12050083 CITY.OF C'UPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19885 STEVENS CREEK.BLVD CONTRACTOR:NORTHWEST SIGNS PERMITN0: 12050083
OWNER'S NAME: CUPERTINO INVESTMENT PARTS LLC 120 ENCINAL ST DATE ISSUED:05/08/2012
OWNER'S PHONE: 4083692920 SANTA CRUZ, CA 95060 PHONE NO:(831)469.8209
❑ LICENSED CON'rRACTOR'S DECLARATION r r r
ryBUILDING PERMITINFO: BLOC ELECT PLUMBLicense Class �-r7 S` Lic.N 79K1�9� r r r_
NIECII RE.51DEN'I IAL CO\I.\IEROAL
Contrac� DatcL
JOB DESCRIPTION: COR'f FllRNl fl1R1 INS'I'ALL 42X78"AWNING
1 hereby affirm that 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.
1 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[his permit is issued Sq.ft Floor Area: Valuation:52500
I 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 ,\PN Number:31621031 19895 OccupancyI'ypc:
permit is issued 2 _ -
APPLICANT CERTIFICATION I .. ._
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city(center
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City ol'Cupertino against liabilities.judgments,
costs,and expenses which may accrue against said City in consequence of theC ` G
granting of this permit. Additionally,the applicant understands and will comply Issued by:�i V f Date: I2
With all non-point source regulations per the Cupertino Municipal Code,Section
9,18.
Rh:ROOFS:
Signal�lL7ilj Date /y All roofs shall be inspected prior to any roofing material being installed 11'a roof is
installed without first obtaining an inspection.I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant: Date:
1 hereby affirm Thal l nm exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS']0 BE CLASS"A"OR BFATER
h 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(See 7044,
Business&Professions Code)
h as owner of the property,am exclusively contracting with licensed contractors to IL\%ARDOUS\IA TRIMS DISCLOSURE
construct the project(Sec.7044,Business&Profession Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. twill
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino\lunicipal Code,Chapter 9.12 and the
declarations: Ilealth&Safety Code.Section 25532(a)should I 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 defined by the Bay Area Air Quality Management District 1
performance of[he work for which this permit is issued will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and Will maintain Worker's Compensation Insurance,as provided for by the Ilealth&Safety Code,Sections 25505,25533•and 25534.
Section 3700 of the labor Code,for the performance of the work for which thisOwner or authorizrdag3�bl7
permit is issued rn •,/�; Date:
I certify that in the performance of the work for which this permit is issued,I 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 CONSTRUCTION' LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must 1 hereby affirm that there is a Construction lending agency lir the performance rl
forthwith comply with such provisions or(his permit shall be deemed revoked w'ork's for which this permit is issued(Sec.3097,Civ C,)
Lender's Name
APPI.IC.\N''I'CER'1'IFICA'1'ION Lender's Address
I certify(hal I have read this application and sm[c that the above information is
correct. I agree to comply with all city and county ordinances and stale 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 AR(:III'fF:CI"S DECLARATION
and keep harmless the City of Cupertino against liabilities,judgments,
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
4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 31621031 . 19885
DATE ISSUED. . . . . . . : 05/08/2012
RECEIPT #. . . . . . . . . : BS000016749
REFERENCE ID # . . . : 12050083
SITE ADDRESS . . . . . : 19885 STEVENS CREEK BLVD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CUPERTINO INVESTMENT PARTS LLC
ADDRESS . . . . . . . . . . : 1975 HAMILTON AVE UNIT 33
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
RECEIVED FROM . . . . : NORTHWEST SIGNS
CONTRACTOR . . . . . . . : JEFF FRANK LIC # 23665
COMPANY . . . . . . . . . . : NORTHWEST SIGNS
ADDRESS . . . . . . . . . . : 120 ENCINAL ST
CITY/STATE/ZIP . . . : SANTA CRUZ, CA 95060
TELEPHONE . . . . . . . . : (831) 469-8208
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
- - ------ ------ ---------- ---------- ------- --- - --
lAWNATTBLD EACH 1 . 00 327 . 00 0 . 00 327 . 00 0 . 00
1BCBSC VALUATION 2, 500 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1BSEISMICO VALUATION 2, 500 . 00 0 . 53 0 . 00 0 . 53 0 ..00
1BUSLIC FLAT RATE 1 . 00 119 . 00 0 . 00 119 . 00 0 . 00
- --------- ---- ------ ----- ----
TOTAL PERMIT 447 . 53 0 . 00 447 . 53 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
------------ -- --- --------- ------ ---
CHECK 447 .53 6597
---------------
TOTAL RECEIPT 447 . 53
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 19885 Stevens Creek Blvd DATE: 05/08/2012REVIEWED BY: Sean
APN: BP#: 'VALUATION: $2,500
"PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair
PRIMARY SFD or Duplex PENTAMATION 1GENRES
USE: PERMIT TYPE:
WORK Installation of 42" X 78"awning for cort furniture.
