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Certificate of Compliance (Sign Lighting)(Page 1 of 4)SLTG-1C
<br />Project Name:EAOJrshaits Onto: 7/111 5
<br />Projcct Address:
<br />) 61- O.rn CO 10/,u'«Arn
<br />Location of Sign Outdoor Signl 0 O Indoor Signs
<br />Phase of Sign Construction „0'Ncw Signs ¤Sign Alterations
<br />Typc of Lighting Control .0Ncw Lighting Controls O Replaced LightinR Controls Not Installing Lighting Controls
<br />This Certificate of Compliance Includes the following components (check all that apply)
<br />2'Mandatory Measures (Lighting Controls) VE Maximum Allowed Lighting Power ,0'Specific Lighting Sources
<br />1. Certificate of Compliance Declaration Statement (this may bea Cl 0, (45 or othcr eligible person)
<br />4 I certify under penalty of perjury, under the laws of the State of Cali fornia, the information provided on this form is true and
<br />correct.
<br />40.4 I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the lighting design.
<br />4 This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with
<br />Title 24, Parts 1 and 6 of the California Code of Regulations.
<br />··Gl' The design features represented on this Certificate of Compliance are consistent with the information provided to document
<br />this design on the other applicable compliance forma, worksheets, calculations, plans and specifications submitted to the
<br />enforcement agency for approval with this building permit application,
<br />Name: -Signature ,14©11 9 Hunt 4&6644.44-St-Company.
<br />-114 --71.1 -as-oox:wa
<br />Phone
<br />6 i 4 n.9 an 01 9-,enA res Co.
<br />Address:u License number (mity bc contractor's tic #)
<br />to 9 91) eaa*nan avo_.(014 (016
<br />City/State/Zip Date , ,Stan+Dn , cA. 90670 5/:w // 1
<br />2. Installation Certificate (tobo signed by responsible person aftor installation)
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<br />installation Declaration statement
<br />er' 1 certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and
<br />con'ect.
<br />ld' I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized
<br />representative of the person responsible for construction,
<br />9(/I certify that the installed features, materials, components, or manufactured devices identified on this certificate conforms to all
<br />applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the
<br />enforcement agency,
<br />14' 1 certify that the requirements detailed on this Certificate of Compliance have been met,
<br />4 1 will ensure thata completed, signed copy of this Installation Certificate shall be posted, or made available with the building
<br />permit(s) issued for tile building, and made available to the enforcement agency for all applicable inspections. I undetstand
<br />that a signed copy of this Installation Certificate ig required to be included with the documentation the builder provides to the
<br />building owner at occupancy,
<br />Company Name:
<br />5 \2173 anci Ser,Rcic. 08·Responsible Person's Name:Rcspo ;Signature:
<br />Ke. 191-+ U.A.«11. 1401-
<br />License number (n y be contractor's lic #)Date Signed:Position With Co**ank
<br />Ga. 4 4-75 5/2.1/19-5€.rubr Yrojicd- Clla-nacr
<br />2008 Nonreaidemial Compliance Forms October 2010
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