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11100072CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19620 STEVENS CREEK BLVD I CONTRACTOR: SUCCESS GRAPHIC SIGNS I PERMIT NO: 11100072 OW-7R'S NAME: EVERSHINE VI & ANNIE CHAN OW _ R'S PHONE: 4083431088 im LICENSED CONTRACTOR'S DECLARATION C� $ License Class � Lic. # Contractor Date :: 1 I hereby affirm that I am licensed under the provisions of Ch liter 9 (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. 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. APPLICANT CERTIFICATION 1 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 re s per the Cupertino Municipal Code, Section 9.18. Signature Date Y 0 t ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one 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 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. 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 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 ur the above mentioned property for inspection purposes. (We) agree to save i iify and keep harmless the City of Cupertino against liabilities, judgments, cobt6, 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 1744 QUEENS CROSSING DR 1 DATE ISSUED: 10/11/2011 SAN JOSE, CA 95132 PHONE NO: (408) 667-1777 BUILDING PERMIT INFO: BLDG F ELECT F_ PLUMB MECH r RESIDENTIAL r COMMERCIAL JOB DESCRIPTION: GYU KAKU RESTAURANT - INSTALL 2 SET SIGNAGE OF CHANNEL LETTERS Sq. Ft Floor Area: I Valuation: $5500 APN Number: 36906010.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 1 0 DAYS OF PERMIT ISSUANCE OR 180 DA OM 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 I 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 & Safe ections 25505, 25533, and 25534. Owne r authorized agent: �.J-,J Date: 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 Add ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional i 44 } } Plywood Backing - —Wall 2"A" Stub c e o Stucco Fascia--► Junction Box — . . —Primary Electrical Source Aluminium I _ .060) Aluminium Return(.040) a Trim Ca r�sr IAcrylic Face ' Power Supply(120-277 VAC) LED PLOT MANZ, f 18 AWG Jumper Wire � � a ' x 3.8"x 3"Bolt Lag Screw � � 8 110 ® � ��rFa ea.min.) _. F U.� Trim Cap-1. VLAMINGA. 1/4"Drain Hole___) -Disconnect Switch s cmv E314410 WIXOM 218" 2411 a, ZAI Sign Type: (1)Internally illuminated LED Individual Channel Letters Sign. Japanese BBQ Dining is Push-thrudetters sign face Letter face: 3116"Thick acrylic face color as shown I € I a Trim Ca ! '} t 3' Letter Returns: 6"black with.040 Aluminum i Pun p: 314"black@g ft " t 1744 Queens Crossing Drive-San Jose-CA 95132 ftoQ2 I ►S'v T. (408) 667-1777 E-mail.swul966@gmail.com 19620 Stevens Creek Blvd, Cupertino i 4 E E •— 3/8"-1/2"Bots (4pcs)as requires � .r s .— Junction Box 3 v Aluminium (.060) ► Primary Electrical Source Aluminium Return(.040) Trim Ca Acrylic Face LED Trim Cap 1/4"Drain Hole �'� E! Disconnect Switch E"4210 218" t 24" l Sign Type: (1)Internally illuminated 1.41)individual Channel Letters Sign. Japanese BBQ Dining is Push-thru•fetters sign face Letter Face: 3116"Thick acrylic face color as shown Letter Returns: 6"black with.040 Aluminum cks Trim Cap: 314"black i ' m%Q 1744 Queens Crossing Drive—San Jose—CA 95132 19620 Stevens Creek Blvd, Cupertino T,• (408) 667-1777 E-mail.-swu1966@gmail.com i ea m`�Kai® g > � � �� :yam � '��.• r 3 s r - Nh 'u�/y ••tea T { AW r FyJ u'c"'c'-e' ss MM " 1744 Queens Crossing Drive--San Jose-CA 95132 T.• (408) 667-1777 E-mail:swu1966@gmail.com ( 19620 Stevens Creek Blvd, Cupertino E i .