12120094 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10837 N WOLFE RD CONTRACTOR:ALLEN SIGNS INC PERMIT NO: 12120094
OWNER'S NAME: CUPERTINO VILLAGE,LP 1982 STONE AVE DATE ISSUED: 12/18/2012
OWNER'S PHONE: 6507562162 SAN JOSE,CA 95125 PHONE NO:(408)280-6500
❑ LICENSED CONTRACTOR'S DECLARATIONr
Q � BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class �- Lic.# 'J�`�"=�
2 MECH I— RESIDENTIAL F COMMERCIAL
Contractor Date \ )g Z
I hereby affirm that I -licensed under the provisions of Chapter 9 JOB DESCRIPTION:SHIBUYASJ-WALL SIGN,ELECTRIC
(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 Labor Code,for the
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$1800
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. APN Number:31605052.10837 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 construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 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 /
with all non-point source,regulations per the Cupertino Municipal Code,Section Issued by: v /� �%li�/ Date:/o2/,e 'lp2
9.18.
Signature Date ( 1 Z
RE-ROOFS:
❑ OWNER- ILDER 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 I am exempt from the Contractor's License Law for one of inspection.
the following two reasons:
I,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).
I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE
declarations: I 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. I 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 I use equipment or devices which emit hazardous air
Section 3700 of the Labor Code,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
[certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534.
not employ any person in any manner so as to become subject to the Worker's Ownorized AVO:
e f
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 construction,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 against said City 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. Licensed Professional
Signature Date
-1"10 I q
SIGN PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228• FAX(408)777-3333• buildino(a5cupetno.org
PROJECT ADDRESS ao 7,-�- IV APN# �, 11 0
OWNER NAME rn U PHONE _?S&21
22 E-MAIL
STREET ADDRESS < u' CITY,STATE,ZIP ` /�A FAX
CONTACT NAME J PHONE ( C E-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR N ' LICENSE ER _ LICENSE TYPE BUS.LIC M
t Vn l
COMPANY NAME I l E-MAIL ( D� FAX
1elll
STREET ADDRESS CITY,STATE,ZIP a PHONE
ARCI I T'ECTIENGINEER NAME LICENSE NUMBER BUS.LIC!k
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
USE OF ❑ SFD or Duplex ❑ Multi-Family ILLUMINATED SIGN TYPE NO.OF SIGN AREA VALUATION
sTpUCTURE: ❑ Commercial (YIN) (CODE) SIGNS (SQ.FT.) (s)
SIGN TYPE CODES:
B -BANNER SIGN M - MONUMENT(GROUND)SIGN
BL - BLADE SIGN P. - PROJECTING SIGN
D - DEVELOPMENT ID SIGN SP - SPECIAL EVENT BANNER
DI - DIRECTIONAL SIGN T - TEMPORARY
E - ELECTRONIC W - WALL SIGN
READERBOARD WI - WINDOW SIGN
- � TOT N:
-� _
By my signature below,I certify to each of the following: I am the property owner or thorized agent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and ve-ify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating t it ing cons tion. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
l2//p
Signature of Applicant/Agent: Date:
SUPPLEMENTAL 1ATION REQUIRED
_Site Plan
am Mi
Elevations �iT[EDL*TfxPLr4*1RLtXIESIF�Yk _
Si g( )applicable ST. DARD
Details-including UL listin s a licae 0M
Structural Calculations If applicable)
Copy of Planning Approval Letter or Meeting with Planning Prior to JOTS _'
t �—
Ei
submittal of Building Permit application. :
Si m4pp_2011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
DDRESS: 10837 n.wolfe rd DATE: 12/18/2012 REVIEWED BY: larrys
PN: BP#: *VALUATION: $1,800
I*PEkRMITYPE: Building Permit I'I. 1fIMARY PENTAMATION
USE: Sign PERMIT TYPE: 1 CEAPS
WORK wall sin electric
SCOPE
SIGN TYPE FEE ID QTY SIGN FEE
Wall Sign,Electric 1SIGNWELEC 1 $266
TOTALS: $266.00
lc,,h. Plan('h,,cki'l:utrh. c�rt t.`Ix�ck #Branch C1rCultS $0.00
14,,ch_ A,rmii fOc. Pr"Tnh. Fruit Pc", EIeC.PermitFee:
L
Mcc�h. Insp, Oti�c�,Piurta tn�7> Other Elec.Insp. 00 $0.00
h. In p. Fcc,: T'humb, Fl"p, Fc". I>ter lash,t°ire:
NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). Thesefees are based on the prelimina information available and are only an estimate Contact the De t or addn 7 info.
