Loading...
B-2016-2653CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19505 STEVENS CREEK BLVD CUPERTINO, CA 95014 (316 49499} s tot * 31(_gq"Do9 OWNER'S NAME --ghee `�/7 f OWNER'S PHONE: 650-3886121 (� LICENSED CONTRACTOR'S DECLARATION License Class S4 Lic. #1013668 Contractor NINGZHI HU SIGNS COMPANY Date 04/30/2018 hereby affirm that I am licensed under the provisions of Chapter 9 (commencing nth Section 7000) of Division 3 of the Business & Professions Code and that my cense is in full force and effect. hereby affirm under penalty of perjury one of the following two declarations: t. 1 have and will maintain a certificate of consent.to self -insure for Worker's r 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. Sq. Ft Floor Area: Valuation: $1500.00 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 316 49-299-- 00 A (Tenant Improvements) representatives of this city to enter upon the above mentioned properly for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. CONTRACTOR: PERMIT NO: B-2016-2653 NINGZHI HU SIGNS CA 94605 DATE ISSUED: 09/06/2016 NO: (510) 697-1668 BUILDING PERMIT INFO: BLDG —ELECT —PLUMB MECH _ RESIDENTIAL X COMMERCLAL JOB DESCRIPTION: (I) 1 ILLUMINATED SIGN.(120 SF X 18 SF) - INTEANET Date 9/6/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) 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. a. 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, 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. Date 9/6/2016 Issued by: Kim Dunbar Date: 09/06/2016 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: 9/6/2016 ALL ROOF COVERINGS TO BE CLASS "A" 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, ctions 25505, 25533, and 25534. Owner or authorized age Date: 9/6/2016 CON 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 understand my plans shall be used as public records. Licensed s SIGN PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingP-cupertino.org /3 z / 2 PROJECT ADDRESS, ®15 � V �a &N& ( APN # i % OWLL NER NAME n i' VV C_ P ONEI• o EIL STREET ADDRESS © CITY, STATE ZIP FAX ;�c.n c er ,K.-) C -A q CONTACT NAME',LQ �� PH ?0 E MAIL h a e r STREET ADDCIT ® S a ag� cDm ll � ,STATE, ZIP �! Z FAX ❑ OWNER `❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME f LICENSE R� ® LICE�N�SE E l_ BUS. LIC # COMPANY NAME _'' s` n S f E_M�L �' FAX STREET RES CITY�n4 q40 e PH N/ �--6 —6 ! / ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE. DESCRIPTION OF WORK w USE OF ©©SFD or Duplex E] Multi -Family ILLUMINATED SIGN TYPE NO. OF SIGN AREA VALUATION STRUCTURE: IR/Commercial (Y/N) (CODE) SIGNS (SQ. FT.) ($) 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: TOT& VALUATION: 8th By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provide is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building c nstraction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION RE&JIRED OFFICE USE ONLY Site Plan PLAN CHECK TYPE ROUTING SLIP /Elevations ❑ OVER-THE-COUNTER BUILDING PLAN REVIEW Sign Details - including UL listing(s) applicable El EXPRESS r A C2 LAA PLANNING PAN REVIEW ^nom 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_2011.doc revised 03/31/11