06080089CITY OF CUPERTINO
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BUILDING DIVISION PERNUT n
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CQiV'SUkAW-TOR'INS �
BUILDING ADDRESS:
10789 S RT-ANF.V AVE
ALLEN SIGNS INC
PERMIT NO.
06080089
f �u S NAME:
PERMIC �IIE DAiE
GILLYFLOWER VEGETARIAN
1982 9TONE
SANITARY NO. CONTR01. NO.
(408)280-6500
ARCHREC17ENGIN12M
BIIIIDWG PERhar INFO
BLDG EIFCr PLUMB MECH
0
LICENSED CONTRACTORS DECLARATION
Job Description
1 tachy •atm thu I w li,vfd Dada provisou of CGaper 9 (c,mrmhKinS
villi Scotto 7010) afDivislm 3 of to Buti.Ka and Pmfcuiou Cox.ad my li¢ns V
a rm rma .ae ym.
CHANNEL LETTER SIGN.
Lk.r
DR.�Cmuclm
(((d �w ARC OH
Oj
Nblic
I aMcrvnd my Pluu.mB � coed a paeBe harorm
Mb, nc
.
Locoed Pruf.nal
OWNER.BUIIDER DECV,RATION
I bcrcby =arm Nu I am or from the Cm oes Lianrm the
i folbwin5 matnro(SecJoo 7031.5, Bunnras aM Profeaiom Cade: Any city or county
p
Avia
o, I R,tion 1 pminit t0 LMWYCI. VYl. knP•ose. do -orb 1. - ICpLQ toy Lronum
primoil]ISYYKC..I1O(CGNt61re=pPIKNt rMMh per -rat to Blcauped WlCmCNy�
con nruc ca B:nrfu� u.(m.Pta9
Y
Sq. Ft. Floor Area //N129,
Valuation
mac uB a9a puna,nlwunpa
SCaim7000)o(Divisdn3of Ne Busi.cuand Profcuimu Codc)m
Vol
(comm ngvl
dot W 'v camp Ncmfrom rM de b.d1 !m de allgcd v®ploo. Any Wwauoo of
F--. Occupancy Type
Sen{on 7031.5 by my.n til fm. PCrmh -bit= to app04tm ta. clsbl P-WIY of
a (55(101.
oro come Nan fiK hundmd dwn
♦
.
❑Lnoc of to mry,mmyempbyni camp .
M
Vquired InSp�e.'C]Dns
�F (�
or cff couJeG.ole
Buts
i0 do Wewmk, CC 8e swntvcUnm Inm.dcdm W'I rm LAwy 70.4,Businou
or,
=na Pm(esslom cox: The Cmoaclarl I3®te Vv dory oat apply n u ownm Of
ulK.AdodrelWmmo,urdaro daea.mhwvrt hl
Wxr lin
o[Ttred
,,, ttapbyaa,pwded charart eagvemw...crot .or m*d00. fm»k u.
.cooplo,
however. We bwminpmbagowmvnt rolawiWp�no ym p ioc Ae000d
orirc
bullar v10 hive tie bu.dm d porins lNt h: dm rot bulb m impose fm Pu•P� w
alb).
❑ I, u owar H the pvpeny, w oelvsivery co.vaclie5 vW liaurd a.mrmn b
uruuuCt Ne project (sec. 7044. Buslom ..d P cninhn Cmc:) The Cmuraml u.
-
ccvx lav dors rot appiy n u ower of P -o 11 via bw)d1 m impose+ Acroonn, and .
win conva ufor aueh pojcm vdth•cmoactor(1) t-.^rnd pmoml nthe Cootr l s
13ceea Taw.
❑Tun evmap order See ,B&PCforllJamlfO.
Dam
W ORKEAS COMPENSATION DECLAIUTON
I emeby aRba order pctud ry of Pmjury ono of the fcl ring dccbon imcc
I have aM will maioW v a CmJfiam of Couem b df-inaa.e fm Wakcla Campo
ruim, a prosixd for by Section 3700 a de L.bm Code. fm de pmfOrco a o(We
work fm which W,t permit is iaued.
❑ 1 has, " mU maioub wwka's ComRnaaon Ivu.ana, u rm)ulrcd by Semen
.
3700 of tkc lobar Cox, for do perfmm ncc of dt, m for which tm pc.mit 1111—rl
My Workd. Compema . hhaapa mric "I Polley numb r art
ca,ic Inc Polk, Na.
CERTIFlU'fE�PnINN FA wORI
COMPENSATION INSURANCE
'
(This sedim vad rot W campkrd B We ptmh Y ra ono hued doom (5100)
m MaL)
I eudN � is the ptfiprrhl.me ar Ne wmt rm whi.b lei, pmvn :, ianoa. 1 dW 1 ml
wpo0 any pard in aY maucrn u n bcaoe wbject n tin Warkuf Campcmulm
lJos GlitadL Dile
of
,
NOTICE this ..,. M Evamplmn, you comm
NOTICE TO APPLICANT: If.
Cg.onnmWngmd proHuov N tie Lahm code, yw mu
n We wmb Co vbd
or L1lm
Z rmww;m comply wm mKe Proviims m tw Perma.wl x ara.m m.akm
ro nd,%e More K
It�JDINdlin,. CV
CONST"Acn,
'
Iberobyaathi thu dc.c it. mo lrndi,,.0-)Yfar tie pvfomuntxw
it.
.
the wank rm which this fEnlil V ianoG (Sar 309'!. CW. C)
r<Mcfs
.
a
Z l�ndefs Address
Add
I coria N.t I has, mad Ibis .Wjcuian aM sum Nu the above Information U
^ comm. l yrcc on comply with al l city. county, onliru and sWc lava rcWUOZW
JWidinScow.mtian, and Wmby wthad.c mpexwtivu of Niscity to rnnroprvhte
for my
.bo.,-mcndamd pre crty ectim prim.
(We) acme n ave. irdcmnily.nd kap humlm the city of Cupcni at.imt
Z lmbiBJei* ludSmmW, eons ud cape cs which nay in any prey a amc Mlim aW City
Zin co^
APPLICCAANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
Issued by: Date
SGUR TIONS.
Re -roofs
Type of Roof
SISwt Apel' H m S MAlER1AlS DISCLOSURE
W50 the ap tmr,u....b ding meup.mmmcmbudk hruNan m 1cm!
a xnnod by Ne Cupenim Municipal Code. cooper 9.11 aM tie H tb and Wny
Serfim 25532(•)' ,,,���///
No
All roofs shall be inspected prior to any roofing material being installed.
❑ya y1
If a roof is installed without first obtaining an inspection, I agree to remove
uipaml m do i whKn mPP at w
Win e c, f.. WildinS aa„p..t me
emit 1122 u air WpMomm a dc0.rd by the Bay Arca Air Cmi'tY Maupcmcm
all new materials for inspection.
DISWU'
C] Y. INu
I has, mad to huuxu maerWsrequhcmcouumtr CTvpes 695 of the Califm-
nuHralJt& Wny Cox. Smimo25505,25533" 25534. I wdclpwd Natiflhe hdk11n5
rotcuely enotfy d¢ aof e
mwm ma.mr ea
Applicant
y d
All roof coverings to be Class "B" or better
Ovncr or KboqIsd cm =m
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