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041000964 yL0, !ZU W r�Z n�vvvy�yyy 3W� you y J zOC ymlr. HZYQ fFo 0 zN WQ Z)z UO_ U F'z �z CITY OF CUPER'fINO TOR IN INFORMATION BUILDING DIVISION PERMIT BUILDING ADDRESS: - ALLEN SIGNS INC PERMITN04100096 9674 STEVENS CREEK BLVD OWNER'S NAME: PERMIT ISSUE DATE ok ACUPUNCTURE 1982 STONE AVE 10 14 2004 NE: SANITARY NO. CONTROL N0. (408)280-6500 ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDGELECT PLUMB MF.CH I 0 LICENSED CONTRACTOR'S DECLARATION 1 hereby Chapter 9 Job Description P affirm that 1 am licensed under provisions of teom ming with secreandC,ufonisinn Sof the Business and Prufcssinns Cntic, end mYlrivcnu is in full force and cffp�t. SIGN FINALE® License Class (, Lic.N!h��'OD Date Contractor ARCHITECPS DECLARATION I understand my plans shall he used as public records DECtl1 C A 2004 7 Licensed Pmfessinnal OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Low for the following reason. (Seem.. 7131.5, Business and Professions Code: Any city .r county which requires a permit m construct. alter, improve, demolish, Or repair any soudtoo $2200 prior ba its issuance. also requires the applicant for such permit to File a signed matamcm that he is licensed pursuant o the provisions or the Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation (commencing with Secti.n 7") of Division 3 of the Business odd Prafessi..s Qvle) or Nat he is exempt therefrom and the basis for the alleged exemption. Any vioimton of Section 7031.5 by any applicant for a Pesmh subjects the applicant o a civil penally of 3 6 A IN RSVqq D OccupancyType not more man five hundred Call... (S500). YP C 1, as owner of the prefixty, or my employees with wages as their sole compensation, will do the work, and me structure is not intended or offered for sale (Sec. ]044, Business and Pmfessions Code: The Contractor's License Law does not apply to an owner of Required Inspections pr.peny who builds or improves thereon, and who does such work himself of through his awn employcee, provided that such improvements are not intended or offered for mile. If, however, me building or improvement is sold within one year of completion, the owner builder will have the burden of proving that he did not build or improve for puryou of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to contract the project (Sec, 7044, Business and Pmfessions Code:)The Contractor's Li. cense Law does not apply to an owner of property who builds or improver mereon. and , who contracts for such pmjeets with a contractors) licensed pursuant to the Contractor's License Law. ❑ I am exempt under See. , B & P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a C(inificae Of Consent to rel f -insure for Worker's Compem anion, as provided for by Section 3700 of the Labor Code, for me perro mono of the work for which this permit is issued. 0 I have and will maintain Worker's Compensation Insufanec, as required by Section 3700 of me Labor Code, for the perormarce of the work for which this permit is issued. ' M1y—WWorkers Compensation Insurance earier and Policy .umber am: car:y;YA� Policy N..D&C'Qd)/Q-Z� ' ERTIFICATE OF EYEMPTION FROM WORKERS' COMPENSATION INSURANCE '. (Thissection need not he completed Run, Permit is forum hundred dollars DIIgB or less.) I coni fy mut in the performance of the work for which this Form it is issued, I shall Lot employ any person in any manner so as in become subject to the Wormri Compcnaati.n Laws Of California. Date Applicant NOTICE TO APPLICANT: IL after making this Cenifcate of Exemption, you should become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. ' CONSTRUCTION LENDING AGENCY I hereby afOrm that mere is a construction lending agency I'or the performance of me work for which this permit is issued (Sec. 3097. Civ. C.) Lender's Name Lender's Address 1 certify mat 1 have read this application and store that the above information is Correct. 1 agree to comply with all city and county ordinances and state laws relating to hereby scnmtivcs of Nis city m enter upon the Construction,ne proand abonng shove action Proposes, property for inspection (We) are (We) agree m save, indemnify and keep harmless the City of Cupertino against ankeeph liabilities, judgments, costs and expenses which may In any way accNe agalnal.