B-2016-1312CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
10050 S DE ANZA BLVD CUPERTINO, CA 95014-2128 (369 01 065)
CONTRACTOR:
( VIKING SIGN
INSTALLATIONS INC )
MANTECA, CA 95337
PERMIT NO: B-2016-1312
OWNER'S NAME: CUPERTINO HOTEL OWNER LLC DATE ISSUED: 02/04/2016
OWNER'S PHONE: 408-253-8900 PHONE NO: 209-239-3339
LICENSED CONTRACTOR'S DECLARATION
License Class C-45 Lic. #963816
Contractor ( VIKING SIGN INSTALLATIONS INC ) Date 02/04/2016
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.
I hereby affirm under penalty of perjury one of the following two declarations:
1.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.
2.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
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 non-point source regulations per the Cupertino Municipal
Code, Section 9.18.
Signature___________________________________ Date 02/04/2016
OWNER - BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor’s License Law for one of the
following two reasons:
1.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)
2.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:
1.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.
2.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.
3.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 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___________________________________ Date 02/04/2016
BUILDING PERMIT INFO:
X BLDG ELECT PLUMB
MECH RESIDENTIAL X COMMERCIAL
JOB DESCRIPTION:
JUNIPER HOTEL - SIGNAGE THROUGHOUT INCLUDING 2 (E)
MONUMENTS (1 REPLACE & 1 RE-FACE), 3 ILLUMINATED & 1 NON
ILLUMINATED WALL SIGNS, 7 WALL PLAQUES AND 2
DIRECTIONALS
Sq. Ft Floor Area: Valuation: $30040.00
APN Number:
369 01 065
Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: MELISSA NAMES
Date: 02/04/2016
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: 02/04/2016
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(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 I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent: ________________________________
Date: 02/04/2016
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________________________________________________
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1312
10050 S DE ANZA BLVD CUPERTINO, CA 95014-2128 (369 01 065)
(VEONG SIGN
-
INSTALLATIONS INC)
MANTECA, CA 95337
OWNER'S NAME:, CUPERTINO HOTEL OWNER LLC
..
DATE ISSUED: 02/04/2016
OWNER'S PHONE: 408-253-8900
PHONE NO: 209-23M339
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C-45 Lib. #963816
Contractor (VIKING SIGN INSTALLATIONS INC ) Date M0412016
X BLDG —ELECT —PLUMB
MECH RESIDENTIAL, X COMMERCIAL
'
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.
SOB DESCRIPTION:
JUNIPER HOTEL - SIGNAGE THROUGHOUT INCLUDING 2 (E)
I hereby affirm under penalty of perjury one of the following two declarations:
MONUMENTS (I REPLACE & I RE -FACE), 3 ILLUMINATED & 1 NON
r. 1 have and will maintain a certificate of consent to self -insure for Worker's
ILLUMINATED WALL SIGNS, 7 WALL PLAQUES AND 2
Compensation, as provided for by Section 3700 of the Labor Code, for the
DIRECTIONALS
the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for
I lure. al w ll
by Section 3700 of die Labor Code, for the performance of the work for which
Sq. Ft Floor Area:
Valuation: $30040.00
this permit is issued.
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
APN Number:
Occupancy Type:
ordinances and state laws relating to building construction, and hereby
369 01 065
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
PERMIT EXPIRES IF WORK IS NOT STARTED
expenses which may accrue against said City In consequence of the
't.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of t er Additionally, the applicant understands and will
comply all non-p Int source r fie aliens pe4r the Cupertino Municipal
180 DAYS FROM LAST CALLED IN ECTION.
Code ectio . 8
-
Issued by: MELISSA N
Signatur Date 02/04/2016
Date: 02/04/2016
OWNER -BUILD ItDECLA ION
RE -ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of the
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
installed without first obtaining an inspection, I agree to remove all new materials for
r. 1, as owner of the property, or my employees with wages as their sole
inspection,
compensation, will do the work, and the structure is not intended or offered
for sale (See.7044, Business & Professions Cade)
Signature of Applicant:
z. I, as owner of the property, am exclusively contracting with licensed
Date: 02/04/2016
contractors to constrict the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
r. 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
HAZARDOUS MATERIALS DISCLOSURE
performance of the work for which this permit is issued.
