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03030133 CITY OF CUPERTINO BUILDING DIVISION PERMIT BUILDING ADDRESS: CAL-NEON SIGN PERMITNO. OWNER'S NAME: PERMIT Lg 1577 ALMADEN RD PHONE: t SANITARY AN OL NO. (408) 289-1883 1ECDPNOINEER: BUILDING PERMIT INFO OEO PLUMB MECH +�O o LICENSED CONTRACTORIS DECLA ON O ly I hereby AmnonOA a am "a anmr previsions Gapmr 9(commencing Job Description wahsa ] )ofDIVIAW3oflho�Simon A 11som na aces ^n '�z uceliuc `"IJe.d -�� SIGN-1 MONUMANT & 1-CHANNEL Lrt�R�u V A E D _ Dem Fe15 CHIIECT ECLARA N t55 lA=41 hudWlbe MPublic reeam, JUN 1 9 2003 S� Licensed Professional OWNER-BUILDER DECLARATION ConTION >: 1hereby.mere that 1Am 1. ,Bump:from me CssionC,e:Licenso anchor forth.followBUILDING A00p DpB G O o which repenm permit t IID L5,Business and Re.de Profession Code:My city m ewmy {J I4m 1 A X 6%1 $ which rcyahu a pvmlt re conatruc4 ober.hnprove,demoWh,on repair any munare prior mits Issuance,also nt M the the applicant for such Conuncmil mnleeeLA*(tslomenl C Oat ommencconrcdpamtion 700the pmvblov of me Comnamrl LIanselawaCode)9 Sq.Ft. Floor Area V IOn >a (cot It far ng pt Octal.and Onof hauls f r of nu B.Iaged o ma Prorestion.Any u Atino ortha +�3 1 �f .• So io 4 eaL5 b any applicant p li and far aper for 0.allsubjects the tmmpnt to Any•iohaon of &qim 7031.3 M any red d.ntn(a prwuobjau me sPDlkanl m a civil Pendry of not mom than nam beedred adrts(ssm). ,3 dINS Ngtglker 0 0 Occupancy Type ❑I,uawou of Om propeny,umy mpl)ycc,wlN weguuthe4 sok mnpenunon, willdo th)work,and Wasaaalum is nottmlondedar.fund forum(San.7044,11udneu 101 - FOUND P. 61Ud inspections and Proludons Code.The Conemtoreu s Uee law doas cot apply m Mannar an or of property who bila;orimproves de eon,and who doescuchwoh himselfuthrough his 103 - UFER own employaca,pmvlded that such Improvements am n)timmded orolfcmd!uvea.IL 104 - RE BAR however,the building u m improveent r sold within one year of cuopkilon,the owner• builhr wen have the buNm of proving that M did nm Wild or improve for Whom of 105 - ANCHOR BOLTS ❑1.asawMrof the property,amoalnaivelyemrmIngwith nren,eaona.aa.m 304 - ROUGH ELECTRICAL coaswm On project(Sm.7044,Business and Pmrewon,Code:)The Gaupee70r's U- 505 - FINAL ELECTRICAL ecus Law does not apply m an Wrour of property who builds or improves thereon,and, who contracts for such projects with a coamaclor(s)licensed pursuant in the contractor, 514 - FINAL PUBLIC WORKS Licence Law. [3I Am exempt under See. ,B t P C for this reason Owner Dam W ORKER'B COMPENSATION DECLARATION I hereby amtm under penalty of perjury one of the following dNiarsti C eve andwill mdnAd aCwnestsof Content m self-Inure(u Watke/aCompen. u provided far by Sation 3710 of the labor Code,for On performances of Ne u which this petmil Is iu md. ❑1 beN and will maintain Workers Compensation Incomes.As required by Semon 3700olthe Labor Code,for thepetforman afW fuwhich Niapemrltrluma. My Worker,Co mutt 1 7011_nier,of Po numbb/yy/�er�lmA ////��'lIII2 G �r PoII o.: � C IFlC •OF (PMPIION FROM WORKERS COMPENSATION INSURANCE nbr,ection reed not he completed if the permit Isforomhundraddolrrt($10)) or kat.) 1 ecnify that in tho performance of No work for which this permit Is rsue4l&bell not employ any poison In any mmaxrm As 70 become subject 0 the WMIMW CDmpensw M Law of California.Dam Applleanl NOTICE TO APPLICANT:If.Aber making Nr CenlRcam of Exemption,you should bezme subject in Ne Weaker'Compensation provisions of No Ubnr Code,you must .,O forthwith comply with each Provisions ext this permit&hall be dammed conked. 