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08120073yaiC; 0E :t Ll n�u gt% boo, �OC lie —Z> CITY OF CUPERTINO'�«+q,as?''•-"' BUILDING DIVISIONPERNIIT CONI RACTFORINFPP R�MATIE3 BUILDING ADDRESS: PERMrr NO. 19770 STEVENq 2RF.FK RLVD ACTIVE SIGN CO ,NEWS NAME: PERMIT ISSUE DATE O E: A CONTROL NO, 408)297-6640 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLIX'. ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION lob Description 1 bereby affirm the 1 son licensed maker provisions of ChW. 9 (am nconal P with Seeaon 7") of Division 3 of the Business ad Pmemmm Cocks. and my license 13 inlull race a d �_ 2 SETS OF ILLUMINATED MONUMNT SIGN Licca Clear ` OmN Dawe Camrecwr ARCHITECTS DECLARATI f 1 undewnJ my plan dull W used as public records Licensed Profcssionsl OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from Ne Contractors License Law far to following moron. (Section 7031.5, Business and Profcaduv Cale: Any city Or county which require a permit to co muut, almr, improve, demolish. Or repair my swclure prior to its issuance. ala regwms the applicant for such permit w file a signed atskment Sq. Ft. Floor Area Valuation the he is licensed purmant to the Provisions of the conumor's Liana law(Cbapeor 9 (commencing with Section 7000) of Division 3 of the Business uM Pmfcssamn Codc) err $17500 that he is eampl therefrom and me bus for the alleged exmpticn Any violation of APN Number Occupancy Type P Y YP Section 7031.5 by arty applkut far a permit ablcm the aPPlicmuo a civil pmalty of rut mom roan five hundreddollam (5500). 36906088.00 ❑I, as owner of the properly. amy unploycu with wages as Neo ale compensation, Required Inspections will do the wort and the stratum, u not mounted ser offered for sale (Sec.7W. Business ad Piefesdons Cade: The Contractors Limrse lap doe at apply to m Owner of property wW WilNouimpmves Nunn. sdwha aoesumb wmkhuuelfoumrough his vooemployev, provided thatsuch improvements me rot intended uo0hmd feage. IL however, the building or improvement is mid within one year of completion. the owner. builder win have the hada of paving Nu he did Out build or improve for purpose of ssleJ. ❑ 1. u comm, of the property, am exclusiveIY contracting with licensed contractors ed construct the pmjea (Sec. 7016. Bounm and Professions Code:) The Conmetora Li - neve law doe not apply to sin caner of property who builds or improve themen, md, who coarsest for surth projem with a conu,am(s) licensed Pascal to the Charaewh License Taw. ❑ I at =cap, under Sec ,B B PC for, this moron wnu Duk WORKER'S COMPENSATION DECLARATION I hereby affirm under porosity of perjury arc of the following decuratiortti: ❑ I here and wnl mainuin • Cenifiok ofCovenlw vel( ivum for Wmkela Campem titian, u provided for by Section 3700 of the labor Code, fit the performance of ft work, for which this permit is issued. 1 have and will maintain Worley's Compensation lose ma, u required by Section 3700.f the Labs Code, for the perfamace of the work for which this permit is issued ' My Workers Compensation loans cart WPolicy number limier:6a Policy No.: CERTIFlCA OF EKEMMON PRO MW0/ S - COMPENSATION INSURANCE (Thu=am need at W conplekJ If the permit is lounge hundred dollars (SIOB) or Ws.) 1 coruCv that in Ne pulcmeme. of the work for which this permit is issued 1 shall am employ anypermn In my manrcr to as as become subject w the Workers' Compens,tion Laws of Califamix. Due Applicant NOTICE TO APPLICANT: If, i fkr rusting this Certificate of Exmption. you should become subject w the Worker, Com,tt rstion provisions of Ne labor Code, you mut ' farmwith comply w W such provisions or this permJ shall W doomed mvokd. CONSTRUCTION LENDING AGENCY , 1 Wrohy a1Drm Nu them is a Construction knding agency for the perfarmarcm of me were for which this permit is small (Sec. 3097, Civ. C.) Landers Name , Leder: mamas I certify that 1 have mad this applicukn and sue that me above information is