08070020 CTTY OF CUPERTINO s' wd'sN+:s w:*: N7x'
BUILDING DIVISION PERMIT COL�ITRACT "R54NFORMAT ON`-
v ?°
PERMIT NO.
BT U' DE ANZA BLVD BAY MARK SIGNS INC 08070020
OWNER'S3NA�ME: J PERMIT ISSUE DATE
CIVIC PARK CUPERTINO LLC 4195 PESTANA PL 07/02/2008
NE: SANITARY NO, CONTROL NO.
(510) 623-1300
ARCHI7ECT/FNGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
O p LICENSED CONTRACTOR'S DECLARATION lob Description
1 hcmby alliin TNI 1 am Ikemm under pmvivom of Chpmr 9(mmmcnein8
nZ6 with SocccMI)o(DlvidanlaftheBUUnessand (Sas eme..�dmylmel�� 1 INTERNLY ILLMNTD DBL—SIDED ALUMINM MMMT SIGN
n ren famerou"and art }�l6
ucenaacl . S Lm.• BAY MARK SIGNS INC. RENEWED BUS LIC 7/2/8
Fq Due contractor
n W Aashall too OEC r N
jig I uMeuuml my Plans shall Ee ufed u public ruvNs
JyU
a LL G Llcerued professional
Sct� OWNER-BUILDER DECLARATION
1 hereby alTrm that I am exempt from tN ConeactoYs license Law for IM
HC
O following mason.(Section 7M 1.5.Business and Profession Oul:Any city or county
which inquires a permit to construct.alter,improv.,demolish.o mpair any rostrum
_2y prior to is iuussce.also mquires de applicant for such pcmil to file a signed summcm -
Z< Iholheisliccmedpursomil.dla
epmvisemoftheCmtracus/slxeomw(Chplm9 Sq.Ft.Floor Area Valuation
Em-s (commencing with Section 7000)ofDivision 3oftheBusinessand ProfessionsCode)or $8600
that he is exempt themfmm and the bus for Ne allegrd examption.Any violation of
Sation 7031.5 by arty applicant fora permit subjew the applicant to a civil penalty of tuber
mlmore WnfiwbuMmddollun.s(Ilm36940003 .Wtp Occupancy P Y Type
I,uowncr el Ne ryopmy,omY m.Ployrca with wagesudevsule conpematim,
will do thewanc Cod Ih int Core u nch's Li led oo vv do fmaale(Sec.70th. .of
of
and ProGad.0 Cade TN Cantranmr's Umme law arca rot apply m an owner of Required Inspections
muncrywbo WiWo idedtaves Ih imrow whosacsamhwdold,oelfor Waugh M1u
own employees,provided dui such int issold nth are not intended molRrW far salsa r,
however,Ne Wilding mImprovementshalt withinot ywammpomforWownm-
ask.). will have W buNan of proving Nu bo did not Wild w improve for purymc of
vleJ.
❑1.u arra a the Progeny.am exclusively contracting with Hommel contractors m
mmtrml W project(Sec.7014,Business and Pofeuiou Code:)The Conuanoh U. .
come Law docs not apply at an ower of property who Wilds or improves Merton.and
who contracts for such projects with a conlunor(U licensed pursuant to the Contaaclols
Lice.law.
❑I am eamnpl maW See ,B&P C for this ream
Ownm Data
WORKER'S COMPENSZON OECLARATION
1 hereby affim under porosity of perjury ane of the following declarad.m:
1 Nae and will maintain•Cmoifinu of Coucm as self--imam for WokeYs Compen-
703700.f
on,u provided for by S=don 3700 of the Labor Code.for tN perfomace of the
for which this pmmh is ismoti.
1 hve aM will main Wn Wo es Compemadn Imunn¢,u lequimd by ScOhn
Ne labor Cole.for the No..,.of the work for which this peon is issued.
Wmt Campesuia bran. "erandPaltrymunbouam.
rier. Policy No.:4 4Q2
I�
CE FLUTE OF EMPTIONFROI&WORKERT
COMPENSATION INSURANCE
fads station need not beconpleed if the pcmil Is fmone hundrW dollars($100)
m len)
I certify that in the perfomarce a the work for which this Peril Is Wood.l aa11 not
employ any person in any manner so as to bocmme subject to the Workers'Cmnpcmatim
laws of California.Dam
Applimnl
NOTICE TO APPLICANT:IL afar making this Cenifime of Exemption,you should
bR'ame subjeel to IN Warkelf CompenHtion provisions of de Ulw,Cade,you most
.J O f.Mwith mmp1Y with such pmvisiom or Nis peril shall bo deemed lewkcd.
Z y CONSTRUCTION LENDING AGENCY
fYNe woh f which ah this�bort u a mluuuctim ending agency for W puformanm of
A pa'nlit a Wood(So,.3097,Civ,C.)
LLnldeh Name
0.
.7z Landefa Addreas
'U Q 1 codfY that I hove rod this appliwim and sum dw tbo above information is
Ug P mlmct.1 Mme in comply with all city and county oNinantts and scale laws totaling u
.0 Wilding construction.and hmby auNoire epmaemadvesaf this city to cow,mnnW
0.Cal abow-mnnd.md pmpeny impeNan purymea
(We)agme to u ,i nify and keep Nmleu the Cly of Cupcnino ag iml
VfA liabilitim,judgmenu, ser spemuwM1lchmayinanynyammagainslsaid0ly
Z AcPLICANmof of AND WfamILL
Issued by. Date �' f
^� APPLICANT U E DS AND WILL COMPLY WITH A NO -POINT
SOURCE REGU N
Re-roofs
unto pplicanuCmmctar Dae
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant m fin.building mcePant atom or handle havrdom malenal
u defired by W Cupcomo Municipal Code,chapler 9.12,arta the Haub and Safely
code.Section
.2ss32(.)7 I All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or tum building o copant use cquipmcnl or dcviva which If a roof is installed without first obtaining an inspection,I agree to remove
it huallom air emumimn u defined by the Bay Ama Air Qmlity Management all new materials for inspection.
District?
❑Yes No
IhavoloadW riabrequimmcnsunderChpw6.95ofthc Califon
ria H.hh&Safcryeotic 25505,25533u 25531.1undcnuedthoifWbuiidiog
dos mL cumndy lose "it s my remora ibililY to
"fY occupant nr W
mquimmenu whichm s prior to issuance.'a Ccrdfica a(Oc Signature of Applicant Date
All roof coverings to be Class'%W'or better
Owmromtho a agent pee' g