14090022CITY OF C UlPlERTINO BUILDING PERMT
BUILDING ADDRESS: 10455 S DE ANZA BLVD
CONTRACTOR:-9'-B&-Z"E
PERMIT NO: 14090022
OWNER'S NAME: BDC HAYWARD LP
Q S
DATE ISSUED: 09/04/2014
OWNER'S PHONE: 9255882200
PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL 0
MC CLELLAN SQUARE; INSTALL ILL ONE MONUMENT SIGN
License Class �- 4f� Lic. 9 /7 `�(
AND
Contractor 64),r_- c% J' ct Date
REFURBISH EXISTING SIGN
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:
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 Floor Area:
Valuation: S18000
performance of the work for which this permit is issued.
ave and will maintain Worker's Compensation Insurance, as provided for by
ection 3700 of the Labor Code, for the performance of the work for which this
APN Number: 35917019.10455
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
]P]ER]�/j[][T EXP ®RK)(S NOT S'1<'.4111�`I<']ED
correct. l agree to comply with all city and county ordinances and state laws relating
���)E��� �® ���� ®� Ily ��� ISSUANCE ®�
E
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 ][i ALLED I ECT ON.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
9
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
9.18.
�- !�
RE -ROOFS:
Signature Date
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, l agree to remove all new materials for
inspection.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant; Date:
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of
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)
I, 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. 1 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(x) should 1 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
1 have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Cod 505, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized a nt: " 7 Date: - r c i
permit is issued.
1 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, ]
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. 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
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
CUPERTONO
SM PERN`ll' A pp IUCD °,`ll'ON
COMMUNITY DEVELOPMENT DEPARTMENT < BUILDING DIVISION
10300 TORRE AVENUE o CUPERTINO, CA 95014-3255
(408) 777-3228 < FAX (408) 777-3333 < buildingacupertino.ora
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PROJECT DDRESS APN # ®/
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❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR R CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER 11 TENANT
CONTRA TO
LICENSE-/ UN BEI,,/
LICENSE NUNIBER
LICE E Tj;E,,
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BUS. LIC N
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SIGN TYPE
(CODE)
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E-MAIL
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FAX
47-7-- 93,057
ST ET DDRESSITY,
STREET ADDRESS
STATE. ZIP
CITY, STATE, ZIP
PHOT E
ARCHITECT/ENGINEER NA41E
LICENSE NUNIBER
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BUS. LIC H
COMPANY NAME
SIGN TYPE
(CODE)
E-MAIL
SIGN AREA
(SQ. FT.)
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
,I �
f`d
eyl
USE OF �❑l SSFD or Duplex E]Multi-FamilyILLUMINATED
STRUCTURE: I-1 Commercial
(Y/N)
SIGN TYPE
(CODE)
NO. OF
SIGNS
SIGN AREA
(SQ. FT.)
VALUATION
(($
SIGN TYPE CODES:
,I �
B - BANNER SIGN M - MONUMENT (GROUND) SIGN
BL - BLADE SIGN P - PROJECTING SIGN
D - DEVELOPNIENT ID SIGN SP - SPECIAL EVENT BANNER
DI - DIRECTIONAL SIGN T - TEMPORARY
F - ELECTRONIC W - WALL SIGN
READERBOARD WI - WINDOW SIGN
RECEIVED BY:
TOTAL Vt�UATTIIOONN:
By my Signature below, I certify to each of the following: l am the property owner or authoriz e property owners behalf. I have read this
application and the information l have provided is correct. l have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating t traction. I authorize representatives of Cupertino
to enter the above -identified property for inspect n purposes.
Signature of Appl icantiA t:
Date:
SUPPLEMENTAL INFORMATION REQUIRED
OFFICE USE ONLY
PLAN CHECK TYPE
OUTING SLIP
Site Plan
VF.R-THE-COUNTER Ir
❑ BUILDING PLAN REVIEW
Elevations
Sign Details - including UL listing(s) applicable
❑ EXPRESS
LANNINC PLAN REVIEW
Structural Calculations (if applicable)
❑ STANDARD
❑ OTHER:
Copy of Planning Approval Letter or Meeting with Planning prior to
❑ LARGE
_
submittal of Building Permit application.
❑ MAJOR
SignApp_201 Ldoc revised 03/3111
- CITY 1 OI S I I" I I' I I S O
FEE ESTIMATOR I.,I II IIING II►IVIMON
SIGN TYPE
ADDRESS: 10455 de anza blvd
DATE: 0910412014
REVIEWED BY: Mendez
Lf ch. l'a rnrit Fc>e:
APN:
BP#: D,
-VALUATION: 1$18,000
*PERMIT TYPE: Building Permit
1"!.-1-v I, -']k C,V I"Jll:-
PRIMARY Sig n
USE:
P11 '111h. hiSj).1:•c,L..
PENTAMATION 10EAP5
PERMIT TYPE: �
WORK
me clellan square; install one monument sign and refurbish existing
SCOPE
SIGN TYPE
FEE ID
PlroFri, i'luti Chec l
QTY
Lf ch. l'a rnrit Fc>e:
SIGN FEE
IESIGN Elec. Permit Fee: IEPERMIT
Ground Sign
1SIGNGRIRF
Other Elec. Insp.E-7-1 $48.00
2
P11 '111h. hiSj).1:•c,L..
