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Permit Number x 09100090
Status " C - Closed
Master Number I4I
Project
Apply Date 1011412009
Permit Issue Date 10/14/2009
Certificate Issued 10/20/2009
Certificate Type
Certificate Number
Permit x Property Zoning
Permit Details
Address x I 19620 STEVENS CREEK BLVD STE 160
City/State/Zip CUPERTINO
Notes 0 APN 36906010331=.
141 Unit
Operator patg
Operator patg
Operator PALM
Applicant Contractor ` Defined Fields
CA 95014
ov"iJ:r E-116;111 hlormalion
Owner Name xl CHINA TRUST BANK
Use Default ❑
Address Business -19620 STEVENS CREEK BLVD STE 160
CitylState/Zip CUPERTINO
Permit Type
1 CEAP5 I41
SIGNS, OUTLINE LIGHTING & MARQ
Usage Class x
N/A I41
NON APPLICABLE
Applied Value "
1600
SQUARE FT.
0
Calculated Value
0 I1
US C-404 Type
437 Al
ALT: NON -RES, NON-HSKPG
Permit Form "
--- -- ---_ _-- — - -- - ------------------
AUTOPERM - PERMIT
Ownership
1 - Private
Project Size
COUNTER -OVER THE COUNTER
'ermit issued 1011412009
anter the purpose or any special conditions for this permit
Purpose/Special Conditions
CHANNEL LETTERS WALL SIGN
FILMED 6/2011
CA 95014
1COAdd Default T
,/ OK
I�ft Back
Contractors
Fees
Int, Plan Reviews
I¢ Inspections
Print Permit
'.Adjustments
Holds
1CI Copy Permit
J Close Permit
Overrides
Supplemental Fields
�.'`�jNotes
EAttachments
I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 19620 STEVENS CREEK BLVD STE 160 1 CONTRACTOR: SIGN ART CO I PERMIT NO: 09100090 1
I OWNER'S NAME: CHINA TRUST BANK 1 423 S CALIFORNIA ST I DATE ISSUED: 10/14/2009 1
OWNER'S PHONE: 3107912828 1 SAN G.ABRIEL, CA 91776 1 PHONE NO: (626)287-2512
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Li c. #
Contractor
I hereby affirm that I am licensed 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.
I hereby affirm under penalty of perjury one of the following two 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.
APPLICANT CERTIFICATION
1 certify that I have read this application and state that the above information is
correct. 1 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.
Z4
Signature Date r --r
❑ 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)
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:
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 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
1 certify that I have read this application and state that the above information is
correct. 1 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
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB f—
MECH r RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: CHANNEL LETTERS WALL SIGN
Sq. Ft Floor Area:
Valuation: $1600
APN Number: 36906010.STE160 I Occupancy Type:
PERMIT EXPIRES IF WORD IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued b�� Date l G �l Lr p
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 & Safety Code, Sections 25505, 25533, and 25534.
Owner or a �r rize en
ate. i L -L14 -�
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 Ad
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CITY OF
CUPE1Q:1NO
CITY OF CUPERTINO
SIGN
PERMIT APPLICATION FORM
C91I��OgO
APN #
Date:
3(9C)�aos-TEJ�4o
�I-4--()
Building Address:
Mailing Address (if different from building address):
Owner's Name:
Phone #:
I�i)7gl
Contractor:
Phone #: 6>6
�f "N 4(,8,T " C D
Fax #: (:),-6 —42-6 ES4.
Contractor License #:
Cupertino Business Lic nse #:
7s-�
Contact:
Phone #: 6 — '7�
1
Fax #:
Building Permit Info:
Bldg ❑ Elect [X\ Monument ❑
Mounted on Building ❑
Residential ❑ Commercial
Job Description:
Valuation (cost of project): �j tz) 0
Project Size: Express ❑ 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
aliz,
CITY OF
CUPEkTINO
I
1
CITY OF CUPERTINO
SIGN
1 FEE SCHEDULE
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
1 SIGNDIRE;CT.
i
Directional
B
1SIGN/RF.
Ground/Roof/Projecting Signs ;
B
1 SIGNMASCK
Master Plan Sign Check
B
1 SIGNREWRKG
Rework of any existing Ground
Sign .
B
1 SIGNOTHER .
Other Sign
B
1
1 SIGNREINSP
�
Re -inspection Fee
B
'
1 SIGNWNONEL
Wall/Awning Sign, Non-
Electric
B
1 SIGNWELEC
f
Wall, Electric
E
I
IESIGN;
Sign, Outline Lighting System,
or Marquee supplied from one `
branch
E
10EAP5
IESIGNADD
Additional Branch Circuit on
Same Sign, Outline System or
Marquee
E
10EAP6
i
I
IELCPLNCK
Plan Check Fee
E
1EPERMITFEE
Electric Permit Fee
E
1BCBSC
I
Cal Bldg Standards Commision
Fee
B
ALL PERMIT TYPES
1 BSEISMICOM
Seismic Commercial
B
1 BSEISMICRE
Seismic Residential -
B
1 TRAVDOC
Travel & Documentation
B
1 BUSLIC
Business License
B
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19620 STEVENS CREEK BLVD STE 160
CONTRACTOR: SIGN ART CO
PERMIT NO: 09100090
O'."*�'F.R'S NAME: CHINA TRUST BANK
423 S CALIFORNIA ST
DATE ISSUED: 10/14/2009
68, ..,R'S PHONE: 3107912828
SAN GABRIEL, CA 91776
PHONE NO: (626)287-2512
Cl LICENSED CONTRACTOR'S DECLARATION
f—
r
License Class r Lic. # � �
BUILDING PERMIT INFO: BLDG ELECT PLUMB
f— f—
Contractor —b�%
MECH RESIDENTIAL COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9 `
JOB DESCRIPTION:CHANNEL LETTERS WALL 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 Labor Code, for the
Sq. Ft Floor Area:
Valuation: $1600
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
APN Number: 36906010.STE160
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
upon the above mentioned property for inspection purposes. (We) agree to save
180 DAYS FROM LAST CALLED INSPECTION.
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
Issued b�T /y—�y— y--- Date.
with all non-point source regulations per the Cupertino Municipal Code, Section
9.18.
Sip--rureDate "o-
�GviE:7
RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
❑ OWNER-BUILDER DECLARATION
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
Signature of Applicant: Date:
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)
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
HAZARDOUS MATERIALS DISCLOSURE
I hereby affirm under penalty of perjury one of the following three
1 have read the hazardous materials requirements under Chapter 6.95 of the
declarations:
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
I have and will maintain a Certificate of Consent to self-insure for Worker's
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Compensation, as provided for by Section 3700 of the Labor Code, for the
Safety Code, Section 25532(a) should I store or handle hazardous material.
performance of the work for which this permit is issued.
Additionally, should I use equipment or devices which emit hazardous air
I have and will maintain Worker's Compensation Insurance, as provided for by
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
Section 3700 of the Labor Code, for the performance of the work for which this
Health & Safety Code, Sections 25505, 25533, and 25534.
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
Owner or a t rize en
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
CONSTRUCTION LENDING AGENCY
forthwith comply with such provisions or this permit shall be deemed revoked.
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.)
APPLICANT CERTIFICATION
Lender's Name
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
Lender's Address
to building construction, and hereby authorize representatives of this city to enter
c le above mentioned property for inspection purposes. (We) agree to save
ARCHITECT'S DECLARATION
.ify and keep harmless the City of Cupertino against liabilities, judgments,
cows, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date