE 120 CUPERTINO, CA 95014 (316 20 112) YESCO SIGNS LLC SALT LAKE CITY, UT 84109 OWNER'S NAME: MAIN STREET CUPERTINO DATE ISSUED: 03/20/2017 OWNER'S PHONE: 408-777-3081 PHONE NO: (801) 464-4600 LICENSED CONTRACTOR'S DECLARATION TION BUILDING PERMIT INFO: License Class CC5 Lic. #980698 Contractor YESCO SIGNS LLC Date 01/31/2019 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: MERIWEST - INSTALL ONE (N) ILLUMINATED WALL SIGN I hereby affirm under penalty of perjury one of the following two declarations: 1. 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. z. ' 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: $9300.00 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 20 112 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 pplica t and will comply with all non-pointsource reg lat' serMunicipal Code, Section 9.18. 180 DAYS FROM Lund9tstands ��ION*Signatur . / Date 2 1 Issued : MELISSA OWNER-BUILDER DECLARATION Date: 03 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: 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 (Scc.7044, Business & Professions Code) z. 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: 03/20/2017 I hereby affirm under penalty of perjury one of the following three declarations:ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. 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 z. 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 Luse equipment or devices which emit hazardous air 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 Super '6o Munici al de, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code,S o 05, , and 25534. <. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: Gam/ APPLICANT CERTIFICATION Date: 03/20/2017 1 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 CONSTRUC LENDINGAGENCY I hereby affirm that there is a con truction 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. I understand my plans shall be used as public records. Licensed Signature Date 03/20/2017 9 Professional CUPERTINO SIGN PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingft—cupertino.ora -2UA �y PROJECT ADDRESS 19459 STEVENS CREEK BLVD, STE 120 7APN# 316-20-112 OWNERNAME MAIN STREET CUPERTINO RETAIL- PROPERTY LLC PxoNE408-777-3081 E-MAILmrohde sh co.com STREET ADDRESS 10123 N. WOLFE RD, STE 1095 , CITYSTATE, ZIP CUPERTINO, CA 95019 FAg 408-725-0370 CONTACT NAME NATE BUCHAKLIAN PHONE 1 916-993-7105 E-MAIL nbuchaklianayesco.com STREET ADDRESS 4119 SO. MARKET CT., STE 10 CITY, STATE, ZIP SACRAMENTO CA 95834 FAX 916-419-8108 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT 19 CONTRACTOR IN CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME YESCO SIGNS, LLC LICENSE NUMBER 980698 LICENSE TYPE C-45 BUS. LIC # 21829 COMPANY NAME YESCO SIGNS LLC E-MAIL nbuchaklian@yesco.com FAX 916-419-8108 STREET ADDRESS 4119 SOUTH MARKET CT, STE 10 CITY, STATE, ZIP SACRAMENTO, CA 95834 PHONE 916-993-7105 ARCHITECT/ENGINEER NAME N/A LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK INSTALL ONE 1 NEW LED ILLUMINATED WALL SIGN READING "MERIWEST CREDIT UNION" USE OF ❑ SFD or Duplex ❑ Multi -Family ILLUMINATED SIGN TYPE NO.OF SIGN AREA VALUATION STRUCTURE: ❑ Commercial (Y/N) (CODE) SIGNS (SQ. FT.) ($) SIGN TYPE CODES: Y W 1 33.5 $9,300.00 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 T �orZ OTION: ItIffnzed ag>L46a the property owner's behalf. I have read this By my signature below, I certify to each of the following: I am the property owneroLA application and the information I have vid c ct. I have read the Descrip n of Work it is accurate. I agree to comply with all applicable local ordinances and state laws relating to Il n tion. