10080164 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10935 N WOLFE RD CONTI:ACTOR:SUCCESS GRAPHIC SIGNS PERMIT NO: 10080164
OWNER'S NAME:
LICENSE CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class Lic.# <—Co�— I MECH r RESIDENTIAL COMMERCIAL r
Contractor Date
JOB I DESCRIPTION:NUTRITION RESTAURANT-INSTALL ONE(1)SET
I hereby affirm that I am licensed under the provisions of Chapter 9 INTERVALLY ILLUMINATED CHANNEL LETTER
(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 Sq,Ft Moor Area: Valuation:$1000
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. APN Plumber:31605051.00 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 P ERMIT 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 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 130 D YS FRO CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and ill comply , f O
with all non-po' re gu a' s per the Cupertino Municipal C qion
9.18. ^-� Issue i by: Date:
Signature Date V
U OWNER-BUILDER DECLARATION RE-ROOFS:
All roifs 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: inspe<tion.
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, Signature of Applicant: Date:
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 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 Calif)rnia Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
performance of the work for which this permit is issued. coml fiance 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(a)should I store or handle hazardous material.
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 cont:Lminants as defined by the Bay Area Air Quality Management District I will
permit is issued. maintain compliance with the Cupertino Municipal Code, hapter 9.12 and the
I 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
Compensation laws of California. If,after making this certificate of exemption,I Own er
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 LENDIN AGENCY
APPLICANT CERTIFICATION I her affirm that there is a construction lending agency for the performance of work'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 Len,ler'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 Len-ler's Address
-unify and keep harmless the City of Cupertino against liabilities,judgments,
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 un,lerstand my plans shall be used as public records.
9.18.
Lia nsed Professional
Signature Date
CITY OF CUP ERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: DA TE: REVIEWED BY:
APN: BP#: *VALUATION: $1,000
;PERMIT TYPE: Building Permit
PENTAMATION
PRIMARY Sign 1,7O(R ARI;'A PERMIT TYPE: 1 CEAPS
USE:
WORK
SCOPE
SIGN TYPE FEE ID QTY SIGN FEE
Select Sign Type
TOTALS: $0.00
l.t� h, I'`,a„Ch, it I'llmd. #Branch CircultS 1 $42.00
IESIGN Elec.Permit Fee: IEPERMIT
1t :r'? P rnrt f e , J'1r:nzT,, Pcrrr it Pae:
(?rttcr ats/,. LiOo'lLJ
Other Elec.Insp. 0.0 $42.00
Pr';r,lh, lv"p, Gtc(_hlzp Pcc
NOTE. These fees are based on the preliminary in ormation availalle and are on1v an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 09-051 Ef'. 7,1.;10j FEEQTY/FEE MISC ITEMS
Ph,in C hc';k Fcc:
Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00
Plumb flee r.%I'l v P/aII Check'
Permit Fee: $0.00
Suppl. Insp.Feed Reg. OT 0.0Fhrs $0.00
PME Unit Fee: $42.00
PME Permit Fee: $42.00
C`anSt1-IWt1C,1f7 T1l
Sign Master Plan: 0 Yes (F) No $0.00
Work Without Permit? 0 Yes 0 No $0.00
Plt ylli 7 7 Fc c,.
Travel Documentation Fee: ITRAVDOC $42.00 i
Strong,Motion Fee: IBSEISMICO $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $127.50 $0.00 TOTAL FEE:' $127.50
Revised: 8/17/2010
CITY OF CUPERTINO
5 ITEMS OF 5 PERMIT REC',EIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31605051. 00
DATE ISSUED. . . . . . . : 08/23/2010
RECEIPT #. . . . . . . . - : BS0000:.1255
REFERENCE ID # . . . : 10080164
SITE ADDRESS . . . . . : 10935 lJ WOLFE RD
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : KIMCO ZEALTY CORP
ADDRESS . . . . . . . . . . : 10935 :J WOLFE RD
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : SEAN WEN WU
CONTRACTOR SEAN WJ LIC # 29738
COMPANY SUCCESS GRAPHIC SIGNS
ADDRESS . . . . . . . . . . : 1744 QJEENS CROSSING DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95132
TELEPHONE . . . . . . . . : (408) 667-1777
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 1, 000 . 00 1 .00 0 .00 1. 00 0.00
1BSEISMICO VALUATION 1, 000. 00 0 .63 0. 00 0 .63 0 .00
1EPERMITFE FLAT RATE 1.00 42 .00 0 .00 42 . 00 0 .00
1ESIGN UNITS 1. 00 42 . 00 0. 00 42 .00 0 .00
1TRAVDOC FLAT RATE 1.00 42 .00 0 .00 42 . 00 0 .00
---------- ---------- ---------- ----------
TOTAL PERMIT 127 .63 0.00 127.63 0 .00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 127 .63 #1003
---------------
TOTAL RECEIPT 127.63
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
