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11030051CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19070 STEVENS CREEK BLVD I CONTRACTOR: DIABLO VALLEY SIGNS I PERMIT NO: 11030051 I OWNER'S NAME: UNITED POLARIS INC G E.R'S PHONE: 4082553999 01 LICENSED CONTRACTOR'S DECLARATION /� `. 2 License Class � Lic. #_Td'j fi � ) � n r Date Contractor k�,n �// i I hereby affirm that I am licensed iWder 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: 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 fp hich this permit is issued. l 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 no oint ce regulations per the Cupertino Municipal Code, Section 9.18. Signature Date .7, Z ❑ 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 PO BOX 452 SAN LORENZO, CA 94580 DATE ISSUED: 03 /16/2011 PHONE NO: (510) 333 -5483 BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r MECH r RE��§IDENTIAL r COMMERCIAL r A#14 l�'41C vc, lyl JOB DESCRIPTION: WALL SIGNAGE, INDIVIDUALLY ILLUMINATED CHANNEL LETTERS @STORE FRONT Sq. Ft Floor Area: Valuation: $2100 APN Number: 37507046.19070 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued �L� — 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(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 Health & Safety Code, Sections 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 Owner or i • ed age become subject to the Worker's Compensation provisions of the Labor Code, I must Date: '�Zf forthwith comply with such provisions or this permit shall be deemed revoked. t 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 nify and keep harmless the City of Cupertino against liabilities, judgments, cu...,, 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 -�Qmt source regulations per the Cupertino Municipal Code, Section 9.18. \ _ —� Date '3 '?-)- I I 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional SIGN PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333• building(a,cupertino.org CUPERTINO PROJECT ADDRESS`,�.- I t .� APN# jI �q�• ) pJ®^ p I ® J { 9 0 OWNER NAME r ,I ` /I� IONJr�fa� 7��6_ IR6V_ E-MAIL STREET ADDRESS - E' ITY, STATE,ZIP ( - FAX ti APPLICANT NAME E-MAIL t ) - 0 /JJL Q v`- L(1 L/041- STREET 41STREET ADDRESS q CITY,STS ZIP L� FAX t ) C c9 ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME I//I LICENSE NUMB LICENSE TYP BUS.LIC# n L C tE%t2� c" COMPANY NAM // E-MAIL ( FAX fence G ��far G STREET ADDRESS (1 (` �. CITY,ATE,ZIPt. fo p .e � c� PHONE 50 _ ,- ARCHITECT/ENGINEERNAME ( LICENSE NUMBER BUS.LIC# J l COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCWTION,OF WORK t ( I V c 2 ltr 1. USE OF BUILDING ❑ Residential ,,E—Commercial ILLUMINATED SIGN TYPE NO.OF SIGN AREA VALUATION (Y/N) (CODE) SIGNS (SQ.FT.) (S) SIGN TYPE CODES: v" `, �" ((7 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 RECEIVED BY r- - - TOTAL VALUAfiTION: By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I ave read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bu truction;--I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED - = orticE USE ONLY _Site Plan - PLAN CHECK TYPE _ - ROUTING SLIP - _Elevations t-LI :BVILDINGPLANREVIEw _Sign Details-including UL listing(s)applicable ❑AsT ARD - ❑-PLANNINGrLANRE-yIEw _ Structural Calculations(if applicable) ❑ LARGE:. ❑ OTHER: _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR submittal of Building Permit application. I i SignApp_2011.doc revised 03/02/11 I i CITY OF CUPERTINO 12 FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 19070 stvns crk blvd. DATE: 03/10/2011 REVIEWED BY: bobs. APN: BP#: VALUATION: $2,100 rPERMIT TYPE: Building Permit hr.i'` T P >. PRIMARY Sin PENTAMATION 1 CEAP5 USE: g PERMIT TYPE: WORD install illuminated channel letter sign for comm. storefront. SCOPE SIGN TYPE FEE ID QTY SIGN FEE Wall Sign,Electric 1SIGNWELEC 1 $253 TOTALS: 1 $253.00 m i ttc #Branch Circuits 1 $42.00 IESIGN Elec.Permit Fee: IEPERMIT ElOthersy Elec.Insp. 0.0 $42.00 NOTE: These,fees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 111/a. FEE ITEMS (I ee Resohaion 09-051 Etf. LLLfFEE QTY/FEE MISC ITEMS t s Sup pl.PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 Permit Fee: $253.00 Suppl.Insp.Fee:O Reg. 0 OT 0.0 his $0.00 PME Unit Fee: $42.00 PME Permit Fee: $42.00 t:`om,fi cf (m Tyr,; F7 Sign Master Plan: 0 Yes 0 No $0.00 Work Without Permit? 0 Yes G No $0.00 Travel Documentation Fee: ITRAVDOC $42.00 Strong Motion Fee: IBSEISMICO $0.50 Select an Administrative Item i Bldg Stds Commission Fee: IBCBSC $1.00 i SUBTOTALS: $380.50 $0.00 TOTAL FEE: $380.50 Revised: 01/15/2011 i I i r' ;�� !,j K, NA�", ILLUMINATED INDIVIDUAL CH NN L LETTERS Approved Chann I Letter L yut LETTER TION PCL-LED FRONT LIT AAA INTERNALLY ILLUMINATED PAN CHANNEL LETTER ,rr ILLUMINATED INDIVIDUAL CHANN L LETTERS 5" .040ALUM. RETURN FACE RED ACRYLIC 1/4"DIA.31/2"EXTERIORSCREW STUCCO AND PLYWOOD WALL RETURN : D. Bronze (4) PER LETTER WITH#14 ANCHOR TRIM CAP : 3/4" Yellow MIN.21/2"IN TO MASONRY 4"Deep X 8"H WITH 1/2"DIA.STAND OFF RACEWAY LEDs : RED GTO CABLE THRU 1/2"DIA. r FLEXIBLE SEAL TIGHT CONDUIT ` DISCONNECT SWITCH 1�7-�ILLU INT D L X LEDs FACE WHITE ACRYLIC With CUT-OUT LETTERS LOW VOLTAGE POWER SUPPLYHaw RETURN . D/ BRONZE TRIM CAP : 3/4" WHITE LN U 'urnarc n+N mesµo LEDs : WHITE � o v 02 a N�tl"MI[kN � � iiawxwe cm,cu cocea. Typical LED Mounting Detail not to scale 40" ILLUMINATED INDIVIDUAL CHANNEL LETTERS FACE WHITE ACRYLIC MANGO (230125) VINYL TOTAL STOREFRONT, LINEAR = 40' RETURN : ®/ BRONZE TOTAL PROPOSED SIGNAGE SQ FOOTAGE 59 TRIM C,AP : 3/4" YELLOWJC , LCDs WHITE I� I LA co co DATZ 18 y v sa aax+aa5rr✓N.+.� :. CV A pp� 2614„ 1 -7 0