$718
$718.00
Suppl. Insp. Fee -E) Reg. 0 OT Q,Q hrs
$0.00
PME Unit Fee:
$48.00
PME Permit Fee:
$48.00
Cutc,•It•rtc tion Tax:
r$C.�112t1'll �:IfCrit 4'P f L'[':
Work Without Permit? Yes E) No
$0.00
Sign Master Plan: Q Yes E) No
$0.00
Travel Documentation Fee: ITRAVDOC
$48.00
Strong Motion Fee: IBSEISMICO
TOTALS:
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
$718.00
$868.04
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.. These fees are based on the preliminar information available and are onLy an estimate. Contact the De t or addn'1 ino.
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13)
l'1oI Ukic k
PlroFri, i'luti Chec l
# Branch Circuits 1 $48.00
Lf ch. l'a rnrit Fc>e:
I'hunh. Pu rrul ! r
IESIGN Elec. Permit Fee: IEPERMIT
l)the� We, h. /rr,vt�
Ea --L-
Other t'lr.,,(, hc,P_
Other Elec. Insp.E-7-1 $48.00
1, 1; F, -(
P11 '111h. hiSj).1:•c,L..
[*,' I I r t,- ,,. l.�_„..
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.. These fees are based on the preliminar information available and are onLy an estimate. Contact the De t or addn'1 ino.
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13)
FEE
QTY/FEE
MISC ITEMS
Mar, C7,ecl,- Fee:
Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs
$0.00
Permit Fee:
$718.00
Suppl. Insp. Fee -E) Reg. 0 OT Q,Q hrs
$0.00
PME Unit Fee:
$48.00
PME Permit Fee:
$48.00
Cutc,•It•rtc tion Tax:
r$C.�112t1'll �:IfCrit 4'P f L'[':
Work Without Permit? Yes E) No
$0.00
Sign Master Plan: Q Yes E) No
$0.00
Travel Documentation Fee: ITRAVDOC
$48.00
Strong Motion Fee: IBSEISMICO
$5.04
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$868.04
$0.00
TOTAL FEE:
$868.0.4
Revised: 07/10/2014
A
August 25, 2015
TI L
6221 ENTERPRISE DRIVE DIAMOND SPRIGS, Cts 95619
PHONE 916.333.3765 530.622.1420 FAx 530.622.9367
E-MAIL WESTERN@WESTERNSIGN.COM
To: Cupertino Community Development Department
Attn: Patricia Garcia
Permit # 14090022
REQUEST FOR PERMIT EXTENSION
5 1 k -z -
-bU C�--
Based on the enclosed email outlining the reason for the delay in completing this permit, we hereby
request an extension of 90 days from the current expiration date of Sept 13, 2015 until December 13,
2015.
Respectfully submitted,
Dennis Schneider
Permitting
530.622.1420
Print
M
Subject:
RE: Building Permit Expiration Letter
From:
Brian Aita (BAita@BrowmanDevelopment.com)
To:
denniswesternsign@yahoo.com;
Cc:
keithwesternsign@yahoo.com;
Date:
Tuesday, August 25, 2015 9:38 AM
Thanks Dennis.
Page 1 of 2
Can you file for an extension with the City of Cupertino (90 days)? I'll work on getting the sign electrified in
that time.
The thought here was to wait to electrify the sign until the fagade work for the shopping center was done. As
that fagade work has been delayed until after the first of the year, I'll be coordinating with my electrician to get
his sign electrified now, rather than waiting.
Sincerely,
Brian Aita
Property Manager
BROWMAN DEVELOPMENT COMPANY, INC.
1556 Parkside Drive
Walnut Creek, CA 94596
(925) 588-2213 Direct
(925) 588-2230 Fax
BAita(i�browmandevelopment.com
]From: Dennis Schneider [mailto:denniswesternsign@yahoo.com]
Sent: Tuesday, August 25, 2015 9:00 AM
To: Brian Aita <BAita@BrowmanDevelopment.com>
https://us-mg6.mail.yahoo.com/neo/launch?retry_ssl=1 8/25/20115
Print
M
A
Cc: Keith Wills <keithwesternsign@yahoo.com>
Subject: Building Pen -nit Expiration Letter
Good morning Brian,
Page 2 of 2
Please find attached a notice of Building Permit Expiration from
Cupertino. ]Let me know What We can do. We Were advised by a
Cupertino Building Official that the date Was -the 17th however, this
letter refers to the 13th.
'hank you,
Dennis Schneider, Permitting
-q*�D' ES17ERN
SIGN COMPANY
DINc5 1959
dennis2 cgwesternsi n.com
530-622-1420 Phone 530-622-9367 FAX
https:Hus-mg6.mail.yahoo.com/neo/launch?retry_ssl=1 8/25/2015
-7y
S'FATE'OF CALIFORNIA -3
SIGN LIGHTING �1-5 E :,
CEC-NRCC-LTS-01-E(Revised061141 �J� �'--� CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 5 of 5)
ProjeR Name: j4, /� i / a A _a - w _ Date Prepared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
0 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Sign
Company: .y�-�
/ cc
Signature Date:
Address: / • ' s �—
CEA/ HERS Certification Identification (if applicable):
City/Sta /Zip:
Phone:
`?
RESPONSIBLE PERSON'S DECLARATIO STATEMENT
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design
identified on this Certificate of Compliance (responsible designer).
3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system
design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of
Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building permit application.
5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the
building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this
Certificate of Compliance is required to be included with the documentation the builder proviclesK—th't buildin weer at occ ancy.
Responsible Designer Name:
Responsible Designer signature:
Company:
Date Signed:
Address: 1
License: —r ?6 ZY
('M
City/State/Zip:
Phone:
i tY
3 � y/ 99�
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014