[ald City in consequence of the granting of this Permit. / :7D42I APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NOWPOINT Issued by: SOUR E G ATION (o// oleo Re -roofs Signamrc of App ratmiractor HAZARDOUS MATERIALS DISCLOSURE Data Type of Roof 1 Will the applicant or future building Occupant store or handle Infamous material as defined by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety Code, Section 75532(x)7 IlyN. All roofs shall be inspected prior to an roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove the applicant or bootie building occupant use equipment or devices which kWill it hao.artlnus air crnmminan. as defined by the Bay Arca Air Quality Management all new materials for inspection. istrict7 ❑Yes. I have read the haoardous materials requirements umler Chap¢r 5.95 of the Califon (�^3 ria Health&Sofmy Codc. Sections 25505,25533 and 25534.1 understand thotifthc building does not curemly haw a tenant mat it is my responsibility m n.rfy the Occupant of me requi s wit must met pri.r to asccrce 0f a Cen�Oca¢o Occ. ancy. Signature Of pphcan[ � Date b All roof coverings to be Class "B" or better Owner or auth ejed .,at, arc BUILDING DIVISION ACUPUNCTURE Loo LICENSED CONTRACTOR'S DECLARATION inu � 1 hereby affirm that l am licensed under provisions of Chapter 9 (commencing <with Se n ction7000)u(Division Sof the Rusinea and Professions Code, antl my license is in full force and eft t. LiLic. p3T n F ❑ Dam Cummctor ARCHITECTS DECLARATION I understand my plans shall he used as puhlic records 3oG Lmcnscd Pmfcxianal 5 OWNER -BUILDER DECLARATION j<i 1 hereby affirm that 1 am exempt from the Contractor's License Law for the ❑ O fallowing reason. (Section 71D1.5, Business and Professions Code: Any city or county >; fL which requires a permit or construct, alter, improve, demolish, or repair any structure Fes- prior ln its issuance, also myuims the applicant fonuch permit file asigncJ statement Cl that he is licensed punuam to the provisions or the Contncmr's License Law (Chapter 9 ngI (commencing with Section 7mah or Division lof the Business and Professions Code) or �.. Nat he is eaempt Ihemr1ma and the basis for the alleged esemption. Any vinlntion of Section 7031.5 by any applicant fora permit subjecls the applicant to a civil penalty of not more than rive hundred dollars (5500). D I, as owner of the pmperty, or my employees with wages u Ncir.sole compensation, will do Eric work, and the swctum is not intended or offered torsed. (Sec. 7044, Business .it Professions Code. The Convector's License Law docs not apply to an owner of property who builds or improves themon, and who does such work himsel(or through his awn employees, provided that such improvements are not intended or o(fexd for sale. If. however, the building or improvement is sold within one year of completion, the owner, builder will have the burden of proving that k itid not build or int prove for purpose of sale.). D I. as ownef of the propeny, am exclusively contracting with licensed contractors to consuuct the psojcct (Sec. 7054, Business and Professions Code:) the Convector's Lf. cense law does not apply m an owner of property who builds or improves themon, and who contracts for such pmjecs with a contractor(s) licensed pursuant 0 the Contractor'a License Law. D l am exempt under Sec, ,B& P C for this reason Data ' WORKER'S COMPENSATION DECLARATION 1 hereby effinn under penally of perjury one of the following dcclarnions: ❑ I he ve and will maintain a Ccnifcala of Consent o setf-asumfor Worker'sCompcn- eatitn, sa Provided for by Section 37W of the labor Code, for the perramance of the work for which this permil is issucd. Cl 1 have and will maintain Workers Compensation Insurance, as required by Section 3700 of the Labor Cade, for the performance of Ne work for which This permit is issued. My Workers Compensation Insurance carrier and Policy number am: C; ' ,: MTbl j\ )C $u rc�.y Policy No.01 [ �1/.