04080022YpC
aE
3
a.pt
pC
xme
m—v
FZ>
mF`'e
a
CITY OF CUPERTINO
r
%Wrrrci�"- N m
BUILDING DIVISION PERNl�
RN[
«cm�r an
BUILDINGADDRESS:
PERM IT NO.
04080022
OWNER'S NAME:
PERMIT ISSUE DATE
ONE:
SANITARY t8 NO.
ARCHITECTIENGINCER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACT'OR'S DECLARATION
lb Description
oP
1 hcrchy affirm thm I am licensed under provisions of Chapter 9 (commencing
with Sectio IXM7 tf Divi ionJof NC Ousines an adevatmo Cotlga� oryliccnu is
IL-�
in full force s tett
L,SSCT
SIGN
u,enae n
Date�>r cIllet
HITECTS DEC'6 TION
CONTRACTOR: LEE BOLLA SIGNS
9crsmnd my plans shall he used as pB records
Cursed P.1f.a.nal
OWNER -BUILDER DECLARATION
1 hereby alfirm that I am exempt from the Contractors License Law for the
following mason. (Section 703 1.5, Business and Prof vxioro Cade: Any city or county
which requires a permit to stainer, eller. improve, demolish, at repair any nmerum
prior to its issuance, also requires the applicant for such permit to file aligned statement
License Law 9
Sq. Ft. Floor Area
Valuatypg250
that he is licensed Pursuant o the provisions of the Connectors (Chapter
(commencing with Section 7") of Division 3 of the Business and Professions Code) or
4 �
that he is exempt therefrom and the basis far the alleged exemption. Any violation of
APN Number
Occupancy Type
Section 7031.5 by any applicant for a Permit subjects the applicant to a civil penalty of
not mare than rive hundred dollars ($500d.
r,
I, az Owner of the Pmpenr, or my employees with wages az their sole compensation,
Required Inspections
will do the work and the strums a is not intended or offered for sale (Sec. 7094, Business
and Professions Cade: The Contractor's Liana Law does not apply to an owner of
property who builtlwr impmves mon, and workoofhimself or his
does sucham
edthrough
awnemployees,provided tsuch improvement aero or for sale.
r
soldwithin oneyen or learn. the owner
priworhimprovementsarene for ff
huilder Ne hve
argorimprovementis
improve
builder will have Ore burden of proving Nat he did not build or improve for purpose of
tifi
1, as owner of the property, am exclusively confessions with licensed i.
01,
See. ntraacmrs
cense La the project apply in an Business and Professions Code:) The Contractor's Lid
cense Law does not apply je an owner of property who builds or improves thereon, and
/
whocontracts for such projects with a connaetor(s) licensed Pursuant 10 the Contractor's
Y ,
LicenseL
Law.
laexempt antler Sec. ,B&PCfor this reason
1 an
0
Owner Date
WORKER'S COMPENSATION DECLARATION
1 hereby affrmr under penalty of perjury one of dm fallowing declarations:
❑ 1 have and will maintain a Cenificam of Canscnt to self -insure for Worker's Compeer
cation, as provided for by Section 37M of fire lobar Code, for rhe performance of thc
work for which this permit is issued.
❑ I have and will maintain Workers Compensation Insurance, az impaired by Section
3900 of the Labor Cade, for the performance or the work for which this permit is issued.
My Wofto - Compense n lnsumnec carrier and Policy number am:
Camel I/LL[,^%M Policy
CERTIFICATE OF EXEMPTION KERS'
,
COMPENSATION INSURANCE
rrlru.,arm need not be completed if the permit is rano hundred dollars($100)
in, less.)
1 certify that in the performance of the work for which his permit is issued. I shall not
employ any person in any mannerso M in Income subject to the Workers' Compensation
Laws of California. Date
Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should
become subject to Ne Worker's Compensation provisions of are Lothar Code, you must
forthwith comply with such provisions ar this permit shall be doomed revoked.
