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04040187 CITY OF CUPERTIN0 BUILDING DIVISION PT _ CONTrRACTnRh®RN�ION: BUILDING ADDRESS: ALLEN SIGNS INC PERM1".04 O 187 I OWNER'S NAME: PERMIT ISSUE DATE LAT LAT TRAVRT, L.982 ST NE AVE 04/29/2004 PHONE: SANITARY NO. CONTROL NO, 408 280-6500 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LOo LICENSED CONTRACTOR'S DECLARATION (� {{��a�k�D�n5( l������''' O O O 1 hereby affirm that I am fOc Bd under provisions nochopc, 9(commencing �' ItAC ltJnr{0, with Sec'ion7o(k)or Divixion3of me Busincv and Profcssiom Coec.ane mylicenu is 1{ly=. Ilplg�An in mD fora and crfee IGN 7,t3Z Lmcnu Claza Lie A 2J O Zr, _p Dau `a Contraclm n £�£� ARCHITECTS DECLARATION MAY ��2U04 K I understand my plans Shull W Saud vs puhlm moor e JyU iC Uccnud Pmfcsnonal 11L g Dat I am exempt from DECLARATION BUIL" ����� E:0 I hereby Maso ,(Sero on 11. excmp'from lW Contractor's o e:Any Low co the Spo following Mason,Permit 7031.9.Business and ere.de tom Code:Any city Smanly a which mquiraz a p.nnil to.tmnrvct alter,improve.Jcmnliah,or repair any xtmctum Qprior m its issuance.also pp parrot signed 2600 rtto(be coca lnsoffor such aomonse dnammcm that(Commencing With Section? he of n of On usin= nialuclaw(Chapter S Ft.Floor Area Ere p P ( p q� Valuation rel—$ Out he ise sco it Section Aid of Divisiin3 nfthe Business andon.Any m❑xk)or .- Natio u exempt any applicant p li and Ota Per for me subjects the exemption.Any vialat, or Section 7031.5 by anyydallanrapermilsubjects the Applicant macivil penalty of 369AFSIQ1NIImR0 not more man Bn hundred apnoea(asoo). Occupancy Type ❑L az owner of the property,or my employees with wages AS Umir sale compensation, will do Be,work,and the atmcw¢is not intended or offered per sale(Sol.7044,Bulinus And Profession.code:The Cant axwel Lice.law does nal apply m an owner of Required Inspections prereny who buildsor improves mcrmn,and who doessuch work himaelfor through his own employees,previded that such improvements art not intended oroEered for Sale.IL however,the building or improvement issild within one year of completion.the owner. builder will ban the burden of proving that he did not Wild or improve for purpose or sale.). ED 1,as owner of On pmpcny,am exclusively contracting with licensed con0aams th conslmct she project(Sec.7044,Business and Professions Cade:)The Contractor.Li. come Law does not apply Io an owner of propcny who builds or improves themon,and who contracts for such projects with a conoactor(s)licensed pursuant o dm Contractors License law. El I am eumpl under See ,B&P C for this mason Own Dau WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of pe jury one of the following declarations: ❑I have and will maintain v Certificate.[Consent m aelr-insum for Worker'sCompen- snsion,as provided(.,by Section 3700 of the Iabor Code.far the p.rf0rman c of the work for which this permit is issued. 1 Mn and will maintain Worker's Compensation Insurance,exayuined by Seaion 37 of the labor code,for dta perrmaranee of me work for which mil permit is issued. My Warkors Compensation locum¢carrier and Policy number art: ,tea Carrier;, J-[' Poliry No.: C TI -CATS OFEKEM ONFROM WORKERS' COMPENSATI NINSURANCE of less.)(ILis section need not W completed If the permit is for one hundred dollars I$I(III) 1 ecNfy that in she p.rrmmance of the work for which this permit is iaued.I shall not employ any pclson in any manner an az in become sti Irt the Workers Cimpensauon Laws of Caldism..Dna Applicant NOTICE TO APPLICANT:Jr,voter Making'his Cenifcau of Fanna,lu n,you should become Subject m the Workers Compensation previsions of the labor code,you must z(� forthwith comply with such provisions or this permit ahall be d.emcd rovokca. Z O CONSTRUCTION LENDING AGENCY .F I hereby affirm lhn then is a corowaion lending agency for the performanro of fYi the work for which this p.I,is issued(Sec.3097,Co.C.) aQ Lcnd.r's Nam. Z Lenderi Adeno V 0 1[entry that I have read this application sad n]m lbw's.a W ve informuiun is CO F coned 1 agree m comply with all city and county ordinances and sum laws selling to Q