12060169CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19501 STEVENS CREEK BLVD STE 101
CONTRACTOR: ALLEN SIGNS INC
PERMIT NO: 12060169
OWNER'S NAME: LEUNG KELVIN L ET AL
1982 STONE AVE
DATE ISSUED: 0628/2012
OWNER'S PHONE: 6506053150
SAN JOSE, CA 95125
PHONE; NO: (308)280-6500
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL El CO\IhI F:RCLy I.
License Class Lic. a 9_3
STE 101 -CAFE LATTEA - INSTALLATION OF TWO WALL
�
SIGNS WITH ELECTRICAL
ContractorDale j2
1 hereby affirm that em iccnscd under the provisions of hapler 9
(commencing with Se i 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:
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
Sq. Ft Floor Area:
Valuation: $2000
performance of the work for which this permit is issued.
1 have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Cade, for the performance of the work for which this
APN Number: 316491 10.101
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
1 certify that I have read this application and slate that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct_ I agree to comply,ith all city and county ordinances and state laws relating
WITHIN 180 DAYS OF PERMIT 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
180 DAYS FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
11 t4�
Issued by: ����i Date: ✓O -/�
granting of this permit. Additionally, the applicant understands and will comply
with all non-poinl source egulauons per the Cupertino Municipal Code, Section
9.18.
_ �s
RF: ROOF'S:
Signature �� Date `�
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.
11 OW4SIBUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Lew for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BEFI'F.R
1, 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)
1, as owner of the property, am exclusively contracting with licensed contractors to
ILI7.ARDOUS 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 & Safely Code, Sections 25505, 25533, and 25533. 1 will
I hereby affirm under penally of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safely Code. Section 25532(x) should 1 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 Area Air Quality Management District 1
performance of the work for which this permit is issued,
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the llealth & Safely Code, Sectio s 5 , 2553 and 25534.
Section 3700 of dte Labor Code, 1'or the performance of the work for which this
— Z
Owner or authorized agent: Dale:
permit is issued.
1 certil') that in the performance of the work for which this permit is issued, I shall
\
not emplo) any person in any mauler so as to become subject to the Worker's
Compensation Imus of Calilbmia. If, after making this certificate of exemption. I
CONSTRUCTION LENDING AGF.NCI'
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 complywith 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 cenify that 1 have read this application and slate 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 nun -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Dale
CUPERTINO
SIGN PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildinGacuoertino-ora
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STREET ADDRESS
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❑ OWNER 13 OWNER -BUILDER 13}� OWNERAGFNT /\CONTRACTOR ❑CONTRACORAGENT ❑ ARCHITECT ❑ ENGT.NEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE
LICENSE TYPE
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COMPANY NAME
E-MAIL tl
FAX
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STREETADDRESS
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ARCHITECTJENGINEER NAME
LICENSE NUMBER
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COMPANY NAME
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STREET ADDRESS
CITY, STATE, ZIP
PHONE
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USE OF ❑ SFD or Duplex ❑ Multi -Family
ILLUMJNATED
SIGNTYPE
NO, OF
SIGN AREA
VALUATION
STRUCTURE: Commercial
(Y/N)
(CODE)
SIGNS
(SQ.M
(S)
SIGN TYPE CODES:�v-
B - BANNER SIGN M - MONUMENT (GROUND) SIGN
BL - BLADE SIGN P - PROJEC[TNGSIGN
D - DEVELOPMENT In SIGN SP - SPECIAL EVEN BANNER
DI - DIRECTIONAL SIGN T -TEMPORARY
E - ELECTRONIC W - WALL SIGN
READERBOARD WI - WINDOW SIGN
TOTAL VALUATION:
By my signature below, I certify to each of the Following: I am the property owner or authorized agent to act an 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 -,,e, ly, it is accurate. I agree to comply '.pith all applicable local
ordinances and state laws rearing to building cars w on. I authorize mpresenmrives of Cupertino to enter the above-idep[i red p per[y for inspection purposes.
Signature of Applicant/Agenc: Date: 2
SUPPLEMENTAL INF TION REQUIRED
/
T/ $i[e Plan
Elevations
❑ exnteSS � �- �..
BQ60LNCPuvItevlew.r '„�.,_
Sign Details -including UL listing(s) applicableGLNN
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Calculations (if applicable)o
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ofPlannin A \oval Letter or Meeting with Plannin
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❑ MAsoR �.. - `� $''" "`
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submittal of Building Permit application.
