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06080191CITY OF CUPERTINO �CONTR`e�CTIi,1NF0RNI?W ' r BUILDING DIVISION PERMITV BUILDING ADDRESS: RAGO NEON PERMIT NO. 06080191 ANLA,05 STEVENS CREEK BLVD 1ME: �QgCJ' PERMIT LSUE DATE GEO YAMAOKA 235 LAUREL AVE 08/21/2006 PHONE: SANITARY NO. CONTROL NO. (105)719-3 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH O O O O LICENSED CONTRACTOR'S DECLARATION Job Description P I kteby affirm Nat 1 am 1¢tued under pmvWOM of Clu es' 9 (mmmcne ng with. Section TWO) of Division 3 of d,e Business W Profeniom Code, and my liceue is in full fome and of c �p 2-4" INSTALL 1 SET ILLUMINATED CHANNEL LETTERS 1 BRA Liu. "°clSIGN Dam D WILL SAY: CHUCK E. CHEESE (RED SIGN) TSDEC ARCHITECTS DECLAc meord 1 understand my plans shall he tied as public nxnNa Licensed Professional OWNER -BUILDER DECLARATION I Imrehy n1iifm Nat I am exempt Wm the Conttaewe, License Law far we following mason. (Section 703 1.5, Business and Professions Code: Any city or county which requires a permit to construct, char, improve, demolish, or repair any suunure prior us its issueoe. also requires the applicam for such Permit he file a signed aamment that he is licensed pursuant to the provisions of the Conuuur's License law(Chaptcr 9Sq. F1.Floor Area ValuatiQQ3000 (commencing with Section TWO) of Division 3 of the Business and Professions Code) or that he u exempt thmefrom and Ne basis for the alleged eaemplion. Any vulaslon of APN Number Occupancy Type Section 7031.5 by airy applicant for a permit subjects the applicant to a civil pointy of not more man five hundred dollsn ($51(). 31621032.00 0 1, u owmr of Ne psopmy, or my employcu wlth wagrs u the4 ulc compemadon, Required Inspections willdathcwmk. and these 703a,Busitess Liaise law doss hes appy m an owher aW The Commerce,License 9 P senuacmrs builds is enywhobuildsorimpmsesthereon,and who property At. Am matihwork oroffeortlwugh semen0 art nos intended ed for um.lf. own the improvements own a Me Wiprovided however. vete is caplen dse owher- old within oche yeti of mmove however, Ne Wildingofder /tom Of pmmttg for builder will have Ilse bmticn of proving ma K did oat build a improve far puryose.f tile.). I, as owner of the Properly, . B exdusivnd contracting with ) The, C .—we$ U. counted the project (Sec. 7044, Business Cade:) odd property whe wilds., provesotracmrs actio law does rot apply je an owner of amemo rho Wilds or impmvu Nano, sad. who contends for such pmKeu wiNaconuxmgs)Ilunttd pursuam came Conuacmh �.a., e Law. meaemps under Sec. ,B&PC for Nis recon"©� W✓ 0m Gv I Data sq� It y WORKER'S COMPENSATION DECLARATION I hereby Nae under pctulty, of perjuty oro of the following declauua.s: 0IM1zre and will mainuina Cemficam of Coocmmself-insure far Worker's Compcn- /s union, As provided for by Section 37W of the labor Code. for the performance of But, work for which this permit is issued. 0 1 have and will maintain Workers Compensation Inurence, u requimd by Section 37W .(Me labor Code. for the performance of the woh for which this F omit is issued. My Workers Compo . Imo mcami and Policy number art: Carrier. lMyN..: �65-3910 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE - (This union head os he completed if the person is IMAM, hupdrtddallua (SI W) or less.) I cenify Nut in the performance of me work for which this Permit if issued. 1 shall not employ any person in any ma.orao as As became subject to the Workers Compensation U., of California. Date Applicant NOTICE TO APPLICAW. If. after making this Ceni0cale Of Exemption, you should become subject on the Workers Compound.. provisions of the Lora Cocc, yaw muss ' f.Mwith comply wit such provisimu or mu Permit shall W decmeG revoked. UCTION LENDING AGENCY Ihertby Me them used(Se.construction0 lending agency I'nr dm Performance of whaffirm pemart Me wash fm which thio permit u usmtl (Sec. 309'1, Civ. C.) j Lenders Name ` Lender: Addn,u I modify that I have read this application and sate to Ne above informadun is ' ' correct. I agree to comply with all city and county onlimmeta and sum laws rearing m building eonswethm, and hereby au luxim mprcacmasivrs of this ch, w,mcr upon the 3 hovememioned Properly farpe (We) agree 1. save. indemnify and keep bermlcas Or City vel Cupertino egaitut nsip.us. liabilitica.judgmcnu.cosand expenses u Whwhich may in anyway atom against said City Ming Of ' t APaLs`ANT`UN ERSTVDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date �- 2 3 G 50 REGULATFR[J V 23106 Re -roofs Type of Roof JmOf Applic=VC moor t ate �I- HAZARDOUS MATERIALS DISCLOSURE Will the applicant car forum Wilding occuputssort Or handle hamdous material Rod by the Cupertino Municipal Code. Chapter 9.13, and the He bin and Safety .,mc. Sc.d.. 25532(.)? ❑ Yu zin-N. All roofs shall be inspected prior to any roofing material being installed. Wrmusll Me If a roof is installed without first obtainingan inspection, I agree to remove Pe g ' air contnminant Of ts a Wilding by Me Bayra AMA AirtseualitynE or vinagemces ch emit h.xardnw air contaminants u dcOnctl by the Bay Arta Air Quality Management all new materials for inspection. DistricsT ❑Yes Nu I have mad the hemand. maurialsnequiremenu under Chapmr 6.95.EMc Califor- nia Health& Safely Code, Secdoo 35515.25533 and25534.1 undcnund thaif thc building docs trot'Mmmly W a tenant this it u my rup.asibility m notify de uP.1 of me mqu" ma wit mw tPd.,doin.a. of. certakme when. Signature of Applicant Date 2 All roof coverings to be Class "B" or better o nu otharived.. Dam