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Permit Number x
0$1000$1
I Address' I
19750 STEVENS CREEK BLVD
I OK ;.
Status"
C - Closed
City/State/Zip
CUPERTINO CA 95014
#at Back c
Master Number
Kil Notes
0
APN
36960008.MRKI
Imo, Contractors
Project
Q�
Unit
Apply Date"
10/15/2008 Operator
patg
Fees
Permit Issue Date
10/15/2008 Operator
patg
I Owner Name'l
MURUKI CORPORATION
a>Plan Reviews
Certificate Issued
11/26/2008 Operator
suew
Use Default
Ll(.
Certificate Type
CO CERTIFICATE OF OCCUP
Inspections
Address
Home -19750 STEVENS CREEK BLVD
Certificate Number
�r Print Permit
City/State/Zip
CUPERTINO CA 95014
Adjustments
Permit
Permit ` Property
Zoning Applicant Contractor "
Defined Fields
f 'yx Holds
i
Permit Details
-
Purpose/Special Conditions
��Copy Permit
Permit Type
1 CEAP5
NEW SIGN @FRONT OF MRKKET (ILLUMINATING)
Close Permit '
SIGNS, OUTLINE LIGHTING & MARQ
Usage Class
N/A IQI
FILMED 5120111
•; Overrides
NON APPLICABLE
I Supplemental Fields
Applied Value "
8300
,-:
�•-..jlNotes
SQUARE FT.
0
Calculated Value
0 I�
J�ijAttachments
US C-404 Type
437 141
ALT: NON -RES, NON-HSKPG
Permit Farm "
AUTOPERM -PERMIT
Ownership
1 -Private--
Project Size
COUNTER - OVER THE COUNTER
[[Add Default T
'ermit issued 1011512008
anter the purpose or any special conditions for this permit "'
BUILDING DIVISION PEt RNUT C Ql;]OjiF.ICT�t ll�i7t`l1iZV1tA11VLr.; ;':
BUILDING ADDRESS: PERMIT NO.
19750 STEVENS CREEK BLVD AMCOE SIGN COMPANY 08100081
OWNER'S NAME: PERMIT ISSUE DATE
MURUKI CORPORATION 974 COMMERCIAL ST 10/15/2008
PHONE: SANITARY NO. CONTROL NO.
(650)858-1221
ARCHrIECT/ENGINEER:
BUILDING PERMrr INFO
BLDG ELECT PLUMB MECH
O p LICENSED CONTRACTOR'S DECLARATION
iami P 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing
z LUUwith Section 7000) of Division 3 of the Business and Professions Code, and my license is
! e. in full force and affect. �� C
r in License CI s 21- Lic. #
F, � Data jo� ! ae( Contractor
ARCHI Mi DEC
i a < 1 understand my plans shall be used as public re ords
7a.
y Licensed Professional
o
r 0 OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the
3
00
following reason. (Section 7031.5, Business and Professions Code: Any city or county
which requires a permit to construc4 alter, improve, demolish, or repair any structure
Z y prior in its issuance, also requires the applicant for such permit to file a signed statement
a that he is licensed pursuant to the pmvisions of the Contractor's License Law (Chapter 9
I=- (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he is exempt therefrom and the basis for the alleged exemption. Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a Civil penalty of
not more than five hundred dollars (5500).
❑ 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
and Professions Code: The Contractor's License Law does not apply to an owner of
property who builds or improves thercon, 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.).
❑ I, as owner of the property, am exclusively contracting with licensed contractors to
construct the pmject (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.
E]I 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:
❑ I have and will maintain a Certificate of Consent to self -insure for Worker's Compen-
salion, 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 ate:
Cartier. 0&\I I►�l .r�
10114 Policy No.: SL 1, 7AZ
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
Jbis section need not be completed if the permit is forone hundred dollars ($100)
or less.)
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 Workers Compensation
Laws of Califomia. Date
Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should
become subject to the Worker's Compensation provisions of the Labor Code, you must
Z forthwith comply with such provisions or this permit shall be deemed revoked.