coral. I agree to comply with all city and county ordinance and sum laws muting to . building construction, and hemhg m horim repmsentaves Of this city to cnkrupnn the Oma-usadund property for inspection purpnves. (We) agree w save. indemnify and kap harnka, dto City of Cupertino agsinm j nabilitie,jdgmenu. cots ard experuca which may to any way.roue Mg., aid City r in consequence Or the {renting of this permit APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date G SOURCEREGULATIO S. Z Type of Roof m�), ems % od nature ApplianVCaliAZARDOUS MATERIALS DISCLOSURE a�� Will the applicant or f num Wilding axuPat.. Or handle haamdov mucrial as defined by Ne Cupoam Municipal Code. Cbapkr 9.13. and the Health and Safety Cale. Section 1553x(,)? All roofs shall be inspected prior to any roofing material being installed. ❑Ye 0 N If a roof is installed without firs[ obtaining an inspection, I agree to remove Will the applicant or future building Occupant sax equipment or devices which COIL wardov air emuminm s u JaOncd by Ne Bay Ama Air Quality Management all new materials for inspection. Diana? ❑Ya ONO y I have mad the huallousmakruls roquimmenu underampler6.95 of Ne Giifor. nia Health&Safety Cade, Sxtiov 25505.15533 ad 25536.1 understand thmif Jm Wilding does not.met ntly have • u n m, Jur it u my mspecoblity to notify the occupant nr the req tswhkhmustbemetp. vanaarac rd0akoraa th y. Signature of Applicant Date i All roof coverings to be Class 'R or better own¢ Named qcm Deck 7 til} 'i'"Fli I I-, le Edit Actions Details Links Favorites Help f �f�flll �tUfi'Cl�li0i 10EAP5 ISI. Address' I Permit Number' '08120073 CUPERTINO Status E - Expired IQI Unit Master Number patg 0Lri?i I CLI Notes Project %I EVER SHINE VI, LP/ KCR MNGMNT Use Default Apply Date 1210812008 Operator Permit Issue Date 1210812008 Operator Certificate Issued 0610812009 Operator Certificate Type Certificate Number EXPIRED Permit x Property Permit Details Lr,_b�hJrl �I',tnil"�.�pr7fi 10EAP5 ISI. Address' I 19770 STEVENS CREEK BLVD City/State/Zip CUPERTINO 0 APN 36906088.00 IQI Unit 17500 patg 0Lri?i 0,Tn',at1,--"1 patg (Owner Name %I EVER SHINE VI, LP/ KCR MNGMNT Use Default 1-1 Address Home -19770 STEVENS CREEK BLVD Zoning Applicant Contractor' Defined Fields Permit Type' 10EAP5 ISI. SIGNS, OUTLINE LIGHTING & MARQ Usage Class ' N/A ,I NON APPLICABLE Applied Value x 17500 SQUARE FT. 0 Calculated Value 0 1I' US C-404 Type 437 ALT: NON -RES, NON-HSKPG Permit Form' AUTOPERM - PERMIT Ownership 1 - Private Project Size COUNTER,-- OVER THE COUNTER CA 95014 City/State/Zip CUPERTINO CA 95014 Purpose/Special Conditions 2 SETS OF ILLUMINATED MONUMNT SIGN NO INSPECTIONS PERMIT EXPIRED 618109 FILMED 5/20111 IWAdd Default T ;f0K Iiv Back Jr. Contractors 17::JJ1 Fees 4 Plan Reviews Irl -Inspections IGS Print Permit Ic_ "'Adjustments `M Holds E,`1 Copy Permit IJ Close Permit �; Overrides I '-� Supplemental Fields I.`` -.Il Notes la:�,hnrt��rr a rr 'ermit issued 1210812008 C';R anter the purpose or anyspecial conditions for this permit I ad Q 00 _'U 3E"u�i J0a 7aU IL 1,- �0< Y00 K'm Pi Y 1,-i 0z z� Lea ? �z UO rz F, �U Fa U CITY OF CUPERTINO BUILDING DIVISION PERMIT BUILDING ADDRESS: PERMIT NO. 19770 STEVENS CREEKACTIVE SIGN CO nR12.n07-1 OWNER'S NAME: PERMIT ISSUE DATE PHONE: A CONTROL NO. (408)297-6640 ARCHrfECr/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Co and my license is in full force and a . 2 SETS OF ILLUMINATED MONUMNT SIGN License Class Lic. # Date Contractor ARCHITECTS DECLARAT N I understand my plans shall be used as public records . Licensed Professional OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county which mquires a permit to construct. alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violadon of $17500 Section 7031.5 by arty applicant for a permit subjects the applicant to a Civil penalty of APN Number Occupancy anC p y Type not more than five hundred dollars (5500). 