�>/3 ( is c� ERTIFI :ATE OF EYEMPnON FROM WORKERS' COMPENSATION INSURANCE need not be completed if the Permit is for enc hundred dollars (SIM) ccnify that in Eric perromunec of the work for which this permit is issued, 1 shall not mploy any person in any mannersee as us become subject to thC Workers' Compensation Applicant NOTICE TO APPLICANT: IC after making this Ccnificam of Exemplioo, you should become euhjcel m the Worker's Compcnsaion provisions of the Lobar Code, you must .JO forthwith Comply with such provisions or this permR shall M deemed favored. z� CONSTRUCTION LENDING AGENCY f -n I hereby affirm that there isa construction lcodingagency lot he perfurmanecof !Yi > thc work for which this permit is issued (Sec. 3M, Co, C.) a (� Lender's Name 7 z Under's Address U O 1 ccnify that 1 have read this application and sure that the above information is Ll (•^coned 1 agree to comply with all city and county ordinances and state laws Olsten, a 0U building construction, and hereby aulhorin, represenutiws of his city to enter upon the Fchow -mentioned pmperty for inspection purposes. y (We) agree to save, indemnify and keep harmless the City of Cupcnino against N Iiabililies.judgmcroorcosls and expenses which may in any way accrue against said City Uz in consequence of the granting of this Permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT e„n rake —,, ­­­ \.) HAZARDOUS MATERIALS DISCLOSURE Will die applicant or future building occupant stoic or handle hamruus material U defined by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety Code, Section 25532(ap D Yes ON. Will the applicant or future building occupant use equipment or devices which .,it hovenduus air cnnmmioents as delinCd by the Bay Arca Air Quality Managnncn. DI... "7 DYE, Nu I have read the humorous materials requirements under Chapter 6.95 of the Cali foo- nia Hcallh &Safely Codc, Sadons 35505.]5533and 25534.1 undersand thatifth. building does not currently haw a mnam. pmt h is my responsibility m nutily the no,o ent of the t 4 rcqui s ch musmctpdorm issuance ofa Ccrficam of Occu ancy. 91. �''. � _ SIGNS INC (408)280-6500 PERMIT NO 4 1 �craMll LV IIC VMIC 10/14/2004 SANITARY NO. CONTROL N0. Job Description SIGN 9� Sq. Ft. Floor Area 7M6 Owner Issued by: Re -roofs Type of Roof BLI C Required Inspections Date All roofs shall be inspected 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. 1 Signature of ppricant Date All roof coverings to be Class "B" or better CALIFORNIA ACUPUNCTURE BUILDING 51GN ELEVATION: 196745TEVENS CREEK BLVD. CIN OF CUPERTINO I; APPROVAL: m RACEWAY PAINTED KM -587 gFn ��-unc- urC�u 5" THICK INDIVIDUAL CHANNEL LETTERS, NEON FOR INTERNALLY ILLUMINATION, 3/4" RED TRIM CAP, RETURN PAINTED 701-M STONE AGE (DURAPO)(Y) COLOR SCALE: 1/4"=1'-0" DATE: OCT -01-2004 EX15TING WOOD BEAM SHEET METAL RACEWAY FOR ELECTRICAL WIREING 1/4"x.2" LAG SCREW INTO WOOD BEAM TOP & BOTTOM ® 4'-0" O.C. DISCONNECTED SWITCH #10x1" SCREW MIN.3 PER LETTER TRANSFORMER BOX #10x1/2" SCREW FOR RACEWAYCOVER CHANNEL LETTER INSTALLATION DETAIL DATE: PROJECT: • 0 !' 2 F STORE FRONTAGE NEW SIGN LOCATION OffICE CW1 0 • 1 • All designs & art works PLOT PLANS eaekl q , f a qmrf m 44y Oman vs am, .Ciaofn �& WALL hOT be hIs eld to *M t7 DDroval of the Vi0laap �w . da R oI any ao any % Ordrnanla py Ift � IT to Allen Signe, Inc. Any duplication is prohibited. COPY RIGHT 2004 rf�408/Y80-6500 lip fN4408/289-8700 2982 STONE AVE. SANJOSE CA. 95125 State Lic.#385551&5 Saudi •CITY OF CUPEkTINO CITY OF CUPERTIN • SIGN PERMIT APPLICATION FORM APN # 30-06-oo Date: 1"Mo Building Address: I q6 T4 ZIVOO Creek i Vd Owner's Name: Phone #: BPLANCHK Plan Check Fee Contractor: License #: 1(-- BUILIDNG Contact'/: _JJ� , K; wl1 I Phone #: Applicant/Contracto : Building Permit Info: ld lect Plumb Mech Job Description: Residential: _1—YI /' 9 ommercial: Sq.Ft. Floor Area: Sq.Ft Architect/Engineer: Oost of Project: ELECTRICAL 4 aa6yp — Type of Construction: Qccupancy Group: j Qyy. if I ' A heable Fee ID FPe T1Pacrintinn FA< B NERGY Ener 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 Signs, Marquee ELECTRICAL BUSLIC I Business License BUILIDNG �# 2�7 e( 2-7