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: 3/16/17 SUPPLEMEN AL INFORMATION REQUIRED _ Site Plan 4/ Z // Elevations OFFICE USE ONLY PLAN CHECK TYPE ROUTING SLIP OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW Sign Details - including UL listing(S) applicable ^ Structural Calculations (if applicable) C\> � EXPRESS ❑ STANDARD El PLANNING PLAN REVIEW ❑ 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 19459 Stevens Creek Blvd, Suite 120, Cupertino, CA 95014 CE -IND Building Department Re;i=-k=ed—=Y- Me —a 4119 S. Market Court Suite F/ 10 Sacramento, CA 95834 19161419-8101 CA. CONTRACTOR LICENSE NO. 980698 Notice to the Customer © 2017 by MEN All rights reserved TORK 12112116 R1 TORK 02108117 R1TORK 02108117 e Nolen 03116117 APPROVAL CUSTOMER RATE LANOLRRR OATS SI- RATE ESTIMATING RATE SURVEY RATE SHEET INDEX DESIGN NUMBER CV -Cover Page 571544 prod SP - Site Plan ARCHIVE NUMBER 1.D - Design I Details 2.0 - Elevations SHEET 3.0 - Photo Sims CV AERIAL PHOTO SIGN PROJECT ELECT. LOAD SOFT (1� DNE (1) NEW SET OF ILLUMINATED PAN CHANNEL LETTERSILDGD 3.0 arms 33.5 C Illtag TOTAL I 3-D a,q_e, 4y_ Me VICINITY MAP GENERAL NOTES _, --_ ::_ UIVii — -- ----- ,# __--_y_ __ ,-—CU _ A 1- SPECIAL INSTRUCTIONS This sign u intended to be installed in accordance with the requirements of U` Article 600 of the National Electrical Code and/or other applicable local codes. This includes proper grounding and bonding of the sign. 4119 S. Market Court Suite F/ 10 Sacramento, CA 95834 19161419-8101 CA. CONTRACTOR LICENSE NO. 980696 Notice to the Customer © 2017 byO YESC e All ylt SUSr[de In u 19459 STEVENS CREEK BLVD. ADDRESS'. Ste. 120 CUPERTINO, CA 95014 CIN: TONT HUFF ACCCUNT EXECUTIVE: DESIGNER DATE R1TORK 02108177 e Nolen 03116177 I SURVEY DATE DESIGN NUMEER 571544 prod ARCHIVE NUMBER SHEET SP RETAIL -In-Line Tenant RETAIL - Pad Building Tenant RETAIL - Shop 1, 2, 5 &band Major Retail OFFICE w en o M a SHOP' .e `-. rt Kn V-51 SIX veal - $. � .-k .—;—H.�:. VHDL ,. C=1r �S. - dv.re �€ t_aa k tc. 7f eM,2 1 ` = ,..... ... .. AFFSE 1 ..... "; _ OFFICE MAJOR rM IM, a S} ih �sHa AERIAL PHOTO SIGN PROJECT ELECT. LOAD SOFT (1� DNE (1) NEW SET OF ILLUMINATED PAN CHANNEL LETTERSILDGD 3.0 arms 33.5 C Illtag TOTAL I 3-D a,q_e, 4y_ Me VICINITY MAP GENERAL NOTES _, --_ ::_ UIVii — -- ----- ,# __--_y_ __ ,-—CU _ A 1- SPECIAL INSTRUCTIONS This sign u intended to be installed in accordance with the requirements of U` Article 600 of the National Electrical Code and/or other applicable local codes. This includes proper grounding and bonding of the sign. 4119 S. Market Court Suite F/ 10 Sacramento, CA 95834 19161419-8101 CA. CONTRACTOR LICENSE NO. 980696 Notice to the Customer © 2017 byO YESC e All ylt SUSr[de In u 19459 STEVENS CREEK BLVD. ADDRESS'. Ste. 120 CUPERTINO, CA 95014 CIN: TONT HUFF ACCCUNT EXECUTIVE: DESIGNER DATE R1TORK 02108177 e Nolen 03116177 I SURVEY DATE DESIGN NUMEER 571544 prod ARCHIVE NUMBER SHEET SP 11' 2" o��.. E O�\\ QC - A _ _ �oo�_ - 17 - - ____ N 10 ___ N � NEW SINGLE FACE ILLUMINATED CHANNEL LETTERSILOGO Scale: 314" = V -O" QUANTITY: One (1) set, Manufacture and Install 33.5 Sq. Ft. Ir -11 C-UP—R-111BA110 OThis d to be installed m accordance with the requirements of ` Artic e o t e at anal Electrical Code and/or other a �llcahle local code ahi ROesr©hkru's� asid;uin;-DtR§i�. SIDE VIEW GradlE� Rend 5 Icor Pm 1aA Ell O 1coY P �L z87 I r - v Ito Dnk�rou tdl "'. .R . D a .e U N 10 N , PLts to "I �_ LETTERMLDGD'', TYPE ALUMINUM, 3" DEEP TRIM CAP '', 1" BLUE 3" RETURN COLOR PRE-CDATALUMET CHEVRON ALLPENETRATIONS OF BUILDIHG STRUCTURE BLUE FACE (WHITE ACRYLIC FOR SIGNAGE INSTALLATION MUST BE NEATLY SEALED FACE COLOR PRINTED VINYL WITH CLEAR P U.V. LAMINATE AND WATERTIGHT. LIGHTING MINI WHITE LED'S t 't GENERAL NOTES: All work shall comply with 2016 Edition of CCR Title 24 which adopts and amends the 2012 ED to 2016 California 1 Building Code, 2013 UMC to 2016 California Mechanical Code, 2013 UPC to 2013 