36906088.00 ❑ I, as owner of the property, or my employees with wages as their sale compensation, Required Inspections will do the work, and the structure is not intended or offered for sate (Sec. 7044, Business and Professions Code: The Contractor's License Law docs not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered 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 he did not build or improve for purpose of ' sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:) The Contractor's U. . cense Law does not apply to an owner of property who builds or improves thereon, and • who contracts for such pmjects with a contractors) licensed pursuant to the Contractor's License Law. C]I am exempt under Sec B & PC for this reason Owner Dale WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a Certificate of Consent to self -insure for Worker's Compen- salon, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued ' My Warker's Compensation Insure c carri and Policy number are: Carrier. Policy Nm.: i CERTIFICAT50F EXEMPTION FROM WO E S' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become 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 the Workces Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed evoked CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (See. 3097, Civ. C) Lender's Name ' Lender's Address I certify that 1 have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and stale laws mlating to building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT / Issued by: Date SOURCEREGULATIO S. Re -roofs Type of Roof Sitnature Applicam/Contractor attic HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety cede, Section 25532(a)? All roofs shall be inspected to any roofing material being installed. ❑Yrs ❑No prior If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑ Yes ❑ No :b 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health & Safety Code, Sections 25505.25533 and 25534.1 undersivrd that if the building dors not currently have a tenant, that it is my responsibility to notify ncc occupant of rhe req cnis which must be met pd ssuance of certificate of Occu ancy. Signature of Applicant Date %1 °All � t roof coverings o be Class'r "or better g � Owner Date o thonxcd agent 0075 CITY OF CUPERTINO SIGN CUPEkTINO PERMIT APPLICATION FORM APN # Date: 70 Building Address: %,r7 -7 12 96,X0 - /9V0 6*i s Mailing Address (if different from building address): Owner's Name: E-J&-� jmo, 0/,r : ke je kkPP Phone #: //CCF - 3 40 %yr! p &Ikas 0.-w-& 4 Contractor: Phone #: 0013 —X33 j A&ap sp Fax #: Contractor License #: e Cupertino Business License #: Contact: Phone #: Fax #: c�7�43 Building Permit Info: Bldg ❑ Elect Monument Mounted on Building ❑ Residential ❑ Commercial Job Description: Valuation (cost of project):, Project Size: Express ©--l-tandard. ❑ Large ❑ Major ❑ Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Revised 6/16/08 CITY OF CUPERTINO am SIGN OTYOF CUPERTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type 1 SIGNDIRECT Directional B 1SIGN/RF Ground/Roof/Projecting Signs B 1 SIGNMASCK Master Plan Sign Check B 1 SIGNREWRKG Rework of any existing Ground Sign B 1 SIGNOTHER Other Sign B 1 SIGNREINSP Re -inspection Fee B 1 SIGNWNONEL Wall/Awning Sign, Non- Electric B ISIGNWELEC Wall, Electric E IESIGN Sign, Outline Lighting System or Marquee supplied from one branch E 10EAP5 1ESIGNADD Additional Branch Circuit on Same Sign, Outline System or Marquee E 10EAP6 IELCPLNCK Plan Check Fee E EPERMITFEE Electric Permit Fee E BSEISMICOM Seismic Commercial B BSEISMICRE Seismic Residential B TRAVDOC Travel & Documentation B BUSLIC Business License B ,.tom t a{ CITY OF CUPEf�TINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: /91mp SAVCiv A1val PERMIT # OWNER'S NAME: AAM4X zpw PHONE # GENERAL CONTRACTOR: ��{,P FAX # _o I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: Owner/ Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/ Contractor Signature Date