SignApp_2011.doc revised 03/16/11
k
Certificate of Com liance. Si n.Li htin)
(Page 1 of 4)
SLTGIC
Project Name: ' 't -' ""
Cafe Lattea• - -
Date: 6-2
lf�(
Project Address:
JUN
28 2012
105501 Stevens�Creek Blvd,:#101, Cupertino CA
�'%�`:'.:`;
Signature
Location of Sign §l 0utdoor Signs ❑ Indoor Signs
BY:
Phone
408-280.6500
Phase of Sign Construction. ® New Signs ❑ Sign Alterations
—
1982 Slone Ave
Rciyfgmrl By-
Type of Li htin Control ]i0 New Lighting Controls ❑ Replaced Lighting Controls
❑ Not InstallingLight,,
ControTs
This Certificate of Compliance, includes the following components (check all that apply)
License number (may be co tractor's lic #)
Date Signed:
❑ Mandatory Mcasures,(Lighting'Commis), -❑ Maximum Allowed Lighting Power
M Specific Lighting Sources
1. Certificate of COmpliance'Declaration Statement phis maybe a C I9, C45 or other eligible person)
X 1 certify under penalty of perjury; under the laws of the State of California, the information provided on this form is true and
correct.
xl I am eligible under Division Yof the California Business and Professions Code to accept responsibility for the lighting design.
x: This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with
Title 24, Parts 1 and 6 of the California Code of Regulations.
® The designfeatures represented 'ficate.of Com li��gqcSi�q� �cg� tt�flflyt�yyyyth the information provided to document
to the
this design on the other applicab a forms, workshebl51��e6i51+dt#��ds and specifications submitted
enforcement agency for approva fit ilding permit a*iWmWDeparlmwt
Name: Kimberly Lin
�'%�`:'.:`;
Signature
Company:
Allen Signs, Inc
• I certify that the requirements'detailed on this Certificate of Compliance have been met.
Phone
408-280.6500
Address:License
number (may be contractor's lic #)
1982 Slone Ave
Rciyfgmrl By-
C-45 834580
City/Blatt/Zip:
San Jose, CA 95125_.
.Date
2 Z
2. Installation Certificate to be signed by responsible person atter installation)
Permit numbernnl•,.. ..
. Chinked by/Dine,. —. ..
(Enforcement A enc Uw �i_-.�
Enfo.nurnt A n Use
.Installation Declaration statement
1 certify under penalty;of perjury, under the.laws of.the State of California, the information provided on this form is true and
correct.
X I am eligible under Division3 of the'Business-andProfessions Code to accept responsibility for construction, or an authorized
representative of the person responsible for construction.
X i certify that the installed features,' Materials, -components, or manufactured devices identified on this certificate conforms to all
applicable codes and regulations; and the installation inconsistent with the plans and specifications approved by the
r
enforcement agency.
• I certify that the requirements'detailed on this Certificate of Compliance have been met.
X I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building
permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. 1 understand
that a signed copy of taxis Installation Certificate is required to be included with the d n ' t! 'Id ovide e ,
FA
building owner at occupancy. �_ Vf/
Company Name:
Allen Signs, Inc
Responsible Person's Name:
Response e P o 's Si tore:
License number (may be co tractor's lic #)
Date Signed:
Position With Comp ny:
834580 -
_
Project) anager
2008 Nonresidential Compliance Forms October 2010
Certificate of Compliance (Sign Lighting) (Page 2 of 4 SLTG-1 C
Project Name:
Cafe Lattea
Dara 6-27-12
3. Mandatory Sign Li htin 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.
1. The Afandatory Measures (sign lighting controls) are required far compliance with the .sign lighting Standards. If the person
responsible for installing the sign lighting power is not also responsihle 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 firs which they are responsible;
allernalively, the person with chief responsibility for construction .shall prepare and sign the Certificate of Compliance
Declaration Statement or the entire construction.
3a. Statements of Responsibility: Any person signing the Certificate of Compliance Declaration Slatement on page I of
4 on this SLTG-I C shall complete Pan 3a. Check Yes or No for all of the following statements:
19
I have responsibility for installing the sign lighting controls
I
❑ Yes, complete parts 3a and 3b of this form ® No, complete part 3a of this form
N
There arc no existing sign lighting controls and 1 will be installing compliant sign lighting controls
2
❑ Yes ® No
®
There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls
3
❑ Yes W No
Exception to §133(a)2. Outdoor signs in tunnels or large covered areas that require illumination during
There arc existing sign lighting controls that do not comply with the applicable provision of § 119 and § 133 and I will be
4
installing compliant sign lighting controls
daylight hours.❑
❑ Yes ,r ,. ® No
M
There are existing sign lighting controls that do not comply with the applicable provision of §119 and §133 and someone else
5
will be responsible to install compliant sign dighling.controls
N
❑ Yes 50 No
3b. Mandatory Sign Lighting Controls
If the person signing the Certificate of Compliance Declaration Statement on page I of 4 of this SLTG-I Cis 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 sin lighting control note block can be located:
§133(a)I. All indoor sign lighting is controlled with an automatic time switch control that complies with the
Y
N
NA
I
applicable requirements of §119.
❑
❑
19
§133(a)l and 2. All outdoor sign lighting is controlled with an automatic time switch control plus a photo
Y
N
NA
control, or an outdoor astronomical time switch, that comply with theapplicable requirements of § 119.