Carmmia Ple, iog code, 2008 — NEC to 2013 California Electrical Code, 2013 ILE to 2013 California Fire Code and the 2013 Title 24 Energy Efficiency Standards. CBC 1.8.3, LMMC 14.10.01D. This zi... is intended to be Installed In accordanu wlth Ne UL re9niremente of Article too R the National Electrical Code andor other apnllcable local ed - Th, Includes prover or" Nino and bonding A Me sign. SIDE VIEW GradlE� Rend 5 Icor Pm 1aA Ell O 1coY P �L z87 I r - v Ito Dnk�rou tdl "'. .R . D a .e U N 10 N , PLts to "I 4119 S. Market Court Suite F/ 10 Sacramento, CA 95834 19181419-8101 CA. CONTRACTOR LICENSE NO. 988698 Notice to the Customer © 2817 by YESCO All rights reserved 19459 STEVENS CREEK BLVD. ADDRESS'. St¢.120 CUPERTINO, CA 95014 CIN: TOM HUFF ACCCUNT EXECUTIVE: DESIGNER DATE TORK 12112116 R1 TORK 02108117 R1 TORK 02108117 B Nolen 03116117 APPROVAL CUSTDMER RATE LANDLRRR DATE SALES DATE ESTIMATING DATE SURVEY DATE DESIGN NUMBER 571544 prod ARCHIVE NUMBER SHEET 1.0 0 ACRYLIC FACE 3" ALLPENETRATIONS OF BUILDIHG STRUCTURE 02 LETTER RETURN FOR SIGNAGE INSTALLATION MUST BE NEATLY SEALED O LED P AND WATERTIGHT. 04 - HOTUSED- t 't 05 - [JOTUSED- _ © LOW VOLTAGE SECONDARIES 1 07 LETTER BACK — 08 TRIM CAP DRAIN HOLES, TV\'0 (2) LIN. PER 1 LETTER/LOGO MM. TOUR(4141ox1" SCREWS Im INTO Y," NYLON AND OR EQUIVALENT, PER LETTER o r 11 CONDUIT a - 12 PRIMARY ELECTRICAL SOURCE T b t3 DISCONNECT SWITCH e 14 TRANSFORMER BOX t5 POWER SOURCE t1fi GROUND NITRE U� Q WALLA/BRICK VENEER rlTILLUMINATED PAN CHANNEL LETTERS 4119 S. Market Court Suite F/ 10 Sacramento, CA 95834 19181419-8101 CA. CONTRACTOR LICENSE NO. 988698 Notice to the Customer © 2817 by YESCO All rights reserved 19459 STEVENS CREEK BLVD. ADDRESS'. St¢.120 CUPERTINO, CA 95014 CIN: TOM HUFF ACCCUNT EXECUTIVE: DESIGNER DATE TORK 12112116 R1 TORK 02108117 R1 TORK 02108117 B Nolen 03116117 APPROVAL CUSTDMER RATE LANDLRRR DATE SALES DATE ESTIMATING DATE SURVEY DATE DESIGN NUMBER 571544 prod ARCHIVE NUMBER SHEET 1.0 om SACRAMENTO BRANCH v. CP�vSELLS F/ 10 34o CA 95' NETRACTOR LICENSE NO. , \\ - \ \ \\\ \\ ,\ \� CISTDIIEl DATE i" L—LDID DUE —' 's SALES DATE ESTIMATINC DATE \a�g gy STATE OF CALIFORNIA SIGN LIGHTING W) CEC-NRCC-LTS-0 1 -E(Revised 08/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 1 of 5) Project Name: MERIWEST CREDIT UNION Date Prepared: 3/15/17 A. General Information Project Address: 19459 STEVENS CREEK BLVD, STE 120; CUPERTINO, CA 95414 Location of Sign ❑✓ Outdoor Signs ❑ Indoor Signs Phase of Sign Construction 0 New Signs ❑ Sign Alterations Type of Lighting Control 0 New Lighting Controls ❑ Replaced Lighting Controls ❑ Not Installing Lighting Controls This Certificate of Compliance includes the following components (check all that apply): 0 Mandatory Measures (Lighting Controls) ❑ Maximum Allowed Lighting Power 0 Specific Lighting Sources 1. Mandatory Sign Lighting Controls NO TES: 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 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 0 No, I do not have responsibility for installing the sign lighting controls. complete parts la and 1b of this compliance document Someone else will complete parts la and lb of this compliance document. 1a. Check Yes or No for all of the following statements: 1 There are existing sign lighting controls that comply with the applicable provisions of §110.9 and §130.3 ❑ Yes 0 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 0 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 ❑ Yes ❑Q No CU1111EIRTINO Buildling Ipartii n't sI .. . CA Building Energy Efficiency Standards - 2016 Non. uw.fir JJWM_7 [T p7ll "T August 2016 Rev yew d u y:Il yMlhssa ',James DatE�P 03/� )OM i 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 2 of 5) Project Name: MERIWEST CREDIT UNION oatePrepared:3/15/17 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. ® ® E) §130.3(a)2A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time- Y N NA 2 switch control, or an astronomical time -switch control. E) 0 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. 