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12090059 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10562 S DI.ANZA BLVD CON7-RAC`fOR:MID WAY SIGNS PERMITi\O: 12090059 OWNF.R'SNAME: BYER PROPER,rms -P 3290 BASSETT ST DATE ISSUED:09110/2012 OWNER'S 1.11ONE: 4088929696 SANTA CLARA,CA 95054 PIIONE NO:(408)982-9696 ❑ LICENSED CON`fRACfOR'S DECLARATION .JOB DESCRIPTION: RFSIIIENTIAL 11 COMMERCIALS] License Class G°�/S' Lie.# 7Cflo3 FIDELITY NATIONAL TITLE COMPANY- NEW LED ILLUMINATED SIGN FACING THE STREET AFFIXED TO Conmactor CC/ Date —76 /3 THE 1 hereby affirm that 1 am licen d under the provisions of Chapter 9 BUILDING (commencing with Section 7000)of Division 3 of the Business S 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 far which this permit is issued. Sq.Ft Floor Area: Valuation:$2500 1 have and will maintain Worker's Compensation Insurance,yyyaggqs provided for by Section 3700 of the Labor Code,for the performance of `' rk for which this APN Number:36938037.10562 Occupancy'fype: permit is issued. l�/ /... APPLICANT CERTIFIC. "PION 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 Imus relating WITHIN ISO DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST 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 granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulations per the TRRtino Municipal Code,Section 9.18. RE-ROOFS: Signature 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 Signature of Applicant: Date: I hereby nlTinn that 1 am exempt from the Contractor's License Laefor one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with mages as their sole compensation,. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business d Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to IIA%\RDOUS MATERIALS DISCLOSURE construct the project(See.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health S Safety Code.Sections 25505,25533,and 25534. I 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: Ilealth S Safety Code.Section 25532(x)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 defined by the Ray Area Air Quality Management District 1 performance of the work for which This permit is issued. will maintain mmplianee with the Cupertin Municipal-Code.Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Ilealth S Safety•Cole,Sections 2550 ,.5533 _d 255 / � Section 3700 of the Labor Code,for the performance of the work for which this Owner or nuthorized agent: Date•./�? '"z 1 //Z permit is issued — -- I certify that in the performance of die work for which this permit is issued,I shall not employ any person in any canner so as to become subject to die Worker's Compensation laws of California. If,after making this certificate of exemption,I CONS'I'ItI1CI'ION LENDING AGENCY become subject to the.Worker's Compensation provisions of the Labor Code,I 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. w'ork's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I cenifv that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state 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, ARCIIITECI"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 t SIGN PERMIT APPLICATION COMMUNITY-DEVELOPMENT DEPARTMENT•BUILDING_ DIVISION - 10300 TORRE-AVENUE•CUPERTINO, CA 950143255 GUPERTINO (408)777-3228 • FAX.(408)'777-3333•buildinanacupertino.OrG ' M D�tOt?5� PROJECT ADDRESS/OSG J F APNtl OWNEANAME ,�!