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B-2016-2473 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: TERMI NO:B-2016-2473 10159 S BLANEYAVE CUPERTINO,CA 95014--3116(369 03 008) WEIDNER ARCHITECTURAL SIGNAGE/HOUSE OF SIGNS INC SACRAMENTO,CA 95822 OWNER'S NAME: LAKE BILTMORE APARTMENTS DATE ISSUED:08/08/2016 OWNER'S PHONE:650-614-1157 PHONE O:(916)452-8000 LICENSED CONTAC OR' T RA ION BUILDING PERMIT'INFO: License Class C-45,C-61,D-42 Lic.#559090 Contractor WEIDNER ARCHITECTURAL SIGNAGE/HOUSE OF SIGNS INC X BLDG _ELECT _PLUMB Date 03/31/2017 _MECH T RESIDENTLALY 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 JOB DESCRIPTION: license is in full force and effect. 1(N)ILLUMINATED MONUIV ENT SIGN-THE BILTMORE 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. �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 Sq.Ft Floor Area: Valuatio :$29054.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number Occupan cy Type: information is correct.I agree to comply with all city and county ordinances 369 03 008 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 PERMIT EXPIRES IF WORK IS NOT STARTED City of Cupertino against liabilities,judgments,costs,and expenses which WITHIN 180 DAYS F PERMIT ISSUANCE OR may accrue against said City in consequence of the granting of this permit. Additionally,t ap licantl n ers an d will comply with all non-point 180 DAYS FROM LAST CALLED INSPECTION. source regulalio super the Cupertino Mum ipal Code,Section 9.18. Issued by:Abby Ayende Signat Date 8/8/2016 Date:08/08/2016 WNER-B ER DECLARATION 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 1. I,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(Sec.7044,Business&Professions Code) Signature ofApplicant: 2.. I,as owner of the property,am exclusively contracting with licensed Date:8/8/2016 contractors to construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINC.S TO BE CLASS"A"OR BETTER 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 HAZARDOUS h ATERIALSDISCLOSURE performance of the work for which this permit is issued. I have read the hazardous matei'als requirements under Chapter 6.95 of the 2. I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Co e,Sections 25505,25533,and 25534. I will Section 3700 of the Labor Code,for the performance of the work for which this maintain compliance with the Cu ertino Municipal Code,Chapter 9.12 and the permit is issued. Health&Safety Code,Section 5532(a)should I store or handle hazardous 3. 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 theBay Area Air Quality Management District I will maintain compliance with f6eilt ertfiff Municipal Code,Chapter 9.12 and Worker's Compensation laws of California. If,after making this certificate of the Health&Safety�o a ec' s 25505,25 3,and 25534. exemption,I become subject to the Worker's Compensation provisions of the r Labor Code,I must forthwith comply with such provisions or this permit shall ` be deemed revoked. -,Owner 8/authorizedag'en . ,Date:8/8/2016 � _. '. APPLICANT CERTIFICATION N T N LEND A EN Y I certify that i have read this application and state that the above information is I hereby affirm that there is a con 3truction 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 i sued(Sec.$097,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 understands ARCHITECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code,Section 9.18. SIGN PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228►FAX(408)777-3333 building(a-)cupertino.org C,UPERTINt7 PROJECT ADDRESS P APN# T% OWNERNAMEy . .. -. PHONE tiGE -L Xu HMA d-6-IGi Oji��T•'4-+i.sz"',tZ /-S..'��"t'72' 3"t !r°S ® , :�.1 _.'-' ��`.�� STREET ADDRESS CITY, STATE,ZIP FAX l q� �.Aq�- mai ISS SAS--� Ei Cry CONTACT NAME -. PHONE. E-MAIL -. STREET ADDRESS CITY,STATE,ZIP FAX - OWNER ❑-OWNER-BUILDER ❑OWNER AGENT ❑ CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT 11 ENGINEER ❑ DEVELOPER ❑.TENANT CONTRACTORNAME LICENSE NUMBER. LICENSE TYPE BUS.LIC k SAS's� �� 'z9 '7-7ASa COMPANY NAME E-MAIL. FAX - - `lrut � l� P6'T�AG", k iir�Bates ,ft�°�6 STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS.LIC ` COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,.ZIP PHONE DESCRIPTION OF WORK USE OF ❑ SFD Or Duplex ❑ Multi-Family ILLUMINATED SIGN TYPE NO.OF SIN AREA VALUATION STRUCTURE: ❑ Commercial (Y IN) (CODE) SIGNS ('3Q.FT.) M 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 - RECEIVED BY: ...TAL VALUItQV: {n� ``14 By my signature below,I certify to e�ch of th oll0 mg:aI` a property owner or authorized agent to her on the propertyowner's behalf. I have read this application and the information I helve p , id d is.c rrect. I have re d the Description of Work and verify it is accurate. I agr e to comply with all applicable local ordinances and state laws relating o buildin- ction. autho e representatives of Cupertino to enter the above-identifi d roperty for inspection purposes. Signature of Applicant/ - Date: s 1 4 SUPPLEMENTAL INFORMATION REQUIRED OFF CE,USE ONLY Site,Plan PLAN CHECK TYPE. ROUTING SLIP Elevations ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW Sign Details-including.UL listing(s)applicable ❑ EXPRESS ❑ PLANNING 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 MLdoc revised 03/31111