I have read the hazardous materials requirements under Chapter 6.95 of the
z. I have and will maintain Worker's Compensation Insurance, as provided for
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
by Section 3700 of the Labor Cade, for the performance of the work for which
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
this permit is issued.
Health & Safety Code, Section 25532(a) should I store or handle hazardous
a. I certify that in the performance of the work for which this permit is issued, I
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance wi rthe ertinu Municipal Code, Chapter 9.12 and
Worker's Compensation laws of California. If, after making this certificate of
the Health & S ety Code, ctimns 2- and 25534.
exemption, I become subject /o the Worker's Compensation provisions of the
-
Labor Code, I must forthwith comply with such provisions or this permit shall
Owner authorized agen
be deemed revoked.
Date: 0212l04/2016
APPLICANT CERTIFICATION
CON8TR TION LE N C Y
I certify that I have read this application and state that the above information is
I hereby affirm that there Is a construction lending agency for the performance
correct. I agree to comply with all city and county ordinances and state laws
of work's for which this permit is Issued (Sec. 3097, Civ C.)
relating to building construction, and hereby authorize representatives of this city
Lender's Name
to enter upon the above mentioned property for inspection purposes. (We) agree
to save indemnify and keep harmless the City of Cupertino against liabilities,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant
ARCHITECT'S DECLARATION
understands and will comply with all non -point source regulations per the
I understand my plans shall be used as public records,
Cupertino Municipal Code, Section 9.18.
Licensed
Professional
Signature Date 02/04/2016
CITY OF CUPERTINO
FOM FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 10050 S DE ANZA BLVD
DATE: 02/04/2016
REVIEWED BY: MELISSA
APN: 369 01 065
BP#: B-2016-1312
*VALUATION:
$90,040
*PERMIT TYPE: Building Permit
M,I' t.tIL:C;P
PRIMARY
USE: Sign
PENTAMATION
PERMIT TYPE: 10EAP5
WORK
JUNIPER HOTEL - SIGNAGE THROUGHOUT INCLUDING 2 E MONUMENTS 1 REPLACE & 1
scoPE
RE -FACE), 3 ILLUMINATED & 1 NON ILLUMINATED WALL SIGNS, 7 WALL PLAQUES AND 2
SIGN TYPE
FEE ID
QTY
SIGN FEE
Wall Sign, Electric
1SIGNWELEC
3
$858
Directional Sign
1SIGNDIRECT
7
$2,002
Ground Sign, Alteration
1SIGNREWRK
2
$718
Wall Sign, Non -Electric
1SIGNWNONE
1
$286
TOTALS:
$3, 864.00
Hech PhgiiC'he, It
Th""b PlopCheck
#Branch Circuits 1 $48.00
,Vec Permit Fee:
Flinch I'd'tp'a Fee:
]ESIGN Elee. Permit Fee: IEPERA11T
Other -ci=. b'sp.
Orhdr PLaab 1,<,P
Other Elec. Insp. 0.0 $48.00
Aleeh. insZv' J.""
P114mb. halo, 1,1v
Yf(?f:. hI'p. Pee:
NOTE: This estimate floes not include fees due to outer Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). These fees are based on the nrellmina v information available and are onlv an estimate. Contact the Dept for addn7 info.
FEE ITEMS (Pee Resolution 11-053 Eff, 7/1/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
Suppl. PC Fee: (E) Reg. 0 OT
0.0
]us
$0.00
Pittsul>.4ldech,!Ete;r�
Permit Fee:
$3,864.00
Suppl. Insp. Fee: Reg. Q OF
0.0
1 Ins
$0.00
PME Unit Fee:
$48.00
PME Permit Fee:
$48.00
Cemsfracdon 7Gzv
,1cbn,aiwralhv Fee:
Work Without Permit? ® Yes (F) No
$0.00
Sign Master Plan: 0 Yes (F) No
$0.00
A
Travel Documentation Fee: ITRf411DOC
$48.00
Strong-Motmn Fee: I RSEISMICO
$8.41
Select an Administrative Item
Bldg Stds Commission Fee.: IBCBSC
$2.00
SII1TOTALS:
1 $4,018.41
$0.00[
TOTALFIM;
$4,018.41
Revised: 01 /01 /2016