SCOPE
i.
,11,cb. Plan Check Plumb. Plan Check Elm. Plan Check
,Nrrh. l;•nuit ree: Phunh. Pe,",if Fac: tiler. Parruir err:
Oder,ifcch. ln.rP. Other Plumb Insp. Li I
Oche, Elec. hrsp.
'11cch. hr,p. Fec: Phm,b. beep. Fee: Elve. fnsp.FEr:
NOTE: This estimate does not include fees due to other Departments(Le. Planning, Public Works, Fire,Sanitary Sewer District,School
District,eta). Thesefees are based on the prelimina - information available and are only an estimate Contact the De t or addn'l info.
FEE ITEMS (Fcc Resolution 11-053 EIL 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 1 # Awning/Canopy(Support'd by Bldg)
Suppl. PC Fee: (D Reg. Q OT 0.0 hes $0.00 $327.00 1AIVNAMLD I Awning
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee:Q Reg. Q OT O,O hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Conslrnu lion Ta.v:
.I drninixtralive Per:
Work Without Permit? O Yes E) No $0.00
Advanced Plannine Fee: $0.00 Select a Non-Residential
Building or Structure 0
l�rn rel Dnaunenlnliun Fees: �
Shone Motion Fee: IBSEISM/CR $0.50 Select an Administrative Item r
Bids-, Stds Commission Fee: IBCBSC $1.00 q-7, �J
SUBTOTALS: $1.50 $327.00 TOTAL FEE: 1 $328.50
Revised: 04/01/2012
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPER 0 (408)777-3228•FAX(408)777-3333•buildingCcDcupertino.org 12,05- OO&3
❑NEW CONS iRUCFION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT N
PROJECT ADDRESS 03 I/ S/�s�[%AYS GnLZ�IL r✓C-✓✓� APNq
OWNER NAME �v�p�/�'I i-D ?HONE EMAII.
STREET ADDRF CITY. STATE,ZIP FA%
) 7 rlr'6 .qdC 3 3 w. ad r °.ofi 'J66-G7S"
CONTA7AME_ �N Pgl-I�ONF. �(,/. E-MAIL
DDRESS r'9'v'•v CITY,STATE,ZIPD FAX
L ET ACueG'F-1 -9/' =rte- �1•-- 4,--r- 9szLiv
11 OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT flfONTRACPOR ❑CONTRACTOR AGENT ❑ AROUTECr ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTORNAME _ LICENSE NQMBER LICENSE TYPE BUS.LICK
COMPANY, ME F�•yyL FA
T SATS 5' �Y IS Mrs&—t1o17T/4rL9 il7?CYt S.GC/T ( ���� 5177
STYET ADDRESS �rry STATE,ZIP PIIONP,
ICD Sir
A .CT/ENGIN HER NAME IJCE ISE NUMBER BUS.LIC K
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PIIONE
DESCRIPTION OF WORK
L) /i !rx -79"
-CJUL GCJA-� fCJ -TUf�i�
EXISTING USE PROPOSED USE CONSIRTYFE I #STORIES
USE TYPE OCC. SQ.FT. VALUATION tSI
EXLSTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA
BATHROOM KDCIIEN OTHER
REMODEL AREA RENIODEL AREA REMODEL AREA
PORCIIAREA DEM AREA TOTALDECK/PORCIIARFA GARAGE AREA: DETACII
ATTACII
9 DWELLING UNITS-. ISASECONDUNFT [3M SECOND STORY 0M
9EINGADDEDT []NO ADDTIION! []NO
PRE-APPOCATION ❑YES IF M.PROVIDE COPY OF ISTHEBLDGAN ❑YES RECEIVED BY: TOT I.VALUATION:
PLANNING APDL# []NO PLANNINGAPPROVALLETPER EICIILER HOMLT ANO - - m/
By my signature below,I cenify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. 1 have read the Description of Work and verify it is accurate. I agree to comply with all applicable]owl
ordinances and state laws relating to buildin�Rig !iaon. I aulhorim representatives of Cupertino to enter the above-Idee�II'jjjaa�(od roperty for Inspection purposes.
