12040117 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20730 STEVENS CREEK BLVD CONTRACTOR:ACTIVE SIGN CO PERMIT NO: 12040117
OWNER'S NAME: BYER PROPERTIES LP 1365 E TAYLOR ST DATE ISSUED:04/20/2012
OWNER'S PHONE: SAN JOSE,CA 95133 PHONE NO:(408)297-6640
LICENSED CONTRACTOR'S DECLARATION. JOB DESCRIPTION: RESIDENTIAL COM$IF.RCLU.
License as LN6) Lic.4 _l0?2 07-` INSTALLATION OF INTERNALLY ILLUMINATED
CHANNEL
Contractor Date LU 2011. LETTERS FOR 2 SIGNS TJ MAXX AND HOME GOODS
1 hereby affirm I I am licensed under the provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$6000
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this
APN Number:35908020.20730 Occupancy Type:
permit is Issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIR WORK IS NOT STARTED
correct.1 agree to comply with all city and county ordinances and stale laws relating WITHIN 180 S F PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned properly for inspection purposes. (We)agree to save 180 DAYS F AST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities.judgments,
costs,and expenses which may accrue against said City in consequence of the G(/
gran) g o this permit. A ditionally,the applicant understands and will comply Issued by: Date:
with a on oint source r ulalions per the Cupertino Municipal Code,Section
9.18.
RF.-ROOFS:
Signature —Date /Zpp— 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.
❑ OWNER-BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of Signature of Applicant: Date:
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapler 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
1 hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and the
declarations: Health&Safely Code,Section 25532(1)should 1 store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defrn the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance Ith he Cupe lino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code, -et tons 25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Owner or authoriud agent: !`— Date: lU
I certify that in the performance of the work for which this permit is issued,l shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California If,after making this certificate of exemption,I CONSTRIICI'ION LENDING AGENCY
become subject to the Workers Compensation provisions of the Labor Code,1 must I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
I certify that I have read this application and state that the above information is
correct. I agree 10 comply with all city and county ordinances and slate laws relating
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, ARCHITECT'S DECLARATION
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records,
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
CITY OF CUPERTINO
7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: counter
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35908020 .20730
DATE ISSUED. . . . . . . : 04/20/2012
RECEIPT #. . . . . . . . . : BS000016591
REFERENCE ID # . . . : 12040117
SITE ADDRESS . . . . . : 20730 STEVENS CREEK BLVD
,SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : BYER PROPERTIES LP
ADDRESS . . . . . . . . . . : 66 POTRERO AVE '
CITY/STATE/ZIP . . . : SAN FRANCISCO, CA 94103
RECEIVED FROM . . . . : J & S SIGNS
CONTRACTOR . . . . . . . : NANCY BAL LIC # 25506
COMPANY . . . . . . . . . . : ACTIVE SIGN CO
ADDRESS . . . . . . . . . . : 1365 E 'TAYLOR ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95133
TELEPHONE . . . . . . . . : (408) 297-6640
FEE ID 'UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- --------- - ---------- ----------
1BCBSC VALUATION 6, 000 .00 1. 00 0 . 00 1 . 00 0. 00
1BSEISMICO VALUATION 6, 000 .00 1 .26 0 .00 1 .26 0. 00
1EPERMITFE FLAT RATE 1 .00 44 . 00 0 . 00 44 . 00 0. 00
1ESIGN UNITS 1 .00 44 . 00 0 . 00 44 . 00 0 .00
1SIGNGR/RF EACH 1 .00 327 . 00 0 . 00 327. 00 0 . 00
1SIGNWELEC EACH 2 . 00 520 . 00 0. 00 520. 00 0 . 00
1TRAVDOC. FLAT RATE 1 .00 44 . 00 0 .00 44 .00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 981.26 0 . 00 981.26 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- ----- ---------------
CREDIT CARD 981..26 visa
---------------
TOTAL RECEIPT 981.26
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
101 FOUNDATION 103 UFER
104 REBAR 105 ANCHOR BOLTS
304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL
CITY OF CUPERTINO h
FEE ESTIMATOR- BUILDING DIVISION 16 Do qoll'7
ADDRESS: 20730 Stevens Creek DATE: 0412012012 REVIEWED BY: gs
APN: BP#: 'VALUATION: $6,000
•PERMITTVPE: Building Permit PL,1N CHECK 'T)TE.
PRIMARY PENTAMATION
USE: Sign PERMITTYPE: 10EAP5
WORK Installation of 2 Building signs and 1 pylon sign.
