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15040079CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19501 STEVENS CREEK BLVD STE 102 CONTRACTOR: LEE'S SIGNS PERMIT NO: 15040079 OWNER'S NAME: NOBLE BROHTERS LLC 845 E 10TH ST DATE ISSUED: 04/09/2015 O R'S PHONE: 6506053015 OAKLAND, CA 94606 PHONE NO: (510) 452-1420 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL LICENSED CONTRACTOR'S DECLARATION INSTALL 2 (N) ILLUMINATED WALL SIGNS TO (E) `�� Class—— Lic. # BRANCH License CIRCUITS ContractorI fit? - Date —�r��S, � I hereby affirm that I am licensed under the provisions of hapter 9 C R EqIA (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 Valuation: $4700 performance of the work for which this permit is issued. Sq. Ft Floor Area: 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: 31649110.102 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 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 LLED INSPECTION. 180 DAYS upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep hornless the City of Cupertino against liabilities, judgments, ^ costs, and expenses which accrue against said City in consequence of the e: 7 / granting of this permit. ditionally, the plicant understands and will comply with all non -point sour r ul i r the Cupertino Municipal Code, Section 918. RE -ROOFS: Date tit All roofs shall be inspected prior to any roofing material being installed. If a roof is Signature _ ( installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Date: Signature of Applicant: I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, do the work, and the structure is not intended or offered for sale (Sec.7044, will Business & Professions Code) HAZARDOUS MATERIALS DISCLOSURE I, as owner of they contracting with licensed contractors to property, am exclusive) g construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Management District I Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quali will maintain compliance with the Cupertino Municipdl Code, Chapter 9.12 and performance of the work for which this permit is issued. the Health & Safety Code, Sections 25505, 25533, a 2 3 . I have and will maintain Worker's Compensation Insurance, as provided for by vr Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date:�� 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I I hereby affirm that there is a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the Labor Code, I must work's for which this permit is issued (Sec. 3097, Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Name APPLICANT CERTIFICATION Lender's Address 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 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 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 CUPERTINO SIGN PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(W-cuper ino.or4 PROJECT ADDRESS /J % fCheck 'V O'( , j� j�[r APN # *3 ' (f O O J OWNER NAME j� , PH0NEj STREET ADDRESS D 6 O CITY, STATE, ZIP I FAX CONTACT NAME �I1.3 I Vim' PHONE p.pO —wr�� -,� ` ' ` ' ]„ p7� E-MAIL �� r � #WKre CM" I STREET ADDRESS y— rD rJ . l CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER- ❑ OwNE�RrAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Ir PIC. lC - V l LICENSE NUMBER /� TYPE ^ a BUS. LIC # COMPANY NA COMME MAID �'� �LICENSE FAX f STREET ADDRESS CITY, STATE, ZIP ©% 6 PHONE fo �) l ARCHITECT/ENGINEER NAME LICENSE NUMBER #L BUS. LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK �r USE OF ❑ SFD or Duplex ❑ Multi -Family STRUCTURE: R Commercial ILLUMINATED SIGN TYPE NO. OF (YIN) (CODE) SIGNS SIGN AREA FT.) VALUATION ($) SIGN TYPE CODES: 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 E) Y V %(SQ. C ` _ wAw f - i -7 v ,^ iii v TV By my signature below, I certify to each of the following: I am rope rty owner authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I ha r on of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I th ntatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED _ Site Plan _ Elevations Sign Details - including UL listing(s) applicable Structural Calculations (if applicable) _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. OFFICE USE ONLY PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ EXPRESS ❑ STANDARD ❑ LARGE ❑ MAJOR ❑ BUILDING PLAN REVIEW ❑ PLANNING PLAN REVIEW ❑ OTHER: SignApp 2011.doc revised 03/31/11 Construction Tti : Administrative Fee: Work Without Permit? 0 Yes Q No $OAO _ - _ - _ - - ;ATE ARTMENT TPLANNING DE CO E�MENDTINO CUPERTINO ,,,LDING�V oN -CUPER53.6 5" p,PPROVE� tans and specifiion. It 1S cations P�1US Ub1 kepke any This set of p job site during Constr,,ctnt or changes or alterion 'ts on s` without approval fro» tr �' '��! H N therefrom, in of this p'an and l� The be held to PERMIT # SCALE: 3/4"=V-0" NEW SIGNAGE FOR "CREAM" (PUSH-THRU TYPE LETTERS, HALO -LIT SIGN) CUPERTINO • t wilding Dep rtment APR 0 9 2©15N. ZEVIE.v4L= ° tt—OR CODE `3/8"X3-1/2° Painted sign panel with dimensional, interior illuminated corrugated, brown COPY background, push-thru white and blue OFFICE identity elements and halo -illuminated logotype flush -mounted to bldg, fascia PROPOSED VIEW LAG BOLTS TOP 2 00 BOTTOM 2 TOTAL: 4 3/8" 3/8" 3/8 3" 1-1 /2" 47'-0" 18" 3/8"X 3-1/2" LAG BOLTS TOP 2 \ RnTTnKA Single -sided interior illuminated sign pin -mounted to bldg, fascia 3/8 N.T.S /2" 1961 ui a a 0 Z O in J Q 0 W a' W U Z N W Z o W W W z 1ix o X10 �a3 — 3 ��LU yLU ooL 0000 N N p � V H LO iii � 't I J O O W W LoLo v) ai3 Jvn0o�3 JOA