Signature of ApplicanUAgrnc - ' — — Date: 5Z
2
SUPPLEMENTAL INFORMATION REQUIRED �PLANCH"TYPE., � ROUTINCSLIP
_
New SPD or Multifamily dwellings: Apply for demolition permit for ' •y
OVEI4TNE-COUNTER ❑�BUILDING PLAN REVIEW'
existing building(s). Demolition permit is required prior to issuance of building
rmit for new building.g. ❑ EXPRESS 'y,.rl ❑ PLANNING PLAN REVIEW
_Commercial Bldgs: Provide a completed Ilazardous Materials Disclosure 11 STANDARD Materials WORKS' -
To=— if any I luzardous Materials are being used as part of this project. ❑ LARGE ❑'iT1iE Deer
_Copy of Planning Approval Letter or Meeting with Planning prior to .
submittal of Building Permit application. 0,n(,uuR: . _ . _ ❑,SANrreev sEweA olsrRlcr,b._
❑ F.NVIRONMENTALHEALTH
BldgApp 2011.doc revised 06/2////
5CALE 1/8"-1' ,
"FACE "'0ny 002c TAT
- NATIONAL SIGN
•.�.. r ---- PL(ff PLAINS - ._ C O R P O R AT I O N MAY U S 2012
SX. 780 FOUR ROD ROAD :
5 d 74L BERLIN,CT
0 DAA PHONE (860) 829-9060
FAX(860)529-9062
LA MNG DEPT.
v+• �., ' ' dl THIS DRAWMG 15 THE PROPERTY OF
NATIONAL SIGN CORFORATION.ANP ALL
_ O ATE RIGHTS TO ITS USE FOR REPRODUCTION
ARE RESERVED 0Y NATIONAL SIGN CORP
CLIENT/PROJECT
r
coffO
78^ CUSTOMER APPROVAL
6�-6" 12" FILE NAME'CORT FURNITURE. '
WESTMINI5TER,CO -
1"x 2' - DRAWING 140.
32401-02
SCALE
SCALE A5 MARKED
Lo co42" `
� DRAWN BY:
N MIE
I GG II SHED °^
01/zzn0
Front Elevation
Cross Section 48" PROJECT MANAGER
Closed Ends SANDRA FEYNOLD5
78"
SCALE 1".1RREv19GD•N
D IF ERTIN
O
9'LETTERHEIGHT O WWI Dep9hIT1w
DCOMMUNITY D ELOPMENT DEPARTMENI[. I 4^1/4"LETTER HEIGHT MAY 0 8 1011
BUILDING VISION-CUPERTINO 1"L'• �n n1 rT 1 �O� r�l n ' 2
A ROVED U�WJ U `WW1 IllL�J R� LIANCE
This set of plans and sl ecifications MUST be keptat Ithe E viewed By:
Job site during constrL .tion. It is unlawful to m
changes or alters
therefrom,without ap roval from the Building Official.
The stamping Of this pl, i and specifications SHALL NOTGENERAL NOTES
be held to permit ort be an approvaf&W violation ELECTRICAL REQUIREMENTS 51GN CALCULATION5 •QTY.1 AWNING
of any provisions of ai City Ordinan pr§ji RED NONE REQUIRED AWNING PROP05ED 15 22.75 sq.h. •5UM15RELLA RED WITH WHITE COPY
BY i✓ TG n WHITE cony U` E16402A4
DATE
PERMIT NO. .S�G
V
fEPi,O O ,C
OE1YF5
vAPlaO F/11P!WI 'W 0nP11Ot r/mic - 391L1'PROPERiT IJPE
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CUPIERTINO
❑ Sullding Department
VXAWw y pm 212 W OMM74 i •12 1 0 U 1011EXISTIN REVIEWE OR IANCE
SORE ONEr•rTT��–I Reviewed By:
I
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KIDDIE ACADEMY DAY CARE J
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