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15060111 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10793 S BLANEY AVE CONTRACTOR:SUCCESS GRAPHIC PERMIT NO: 15060111 SIGNS OWNER'S NAME: PACIFIC RIM PARK LLC 1744 QUEENS CROSSING DR DATE ISSUED:06/16/2015 OWNER'S PHONE: SAN JOSE,CA 95132 PHONE NO:(408)667-1777 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL MW "HAIR WE GO" INSTALL EXTERIOR WALL SIGN WITH(1) License Class [ .# tt;` r.,=y SET OF CHANNEL LETTERS WITH 1 BRANCH CIRCUIT Contractorat. I hereby affirmlicensed under the provisions of 6apteir 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. Sq.Ft Floor Area: Valuation:$1200 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:36934052.10793 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 upon the above mentioned property for inspection purposes. (We)agree to save 180 DXAYS FROM LAST CALLED INSPE TI N. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the C ,Ut/�-a granting of this permit. Additio�y,the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 918. RE-ROOFS: Signature-100;1.1All 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. ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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) 1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE 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 declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous 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 Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 025533, nd 25534. _ Section 3700 of the Labor Code,for the performance of the work for which this _,. ^'l "�''•, } ' " r .: Owner or authorized agent: - c*Y"t? +� � te:✓..ti 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION 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 SIGN P�RIVIIT APPLICATI®N l. fj��l COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPER,TINO (408)777-3228• FAX(408)777-3333•buildingacupertino.org PROJECT ADDRESS OWNER NAME / PHONE -MAB, STREET ADDRESS v CITY,STATE,ZIP FAX CONTACT NAME v�,v N,A PHONE [� r `;,� E-MAIL STREET ADDRESS l.'WIYvW ✓s1 /7�1 e��/�/� jCITY,STATE,ZIP �J FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT XCONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME v, LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME �� 4 ��' E-MAIL FAX STREET ADDRESS/ CITY,STATE,ZIP --,. ( � PHOT ARCHITECT/ENGINEERNAME LICENSENUMBER Qa BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK �/` , /- 4__b '` 6 ✓1 ` USE OF ❑ SFD or Duplex ❑ Multi-Family ILLUMINATED SIGN TYPE NO.OF SIGN AREA VALUATION STRUCTURE: ❑ Commercial (Y/N) (CODEJ SIGNS (SQ.FT) (s) 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 %RECZjVEDJ3) f TOTAL VALUATION: By my signature below,I certify to each of the following: I am the property owner or autl orrzed agent to act on the property owner's behalf. I have read this application and the information I have provided is c0rrec ye read the Description of Work and verify it is accurate. I agree to omply wi all applicable local ordinances and state laws relating to building cons Ion/ uthorize re esentatives of Cupertino to enter the above-idenY ed operty for spectio�rposes. Signature of ApplicantlAgent: Date: SUPPLEMENTAL INFORMATION REQUIRED Q _Site Plan .. P.LAN..CI�CICTYPE - �,,A. -�., ROUTWGSLIP _Elevations ® t xxr[i> s n ; �� ®° Btn DING PinN s�vrF w' ataa _Sign Details-including UL listing(s)applicable F`73sFaNDAxDIt ❑ PLANNING'PL € Structural Calculations(if applicable) ❑!'LARGE ❑ oTHEx Copy of Planning Approval Letter or Meeting with Planning prior to ❑µN�InIOR j, submittal of Building Permit application. SignApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10793 S Blaney Ave DATE: 06/16/2015 REVIEWED BY: Paul APN: 369 34 052 BP#: �e660 j *VALUATION: 1$1,500 *PERMIT TYPE: Building Permit PLAN CIIEC.K Tl PE. PRIMARY Sign PENTAMATION 10EAP5 USE: g PERMIT TYPE: WORK "Hair W Go" Install exterior wall si n with 1 set of channel letters with 1 branch circuit SCOPE SIGN TYPE FEE ID QTY SIGN FEE Wall Sign,Electric 1SIGNWELEC 1 $286 TOTALS: $286.00 ;blech.Plan Check Phimb. Plan Check #Branch Circuits 1 $48.00 :Meeh. Permit Fee: Plumb.Permit Fee: IESIGN Elec.Permit Fee: IEPERMIT Other;llech. Insp. Other Plumb Insp. Other Elec.Insp. 0.0 $48.00 .Llech.Insp.lee: Plumb. Insp. Fee: Elec.Insp.Pee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info, FEE ITEMS (Fee Resolution 11-053 Eff 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl.PC Fee: 0 Reg. 0 OT 1 0.0 1 hrs $0.00 Phunb./l1lech.1E,lec Permit Fee: $286.00 Suppl. Insp.Fee:Q Reg. Q OT 00 hrs $0.00 PME Unit Fee: $48.00 PME Permit Fee: : $48.00 Construction .Tax: Administrative Fee: Work Without Permit? 0 Yes (F) No $0.00 Sign Master Plan: 0 Yes (F) No $0.00 Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICO $0.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $431.50 $0.00 TOTAL FEE: Revised: 05/07/2015 Me , 1111 tL CUP R'TI`NO `� I g�� Barber SI Plywood Backing Qu(l tlnq Department a it ::,�: — � �� " # ' �r.'••.4 q�. —Primary� i Il1Q. al source JUN15 (supplies by Other5"Aluminium Return s)y . unction Box �y #10 x 2"-3 1/2"Drive Screws ( ;, REVIEWED FOR CODE COMPLI �� Minimum Three(3)per Letters I Class 2 Low Voltage o required I "�� Reviewed By: QUygw = =_ r as r q red per field conditions Wiring ` w/sleeves for stand-off ( Note: No conduit or flex Rubber Brushing required per class 2 low --- - .t voltage wiring guideline ... d Acrylic Face • Power LED I I (120-277a Supply) r �- • Lexan Backing Disconnected Switches Trim Cap 3/48D3537 3/8°Lag Screws as Required. ' 1/4"Drain Hole ... COMMUNITY DEVELOPMENT DEP. RTMENT w BUILDING DIVISION - CUPE INO WS BY APPROVED This set of plans and specifications MUST b kept at the T - TE job site during construction. It is unlawful t make any -o changes or alterations on same, or D deviate j r _ i` r — „ �.�®® a PLAN DEPT therefrom, without approval from the Builc n Official. J� CUPERTINO The Stamping g �I p ng of this plan and specifications HALL NOT be held to permit-or to be an approval of e violation BYny p is�ons f any City Ordnance o tate Law. ---�� PWON DATE1 Raceway F U0 - ERM 1 T# �. b JUN, 16/, 20015 Sign Type: (1)Internally illuminated L.E.D individual Channel Letters Sign. BY Letter Face: 1/8"Thick acrylic face color as shown g� n� Letter Returns: 5"Black with.040 Aluminum Trim Cap: 3/4"Black uccess Project Location Approval M%%OQ 1744 Queens Crossing Drive-San Jose- CA 95132 T.' 408 667-1777 E-mail:SWU1966@gmail.com 10793 S.Blaney Ave.,Cupertino I ( ) @gmail.com was W. vir SIL"i1c14,1 1, y�� .YYIA.pfD,q " wA Go'a w Stai�niraM�Fbs`- a hairWe�,go G n MUSIC v y ". b wa., ze, e k I WON` Cktu Naracile Wh", r " Hair Wor(S z Ak " ' uma i FelPacific Rima F�eijisac_Odck Ne se ER Stl in Genu E • . 741 FIR S2 Acaderaay ,j <` r-11151 Z Al .... � Project,Location ( Approval A Crossing Drive Jose—CA 95132 �J�PK v0Cupertino