®
❑
❑
2
Exception to §133(a)2. Outdoor signs in tunnels or large covered areas that require illumination during
Y
NA
daylight hours.❑
M
§133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce
Y
N
NA
sin power by a minimum of 65 percent during nighttime hours.
❑
❑
Exception 1 to §133(x)3. Signs illuminated for less than one hour per day during daylight hours.
Y
51
NA
13
3
Exception 2 to §133(n)3. Outdoor signs in tunnels or large covered areas that require illumination during
Y
NA
daylight hours.
❑
Exception 3 to §133(x)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps used for
Y
NA
illuminating signs or parts of signs.
❑
§133(a)4. An Electronic Message Center (EMC) having a new connected lighting power load greater than
N/A
15 kW has a control installed capable of reducing the lighting power by a minimum of 30 percent when
IN
ig
4
receiving a demand response signal that is sent out by the local utility.
Exception to §133(a)4. EMC required by a health or life safety statue, ordinance, or regulation, including
Y
NA
but not limited to exit signs and traffic signs.
❑
E1
Field Inspector Notes:
2008 Nonresidential Compliance Forms October 2010
Certificate of Com"liance; Si mLi htin (Page 3 of 4 SLTGIC
Project Name: Cafe Lattea Date' 6-27-12
4. Maximum Allowed Liehtine 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 5
of this Certificate of Compliance if there are signs using the Specific lighting sources method of com liance
A
B
C
D E I F G
H
i
J
Allowed Watts
Design
Complies?
m
Watts
Y/N
LL
O
L
O
U
'e e
O W
0,
VI
0
w'�
r
3
3
w
Field
N
o
ti
a
inspector
u
II
Cn
0—
W .
¢ v ❑J
¢
o
Check that
E g
m
U
Sign
1°
Complies
Description
✓
Internally Illuminated Letter Sign
❑
❑
13
❑
❑
❑
❑
❑
❑
❑
❑
❑
A
Symbol or code used on the plans when plans am 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 Iabel, confirming that
the sign complies with the Section 148 of the California 2008 Title 24, Part 6 Standards, using the Maximum Allowed Lighting Power
method of compliance. The only labels that will be recognized for this purpose arc ENERGY VERIFIED Certification Marks authorized
C
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 1701 I'. Surveillance by the Accredited Certification Body shall be an ongoing annual
inspection program carried out by a Type A Inspection body in accordance with ISOAEC 17020. For signs with such an ENERGY
VERIFIED label, columns'D' through'!' 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 si n area in square feel.
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 "1" 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(d or c .
1
Enter Y if the number in column H is less than orequal to the numherin column G. Otherwise the sign does not comply.
J
This page doubles as a field inspection checklist.
Field Inspector Notes:
2008 Nonresidential Compliance Forms October 2010
»gay
SIGN 0 WEST BUILDING
jl— 36"
SIGN 0 SOUTH BUILDING
5" THICK'INDIVIDUAL CHANNEL LETTERS
HALO 6 INTERNALLY ILLUMINATION
3/4" DLACK COLOR TRIM -CAP, RETURN PAINTED BLACK COLOR.
LETTERS WILL DE WHITE COLOR
5CAIIE:'h"=1'-0" .DATE JUN -22-12,
CA. 95014
ALUMINUM RETURN —� W f�
CHANNEL LETTERS 0
;,ALUMINUM FACE.
LOW VOLTAGE .'
"LED,
TRANSFORMER WITH
CUAR LAKEN BACKING : I DISCOUNT SWITCH _
#IO`AF SCREW .
MIN. $ PER LETTER
1.5 5PAGING: ^
FOR HALO
MOUNTING DETAIL,
WEST BUILDING ELEVATION SOUTH BUILDING ELEVATION
CAFE LAT'TEA75
15501
All designs & art works belong to Allen Signs, Inc. Any dupli
IZOC'Ely F�D
JUN 2 8 2012
;Y:
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION - CUPERTINO
-e-3o (s.4, APPROVED
This set of plan and specifications MUST be kept at the
Job site during;construction. It is unlawful to make any
changes or alterations on same; or to deviate
therefrom, without approval from the Building Official.
The stamping.of this plan and specifications SHALL NOT
'be held to permit or to be an approval of the violation
,of .;any provisions of'any City Ordinance,orState Law. .
BY
PERMIT NO.
N
A
NLI YY MLA!\:
CHECKED BY
� 27 72—
'LANNIN
RLDC'r• 0171W.
All deftgsu G art uvt*s belong to Allen Slgsu. ■
any dupllcallon Is pmblbiled. COP)'RIGNT-1010
E-malladdress: allenslgns@yaboo,com
Te1:4081280-6500 Fax:4081280.6700
19825rone Am San Jose. Ca. 95125 State Lir. # 834580