101 FOUNDATION 103 UFER
104 REBAR 105 ANCHOR BOLTS
304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL
CITY OF CUPERTINO
SIGN
CUPER�TINO PERMIT APPLICATION FORM
APN # Date:
Building Address: �C)C� 3s-
Mailing Address (if different from building address':
Owner's Name: Phone#:
k,(M, C,D eC-A�, 14 <ZP-P �) , /,
Contractor: Phone#:
GeAfC- Fax#:
Contractor License #: Cupertino Business License #:
Contact: Phone#:
Fax#:
Building Permit Info:
Bldg ❑ Elect Monument ❑ Mounted on Building
Residential Commercial
Job Description:
Valuation (cost of project):
C a o
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
LEED for Core and Shell v2.0
Registered Project Checklist
Project Name: �Qbc—P24 ,
Project Address:
Yes 7 No
Prereq 1 Construction Activity Pollution Prevention Required
Credit 1 Site Selection 1
Credit 2 Development Density&Community C Dnnectivity 1
Credit 3 Brownfield Redevelopment 1
Credit 4.1 Alternative Transportation:Public Trar sportation Access 1
Credit 4.2 Alternative Transportation:Bicycle Stcrage&Changing Rooms 1
Credit 4.3 Alternative Transportation:Low-Emittilig and Fuel-Efficient Vehicles 1
Credit 4.4 Alternative Transportation:Parking CE parity 1
Credit 5.1 Site Development:Protect of Restore I-abitat 1
Credit 5.2 Site Development:Maximize Open SpE ce 1
Credit 6.1 Stormwater Design:Quantity Control 1
Credit 6.2 Stormwater Design:Quality Control 1
Credit 7.1 Heat Island Effect,Non-Roof 1
Credit 7.2 Heat Island Effect,Roof 1
Credit a Light Pollution Reduction 1
Credit s Tenant Design&Construction Guidelines 1
Yes 7 Nb
1=31 I
'e
Credit 1.1 Water Efficient Landscaping:Reduce by 50% 1
Credit 1.2 Water Efficient Landscaping: No Potable Use or No Irrigation 1
Credit 2 Innovative Wastewater Technologies 1
Credit 3.1 Water Use Reduction:20%Reduction 1
Credit 3.2 Water Use Reduction:30%Reduction 1
Yes 7 No
's
Prereq 1 Fundamental Commissioning of the Building Energy Systems Required
Prereq 2 Minimum Energy Performance Required
Prereq 3 Fundamental Refrigerant Management Required
•Note for EAc1:All LEED for Core and Shell projects registered after June 26th.2007 are re(uired to achieve at least two(2)points under EAc1.
® Credit 1 op timize Energy Performance 1 to e
10.5%New Buildings or 3.5%Exist ng Building Renovations 1
14%New Buildings or 7%Existing 3uilding Renovations 2
17.5%New Buildings or 10.5%Exi:lting Building Renovations 3
21%New Buildings or 14%Existing Building Renovations 4
24.5%New Buildings or 17.5%Exi:lting Building Renovations 5
28%New Buildings or 21%.E)istinll Building Renovations s
R31.5%New Buildings or 24.5%ExiAing Building Renovations 7
35%New Buildings or 28%Existintl Building Renovations 8
Credit 2 On-Site Renewable Energy 1
Credit 3 Enhanced Commissioning - 1
Credit 4 Enhanced Refrigerant Management 1
Credit 5.1 Measurement&Verification-Base Building 1
Credit 5.2 Measurement&Verification-Tenant Sub-metering 1
Credit 6 Green Power 1
continued...
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120 VOLT/20 AMPS
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5"Aluminium return(.040) --
314" Trim capes
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LED— - �- box&cover
- Transformer(100-240 VAC
(Existing siona9e -.
18 AWG pigtail
3/4" Trim Cap---.- PAN-TO-WALL FASTENER
ANCHOR/LAG(#10 Screw)
1/4"Drain hole v4"X1"TO 3",MIN.OPCS.
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WALL TYPE
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t STUDS WOOD SCREW 318"TO'/z"X 2"TO 4" redhead E+14210
CONCRETE ANCHOR/LAG 3r8"TO'.%"X 2"TO 4" redhead O ELECTRIC
STUCCO SHEETROCK ANCHOR/LAG 318"TO Yz'X 2"TO 4" redhead LIED s c oN
N..X),1i'A:F
CHECKED BY
129"
DATE `
APPROVED NVT R I TI01V
IN ACCORDANCE WITH THE CITY OF
CUPERTINO CODES AND ORDINANCESDi
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....r._._..... ..
SIGNS
This set of plans and s ificat<'ons MUST 1 7
b at all times and It is #�`� �N� �,��5 _._..._
n the o J�
be kept o ► A U_R '
unlawful to make any changes or alterations
on same without written permission from Sign Type: (1)Internally illuminated L.E,D individual Channel Letters Sign.
the Building Department, City of Cupertino. Letter Face: 118"Thick acrylic face color as shown
The stamping of this plan and specifications
Letter Returns: 5"WHITE with.040 Aluminum
SHALL NOT be held to permit or to be an
approval of the violation of any provisions Trim Cap: 314"SILVER
of any City Ordinance or State Law.
ccess
cesssigngroup.com Project • . Approval
• � • 1744 Queens Crossing Drive — San Jose — CA 95132
10935 North Wolf Road, Cupertino
T (408) 667-1777 E-mail:swu 1966@yahoo.com
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1744 Queens Crossing Drive—San Jose—CA 95132
10935 North Wolf Road, Cupertino
T (408) 667-1777 E-mail:swu1966@yahoo.com