7— OCONSTRUCTION LENDING AGENCY
L.4 ►+ I hereby affirm that there is a construction lending agency for the performance of
�4 > the work for which this permit is issued (Sec. 3097, Civ. C.)
:Sa Q Lenders Name
=� Lender's Address
�z
J 0 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
U ahove-mentioned property for inspection purposes.
(We) agree to save, indemnify and keep harmless the City of Cupertino against
rn liabilities, judgments, costs and expenses which may in any way accrue against said City
U z in consequence of the granting of this permit.
APPLICA EULDER
NDS AND WI COMPLY WITH ALL NON -POINT
SOURCEA S.
ta11q
Si aturc o pp rc.'Contractor Date
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety
Code, Section 25532(a)?
F1 Yes ❑No
Will the applicant or future building occupant use equipment or devices which
cmil hazardous air contaminants as defined by the Bay Area Air Quality Managcment
District? ,,y1,,,,,,''
❑Yes ,gnu
I have read the hazard_ouffs materials requirements under Chapter 6.95 of the Cal ifor-
niaHealth&Safety Code, Sections 25505, 25533 and534.1 understand that if the building
does not cu dy have a Want. Ihat it is my res ihility to notify theoccupan[ of the
rcquiremen h met rior to issu of a Certificate o Occupancy.
a� ` G(`�
Owner or ze
h r d auent Date
Job Description
NEW SIGN @FRONT OF MRKKET(ILLUMINATING)
Sq. Ft. Floor Area $8300 Valuation
.•.111:
Required Inspections
Issued by:
Re -roofs
Type of Roof
Occupancy Type
Date
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
All roof coverings to be Class r;.`r or better
CITY OF
CUPERTINO
CITY OF CUPERTINO ah 0 0 09/
SIGN
PERMIT APPLICATION FORM
APN #
Date:
0v lylkk'
/ UO008,
Building Address:
197 S -1W&" S ci Eay �f S LVD
.
Mailing Address (if different from building address):
Owner's Name:
Phone #:
>zv 1< Goszp�.-r,
:25,
Contractor:
Phone #: LSo - Ss _ 2Z/
r"' �C' S/Gr-i row py
Fax #: 6 So ckss 2-/44
Contractor License #:
Cupertino Business License #:
Contact:
Phone #: &c,,o _c6 s4 - f 22ZJ
Fax #: LSb
Building Permit Info:
Bldg Elect Monument
❑ Mounted on Building
Residential ❑ Commercial
Job Description:
tv L -SIN S! L—(' o N T=P-fl ^CT o j—
M,6
Valuation (cost of project):
Project Size: Ex ress [31 --standard ❑ Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green
Building Checklist & attach it to the
application or if applicable, include in plan set & the sheet index.
Revised 6/16/08
-'afX14
CM OF
CUPEkTINO
CITY OF CUPERTINO
SIGN
FEE SCHEDULE
Quantity
Fee I:D
Fee Description
Fee
Group
Permit Type
1 SIGNDIRECT
Directional
B
1SIGN/RF
Ground/Roof/Projecting Signs
B
1 SIGNMASCK
Master Plan Sign Check
B
1 SIGJREWRKG
Rework of any existing Ground
Sign
B
1 SIGNOTHER
Other Sign
B
1 SIGNREINSP
Re -inspection Fee
B
1 SIGNWNONEL
Wall/Awning Sign, Non-
Electric
B
1 SIGNWELEC
Wall, Electric
E
1ESIGN
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
lELC:PLNCK
Plan Check Fee
E
EPERMITFEE
Electric Permit Fee
E
BSEISMICOM
Seismic Commercial
B
BSEISMICRE
Seismic Residential
B
/
TRAVDOC
Travel & Documentation
B
J
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:
ci1 34 CjTEVtFN—e, cmeme/
PERMIT #
0 /Oo a &r- /
OWNER'S NAND: M AtzvL 1 Cc oP.� atJ
PHONE # 3 — L 32i
GENERAL CONTRACTOR: Ai -.M Loc G,,, C,�,,
FAX # GG _ _ 2J,4,}
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
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
� W
Owner/ Contractor Signature Date