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12090054CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10495S DEANZABLVD CONTRACT 'OR:. SUCCESS GRAPHIC SIGNS PERMITNO:12090054 OWNER'S NARIF.: NORTFIWEST DE ANZA ASSOCIATES 1744 QUEENS CROSSING DR DATE ISSUED: 09/102012 OWNER'S PHONE: 4089139200 SANJOSE, CA 95132 PRONE NO: (408) 667 -1777 ❑ Ll CENSE CONT'RACTOR'S DECLARATION License Class C Lic. k Contractor -- Date w hereby affirm that I am licensed under the provisions of C apier 9 (com menci ng with Section 7000) of Division 3 of the Rusi ness & Professions Code and that my license is in full force and effect. hereby affirm under penally 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. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of die work for which this permit is issued. APPLICANT CERT'IFICAT'ION 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 slate Imes 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 Iiabil ities, judgments, costs, and expenses which may aceme against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point sourc a u per the Cupertino Municipal Code, Section 9.18. ❑ OWNER - BUILDER DECLARATION hereby affirm that 1 am exempt from the Contractor's License Law Formic of the following two reasons: 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) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby alarm under penalty of perjury one of the following three declarations: 1 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. 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. I certify that in the performance of die 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 Calif imia. If, after making this certificate of exemption. I become subject to the Worker's Compensation provisions of the Labor Code, 1 must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTI FICATTON 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 Imes 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, costs, and expenses which may aceme against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. BUILDING PERMIT INFO: BLDG r ELECT r PLUDIB Ci D1ECH r RESIDENTIAL Ci CONIMERCIAL r JOB DESCRIPTION:. FOOTSPA & BODY. MASSAGE - REMOVE AND REPLACE THREE(3) SIGNS. TWO(2) NEW COMPLETE LIGHTED ON EXISTING CIRCUIT AND ONE(I) FACE CHANGE -OUT Sq. Ft Floor Area: I Valuation: $3500 APN Number: 35917023.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYSSj FROM LAST CALLED INSPECTION. /' Issued by: , /�/✓ /4�z: / Date: RE- ROOFS: All roofs shall be inspected prior to any roofing material berg installed. If a roof is installed without first obtaining an inspection. I agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER DAZARDOUS MATERIAIS DISCLOSURE 1 have read the hazardous materials requirements under Chapter 6.95 of the California health & Safety Code Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Ilealth & Safety Code. Section 25532(x) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Ilealth o e, ections 25505, 25533, and 25534. - Owner horned g • T - Date: CONSTRUC`I'10\ LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this'permit is issued (Sec. 3097, Civ C.) lender's Name _ Lender's ARCIIITECI "S DECLARATION I understand my plans shall be used as public records. Signature Date I Licensed CUPERTINO DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • buildino(o?cuoertino.oro -2,09 00_5' PROTECT ADDRESS I r l (.i � 7 V " (j W ^ �TG APN d /3 5�! / 1 Z OZ Ei -MAIL OWNER NAIVE PHONE. (-W 17 312-04 STREET ADDRESS 2- A4?-A- CITY. STATE. ZIP FAX �j � tea- C •.-.� � O "1. S JLj CONTACT NAME� I' PHONE / _E-MAIL STREET ADDRESS r.IL L Cr �� STATE, ZM EA_ I If �S/ FAX cY O❑ 11 OWER ❑ OWNER - BUILDER ❑ Ow ERAGET x"oNTRACoR ❑CO MRAGENr ARCHITECT EVGNEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME 1 , , ^ LICENSE NIPN j Y, LICENSE�Tj'P� / BUS. LIC a rrrIII COMPANY NAME E -MAIL t- N /G1 /�(���/(, / ✓V(O UKN� FAX STREET ADDRESS /��� /� C�V �SIt ��b�y� '-/ CITY. STATE. ZIP ®`�. �La PHO �W/6 L� 7 DESCRIPTION OF WORK (1�(G ` I S'�` RESmENnA1 a DWELLING Li, s'.j$L•.ri i A H'- , +. E.CTVPE3 rru V FLOOR AREA UNITS WIN II ;14_10 FLOORFLOOR AREA s' ws - TYPE OF CONSTRUCTION 0 STORIES L y � y R 2a9' TCi 0 a 11 W--- - w' it AQ.Vm JOB NIJ ®EA �- ='-. [ TOTAL V UATI hRECE[VED BY:- ' By my signamre below, I certify to each of the followin � m the prope owner or authorized agent to act on the property owner's behalf I have d this application and the information I have provided' rtect. I have read the•Descrip ion of Work and verify it is accurate. I agree to ca y with all pplicable 1=1 ordinances and state laws relating to buildin -1 nuthor' e r rese dve of Cupertino to enter the above- idendtl rtY for ins etionr-p�urposes�. Ci Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT Q ,�a.p ujpc,n ttiacet..,e._, 'a" �a iolnTCEDSeou:Y -.. ° Provide Job Number from Bay Area Air Quality Management District w•wrv.banamd. ore @415-749-4762. - �+set:Aa CHEac•TYrea±';3� Provide three copies of a site plan showing protection for any trees 10" in diameter or more at 3' above grade. _ Provide letter from PG &E (408 -725 -3325) stating all gas and electric has been disconnected. O• STANDARD. f _Provide aletter of inspection, tests, and abatement of any Hazardous Materials. Letter to be initiated by person(s) - ;r - certified in asbestos, mercury ¢nd/or hazardous material examination. Planning Dept clearance to verify building is not considered an historical landmark. Allow 10 business days. bgP:a Provide letter of clearance of all vermin from a licensed pest control contractor. Applicant shall call the Public Works Department at 408- 777 -3104 and schedule a "habitable dwelling" inspection. `2: - .• _Provide signed Debris Bin and Recyclable blaterial5 form. Commercial Buildings Only: Provide Fire Dept clearance for fire suppression /alarm system review. C:,x•,a: -Ma�P • DemoApp_2011.doc revised 03116111 W CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION SIGN TYPE ADDRESS: 10495 S. DeAnza Blvd. Ste A DATE: 09/1012012 REVIEWED BY: RDW Alech. Permit Fee: APN: BP#: - VALUATION: $3,500 *PERMITTYPE: Building Permit Pl.hV CHECK TYPE: PRIMARY USE: Sign $532 PENTAMATION PERMITTYPE: 10EAP5 WORK Remove and replace 3 signs. 2 new complete lighted on existing circuit and one face than a -out. SCOPE 1 0,0 SIGN TYPE FEE ID Plumb. Plan C'hmA QTY Alech. Permit Fee: SIGN FEE Elec. Permit Fee: Wall Sign, Electric 1SIGNWELEC Other Elea Insp. El $0.00 2 Phmhh. bnp. Fee: $532 Permit Fee: $532.00 Suppl. Insp. Fee0 Reg. Q OT 1 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Cmu•n•uction Tae: Administrotive Fee: Work Without Permit? Q Yes Q No $0.00 TOTALS: $0.00 Travel Documentation Fee: ITR lVDOC $532.00 Strong Motion Fee: 1BSEISAHCO NOTE: This estinmte noes not include jeer due to other Departments (i.e. Planning, Public /forks, Fire, Sanitary Sewer District, School District. etc .). These fees are baser/ on the oreliminary information available and are only an estinmte. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11 -053 F_lT 71111 1) Mech. Plan Check Plumb. Plan C'hmA # Branch Circuits 0 $0.00 Alech. Permit Fee: Phlnlh. Permit Fee Elec. Permit Fee: Odher,lfeeh. Insp. Other Plumb Insp. Other Elea Insp. El $0.00 Plech. Insp. Fee: Phmhh. bnp. Fee: Flee. Insp. Fee: NOTE: This estinmte noes not include jeer due to other Departments (i.e. Planning, Public /forks, Fire, Sanitary Sewer District, School District. etc .). These fees are baser/ on the oreliminary information available and are only an estinmte. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11 -053 F_lT 71111 1) FEE QTY /FEE MISC ITEMS Plan Check Fee: Suppl. PC Fee: Q Reg. Q OT 0.0 1 hrs $0.00 Phimb. 11fech.A:lec Permit Fee: $532.00 Suppl. Insp. Fee0 Reg. Q OT 1 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Cmu•n•uction Tae: Administrotive Fee: Work Without Permit? Q Yes Q No $0.00 Sign Master Plan: Q Yes 0 No $0.00 Travel Documentation Fee: ITR lVDOC $45.00 Strong Motion Fee: 1BSEISAHCO $0.74 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $578.74 $0.00 TOTAL FEE: $578.74 Revised: 07/01/2012 i 66.2 ft. oil r—_ I• -fir— - q -7�- — -66.2 k. — ssffl i 1'-. � 132" 18fl4 M USAGE 328" rMs� IL Replace faces only AS l W41t14 0,11- 90° FOOT SPA A BODY MASSAGE Rrivod Bxkbv —. SMnmd:m Rehm 040 FOOT SPA G' BODY MASSAGE � t COMMUNITY DEVELOPMENT DEPARTMENT Tm`Cap BUILDING DIVISION - CUPERTINO aechical source upplies by othm Junwon Box p Lsv Village Vo mndul or Rex Disconnected Skohn ffl w •» CUPERTINO : Building Department = SEP 10 1012 REVIEWED FIOR ODE COMPLIANCE 4r. a:c:.aD ay: •-lit 5 ti �C Y, C��Dr RECE1 VEIL SEP 10 2012 BY :_ �``j f•d,;.T ;?J lU l : DAW, Rim C lwa Sign Type: (1) Inlemally Illuminated LE ,D IndWual Channel Letters APPROVED 114'Dmin Rol, Letter Face: 1/S' thickness acrylic face color as shown Leger Relums: 5' Back with .OdD Aluminum Trim Cap: 314' This set of plans and specifications MUST be kept at the 4=11 god job site during construction. It is unlawful to make any Chnnne:C nr sl Prntlnnc Q ProjectLocation i 1744 Queens Crossing Drive -San Jose - CA 95132 I The stampinl3 of this plan and specifications SHALL NOT 10495 S. De Mae Blvd. Ste A. t T (408) 667 -1777 E -mail: swu1966 @gmail.com t held to 3ermit or to be an approval of the violation of any provisions of anv Oftv Ordinane' nr 1 ..,.. BY DATE J— l 0— f Z 1 PERMIT NO. _/- 209005.4 aechical source upplies by othm Junwon Box p Lsv Village Vo mndul or Rex Disconnected Skohn ffl w •» CUPERTINO : Building Department = SEP 10 1012 REVIEWED FIOR ODE COMPLIANCE 4r. a:c:.aD ay: •-lit 5 ti �C Y, C��Dr RECE1 VEIL SEP 10 2012 BY :_ �``j f•d,;.T ;?J lU l : DAW, Rim C lwa