V no dingconewction,and hereby authorise representatives of this city to inner upon the LI) shove-mcmix. d2orems.I.S for as names which may gy (We)agree to Save,indemnify and kap harmless the City of Cupertino against Z inca.bdnacqunceofthe granting ex p.nuswnichmayin any way accme againnsaid City O z mcanuq NT UNDERSTANDS of this permit '-� APPLICANT UNnnDTTERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE ED ION./S[� U Signawrt 'i",ls�cal%n 'tracmr Re-roofs Dam H MATERIALS DISCLOSURE Type of Roof Will the Applicant Sar future building Occupant.Chrstore or handle ha�Qusd Safety a ty az defined io In.Cupertino Municipal Code.Chapur 9.12,anti Irk.Health anti Sarmy CUJC,SCCllnn 25532(a)? CYes '6. All roofs shall be inspected prior to any roofing material being installed. Will the applicant or None building Occupant use equipment or devices which -If a roof is installed without first obtaining an inspection,I agree to remove cml'nor ardour air contaminants az defined by the Bay Area Air Quality Management Disall new materials for inspection. uia? VVV,,, byes plN. I have read the hamNuuss materials mquimmenu under Chapur6.95 Qf thc Califor. _ nia Hcalth&Sa(cly Cod.,Seeuons 25505,25533 and 25534.1 undersand Ostrom btildin, docs nil emninnlly have A tenant out it is my reSvemihili'y to rely the l Upxanl regi n wh11 ine unW met priorto issuance ora Ccmrteau QfIXuponey. SignatureofA plicant Date Owner Sar oath rir.cJ afeol �''U Da1e All roof coverings [o be Class "B"or better CITY OF CUPERTINO IC15OF SIGN •CUPERTINO PERMIT APPLICATION FORM APN # Date: 2 r Building Address: Owner's NM, // Phone#: L-�f Contractor: License#: ✓1 C . 5655 Contact: Phone#: K;r4b� 408 Applic nt/Contra or: A I 116M Is i M h Building Permit o: ld Elect Plumb Mech Job Description: Residential: Commercial: Sq.Ft. Floor Area: $/Sq.Ft.: Architect/Engineer: Valuation: 77=ction: r A Occupancy Groue: g!—Y. if Ali ble Fee ID Fee Description Fee Group ` BENERGY Ener BUILIDNG BPERMFEE BldgPermit Fees BUILIDNG ,BPLANCHK Plan Check Fee BUILIDNG BSEISMICOM Seismic Commercial BUILIDNG EPERMITFEE Elect Permit Issuance ELECTRICAL BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Rmd] Si ns, Mar uee ELECTRICAL BUSLIC Business License BUILIDNG • z5'3 6 �8 D ' 71 O D r � 18' w c n zx cn z z y N m N N rn m v n z `a_ z z o m m m N f � oc r 0 2 a Z p " m m > ' m �yVN � m T _ > > C A N (P O C .p m m m T Oi N Uy N > i '' O O o mt N N > r O Gl O O z OCj n'x U) m > O -< > o 3n m m S* m > O O D �q pi M z m 76 �-] z a DoE > z o i � oy 'LL Az a mr o cN y m y0 m ONr 'f3 �' Nm 1 O F A - y m o 5 - o m AO N -2 �)ak 4l O m N z z m o T m z 0 D 0 m o O ' 3 = � O c , BlANEY AVENUE � 1 _ O � 4 Otnt a 7U tri M M a N Ota R13 > R7 R ZZ Z Ioll y $ a a „ off v co �oo� ��aOp ma V Cts CITY OF CUPERTINO w tea, r Buu.olNc ulvlslory PERMIT ,CONTRACTORINFORMATION xF BUILDING ADDRESS: LLEN SIGNS INC PERMI .040187 1 OWNER'S NAME: PERMIT ISSUE DATE TRAVELT NEAVE04/29/2004 HONE: SANITARY NO. CONTROL NO. (408 280-6500 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDGELECT' PLUMB MECH ❑2Z 0 it � C] Lop LICENSED CONTRACT'OR'S DECLARATION U I hemby affirm that l and littnced under provisions of Chapter 9(Commencing Job Descrlptl(ZtL�����© Z ucf with Section 90(0)uf Division Sof the B usineas and Pmfcssions Code.andmylicerecis IBlaa :^ N in full ionic and effec .Je-0. 'IG N j,t2? License Class Lic.N nF❑ Dale "f Cordocmf ARCHITECT'S DECLARATI N - MAY lT 2004 W u I understand my plans shall W used as public menu e ; L¢cnscd Pndcssinnal 3 OWNER-BUILDER DECLARATION BUILDIN sry6'7-1 may K n O I hereby affirm that 1 1S exempt from the Contractors License Law for ntty ❑o follwhich requiresng n.apicnail t IDJLruct after.improve, ve,de iunc Code:Any citynfsnumy m tai which requires n permit to ithe ahcn improve,demolish,are a sig any Amclum dorm its issuance,also requires thea Iream for such $2600 iii Pam Permit Law a (commencing it u uion7 c of or[beB Business and Cha 1 9 S Ft. Floor££x❑ p r p ( porn q. Valuation ta+t- (commencing with Section 1IX10)nf DivixionJ of the Busin•••and Pmfcvians Cade) r E R 3 that he is cxcmpt therefrom