—o OMNI, , Junction Box w Aluminium Return .060 ( ) Primary Electrical Source Aluminium Return(.040) Trim Ca Acrylic Face LED r i Trim Cap-► 1/4"Drain Hole © 911 t Disconnect Switch a„�'u"°" E314210 1 218" 24" l ® ® Sign Type; (1)Internally illuminated LED Individual Channel Letters Sign. Japanese BBQ Dining is Push-thru-letters sign face Letter Face, 3116"Thick acrylic face color as shown Letter Returns; 5"black with.040 Aluminum Trim Cap; 314"black 0 I 1 0 1 � • o • + • • • 14 1 • i 1744 Queens Crossing Drive-San Jose-CA 95132 T.• (408) 667-1777 E-mail:swu1966@gmail.com 19620 Stevens Creek Blvd, Cupertino i FACE LIT & REVERSE LIT CHANNEL LETTER DETAIL DRAWING I r Plywood Backing Wall 2"A" Stub S w e • Stucco Fascia Junction Box -Primary Electrical Source Aluminium Return(.060), Aluminium Return(.040) Trim Ca i Acrylic Face Power Supply(120-277 VAC) LED 18 AWG Jumper Wire 3.8"x 3"Bolt Lag Screw J ea.min.) in. r.� Trim Cap---w ra- 1/4"Drain Hole 911' DisconneO E314210 ct Switch �., 218" + 2411 Sign Type: (1)Internally illuminated L.E,D individual Channel Letters Sign. Japanese BBQ Dining is Push•thru•letters sign face Letter Face. 311ti"Thick acrylic face color as shown letter Returns; 5"black with.040 Aluminum Trim Cap; 314"black u fe ,c-.,,e.,-SO Scl, e e e e a • � • • � e• • • 1744 Queens Crossing Drive-San Jose-CA 95132 19620 Stevens Creek Blvd, Cupertino T.' (408) 667-1777 E-mail:swu1966@gmail.com I i Certificate of Compliance (Sign Lighting) (Page 1 of 2) SLTG-1C Project Name: Phase of Construction ❑New Construction ❑Addition ❑Alteration Function Type 13-6utdoor Signs ❑ Indoor Signs Project Address: '�-� Date: / Compliance Method Used❑Maximum Allowed o 5i;c --Q/ 5, �� t �OCj' /9 Lighting Power ❑Alternate Lighting Sources Documentation Author's Declaration Statement ® I certify that this Certificate of Compliance documentation is accurate and complete. Name ` Signature.., _ z C' Company �Al/�'it' �S ��z..�1�.�'� � ���'✓T,'� C C%� Date Address If applicable: � 4� 3 /els Zl, CEP# City/State/Zip Phone: Principal Lighting Designer's Declaration Statement • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the lighting design. • This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with Title 24,Pages 1 and 6 of the California Code of Regulations. • The design features represented on this Certificate of Compliance are consistent with the information provided to document this design on the other applicable compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with this building permit application. A Name: Signature Company: / Phone Address: License# City/State/Zip: Date i Sign Mandatory Measures Indicate location on building plans of Mandatory Sign Measures Note Block: Mandatory Sign Lighting Controls es No 1 §133(a)1.All signs with permanently connected lighting are controlled with an automatic time switch control Elthat complies with the applicable requirements of§119. §133(a)2. All outdoor signs are controlled with a photo control or outdoor astronomical time switch control. ❑ 2 Exception to§133(a)2. Outdoor signs are in tunnels or large covered areas that require illumination during ❑ 0 daylight hours. §133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce ❑ sin power by a minimum of 65 percent during nighttime hours. 19 Exception 1 to §133(a)3. Signs are illuminated for less than one hour per day during daylight hours. 