CONSTRUCTION LENDING AGENCY
1 herchr off rte Nat there I.. mnsnctinn lending sparer far the perfurman a of
' rhe work fur which this parent is issued (See. 3097. Civ. C.)
Lenders Name
Lendds Address
1 certify that 1 have had this application and seas, that Ne above information is
correct. I agree in comply with all city and county ordinances and ]am laws relating to
building consnction, and hereby authorim rcprcsenatives of this city to enter upon the
ahovcmemioned p.N,tXfor lnspcNoa par ..a.
(We) agree to save, indemnify and keep harmless the City of Cupertino against
I imbaities,judgmc t{cosrs and czpen3� whit may in any way because against said City
in conuquenc a doograining of ii ikto took
i APPLICA NDERSTAND D iLV> oMPLY WITH ALL 19 PO T
Issued b D e 17
SOU3CER G CATIONS. /
Re -roofs
_
Sig lApplicanVConfeacmr �Dm
ser
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will the applicant or furore building occupant store or handle hazardous material
as defined by the Cupertino Municipal Code, Chapter 9.11, and the Health and Safety
Code, Section 15531(x)?
All roofs shall be inspected prior to any roofing material being installed.❑Yrz
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or forum building occupant u. equipment or devices which
emit hazardous air conmminams az defined by the Bay Arca Air Quality Management
all new materials for inspection.
Oistrin?u
❑res
�
,
t
I have mad the haza±`reials requirements under Chapmr6.95 of the Califor
/
niaHcilNgr Safay Secma25505_2W3aad3 4.lundersmndamnifthe building
t,7y x�(inanL "s'mj
`
does nm c a the it res sihility 10 maty Rte w.' up of the
reyuircmcnea wti hmonk tact prig ,,6acerdfiear, tf Ocaap cr.
Signatureo Applicant Date
All roof coverings to be Class "B" or better
Dwrer t ahmire,d spot, Dam
co
N
T
n
N
CD
Q
O-
C
O
,-l�
APPROVED
IN ACCOHDANCWNITH THE CITY
SIGNED_
This s of pl and spec'rfications MUST be
kepr �n tob at all times and it is unlawful
to maKe any changes or alterations on same
without written permission from the Building
Department, City of Cupertino.
The stamping of this plan and specifications
SHALL NOT hA hold permit or to be an
approval of the violatio I of any provisions of
any Grp Ordinance or £ ate Law.
m AM 9 B
LEY OF C!
Fw
3
Cn
Cn
cQ
W/1
co
N
� �
N
CID
N
�
W
CD
un N
CD
O
4
U^
� J
CD
title of california
110"
quare feet 19.4
hannel letters with gold faces, black returns
go boxes white vinyl faces with black opaque vinyl
defining letters and black returns
74"
scale at 4%
®_IM
Z �
CI 0
M
'� c '"`
M ,.,
D mA
maw35
q
Z
Z D
scale at 4%
IIX
X1.08/.03/2004 16:17
■
■
C J
FAX
4087380231
To: Pam Jackson, Stewart Title
AUG 0 5 2004
From: Dena M. Rosa, Property Manager for De An'r OTPOP OPERTINO .
Date: August 3, 2004 BU mild(, nipPARTMENT
Including cover Total pages: 2
Re: ' Signage Approval
NAGE 01
The owner has approved your sign. As attached, next to your signage is Nhere he
initials the approval.
Should you have any questions, please feel free to contact me at (408)73E-4444, or
• via e-mail at dena rosaavahoo.com
•
•
1J
Letter Cross Section
5 "
Black Aluminum
Channel Coil
Trim
'* !!,,
�Nebn Tubing
CITY OF CUPERTINO
- �� z nFPAMMENT
Rubber electrode caps
Glass Stand -Offs
91
Transformers inside raceway
J box elecrical behind concrete wall
by others
Concrete wall