^ PHONE E.MA,J J STREET ADDRESS CITY.STATE.ZIP FAX CONTACT NAME I PHONE /y� E;.tAO, /�� / - 7 /1 STREET ADDRESS CITY.STATE, ZIP F� /\40 7, 9.?70 . ❑OWNER ❑ OtVNFRAU1LDQt ❑ 0WNERAGkM ❑ COtRRACTDR ❑CONTRAC ORACFNT ❑ ARCIarECr ❑ENtatnant r ❑ DEVELOPER ❑TENAtrr CONTRACTOR NAMES`/ ,V S E NUMBER 707 9G 3 U� E BUS.LIC 9 IJ O / 10 COMPANY NAME EM OC (D do 923 7 an=ADDRESS CITY STATE,ZIP PHONE ;Lelo s s •e ST. $sf,v—H e,� vo q ARCHTTEC IEYGINEER.NAME LICENSE NUMBER BUS.LIC 9 COMPANY NAME E-MA L FAX STREET ADDRESS CITY.SPATE,ZIP PHONE . DESCRIPTION OF WORK^' " ' /vk(, St /=fie %•v S%2 AGN Jai( USE OFtQ❑ SFD or Duplex ❑ Multi-Family ELUMD+ATED SIGN TYPE NO.OF SIGN AREA VALUATION STRUCTURF, 3,Commereial (YIN) (CODE) SIGNS (SQ.Fr.) m SIGN TYPE CODES: B - BANNER SIGN M - MONUMENT(GROUNDI SIGN BL - BLADE SIGN P - PROJECTINGSIGN D - DEVELOPMENT In SIGN SP - SPECIN•EVEM'BANNER DI - DIRECTIONAL SIGNTEMPORARY ' E - ELECTRONIC &)- WALL SIGN READERBOARD wi - WINDOW SIGN AL VALUATION: 0. By my signature below,I certify to each of the following: I am the property owner or authoriad agent to Won the property owners behalf. I have read this application and the information I have provided is correct I have read the Description of Work and v_mfy it is accurate. I agree to comply with all applicable Loral ordinances and state laws relating to buil 'ng construe' I authoPi representatives of Cupertino to enter the/2above-identified property for inspection purposes. Signature of ApplicantlAgene pate. %�/0- 12- -SUPPLEMENTAL Z-SUPPLEMENTAL INFQ TION RE UIRED '1°"– '-.••_ -. Q ='� s` =oPiteE.uskZ-",",M Site Plan - ElevationsT- Y4.',t. ''. `. —Sign Details-including UL listing(s)applicable �el,AtrMNGeLY ThRev�, —Structural Calculations(if applicable) -z' 4cEa;: �""' s� trr1��'���• —Copy of Planning Approval Letter or Meeting with Planning prior to Submittal of Building Permit application. ,_ '4 ¢ YS SignApp_201l.doc revised 03/1 Q/l l CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10562 S. DeAnza Blvd. DATE: 09/10/2012 REVIEWED BY: RDW APN: BP#: 'VALUATION: $2,500 *PERMITTYPE: Building Permit PLAN CHECK TYPE: PRIMARY PENTANfATION USE: Sign PERMITTI'PEo 10EAP5 Al WORK LED Sign facing street on building. SCOPE SIGN TYPE FEE ID QTY SIGN FEE Wall Sign, Electric 1SIGNWELEC 1 $266 TOTALS: $266.00 ,blech. Plan Check Plumb.Phnr Check #Branch Circuits 0 $0.00 A-lech. Permit Fee: Plumb.Permit Fee: Elec. Permit Fee: Other A1ech.insp. Other Plumb Insp. Other Elec. Insp. 0.0 $0.00 Me& Insp. Fee: Plumb. loy. Fee; Elce.Insp.Fee: NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Public(Parks, Fire,Sanitary Sewer District,School District, etc. . These ees are based on die prelintinari information available and are on/i,an estimate Contact the Dept for addrt'l info. FEE ITEMS (Fee Resolution 11-053 Eff 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 Phtmb./11ech.lLlec Permit Feer $266.00 Suppl. Insp. Fee D Reg. Q OTEo hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tac: Adiniiiisirative Fee: Work Without Permit? O Yes 0 No $0.00 Sign Master Plan: O Yes Q No $0.00 Travel Documentation Fee: ITRA VDOC $45.00 Strong, Nlotion Fee: IBSEISA-lICO $0.53 Select an Administrative Item Blda Stds Commission Fee. IBCBSC $1.00 SUBTOTALS: 1 $312.53 $0.00 TOTAL FEE: $312.53 Revised: 07/01/2012 m r w >b .. z LIJ S C U \ m C • , 1 � H Yrs:T • -•� ��ti [ ' t i •�1 )�yG pLu O r 1—� n 1 •4 m N �I t 4. . � I w CL 1 Jr b Lu , .44. r N ��• � � � AE�t ' A � W� � ® � � {�i • , ty cE Rai. IR �aa0C �o A'm_ O Q L E 2 > m 0 0� c to Yo n N ¢Z F J� '00 O O m QF 3 m c m 0 W W O 0 a _ oa c ,c. o Zv � c w m E .