14040084 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10891 S BLANEY AVE CONTRACTOR:ALLEN SIGNS INC PERMIT NO: 14040084
OWNER'S NAME: PACIFIC RIM PARK LLC 1982 STONE AVE DATE ISSUED:04/15/2014
OWNER'S PHONE: 3108088830 SAN JOSE,CA 95125 PHONE NO:(408)280-6500
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL 0
z REPLACE(E)ILLUMINATED WALL SIGN WITH(N)
License Class Lic.# ILLUMINALT�ED WALL SIGN 2 IJX o Gl i7v Y
Contractor All-PIAS IZt Date is �l G� ✓�
I hereby affirm that I am lic nsed 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.
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
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$2000
�[ 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 APN Number:36934052.10891 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 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 Date: A�
granting of this permit. Additionally,the applicant understands and will comply i
with all non-point source regulations per the Cupertino Municipal Code,Sec' n
9 18.
RE-ROOFS:
Signature Date All roofs shall be inspect prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
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 Health&Safety Code,Sections 5505,2553 ,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date:
permit is issued.
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 CONSTRUCTION LENDING AGENCY
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 I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
I certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9 18.
Signature Date
SIGN PERMIT APPLICATION O�
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION v\O
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 vVo
CUPERT 1[ O (408)777-3228• FAX(408)777-3333•building a)cuosrtino.org \
PROJECT ADDRESS - � e ,„ APN# / C 3 V—
I 05
OWNER NAME S� C{ A7' !h 1 �J PHO to O�- ^ E MA
`I V
STREET ADDRESS Sb S / 6(e4 CITY,STATE,ZIP vse
FAX
CONTACT NAME t PHONE E-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR N _ I LICENSE ER LICENSE TYPE BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESSCITY,STATE,ZIP PHONE
�- o &A 2s,2 -
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK n
I
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:
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
a
IU T ALVALUATI N:
By my signature below,I certify to each of the following: I am the property o u zed ct on th roperty owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work an urate. I agree to comply with all applicable local
ordinances and state laws relating to b i1jift c nstrufi n. I authorize representatives of Cupert 0 t the abov d roperty for inspection purposes.
Signature of Applicant/Agent: Date: �^
SUPPLEMENTAL INF TION REQUIRED ,a �o i�SWO _-
_Site Plan
Elevations ® ES . IDIN � I�S2EVIE
Sign Details-including UL listing(s)applicable �''"s. 3 PL Prt
Structural Calculations(if applicable)
_Copy of Planning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application.
Sig&4pp_2011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10891 S BLANEY RD DATE: 04/15/2014 REVIEWED BY: MELISSA
APN: 36934052.10891 BP#: "VALUATION: $2,000
'PERMIT TYPE: Building Permit PLAN C'llia`K 7 I'
PRIMARY PENTAMATION 1 CEAP5
USE: Sign PERMIT TYPE: i
WORK REPLACE E ILLUMINATED WALL SIGN WITH N ILLUMINATED WALL SIGN
SCOPE
SIGN TYPE FEE ID QTY SIGN FEE
Wall Sign, Electric 1SIGNWELEC 1 $278
TOTALS: $278.00
@rpa � Pztarb. AI"a Cpic't�" #Branch Circuits 1 $47.00
1 ESIGN
Elec.Permit Fee: IEPERMIT
tJ,?ter ;la`c'ch. Itsun t)/t'tsr f'tunab Irts1, Lj Other Elec.Insp. 0.0 $47.00
11kaanh
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . These fees are based on the prefimina information available and are only an estimate. Contact the Dept for addn'l info,
FEE ITEMS (Tee Resolution 11-053 Ef. 7/1/13) FEE QTY/FEE MISC ITEMS
Suppl.PC Fee: Q) Reg. ® OT0.0 hrs $0.00
Permit Fee: $278.00
Suppl. Insp. Fee: Reg. ® OT Fo,0 hrs $0.00
PME Unit Fee: $47.00
PME Permit Fee: $47.00
Fee:
Work Without Permit? 0 Yes •a No $0.00
Sign Master Plan: 0 Yes (F) No $0.00
Travel Documentation Fee: ITRAVDOC $47.00 i
Strong Motion Fee: IBSEISMICO $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
M
$420.50 $0.00 TOTAL FEE: $420.50
Revised: 04/01/2014
r
S '
Certificate of Compliance (Sign Lighting) (Page I of 4) SLTG-1C
Project Name: - G Date: l
Project Address:
D
Location of Sign W OutdoofJigns ❑Indoor Signs
Phase of Sign Construction ®New Signs ❑Sign Alterations
Type of Lighting Control KI New Lighting Controls ❑Replaced Lighting Controls ❑Not Installing Lighting Controls
This Certificate of Compliance includes the following components(check all that apply)
13 Mandatory Measures(Lighting Controls) ❑Maximum Allowed Lighting Power ®Specific Lighting Sources
1. Certificate of Compliance Declaration Statement(this may be a C10,C45 or other eligible person)
IN I certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and
correct.