'Z°'" CONSTRUCTION LENDING AGENCY (-1 I hereby amrm Nat them is a com ucOm lending agency for the performance of a dm work for which thin permit Is issued(Sac.3097,CIv.C.) W� Lander,Nam) z Lenders Addmas . U 0 1 certify that 1 have read this applintlon sed suss that the above informwon is C7. creat.I&gree 70 comply with all ally and cmnty ominumes and sum law muting m 0 Wilding construction.and hereby aulhonre representatives of Nis city to color upon No shove-memloned properly for Inspection purposes. q (We)agree to save,Indemnify and kmp hatmku Ne City of Cupcnln t against IubilWes,judgmenu,caua despenma which cosy in enywyaccue agalnn said city V F77 in conaequcnce of the ism' Col Nr Permit APPLICANT NO Nos AND WI COMPLY WITH ALL NON- INT ISS d by: Date SOIIMLE REOU 0 t/ -GOOFS signuurc of _ HAZARDOUS OUS MATERIALS DISCLOSURE O't` pe of Roof Will the applicant or futum building=upset nom our huardou mamdd u ddined by Ne CoPatlino Mun(d otic,Chapur 9,12.And On Health and Safety Code,5emlen 25552(a)7 Yes All roofs shall be inspected prio o any roofing material being installed. ❑ a Will Onapplicant orfuture building ottvputmeequipment mdcvia,which If a roof is install without fir t btaining an inspection,I agree to remove C! hazardous air contsmimnu u and by lbe Bay Arca At,Quality Mm,Ccment all new That la r inspecti id7 ❑Yes Na I beve no thehm oumuerials requirements under Clupw6.95ofnm Callfar- D In Raalth&SdclyC esu 25505.25 )uW2553/.lundcmand thulfNo buil ng doe not comedy h nam.that It r nes wblllty m Mnf the naupml the 1 requirements car wnamar topancktr �na fApplicant Dat • Owner or epem D✓ All roof coverings to be Class "B"or better CITY OF CUPERTINO I� 1 of 1 PERMIT RECEIPT OPERATOR: conniew COPY # 3 Sec : Twp: Rng : Sub: Blk: Lot : APN . . . . . . . . : 36901001 . 00 DATE ISSUED. . . . . . . : 03/25/2003 RECEIPT # . . . . . . . . . : 21423 REFERENCE ID # . . . : 03030133 SITE ADDRESS . . . . . : 10100 DE ANZA BLVD SUBDIVISION . . . . . . : CITY CUPERTINO IMPACT AREA . . . . . . : OWNER . . . . . . . . . . . . : ARMADILLO WILLY ' S RESTAURANT ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : CAL-NEON SIGNS CONTRACTOR . . . . . . . : PRIOLA, RICHARD LIC # 20444 COMPANY . . . . . . . . . . : CAL-NEON SIGN ADDRESS . . . . . . . . . . : 1577 ALMADEN RD CITY/STATE/ZIP . . . : SAN JOSE, CA 95125 TELEPHONE . . . . . . . . : (408) 289-1883 OE ID UNIT QUANTITY AMOUNT PD-TO-DT. THIS REC NEW BAL ---------- ------------- ---------- - --------- ---------- - ------- -- ------ - --- BPERMFEE VALUATION 3 , 400 . 00 97 . 00 0 . 00 97 . 00 0 . 00 BENERGY PERMIT FEE 97 . 00 29 . 10 0 . 00 29 . 10 0 . 00 BPLANCHK PERMIT FEE 97 . 00 82 . 45 0 . 00 82 . 45 0 . 00 EPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 BREMSIGNS NO SIGNS/MARQ 1 . 00 22 . 20 0 . 00 22 . 20 0 . 00 BSEISMICOM VALUATION 3 , 400 . 00 0 . 84 0 . 00 0 . 84 0 . 00 ---------- ---------- - -------- - ------- - - - TOTAL PERMIT 267 . 11 0 . 00 267 . 11 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CHECK 267 . 11 1097 TOTAL RECEIPT 267 . 11 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 101 FOUNDATION 103 UFER 104 REBAR 105 ANCHOR BOLTS 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 514 FINAL PUBLIC WORKS • N `ITY OF CUPERTINOSIGN , CITY OF CUPEI,TINO PERMIT APPLICATION FORM APN# �3 /G_ Q I 0 O Date: 2 �/ Building Address:(? �.J J 101.bCo Oe Hu2c,-- (-� Ud Owner's Name: I 1 r e ' l i t� Phone#: Contractor: J A e� \ 1 License#: -3 Contact: /v }JR0� Phone#: �.�'tC •�O )�S UJvV� Applicant/Contractor: Building Permit Info: Bldg Elect Plumb Mech Job Description! ' L Residential: e(tOUtxnGYl� ��/ G Commercial: Sq.Ft. Floor Area: $/Sq.Ft.: Architect/Engineer: aluat' Type of Construction: Occup c Qty. if A c b Fee ID Fee Description Fee Group BENERGY Energy BUILIDNG BPERMFEE Bldg Permit Fees BUILIDNG BPLANCHK Plan Check Fee BUILIDNG BSEISMICOM Seismic Commercial BUILIDNG EPERMITFEE Elect Permit Issuance ELECTRICAL BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Rmdl Sings, Marquee ELECTRICAL BUSLIC Business License BUILIDNG 2r � z3 m � r n H a n m , a z � m r =.caao � m� �-�� y r .1 — i � Ole3•� mo. Z � CD $ M& Z ± m CP3j .p. �4/a �+ 1. .y.n 'Y ,o :2!. \ M p .�.1� is N �• gv g. w 0 N p IL W N a � 0 O w � 7. M10 ,� 7 _ . . . ZQ � 0 CD ..4 dgcs(A - � � � ' - ' a . � CO x••zCL D CII d cz 0='K .(D LC `� m 0 m rtl tial ch too toICL cr � � w 0' 0 ar COL.0 n Z 0 A, 7� 0 06 to m5'-101 /2" n y � a n � m O 0 � 2 C m 3 a (D n � .. ft bT rN r x 7 O z � N D l7V f1 Q m ® fD s I� •. 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