04 ❑ 3 Exception 2 to§133(a)3. Outdoor signs are in tunnels or large covered areas that require illumination during fu daylight hours. ❑ Exception 3 to §133(a)3. Only metal halide,high pressure sodium,cold cathode,or neon lamps are used to IN ❑ illuminated signs or parts of signs. §133(a)4. An Electronic Message Center(EMC)having a new connected lighting power load greater than I, N N/A 15 lJV has a control installed is capable of reducing the lighting power by a minimum of 30 percent when ❑ ❑ 4 receiving a demand response signal that is sent out by the local utility. Exception to§133(a)4.The EMC is required by a health or life safety statue,ordinance,or regulation, Y N N/A including but not limited to exit signs and traffic signs. ❑ ❑ d i 2008 Nonresidential Compliance Forms August 2009 I I i I CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 19620 stvns crk blvd. DATE: 01/18/2011 REVIEWED BY: bobs. i APN: BP#: *VALUATION: 1$3,000 *PERMIT TYPE: Building Permit 1'1AN CAECA T71PE: PRIMARY Sign PENTAMATION 10EAP5 USE: g PERMIT TYPE: WORK �nilluminated channel letter sign for business store front. SCOPE SIGN TYPE FEE ID QTY SIGN FEE Wall Sign,Electric 1SIGNWELEC 1 $253 TOTALS: 1 $253.00 Xfcch. Non Check plumb. Phar Check #Branch Circuits 1 1 $42.00 1.1-1,. pel-mit Fee: f'hnnb. t omit rce: IESIGN Elec.Permit Fee: 1EPERMIT Other A1ech. Insp. Olher Phimb Insp. Other Elee.Insp. El $42.00 Alech.Intip. Fee: Phimb. h,sp. Fee; Elec. hap.Fee: NOTE. Thesefees are based on thepreliminary in ormation available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 09-051 E . 7/1/10j FEE QTY/FEE MISC ITEMS Plan Check F'ee: Suppl.PC Fee: 0 Reg, 0 OT 0.0 hrs $0.00 A Phtmh./IAaech./Ele(.- Plan Oicck: Permit Fee: $253.00 Suppl. Insp.Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $42.00 PME Permit Fee: $42.00 Construction Tax Sign Master Plan: 0 Yes E) No $0.00 Work Without Permit? 0 Yes Q No $0.00 F'lannbl'<y Fees: Travel Documentation Fee: 1TRAVDOC $42.00 Strong Motion Fee: IBSEISMICO $0.63 Select an Administrative Item 1 Bldg;Stds Commission Fee: IBCBSC $1.00 i SUBTOTALS: $380.63 $0.00 TOTAL FEE: $380.63 Revised: 01/03/2011 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19620 STEVENS CREEK BLVD CONTRACTOR:SUCCESS GRAPHIC SIGNS PERMIT NO: 11100072 OWNER'S NAME: EVERSHINE VI&ANNIE CHAN 1744 QUEENS CROSSING DR DATE ISSUED:10/11/2011 OWNER'S PHONE: 4083431088 SAN JOSE,CA 95132 PHONE NO:(408)667-1777 LICENSED CONTRACTOR'S DECLARATION r BUILDING PERMIT INFO: BLDG ELECT PLUMB _. License Class Lic.# / MECH RESIDENTIAL' COMMERCIAL Contractor - Date I hereby affirm that I am licensed under the provisions of Ch pter 9 JOB DESCRIPTION:GYU KAKU RESTAURANT-INSTALL 2 SET SIGNAGE OF (commencing with Section 7000)of Division 3 of the Business&Professions CHANNEL LETTERS 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. I have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$5500 Section 3700 of the Labor Code,for the performance of die work for which this permit is issued. APN Number:36906010.00 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 to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 1 0 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DA OM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all n7R;= s per the Cupertino Municipal Code,Section 9.18. Issued by: Date: Signature Date___10-1 I f 11 ❑ OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. 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, Signature of Applicant: Date: Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS A OR BETTER I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(x)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air 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 I certify that in the performance of the work for which this permit is issued,I shall Health&Safet ections 25505,25533,and 25534. 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 Owne r authorized agen : 1Z, C! t become subject to the Worker's Compensation provisions of the Labor Code,I must Date: l forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of nwrk's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address 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 with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date j i i