FEE ITEMS (Fee Resolution 11-053 Eff. 711,112) FEE QTY/FEE MISC ITEMS
Plan C:'hcc'k
Suppl. PC Feer (F) Reg. C) OT 0.0 1 hrs $0.00
Phnnh.iVec It.iZ lc r:
Permit Fee: $266.00
Suppl. Insp. Fee-0 Reg. Q OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Onstructionhx:r:
.lrltniaistrxiIvc,
Work Without Permit? 0 Yes (j) No $0.00
Sign Master Plan: 0 Yes (!) No $0.00
Travel Documentation Fee: 1TRA VDOC $45.00
Strong Motion Fee: IBSEISMICO $0.50 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
SUBTOTALS: $312.50 $0.00 TOTAL FEE:", $312.50
Revised: 10/01/2012
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CUPERTINO VILLAGE,LP
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All designs 6i,art hocks belong to Allen Signs,Inc. Any duplication if fruhibited.(.OI 20 7t•!'raY;�at�(x��SlNI 1i�r:rrxt;'ri+�-ri-rir�
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SHIBUYASJ BUILDING SIGN ELEVATION: 10837 N.WOLFE RD. CITY OF CUPERTINO
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10•-9" w 1 S I --Lkted(`TO SPAONGT.A -1
A Behmnpnrrtary*vrV ou*atdli0hvoltage wvnq
9 BatreenmWaledNggvobapmm.ganddeaemelaloherewrng �.
pw*'sdeadnW"for more than1'r+t'en■!1isec"r t
C BuNwrir■antuhe(daer7500wnataA)ar>at■arostawface.
r /—(3rOWded oenf+nra•ahee?'MI• D Balaaeen/i U!ttnallated 11011 VOQa(W GerrrAx�Or3 M^_C!IK,Gf1EY1tS.)�"1'y L sled tir or•qn maw I��of 1 endwurs(bheet rased ��npnart�yotmded travhvmer);nd dead metS(0*ound1 We edlaP
A ! V <:ranne,Islam atte&ad ro,& wy. I me enrM AN mw). arcud,xnductors and hgh voW conductors rf opp`"pob*
a naratanner,,nsutWN teats, I
slew
.h smtd l v�dec';mRAabee br�euOdDDorf
Dom' �' (''Luted died v*t nad h pdnury V A B C D
i.a6ona,bufroudfor,x1noron7rm�es ,1 a syn,Paft MqbekalR.i 10D1w5000 1;24 inch 12 inch none 314n {{I
:d' Wlt elgt ae shown.)
5W to 10MG 3/airch 3/4mO iM�Ochif 1-11Sin
+<_ 4 NEC nn3(bl.eoo-z,tpD4.
5"THICK INDIVIDUAL CHANNEL LETTERS,INTERNALLY ILLUMINATED
%9k We 1Doo,1o15tlOD ,,nch 1 nch �soa. ,-t2n f
3/4"SILVER COLOR TRIM-CAF,RETURN PAINTED WHITE COLOR.
� y'may '"�„ robe support
NEC f00.33 b) ray
RACE PA/IN7EC SAME COLOR A5 BACKGROUND BUILDING ,• ,'yh , t;
"�i/JI'I Tol d (� • 1 !f y /7 �( r y#r pe spat n81s 6. ■g. (Sim ling ma i
SCALE:1/4"=1'-0" DATE:DEC-12-2012 e 4' �,..' ._ a has ® -t�en°.'m�`" 2 ! r "y
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x .'�` • —9 e etetennr....w -- wa
ne each
losign mark on sada g9^I
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2Q'0" w`" A wed"wom Instaftor at signs ksted per UL48
,r•, i•: e•■■■■■■•■■■ Note Inskital�on y
.i requirements only.
BUILDING FRONTAGE f Manu(actwmgrequirements contuned P.UL48.
LISTED w.an Rema a.,wd et testin Iaboratc r..al o.-it p m.aWrrw Mi—.W _...1LLUee•eATED CHANNEL LETTER ----
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•y ht by qualified electncei b.rePw"w■eeW..%bm r rry u7 ammo-9.0..WAatl4 rCONTINUOLIS
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syr.,s.cmr exr.a nark 0 ry r.raaeel.■".e ra■maesre recstew4ee.r lenrnierr rir•ee WASUTATING BOOTS SLEEVE
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s•e rlunp.sAB hC ELECT RiC SIGN SECTIO' e,yr�,ae eoo.�a.ante.e c5r^,araaeay•teBM.terca -- .---- —
IN first bW*sere,d•rrhf-the hammer VNO. W•wawa kT ra■•'.4pnlw d W-rete"WON a so V�Date:October 1984
XX-123458 .vream•A W r at cqr m oe■a ee.r�e.rp■e■■e e■•■•h of Y -
r sad-apn uctpn `�setoM ot>nk r pad �-..,of C _ e•� sw...-—T IAEI UkiF7
radiates the toed ranMr of spn:amour None No.
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SHIBUYASJ
IU837 N.waLFE RD. Transformer need to rise up mina 1/2" from
CITY OF Ca,PERTINO
BUILDING ELEVATION 'S "� FWr PL&N:S
M CUD JDX
)DA �� 2
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NOW.-:-. DEC 18 2012
�'�'v'�i'.}'•"iii'���.
All designs&art worlas belong to Allen Signs,
any duplication isprohibited.COPYRIGHT2010
All designs &art works belong to Allen Signs, Inc. Any duplication is prohibited. COPY RIGHT 2012 / E-mail address:allensigns@yaboo.com
Tel 4081280-6500 Fax:408/280-6700
- 1982 Stone Ave.San Jose.Ca.95125 State Lic.#8351580