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11030004
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19875 STEVENS CREEK BLVD CONTRACTOR: NORTHWEST SIGNS PERMIT NO: 11030004 OWNER'S NAME: CHILD CARE, LLC VER'S PHONE: 2148503085 ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. tA' Contractor Date 1 hereby'affirm that 1 am eased 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. 325 WASHINGTON ST. SANTA CRUZ, CA 95060 DATE ISSUED: 03/02/2011 PHONE NO: (831)469-8208 BUILDING PERMIT INFO: BLDG F_ ELECT r PLUMB I— MECH r- RESIDENTIAL f— COMMERCIAL r JOB DESCRIPTION: INSTALL ONE ILLUMINATED SIGN AT STOREFRONT, ONE NON -ILLUMINATED SIGN AT REAR LOCATION 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 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 Sq. Ft Floor Area: 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 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 accrue 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. Signature Date 7i 1: , J OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: 1, 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 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 permit is issued. 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 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. 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 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, sts, and expenses which may accrue against said City in consequence of the ranting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9 18. Date APN Number: 31621031.00 Valuation: $10050 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Date: RE -ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS 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 Health & Safety Code, Section 25532(a) 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 Health & Safety Code, Sections 25505, 25533, and 25534. Owner r autho ized ge r Date: f / CONSTRUCTION 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CITY OF CUPERTINO SIGN I I X 3 0 0 C CUPERTINO PERMIT APPLICATION FORM APN # Date: Building Address: 19875 Stevens Creek Boulevard, Cupertino, CA 95014 Mailing Address (if different from building address): Owner's Name: Child Care, LLC Phone#: (214) 850-3085 Maheswaran Rajasekharan, Managing Member Contractor: Northwest Signs Phone #: (831) 469-8208 120 Encinal St Santa Cruz, CA 95060 Fax #: (831) 469-8172 Contractor License #: 786185 Cupertino Business License #: 23665 Contact: Sarah Oreb Phone #: (831) 246-3046 Fax/e-mall:sarah®northwestsigns. c Building Permit Info: Bldg ❑ Elect ❑ Monument Q Mounted on Building Q Residential ❑ Commercial Q Job Description: Install one (1) internally illuminated lightbox sign on building front, one (1) non -illuminated sign on building rear, and replace two (2) monument sign faces as per attached drawings. Valuation (cost of project): sio, o5o. oo Project Size: CounterEx ress Standard Large 0 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 12/06/10 om F� CITY OF CUPERTINO "Wo FEE ESTIMATOR— BUILDING DIVISION W7D7RE7SS: 19875 stvns crk blvd. DATE: 03/01/2011 REVIEWED Bl': bobs. Mech. Permit Fee: APN: BP#: `VALUATION: IS10,050 *PERMIT"TYPE: Building Permit PL.4NCHECK 'IITE: PRIMARY USE: Sign Hawk Insp. Fre: PENTADLITION PERMIT TYPE: 10EAP WORK install one illuminated sign at storefront one non illuminated sign at rear location. ' SCOPE Suppl. hisp. Feed Reg. O OT SIGN TAPE FEE ID Plnmb. Plan Check QTY Mech. Permit Fee: SIGN FEE I ESIGN Elec. Permit Fee: IEPERMIT Wall Sign, Electric 1SIGNWELEC Other Elec. Insp.0.0 $42.00 1 Hawk Insp. Fre: $253 Permit Fee:. $253.00 Suppl. hisp. Feed Reg. O OT TO-01hrs $0.00 PME Unit Fee: $42.00 PME Permit Fee: $42.00 Construction Tar Sign Master Plan: O Yes (D No $0.00 Work Without Permit? 0 Yes E) No- $0.00 TOTALS: Travel Documentation Fee: ITRA VDOC $253.00 Strong Motion Fee: /BSEISAHCO NOTE: These fees are baser/ on the prelintinar, information available and are ono, an estimate. Contact the Dept for adrin'I info. FEE ITEMS (Fee Rerohaimt 09-051 E2 7/1/10) ,41eclr. Plan Check Plnmb. Plan Check #Branch Circuits 1 $42.00 Mech. Permit Fee: Plumb. Permit Fec: I ESIGN Elec. Permit Fee: IEPERMIT Otherdlech. lnrp. Other Plumb Insp. Other Elec. Insp.0.0 $42.00 Mech. bap. Fee: Hawk Insp. Fre: Ecr. Insp. Fac: NOTE: These fees are baser/ on the prelintinar, information available and are ono, an estimate. Contact the Dept for adrin'I info. FEE ITEMS (Fee Rerohaimt 09-051 E2 7/1/10) FEE QTY/FEE MISC ITEMS Pleat Check Fee: Suppl. PC Fee: E) Reg. O OT 0.0 Itrs $0.00 Phi mb./A/ech./L• lec Plan Check: Permit Fee:. $253.00 Suppl. hisp. Feed Reg. O OT TO-01hrs $0.00 PME Unit Fee: $42.00 PME Permit Fee: $42.00 Construction Tar Sign Master Plan: O Yes (D No $0.00 Work Without Permit? 0 Yes E) No- $0.00 Planning Fees: Travel Documentation Fee: ITRA VDOC $42.00 Strong Motion Fee: /BSEISAHCO $2.11 Select an Administrative Item Blde Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $382.11 $0.00 TOTAL FEE: $382.11 Revised: 01/15/2011 Kiddie Academe of Cupertino, CA Scone of Work — Signage Installation Number of Signs to be added: 2 Number of Signs to be modified: 1 a ' Description of Signs: 1. Building Front sign: Internally Illuminated contour sign bearin- the "Kiddie Academy" logo and non- illuminated "Child Care Learning Center' in 5" letters below, mounted on a panel below the logo sign which will be painted to approximate the color of the building_ encompassing —325 square feet total. Sign output n face = —10.59 L (foot lamberts) a. "I his sign is in compliance with the 2007 California Energy Code; Title 24; Part 6; per section 148; alternate I. 2. Building Rear sign: Non -illuminated contour sign bearing the "Kiddie Acadcmy" logo and non - illuminated "Child Care Learning Center" in 3" letters below, encompassing—22.5square feet total. Sign output @ face =-10.59 L (foot lamberts) 3. Sign Materials: Dark Bronze anodized Aluminum box frame (return) with translucent Lesan face: and printed translucent vinyl graphic. 4. Overall building elevation: included. 5. Front entrance elevation: Included. 6. Rear entrance elevation: included. 7. The existing monument faces will be replaced as shown on the attached proof. No other modifications to the existing monument sign will be made. 8. 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