N I am eligible under Division 3.of the California Business and Professions Code to accept responsibility for the lighting design.
Pl 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 design features represented on this Certificate of Compliance are consistent with the information provided to document
this design on the other applicable compliance forms,worksheets,calculations,plans and specifications submitted to the
enforcement agency for approval with this building permit application.
Name: Kimberly Lin Signature
Company: Phone
Alien Signs, Inc 408-280-6500
Address: 1982 Stone Ave License number(may be contractor's lic#)
C-45 834580
City/State/Zip: Date
San Jose,CA 95125
2. Installation Certificate(to be signed by responsible person after installation)
Permit number „ 3a Checked by/Date
,(Enforcer{ent Agency Use , _.L. _ (Enforcement Agency Use
Installation Declaration statement
9 I 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 Division 3 of the Business and Professions 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 is consistent with the plans and specifications approved by the
enforcement agency.
X I certify that the requirements detailed on this Certificate of Compliance have been met.
X7 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. I understand
that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the
building owner at occupancy.
Company Name:
Allen Signs, Inc
Responsible Person's Name: Respon 'be r ins S' tore:
Kimberly Lin
License number(may be contractor's lic#) Date Signed: Position With o any:
834580 �i Project M ger
2008 Nonresidential Compliance Forms October 2010
Certificate of Com fiance (Sign Lighting) (Page 2 of 4 SLTG-1C
Project Name: Dae
Z- - d
3.Mandatory 5'i n•Ughting LightingConiVrols
NOTES.-
1.
OTES.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 lightingpower.
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 or the entire construction.
3a. Statements of Responsibility:Any person signing the Certificate of Compliance Declaration Statement on page 1 of
4 on this SLTG-1 C shall complete Part 3a.Check Yes or No for all of the following statements:
1 I have responsibility for installing the sign lighting controls
❑Yes,complete parts 3a and 3b of this form ®No,complete part 3a of this form
2 There are no existing sign lighting controls and I will be installing compliant sign lighting controls
❑Yes Q No
3 There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls
❑Yes ®No
There are 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
L
❑Yes 0 No
There are existing sign lighting controls that do not comply with the applicable provision of§119 and§133 and someone else
will be responsible to install compliant sign lighting controls
❑Yes 91 No
3b. Mandatory Sign Lighting Controls
If the person signing the Certificate of Compliance Declaration Statement on page 1 of 4 of this SLTG-I C is responsible for
co!Eplying 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
ma datory measures(sign lighting control note block can be located:
1 §133(a)l.All indoor sign lighting is controlled with an automatic time switch control that complies with the Y N NA
applicable requirements of§119. ❑ ❑ M
§133(a)l and 2. All outdoor sign lighting is controlled with an automatic time switch control plus a photo Y N NA
2 control,or an outdoor astronomical time switch,that comply with the applicable requirements of§119. ❑ ❑ ❑
Exception to§133(x)2. Outdoor signs in tunnels or large covered areas that require illumination during Y NA
daylight hours. ❑ 1 H7
§133(x)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. ❑ ❑ KI
Exception 1 to§133(a)3.Signs illuminated for less than one hour per day during daylight hours. Y NA
3 ® ❑
Exception 2 to§133(a)3. Outdoor signs in tunnels or large covered areas that require illumination during Y NA
daylight hours. ❑
Exception 3 to§133(a)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 Y N N/A
15 kW has a control installed capable of reducing the lighting power by a minimum of 30 percent when ❑ ❑ M
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. ❑
Field Inspector Notes:
2008 Nonresidential Compliance Forms October 2010
Certificate of Compliance (sign Lighting) (Page 3 of 4 SLTGIC
Project Name: Date:
s� a ¢�s i
4.Maximum Allowed Lighting Pow r 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 S ecific li tin sources method of compliance
A B C D E I F G H I J
Ca Allowed Watts Design Complies?
