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09080184Permit ` Property IJ,r . f11 li J Permit Details File Edit Actions Details Links Favorites Help SIGNS, OUTLINE LIGHTING & MARQ Usage Class i Fcirrph irltnrilb=fL61-1 NON APPLICABLE Applied Value x Permit Number 09080184 0 Calculated Value Status E - Expired 437 ICI Blaster Number Permit Form x 14I Notes 0 Project Project Size COUNTER -OVER THE COUNTER ICI Apply Date 08!19!2009 Ilt Operator patg Permit Issue Date r 08/19/2009 Operator patg Certificate Issued 02/19/2010 Operator Certificate Type Certificate Number EXPIRED Permit ` Property Zoning Applicant Contractor ` Defined Fields Permit Details Permit Type ` 10EAP5 ICI SIGNS, OUTLINE LIGHTING & MARQ Usage Class NIA ICI NON APPLICABLE Applied Value x 5000 SQUARE FT. 0 Calculated Value 01--11 US C-404 Type 437 ICI ALT: NON -RES, NON-HSKPG Permit Form x AUTOPERM - PERMIT Ownership 1 - Private Project Size COUNTER -OVER THE COUNTER f. i Permit issued 08J19J2009 Enter the purpose or any special conditions for this permit Lui_aLO11 ll.. �sr. r ;`, Address x I 19620 STEVENS CREEK BLVD City/State/Zip CUPERTINO APN 36906010.00 Unit �-�!^JI i2. �rlit,' �iliC �Ciai'a=rl (Owner Name xl EVERSHINE VI &ANNIE CHAN Use Default ❑ Address Home -19770 STEVENS CREEK BLVD City/State/Zip CUPERTINO CA 95014 CA 95014 Purpose/Special Conditions INSTALL 3 NEW RACEWAY MOUNTED SIGNS NO INPSECTIONS, PERMIT EXPIRED 2/19/2010 FILMED 6/20111 l[OAdd Default T OK 141* Back lC, Conti Fees I> Plan 181 nspE Irk Print IC7 Copy CIOSE Over Supp '' INote lC]Attac CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19620 STEVENS CREEK BLVD CONTRACTOR: JOHNSTON ELECTRIC PERMIT NO: 09080184 SIGN CO. OWNER'S NAME: EVERSHINE VI & ANNIE CHAN 3627 MT VERNON RD DATE ISSUED: 08/19/2009 OWNER'S PHONE: 4083431080 SEBASTOPOL, CA 95472 PHONE NO: (707)829-7332 ❑ LICENSED CONTRACTOR'S DECLARATION I— T_ U C, e e—, C_( y BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class � Lic. # _( r—r— p j ,.. Contractor _Tf Y � ./ `4'7;7" Date r5' r 11 � eld:\ MECH RESIDENTIAL COMMERCIAL� I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: INSTALL 3 NEW RACEWAY MOUNTED SIGNS (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. 1 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 Sq. Ft luati :$5000 performance of the work for which this permit is issued. WW,,!X 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 N 90 ,:0 ancy 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 to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter 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 by: Date: with all non-point source regulations per the Cupertino Municipal Code, Section C� 9.18. Signature (stA Date '6 RE-ROOFS- E-ROOFS:All roofs shall be inspected prior to any roofing material being installed. If a roof is Al I ❑ 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: 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) 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 I have read the hazardous materials requirements under Chapter 6.95 of the declarations: California Health & Safety Code, Sections 25505, 25533, and 25534. I 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 1 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 of the Labor Code, for the performance of the work for which this Health & Safety Code, Sections 25505, 25533, and 25534. permit is issued. issu I certify that in the performance of the work for which this permit is issued, I shall Ow r author'idejf gent: o� not employ any person in any manner so as to become subject to the Worker's !/ Date: Compensation laws of California. If, after making this certificate of exemption, 1 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 1 certify that 1 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 upon the above mentioned property for inspection purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the 1 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 gam, CITY OF CUPEf�TINO CITY OF CUPERTINO SIGN PERMIT APPLICATION FORM 09 0 4F 0) N APN # Date: �9 Building Address: 15 L09 5 (Q�l�� c�oc IC alr v� Mailing Address (if different from building address): Owner's Name: Phone#: S�ILIP Contractor: Phone #: 707 c� Z 1 733 Z J 515n Fax #- %G2 46LI Ta --J Contractor License #: Cupertino Business License #: Contact: Phone #: 7 (/ 7 cc 7-5 ? 3 3 Z ,T-6dW J Fax#. ?U? C6 T Building Permit Info: Bldg Elect Monument ❑ Mounted on Building Residential ❑ Commercial [�— Job Description: Valuation (cost of project): SdGG �i 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. L-Pu� `7?? 321`6 Revised 01/07/09 1. I11- . CITY OF CUPERTINO CITY OF CUPERTINO SIGN FEESCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type 1 SIGNDIRECT Directional i B 1SIGN/RF Ground/Roof/Projecting Signs I B 1 SIGNMASCK Master Plan Sign Check B 1 SIGNREWRKG Rework of any existing Ground Sign B 1 SIGNOTHER Other Sign B 1 SIGNREINSP Re -inspection Fee i B 1 SIGNWNONEL Wall/Awning Sign, Non- Electric B 1 SIGNWELEC Wall, Electric E 3 IESIGN 1 Sign, Outline Lighting System j or Marquee supplied from one branch E 10EAP5 IESIGNADD Additional Branch Circuit on Same Sign, Outline System or Marquee E 10EAP6 IELCPLNCK 'Plan Check Fee E PERMITFEE Electric Permit Fee i E 1 BCBSC Cal Bldg Standards Commision !Fee B ALL PERMIT TYPES /-ff3SEISMICRE SEISMICOM Seismic Commercial B Seismic Residential B jjYRAVDOC Travel & Documentation B I!MUSLIC Business License B CITY OF CU?EkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: �re���►s C�. �i� gc��lG12 PERMIT # OWNER'S NAME: PHONE # 7 d-) .1 7 3 7 2 GENERAL CONTRACTOR: '-10 efd j o T aj FAX # -7c/ -2 C6 2 1. 5 a S I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: O er/Contractor Signature $-(5a'I Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile O er/Contractor Signature $-(5a'I Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19620 STEVENS CREEK BLVD OWNER'S NAME: EVERSHINE VI & ANNIE CHAN O � _R'S PHONE: 4083431080 ❑ LICENSED CONTRACTOR'S DECLARATION License Class o Ci j� Lic. # �' 5 /� Contractor (i ,�a J 6�7 f�C� Date d 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. 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. APPLICANT CERTIFICATION 1 certify that 1 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 (/tet/ Date k^6 ^11-G ❑ OWNER -BUILDER DECLARATION 1 hereby affirm that I 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) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (See.7044, Business & Professions Code). 1 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 'Ie above mentioned property for inspection purposes. (We) agree to save ii ify 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 CONTRACTOR: JOHNSTON ELECTRIC PERMIT NO: 09080184 SIGN CO. 3627 MT VERNON RD DATE ISSUED: 08/19/2009 'iEBASTOPOL, CA 95472 PHONE NO: (707)829-7332 .3UILDING PERMIT INFO: BLDG r ELECT I— PLUMB MECH r RESIDENTIAL f— COMMERCIAL JOB DESCRIPTION: INSTALL 3 NEW RACEWAY MOUNTED SIGNS .Sq. Ft Floor Area: Valuation: $5000 .APN Number: 36906010.00 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: -y- RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 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. 1 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 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owi r author' agent: / Date: CONSTRUCTION LENDING AGENCY 1 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