� a -0 0� w > ot. w o N m0 1_ _ a0 w c N m c m Q OJN o o c O m 9 T Q Zoa y2ma a° 03 p co O N O « C r fJ ZJ N O mot o E 0 I J , •s`u - o o m E .Sao 0` W a z ° E v >,o l] QQ CC C 7 .,If KrO L O i2 mL OfLY Q W N VZ .� WEI m w UN Z�ZOl // 0 w SxS LO w zz fri"il� 4. O V O O o f crOM .t ozwQ �a aa� ZZM,< 0 j y2 00> 0 00 Z�O f 'mow `w iw<k ..X ® rc wwo- a$a� f , a�mz Nara ow 0W "'o \Ozv zk ( � m� E IFN xxw— t dw g ao F OZOw ozM w -. wz - �v m i�Za -¢Nn �a O¢ 3 oc t N�Z� oz h _ • r a - +^ti ioU w U3 p mw0Q �� Page I of I midway From: "Raissa Young' <ryoung@byer.com> To: "Midway" <midwaysigns@earth link.net> Sent: Friday, September 07, 2012 10:24 AM Subject: FW: De Anza Center Sign Program Signage issue is finally resolved. Please see below. From: Charles Kahn [mailto:charlesk@kda-berkeley.comj Sent: Friday, September 07, 2012 9:50 AM To: George Schroeder Cc: Aarti Shrivastava; Simon Vuong; Raissa Young; Alex Byer; Killen, John Subject: Re: De Anza Center Sign Program Dear George, Aarti and Simon, Thank you all so much for your close consideration of the file and finding a reasonable and appropriate resolution and process for moving forward. I will notify the tenant to proceed with their application. Charles On Thu, Sep 6, 2012 at 5:57 PM, George Schroeder<GeorgeS(ir@cupertino.org> wrote: Charles, After reviewing the sign program again with Aarti and Simon, we have concluded that the sign program allows one sign per tenant frontage. Therefore, Fidelity can have a sign facing De Anza Blvd without having to go through a sign program mod. 1 will be writing a memo to the file to clarify what the sign program allows for. In the meantime, please instruct the sign contractor to contact either Simon or myself to review the sign permit drawings. Let me know if you need anything else. George ®ARCHITECTU R E k a h n dc.sien assoc is tea 1810 sixth street,berkeley.ca. 94710 tel: 510.841.3555 - fax: 510.841.1225 kahndesi enassociates.com 9/10/2012 DATE(MMODNYYY) ACORD' CERTIFICATE OF LIABILITY INSURANCE 09/0612012 PRODUCER Phone: (510)790.1118 Few (510)79x6153 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MELLO INSURANCE SERVICES,INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P O BOX 429 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR FREMONT CA 94536 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. AtXalcy Licit:06841518 INSURERS AFFORDING COVERAGE. NAIC#,ji1 - INSURED INSURER A: Golden Eagle Insurance MID-WAY ENTERPRISES, INC. INSURER B: 3290 BASSETT STREET INSURER C: SANTA CLARA CA 95054 NSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED By THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LIR TYPE OF INSURANCE POLICY NUMBER OPo� EcmiE Po Ic� I Aiwa LIMITS ieXinfYI GENERAL LIABILITY OICH647938-6 09/04/12 09/04/13 EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY O CETORENiED $ 200,000 PRFJAISES(Er Rmvacv CLAIMS MADEF'OCCUR MED.EXP(My ore person) S 10,000 A PERSONAL B ADV INJURY S 1,000,000 GENERAL AGGREGATE S 3,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,000 POLICYPRO- LOC $IFCT AUTOMOBILE LIABILITY 01-CH547938-6 09/04/12 09/04113 COMBINED SINGLE LIMB ANY AUTO (Ea accident) $ 1,000.000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Pencen) S A HIRED AUTOS BODILY INJURY NON-0WNED AUTOS (Per modem) $ PROPERTY DAMAGE S (Per accident) GARAGE LIABILY•ITAUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG S EXCESS I UMBRELLA LIABILITY CU8865669 09104/12 09/04113 EACH OCCURRENCE s 1,000,000 OCCUR ❑CLAIMS MADE AGGREGATE S 1,000,000 A Pradws