SCOPE
SIGN TYPE FEE ID QTY SIGN FEE
Wall Sign, Electric 1SIGNWELEC 2 $520
Ground Sign 1SIGNGR/RF 1 $327
TOTALS: $847.00
lL•rlr. l'lnn C'hack Planih. Plan Clux,A #Branch Circuits 1 $44.00
birch. Po mil Fee: 1'111mh. Pe,"61 Fre: IESIGN Elec. Permit Fee: IEPERMIT
Oihrr llcrh. Leq�, other Plumb Insp, Other Elec. Insp. 0.0 $44.00
.Fish. Myr. Fcv.: l'hnnL, hisp. Fra: lGcr.Insp. F,r.
NOTE: This estimate does not includejees'due to other Departments(i.e. Planning, Public Works, Fire,SanitarySewer District,School
District,etc). Thesefees are based on the prelindna in ormation available and are only an estimate Contact the Dept for addn'!info.
FEE ITEMS (Fee Resolution 11-053 Eff' 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Chuck kee:
Suppl. PC Fee: 0 Reg. O OT FO.OThrs $0.00
Plmnh./d/ech.1E1c•(:
Permit Fee: $847.00
Suppl. Insp. Fee-.0 Reg. Q OT 0.0 1 hrs $0.00
PME Unit Fee: $44.00
PME Permit Fee: $44.00
C'un.an w iion Tax.
Acbninixtralive Fee:
Work Without Permit? C) Yes Q No $0.00
Sign Master Plan: O Yes 0 No $0.00
Travel Documentation Fee: ITRAVDOC $44.00
i
Strong Motion Fee: IBSEISMICO $1.26 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $981.26 $0.00 TOTAL FEE: $981.26
Revised: 04/01/2012
Certificate of Com fiance; Si Lighting) (Pae 1 of 4) SLTGIC
Project Name: Dam:
�-
Project Address:
Location of Sign Outdoor Signs- = - ❑Indoor Signs
Phase of Sign Construction • '9 New Signs 17 Sign Alterations \
T of Lighting Control O New Lighting Controls 13R laced Li tin Controls Not Insmllin Li tin Controls
This Certificate of Compliance includes the following components(check all that apply)\
❑Mandatory Measures(Lighting Controls) ❑Maximum Allowed Lighting Power 12 Specific Lighting Sources
1. Certificate of Compliance Declaration Statement(this may be a C10,C45 or other eligible person)
• 1 certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and
correct.
1 am eligible under Division 3 of the California-Business and Professions Code to accept responsibility for the lighting design.
This Certificate of Complianceidentifies the lighting features and performance specifications required for compliance with
Title 24,Pans 1 and 6 of the California Code.of Regulations.
• The design features represented on this Certificate of Co Bance are consistent with the information provided to document
this design on the other applicable compliance forns;.wo 'calculations,plans and specifications submitted to the
enforcement agency for approval,witti-chis building permit icadon.
Name: Signature
Lo G✓GUS
Company: Phone
5 1tr 411 LI
Address: License number(may be contractor's lie ll)
VI ^ o✓ !z L2-- OZ1
City/State/Zip: � Date C.;. . 133. 2v �4 L
2. Installation Certificate to be signed by responsible person after installation
Permit number raeeked by/Dam
fibmearmot Apcy Use (Fnfort =I Agcacy Use
Installation Declaration statement
• 1 certify under penalty of perjury;tmder.the laws of the State of California,the information provided on this forth is true and
correct.
• I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction,or an authorized
representative of the person responsible for construction.
1 certify that the installed features;materials;components,or manufactured devices identified on this certificate conforms to all
applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the
enforcement agency.
• I certify that the requirements detailed on this Certificate of Compliance have been met.
I will ensure that a completed,-signed.copy of this Installation Certificate shall be posted,or made available with the building
permit(s)issued for the building;and,made available to the enforcement agency for all applicable inspections. 1 understand
that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the
building owner at occupancy.
Company Name:
Responsible Person's Name: Responsible Person's Signature:
License number(may be wntraetor's tic t{) .Date Signed: Position With Company:
2008 Nonresidential Compliance Farms July 2010
Certificate of Compliance (Sign Lighting) (Pa!e 2 of 4 SLTGIC
Project Name: /` Dam:
o mtL hluo `A-Ghy.
3. Mandatory Sign Lighting Condols
NOTES:
1. The Mandatory Measures (sign lighting controls) are required for compliance with the sign lighting Standards. The same
responsible person may install both the sign and the sign lighting controls, or a different responsible person may install the
sign lighting controls than the responsible person installing the sign.
2. If the person responsible for installing the sign is not also responsible for the sign lighting controls, then the owner of the
sign,general contractor, or architect shall be responsible to have the sign lighting controls installed.
