10020134CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19503 STEVENS CREEK BLVD
CONTRACTOR: CORPORATE SIGN
PERMIT NO: 10020134
SYSTEMS
OWNER'S NAME: MENLO EQUITIES MGMT. CO.
1521 BERGER RD.
DATE ISSUED:. 022412010
OWNER'S PHONE: 4085979900
SAN JOSE, CA 95112
PHONE NO: (408)292-1600
❑ LICENSED CONTRACTOR'S DECLARA�TION
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BUILDING PERAIIT INFO: BLDG ELECT PLUMB
License Class d (/T
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INIECH
Contractor I, Date
I hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: NEW MONUMENT SIGN
(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 tabor Code, for the
performance of the work for which this permit is issued.
Sq. Ft Floor Area:
Valuation: SI5000
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
permit is issued.
ANN Number: 31649999.BLDG
Occupancy Type:
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
PERMIT EXPIRES IF WORK IS NOT STARTED
to building conswction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. Mle) agree to sate
WITMN 180 DAYS OF PERMIT ISSUANCE OR
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
180 DAYS FROM LAST CALLED INSPECTION.
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
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with all non-point source regulations per the Cupertino Municipal Code, Scetion
Issued b Date: 2-- (—o
9.18.
z
Signet Date
RE-ROOFS:
Cl OWNER-BUILDER DECLARATION
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
I hereby affirm that 1 am exempt from the Contractor's License Law for one of
inspection.
the following two reasons:
1, as owner of the property, or my employees with wages as their sole compensation,
Signature of Applicant: Date:
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
construct the project (Sec.7044, Business & Professions Code).
hereby affirm under penalty of perjury one of the following three
IIA-LARDOUS MATERIALS DISCLOSURE,
declarations:
1 have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain a Certificate of Consent to self-insure for Worker's
California Health & Safety Code. Sections 25505. 25533, and 25534. 1 will maintain
Compensation, as provided for by Section 3700 of the Labor Code, for the
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
performance of the work for which this permit is issued.
Safety Code. Section 25532(x) should I store or handle hazardous material.
I have and will maintain Worker's Compensation Insurance, as provided for by
Additionally, should 1 use equipment or devices which emit hazardous air
Section 3700 of die Labor Lode, for the performance of the work for which this
contaminants as defined by the Bay Area Air Quality Management District I will
permit is issued.
maintain compliance with the Cupertino Municipal Code. Chapter 9.12 and the
health & Safety Code. Sections 25505. 25533. and 25534.
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
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Compensation laws of California. If, after making this certificate of exemption, I
(�' Date:
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
APPLICANT CERTIFICATION
for which this permit is issued (Sec. 3097, Civ C.)
I certify that I have read this application and state that the above information is
Lender's Name
correct. I agree to comply with all city and county ordinances and state laws relating
to building conswction, and hereby authorize representatives of this city to enter
Lender's Address
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 accrue acainst said Cin• in consequence of the
.ARCHITECT`S DECLARATION
granting of this permit. Additionally, the applicant understands and will comply
I understand my plans shall be used as public records.
with all non-point source regulations per the Cupertino Municipal Code, Section
9.18. r 2
Licensed Professional
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Signature Date
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CITY OF
CUPERTINO
CITY OF CUPERTINO
SIGN
PERMIT APPLICATION FORM
AP N #
Date:
2
Building Address:
I �lS[�3 S�eVPnS Crte ���.
Mailing Address (if different from building address
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Owner's Name: WlPry b G u�e5 `/jlv��
Phone #:
,4(Ali
409- sq7 - 9�ov
Contractor: 60rior. Sf�h Sys ✓t1S
Phone#: c(oy-2g2— Ib0
Fax#: c.(U9 -)-o1Z- 103
Contractor License #:
Cupertino Business License #:
%%5-079
Contact: �a�y �Dra r
Y
Phone #: y - 2 -I b0 0 y-
Fax #:
1
qv� - ZA2- X 673
Building Permit Info:
Bldg ❑ Elect ❑ Monument 1 TI— Mounted on Building ❑
Residential El Commercial
Job Description: PZ,, VAjy- A_o� (2 j- I ei y)
Valuation (cost of project):
Project Size: Ex ress ❑ Standard ❑ 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 07/06/09
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CITY OF
CUPERTIN0
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department FEB 24 2010
All Cupertino building permits must meet certain conditions related10 mai'nt-jining—
environ mental quality and public peace and safety. The two most common
conditions are described below.
STORMWATER POLLUTION CONTROL
State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and
the Santa Clara Valley Water District control stormwater pollution. Educating local
residents and businesses and enforcing stormwater pollution control laws are key parts
of the City's compliance efforts.
Stormwater pollution prevention: It's up to us
In northern Santa Clara Valley, storm drains Flow directly to local creeks and San
Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife
dependent on our waterways, for people living near streams and baylands, and for the
local water supply. Common sources of stormwater pollution include:
• Dripped oil, fuel, and antifreeze from vehicles and heavy equipment;
• Construction debris, including dirt, concrete and paint;
Landscaping runoff containing pesticides or weed killers; and
• Any material dumped or spilled into streets or storm drains
The property owner and the contractor share ultimate responsibility for activities
occurring at a construction site and will be held responsible for any environmental
damage caused by subcontractors or employees.
For more information on construction -related stormwater requirements, see the
Stormwater Quality Regulations section of the City of Cupertino web site at:
http://www.cupertino.orqZcity government/departments and offices/
environmental services
COMMUNITY NOISE CONTROL
The basic noise control requirements for construction sites are as follows:
Typical construction work hours are:
- Weekdays - 7 a.m. to 8 p.m.
- Weekends - 9 a.m. to 6 p.m.
• Construction other than street construction is prohibited on holidays.
• Residential daytime noise levels from complaint site - 60 dBA
• Nonresidential daytime noise levels from complaint site - 65 dBA
For more information on noise control, please see Chapter 10.48 of the Cupertino
Municipal Code, which can be accessed at http://www.amlegal.com/cui)ertino ca/
Greg Casteel
Building Official
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