S 1000000 DEDUCTIBLE $ RETENTION$ $ 1YC 6IATx pT1Q:R' WORKERS COMPENSATION AND TORY UMITe EMPLOYERS'LIABILITY YIN ANY Pac` l Cftlim ERIEXEcumE E.L.EACH ACCIDENT S OFFN:ERIMEMBER EXCLUOE07 E.L.DISEASE-EA EMPLOYEE S (MM,eaery In NH) u mdefa tn< E.L.DISEASE-POLICY LIMIT $ EPEGLLL WiON510N5 eebw OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 10 DAY NOTICE FOR NON-PAYMENT OF PREMIUM LICENSE#707963 CERTIFICATE HOLDER CANCELLATION Contractors State License Board SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED,OR MATERIALLY CHANGED, BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MAIL Attn:Waivers Unit 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. P.O.Box 26000 Sacramento CA 95826 AUTUpM R SENTATIVL 'a c `` O Attention: Sandy Vallejos ACORD 25(2009/01) Certificate# 10364 ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD - A & CERTIFICATE OF LIABILITY INSURANCE 011021,2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORLATgN OMLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF RISURAIICE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSU_RERNSJ AUTHORIZED 1 REPRESENTATIVE OR PRODUCER,AND THE cwnFICATE HOLDER. I rGORTAMP. Ifd*a-*—k WOW Na m ADDITIONAL INSURED,dr subcTtts)m Ee awwso& aSUBROGATION O,W VED' o0pettb tae mons and conmtlMr of Itr PotkY,CktAm PONkks MY�K an MCIMSMmwwfs t A asnt m alis C/rBicM dos rot m tlr rights to the Patlactte aero.inGell a mxn anmraer¢erJjal. PROM= CONT Capital Providw Hlsuma Soviccs NYYrfl 818 6760076 2112,VlMura Blvd.,SuBa*307Me- (81 B)fi760015 ' weac-vdzomvw :.s can Woodland Hills.CA 91361 MURERM AWORDMG COWMA s PhmR9 818)676-0018 Fax (818)6760015 INswtEe Mid-Way EnWprise Inc Lumom o: 3290 RassoO Street . Zmicl ArBMW M—s Compuy Saha Clara,Ca 95054 BIB E: COVERAGES CERTIFICATE NUMBER REVISION NUMBER: THIS 6 TO CERTIFY TWAT THE POLICIES OF I15tPANCE LISTED BELOW HAVE BEEN ISSl1ED TO THE MSURED mAuEO ABODE FOR THE POLICY PERWD INDICATED,'NO,WITMSTANDWO ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCWtENT WITH RESPECT TO WHCH THIS I CERT6IGATE WAY BE ISSUED OR WAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, - ExaUSIONS AND CONDITIONS OF SUCH POLICES.LIMITS SH01NN MAY HAVE BEEN REDUCED BY PAID CtAMAS. Nm TYPEGPaL,LVMMCE �7 — ParCYPOUCYEFF POLLYEIV Mats Gt7+ tyAEtLrTY EACH NCE ac ❑ COMW.-RCUL GENERAL UABUTY ERMNrwnk i ❑ Cl IAM&—Me ❑ ocaR mebevchwerrEKW4 IS ❑ I POtsomL a A MAM s - ❑ rDetu AGGREGATE Is GENTAGGAEGATELWRAPPJUPM PROCWTB-WIPIOPAGG s ❑roC ❑ P ❑ LDC s . AUfOMO.^YE LIABufY m LaaT❑ ANTAUTO T(Pa rim, s ALL OVAIED SCHFMv ❑ AUTDB ❑ Y pavs ❑ W AUTOS ❑ AUTOS ' PRQPERrypAMA s n 0 — 71 f ❑ UHMML"Lyth ❑Ocam EACH 00Q1taEYCE f lLCEL.^i WE ❑ e Cl AGGRECNTE s' ANDEMRCCOIQ&N9Ak ®Vic STATRF T}F' s AND EtIPL7fEfl4 L{Ie NQR Y AterIP�RO&pl"tU�R/PAarr��yrtnrrlvE WG88977� 041D1RDi2 OarDtaol3 ELfAOIAtxm; s 1.M.00100 D 11NyMAArd�M Wl tarl FSCllmEo'1 aM/A EL OOPATE-eA EtMRDYEEs 1.000,000.00 f)ESLRI�IO�.V 0-ERATMS 0ebv F1 PLSEASE-POCKY LNIT f 1.000.001100 I IEsrJt.TIOM OF OPf3IATICMS r LaCAt1OY0/VBari.®fAoadr ACGIb.a'1,Ad7ppAM RArvAESdYaAr,a ra.�Rra r rpvrr� :ERTIFICATE HOLDER CANCELLATION SNOUl-D ANY OF THE ABOVE DESOMED POUMS Be CAMCUMM BEFORE HoW Do Arun I THE EJDRAT"DATE THEREOF,NOTICE WML BE DELIVERED IN 233 West Salve Clara SDen ACCORDANCE WITH THE POLICY PROVISIONS, San Jew,Ca 95113 ' A)THOROM REPMEWATNE 019B&ZHO ACORD CORPORATION. AN rights regervad. cCORD u(201D/Da)OF The ACORD nm and IW are regLseolad TlaTln If ACORD ZTS-3 S60-1 8Z00/SZ00d -W08d 0LE62868061 -01 80:£i ZI.-Z0-60 0