and tad basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 369�1 )7lLnL6L0 ' hat more than fin hundred dollars(3500). Occupancy Type ❑I,as owner of the popery,of my employers with wages rs their sole compensation, will do the work,end the swclure is nos intended or offered for We(Sec.7014,Business and Profusions Cade:The Commend's License Law does not apply to an owner of Required Inspections property who builds or improves thereon,and who does such work himself or through his- . own employees,pmvided that such improvements so,nor intended or offered for sale.If, however,the building or improvement is sold within one year of completion.the ownxry builder will have the burden of proving Nat he did not Wild or improve fur purpose of sale.). ❑h as owner of Ne property,am exclusively contracting with licensed cpntnerom to consumer the project(Sec.7B44.Business and Professions Codc:)M Contractors U. corse taw does not apply to an owner of property who Wilds or improves themon,and who contracts for such projects with a contractor(&)licenced pursuant to the Chnuanor's License law. ❑I am exempt under Sec. ,B&PC for this moon Owner Data WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of pc jury one of the following decluadurs: than and will maintain a Cenifcam of Concent to adr-main for Worker'sCompen- antion,ss provided for by Section 3100 of the labor Code.for Ne performance of the work for which this permit is issued. 1 have and will maintain Workcri Compensation Insurance,ss required by Section 3 of the Labor Code,for the performance of Ne work fm which this permit is issued. My Worker's Compensation Insurance carrier and Policy number tie: Carrier: Policy No.:�o-�+'OLJhJ(W C TIF CATE OF EXEM ON FROM WORKERS' COMPENSATI NINSURANCE or Ices.)This section need not W completed if the permit is for ane hundred dollars($100) 1 certify that in thc performance of the work for which this permit is issued.I shall not employ any fiction in any manner so as m become subject o the Workere Compensation Laws of California.Date Applicant NOTICE TO APPLICANT.If,alter making this Certificate of Exemption.you should become subject to the Worker's Compensation provisions of the labor Code,you must �z foMwiuh comply with such provision,or this pefmir shall be,deemed revoked. z N CONSTRUCTION LENDING AGENCY [-+ I hereby aRfen that there is a cummmatinn lendingagemey far the performance of fY.moi Ne work for which this pcorm,is issued(Sec,3W1,Civ.C.) Q Linda's Name a z Lendcrsnddw U O I certify that 1 have read this application and trate that the aW w information is Ly t- wren.l agree Ip comply with all city and county oNimmer,and suite laws relating to pU buildingconsuucrion,and hereby awhofire reprcrmadves of this city to enter upon the shove mentiunW pmpeny for inspection pu0msu H d (We)agree to save,indemnify and keep ham the City of Cupertino against IZ) Iiabilides,judgmcnu,Cosa and capesuca which may in any way acrotic against said City U Z in consequence of the granting of this permit. .r SOURCAPPLICAE NT UNDERSTANDS AND WILL COMPLY WITH ALL NONjPOINT Issued by: Date Lic Re-roofs argnawre br ppli m dnr.etof Date H ARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant Lir future building occupant store of handle ha Mums materia) U defined by the Cupertino Municipal Code,Chapter 9,12.and the Health and Safety Code.Section CYea 25533(a)? N a All roofs shall be inspected prior to any roofing material being installed. r J " If a roof is installed without firs[obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which mit hawrdous air contaminants rs defined by the Bay Area Air Quality Managements all new materials for inspection. ivrin? ❑Yes )kNu _ 1 have mad IW hmallous mawriau mquimmcnu under Chap¢r6.95 of IW Califor- niaFkalth&Softoy Code,Sections 25NI3.355JJ and 2s53d.l undcrsrandthuiflW Willing 2 ,S D drys nol Curendy have a tenant,that it is my resp radmilily m nndly ce occupant mf the !N m4 whit Liu W ma prior w iuuantt of•Ccrtifieate of Occupancy SignatureofA plicant Date Owner or torn rind agent Dem All roof coverings to be Class "B"or better