Watts Y/N
a� > „ yo
-a
a
ca4 p. Ca
41
Field
Inspector
Check that
c d y v Sign
Fo., Complies
Description ✓
Internally Illuminated Letter Sign ❑ ❑
❑ ❑
A Symbol or code used on the plans when plans are reuked 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
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 are 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 17011.Surveillance by the Accredited Certification Body shall be an ongoing annual
inspection program carried out by a Type A Inspection body in accordance with ISO/IEC 17020.For signs with such an ENERGY
VERIFIED label,columns`D'through`I'are not required to be filled out.Note:Using an ENERGY VERIFIED label is an optional
method to validate compliance.An ENERGY VERIFIED label is not needed for compliance.
D The sign area in square feet.
E List"I"if the sign is internally illuminated- List"E"if the sign is externally illuminated.
F Allowed watts per square foot. Enter 12 if the sign is listed as"I"in column E.Enter 2.3 if sign is listed as"E"in column E.
G Multiply the square footage in column D times the allowed Lijhting Power Density PD=watts in column F.
H Show the total installed watts in the sign,as determined according to the applicable provisions of§130(d ore.
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:
2008 Nonresidential Compliance Forms October 2010
Certificate of Com fiance (Sign Lighting) (Pa e 3 of 4) SLTG-IC
Project Name: Date:
Yff2 Acerde4Y7�e
4.Maximum Allowed Li tin 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 compliance
A B C D E I F G H I J
ca Allowed Watts Design Complies?
Watts Y/N
a� c�
U a o ° W-ty � VI
�. w•� � ,��• a� a� ` `� w 3 x
0C'J3 �i
�' A 0 Field
d
� � � ~ N aInspector
>, z ° II II o II u
rr� o.. x ,� Check that
cin w d y v Sign
F°., Complies
Description ✓
Internally Illuminated Letter Sign ❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
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
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 are 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 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 ISOIIEC 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 insquare feet.
E List"I"if the sign is infernally 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 d ore.
I Enter Y if the number in column H is less than orequal to the number in 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
• sco c- -' �ac� e-x�s= �� .�llc« 1 n d ea° toAPJ s �� ► 11um1' nom / 5;V f,-JAd Sly-Y7.
QWW S�f'•e�J,e �'�a.s{�i!`Q . 3(�- ���- $8 3d
? +C P
HS2 ACADEMY BUILDING SIGN ELEVATION: CITY OF CUPERTINO
20'-0"
STORE 101
FRONTAGE ?P,14y 1`LI�e �G�j� J pn /
RACEWAY PAINTED 70 MATCH BUILDING COLOR ci�
+�N6��i 4'c>�fib1t#k
99
CUPERTINO
5"THICK INDIVIDUAL CHANNEL LETTERS.INTERNALLY ILLUMINATED
3/4"BRONZE COLOR TRIM-CAP.RETURN PAINTED BRONZE COLOR. Building Department
LETTERS WILL BE RED COLOR WITH WHITE COLOR OUTLINE APR 15 2014
SCALE:1/4"=1'-0" DATE:MAR-26-2014 REVIEWED FOR CODE COMPLIANCE
BUILDING ELEVATION:
Reviewed By; T FLANS
EMfD BY
BUILDING WALL HS2ACADEMY N
20041 BOLLINGER RD. PL,ANNIR DEPT'
CITY OF CUPERTINO W E
ALUMINUM RETURN
DANE
S `
CHANNEL LETTERS s� 1 ' 30
PLASTIC FACE——� -time $w;kh aow% ��
LOW VOLTAGE ttt���
#10x3"SCREW TRANSFORMER WITH / n 1
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All designs &art works belong to Allen Signs,Inc. Any duplication is prohibited. COPY RIGHT 2012 E-mTel.a
. 1982 St