0 E) §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 3 are illuminated at night and for more than 1 hour during daylight hours shall be considered ON both day and ® 0 0 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 4 reducing the lighting power by a minimum of 30% when receiving a demand response signal. 0 0 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%. Field Inspector Notes: CU1111EIRTINO Buildling tr 1p r°time m CA Building Energy Efficiency Standards - 2016 Non '1iC i"ant" iII August 2016 Reviewed l3yJ\4ehssa ',James i)at:� 03/�:)O i STATE OF CALIFORNIA SIGN LIGHTING CEG-NRCC-LTS-01-E(Revised 08116) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 3 of 5) Project Name: MERIWEST CREDIT UNION Date prepared: 3/15/17 2. Mandatory Sign Lighting Measures I have responsibility for installing the sign lighting E 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 F G H l 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) }N .--. D N Y J $ � d; Mn U7 VI 7 LL T N aj tb K QL1 � C a, m -0 x Q �N O C w N ate+ X II 11 O U ❑ 0 ❑ ❑ 0 ❑ ❑ 0 ❑ ❑ 0 ❑ ❑ 0 ❑ ❑ 0 ❑ ❑ 0 ❑ ❑ o ❑ ❑ 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 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 T 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 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 I This page doubles as a field inspection checklist. Field Inspector Nates: 12, Buildling Departuren't sin-, I f"Lorn an e:r kFrl CA Building Energy Efficiency Standards - 2016 Nonr °'° August 2016 Rev yew d u y:Il yMlhssa ',James DaN03/�:)O/°i 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 4 of 5) Pruled Name: MERIWEST CREDIT UNION Date Prepared` 3115117 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) 1 WALL SIGN ❑ 7 ❑ ❑ ❑ ❑ ❑ 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 be an ongoing annual inspection program carried out by a Type A Inspection body in accordance with 150/IEC 1.7020. 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 082.6-2005. 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%. Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage when tested according to ANSI 082.6-2005. Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 75% 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 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 Y.Qt a medium screw base sockets (E24/E26). E This page doubles as a field inspection ch Field Inspector Notes: 12o CA Building Building Energy Efficiency Standards - 2016 Nonresidential Complianc August 2016 Reviewed l3y� \ssa ',James u: a tEa P 03/�:)O I STATE OF CALIFORNIA SIGN LIGHTING CEG-NRCC-LTS-01-E Revised 08/163 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 5 of 5) Project Name: MERIWEST CREDIT UNION gate Prepared: 3/15/17 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: NATE BUCHAKLIAN Documentation Author Signature: x J�[ Company: YESCO SIGNS, LLC signature Date: 3/15/17 Address: 4119 SO. MARKET CT., STE 10 CEA Certification Identification (if applicable): City/State zip: SACRAMENTO, CA 95834 Phone. 916-993-7105 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: I. 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. Responsible Designer Name: NATE BUCHAKLIAN Responsible Designer Signature: Company: YESCO SIGNS, LEC Date Signed: 3/15/17 Address: 4119 SO. MARKET CT., STE 10 License: 980698 City/State/Zip: SACRAMENTO, CA 95834 Phone: 916-993-7105 CU1111EIRTINO Bulldling Department CA Building Energy Efficiency Standards - 2016 NonrQsi t I!�. t -�. .�._.. 6q� ICTEN"UFrr, 7II .. August 2016 u: a tE< P 03/�:)O i