3. If more than one person has responsibility for compliance, each person shall prepare and sign a Certificate of Compliance
and an Installation Certificate applicable to the portion of construction for which they are responsible; alternatively, the
person with chief responsibility for construction shall prepare and sign the Certificate of Compliance Declaration Statement
or the entire construction.
3a. Statements of Responsibility:
The person sigt'n&the Certificate of Compliance Declaration Statement shall check Yes or No for all of the following statements:
I I have responsibility for installing the sign lighting controls
❑Yes complete arts 3a and 3b of this form v No complete part 3a of this form
2 There are no existing sign lighting controls and 1 will be installing compliant sign lighting controls
❑Yes '9 No
3 There are no existing sign lighting controls and som ne else will be responsible to install compliant sign lighting controls
❑Yes No
There are existing sign lighting controls that do not comply with the applicable provision of§119 and§133 and I will be
4 installing compliant sign lighting controls
❑Yes V No
There are existing sign lighting controls that do not comply with the applicable provision of§119 and§133 and someone else
5 will be responsible to install compliant sign lightinB�controls
13 Yes 6 No
3b. Mandatory Sign Lighting Controls
The person signing the Certificate of Compliance Declaration Statement shall answer all of the following questions if they are
responsible for complying with the sign lighting control requirements.
If there are construction documents,indicate where on the building plans the
mandatory measures(sign lighting control note block can be located:
I §133(a)l.All Indoor sign lighting is controlled with an automatic time switch control that complies with the Y N NA
applicable requirements of§119. ❑ ❑ ❑
§133(a)l and 2. All outdoor sign lighting is controlled with an automatic time switch control plus a photo Y N NA
2 control or an outdoor astronomical time switch that comply with theapplicable requirements of 119. ❑ ❑ ❑
Exception to§133(x)2: Outdoor signs in tunnels or large covered areas that require illumination during Y NA
daylight hours. ❑ ❑
§133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce Y I N NA
sign ower by a minimum of 65 percent during nighttime hours. [31 ❑ ❑
Exception 1 to§133(a)3.Signs illuminated for less than one hour per day during daylight hours. Y NA
3 ❑ El
Exception 2 to§133(a)3. Outdoor signs in tunnels or large covered areas that require illumination during Y NA
daylight hours. ❑ ❑
Exception 3 to§133(a)3.Only metal halide,high pressure sodium,cold cathode,or neon lamps used for Y NA
illuminating signs or parts of signs. ❑ ❑
§133(a)4. An Electronic Message Center(EMC)having anew connected lighting power load greater than Y N N/A
15 kW has a control installed capable of reducing the lighting power by a minimum of 30 percent when ❑ ❑ ❑
4 receiving a demand response signal that is sent out by the local utility.
Exception to§133(x)4.EMC required by a health or life safety statue,ordinance,or regulation,including Y NA
but not limited to exit signs and traffic si ❑ ❑
Field Inspector Notes:
2008 Nonresidential Compliance Forms July 2010
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR / SUBCONTRACTOR LIST
JOB ADDRESS: OY1 C) yt evLr Ct SSI : PERMIT#
OWNER'S NAME: PHONEft
GENERAL CONTRACTOR: r " BUSINESS LICENSE # Q, to
ADDRESS: Scv�S-St C CITY/ZIPCODE: S(:,., C ` 131
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL O UPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL -THEGENERAL CONTRACTOR ANU ALL U CONTR CTORS HAVE OB'T'AINED A CI'T'Y OF CUPERTINO
BUSINESS LICENSE.
am not using any subcontractors: LO bl 2
Signature Date
Please check applicable subcontractors and complete the following information:
✓ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glaring
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
ty Sign Code Administration/Square Footage Allowance
Iuare Footage Formula:1 Square Foot of Signage Per Lineal Foot of Store Frontage
110-
ore Dimensions:
ImeGoods:120'-0"Wide Storefront
I Man:120'-0•Wide Storefront c T�•.7�,
lel Bath Stores Combined:62,200 Square Feet
topping Center Name:Cupertino Crossroads APR 20 Z��Z
�Ir;—ice
T*J*MM
CONCEPTUAL DESIGN PACKAGE p" PI—A_-N;
1942 CE(FCg
Created on: 01.18-2012 �'V ttY
Drawn by: R. Scheffer DA ITE 1 �Z
LOCATION:
Stevens Creek Boulevard @ N.D. NLA?VNI1
Cupertino, CA
Store Number: 628 C
1'O y
IGNS & SERVICES
O M P A N Y , I N C
•o...d��a r.P•u.u.,,.- T800-741-6942 r 714-761-2451 A 10980 Boatman Avenue, Stanton,CA 90680