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08020157ioo ,ULuU oaa ,ern l�Z ?a< )yU :tel �y3 jco a—rn :?a :Sp F' D Q z 2 CITY OF CUPERTINO BUILDING DIVISION PER -No BUILDING ADDRESS: 19700 STEVENS CREEK BLVD SUCCESS GRAPHIC SIGNS PERMIT NO. 08020157 OWNER'S NAME: PERMIT LS5UE DATE KCR DEVELOPMENT 1744 QUEENS CROSSING DR 02/25/2008 PHONE: SANITARY NO. CONTROL NO. (408) 306-9521 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Chapter Job Description hereby affirm that 1 am licensed under provisions of 9 (commencing with Section 70W)ofDivision3ofthe Business and of ssi rsCode,andmylicenseis INSTL 1 INTNL ILLMNTD INDVD CHNNL LETTER SIGN, AS in full force and effect- / License Class Lie. SHOWN Date Contractor - A HMCl'S DECLAAAn 1 understand my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION I hereby affrsn that 1 am exempt from the Contractor's License Law for the following reason. (Section 71131.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement licensed to the of the Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation that he is pursuant provisions $2000 (commencing with Section 7000) of Division 3 of the Businessand Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of e,p�j Number 36906009. Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars (S500). l� b' ❑ I, as owner of the property, or my employees with wages as their sole compensation, Required Inspections will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law docs not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner. builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:) The Contractor's Li. . cense Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. C31 am exempt under Sec , B & P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: have and will maintain a Certificate of Consent to self -insure for Workers Compen- sation, 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 required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ' My Worker's Compensation Insurance carrier and Policy number are: Carrier._ Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (nhissection need not be completed if the permit is foronc hundred dollars ($100) or less.) I certify that in the erformancey��a�-�ork for which this permit is issued, I shall not employ any person tib anyyt nae ncr so as ld become subject to the rk ' Com nsation Laws of California. gafe AppGcaru - �--� NOTICE TO APP a qng this CC ficatc of Eicripition, 'you should become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this petmil shall be deemed revoked. CONSfRUCrION LENDING AGENCY I hereby aMrm that there is a construction lending agency for the performance of the work. for which this permit is issued (Sec. 3097, Civ. C.) Lender's Name Lender's Address 1 certify that 1 have mad 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 in any way accrue against said City in consequence of the gha APPLICANT UND ntin r DS AND .WILL COMPLY WITH L NO -POINT Issued by: Date SOURCE REGU D� Re -roofs Signature of Applicant/Conu actorDate HAZARDOUS MATERIALS DISCLOSU E Type of Roof Will the applicant or future building occupant store or handle haiardous material as defined by the CupertinoMunich Code, Chapter 9.12, and the Health and Safety Inde, Suction 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑ Yrs No If a roof is installed without first obtaining an inspection,agree to remove Will the applicant or future building occupant use equipment or devices which .I emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑ Yes u 1 have read the hVardOUS materials requirements under Chapter 6.95 of the Califor- nia Health & SAkqffodc,Sections 25505, 25533 and 25534.1 understand that if the building docs not cu have a tenant, that it is my, r sponsihility to notify the ocupant of the requirements which mu ' r is a of a Certificate of Oc panty. Signature of Applicant Date All roof coverings to be Class "B" or better DA- ' Owner or authomed agent � CITY OF CUPE INO •CITY OF CUPERTIN# SIGN PERMTT APPLICATION FORM dkoc� 0157 APN # Date: 2(0?0 (o cq t V So x/62g-/ ® e, Building Address: I 760 gmJ0-is C-Qoc-K tclb . Mailing Address (if different from building address): Owner's Name: AT; DOW 7—H Phone #: ,kc* �,,, ")-I- - I D�,bx& q Contractor: Phone #: #,D . e&-!�l Fax #: Contractor License #: Cupertino Business License #: �q6q �3\9 Contact: Phone #: Fax Building Permit Info: Bldg ❑ Elect Monument ❑ Mounted on Building Residential ❑ Commercial Job Description: i fpr► ( ).�t2/v�Ft,t- Valuation (cost of project): l CITY Of CUPEQ:1NO PITY OF CUPERTINO SIGN FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type 1 SIG]VDIRECT Directional B ISIGN/RF Ground/Roof/Projecting Signs B 1SIGNMASCK Master Plan Sign Check B 1SIGI14REWRKG Rework of any existing Ground Sign B 1SIGNOTHER Other Sign B 1SIGI�REINSP Re -inspection Fee B 1SIGNWNONEL Wall/Awning Sign, Non- Electric B 1SIGIWELEC Wall, Electric E IESIGN Sign, Outline Lighting System or Marquee supplied from one branch E 10EAP5 1ESIGNADD Additional Branch Circuit on Same Sign, Outline System or Marquee E .10EAP6 1ELCPLNCK Plan Check Fee. E EPERMITFEE Electric Permit Fee _ E BSEI15MICOM Seismic Commercial B BSEI15MICRE Seismic Residential B TRAVDOC Travel & Documentation B BUSLIC Business License B CITY OF CUPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: q �PERMIT # l�oo ��s G2��c � OWNER'S NAME: C f— -06 yr .� - PHONE #' GENERAL CONTRACTOR: SZ -A-^/ FAX # I am not using any subcontractors: Signature Date Please check arnlicable subcontractors and comr)lete the following information: 0 Owner/ Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile 0 Owner/ Contractor Signature Date f r �JIFJJ[ �IllL111J•'�1�11 ""J" D17JJ Ir! File Edit Actions Details Links Favorites Help *" Permit Number " 08020157 Status x E - Expired Master Number Notes 0 i Project Apply Date ` 02/25/2008 Permit Issue Date 02/25/2008 Certificate Issued k Certificate Type Certificate Number i Permit ' Property Zoning Permit Details ISI Operator patg Operator patg Operator Applicant Contractor " Defined Fields Permit Type x 10EAP5 IQI SIGNS OUTLINE LIGHTING & MARC Usage Class ' N /A 1 RI NON APPLICABLE Applied Value " 2000 SQUARE FT. 0 Calculated Value 011 US C-404 Type 437 1 ALT: NON -RES, NON-HSKPG Permit Form AUTOPERM - PERMIT Ownership 1 - Private Project Size - - Permit issued 0212512008 Enter the purpose or any special conditions for this permit I_C�r-.5:lur f' Address " I 19700 STEVENS CREEK BLVD City/State/Zip CUPERTINO APN 36906009.06 U nit i I,,rer ,�n'.lio I; ;orrr,s�iui i Owner Name xI KCR DEVELCIPMENT Use Default f,] Address Business - 29700 STEVENS CREEK BLVD City/State/Zip CUPERTINO I il 0K CA 95014 Ift Back Ir.; Contractors CA 95014 Purpose/Special Conditions INSTL 1 INTNL ILLMNTD INDVD CHNNL LETTER SIGN,AS SH0JN NO FINAL INSPECTION PERMIT EXPIRED 10/07/08 •FILMED 5/20111 T r' Fees kms' Plan Reviews Inspections Ire Print Permit I�_e-�Adjustments lCk7mi Holds IF' Copy Permit IJ Close Permit Ir ~ #Overrides I, Supplemental Fields I r iI Notes I ii Attachments