B-2016-2695CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-2695
19600 VALLCO PKWY CUPERTINO, CA 95014 (316 20 108)
ARROW SIGN CO
OAKLAND, CA 94601-
4436
OWNER'S NAME: CUPERTINO PROP DEVELOPMENT
DATE ISSUED: 09/19/2016
OWNER'S PHONE: 408-343-1088
PHONE NO: (510) 533-7693
LICENSED D ONT a TOR' I A_R ATION
BUILDING PERMIT INFO:
License Class CONVEYORS - CRANES HOISTING EQUIPMENT DOCK
X BLDG _ELECT _PLUMB
LEVELERS. ERG, MATERIAI Lic. #314794
Contractor ARROW SIGN CO Date 10/31!2016
MECH _ RESIDENTIAL X 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.
INSTALL STATIONARY DIRECTIONAL TX 27' SIGN AT
ENTRANCE (NON -ILLUMINATED) - NINETEEN800
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.
S 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:
.Valuation: $8000.00
permit is issued.
APPLICANT CERTIFICATION
certify that I have read this application and state that the above
APN Number:
Occupancy Type:
information is "correct. I agree to comply with all city and county ordinances
336 20 108'
A (Tenant Improvements)
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 OF PERMIT ISSUANCE OR
may accrue against said City in consequence of the granting of this permit.
Additionally, the applicant understands and will comply with all non -point
180 DAYS FROM LAST CALLED INSPECTION.
source regulations per the Cupertino Municipal Code, Section 9.18.
Issued by: Abby Ayende
Signatur ><GL, drrv�------' Date 9/19/2016
Date: 09/19/2016
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
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
is 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 of Applicant:
i. I, as owner of the property, am exclusively contracting with licensed
Date: 9/19/2016
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 COVERINGS TO BE CLASS "A" OR BETTER
1. 1 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- MATERIALS 'DISCLOSURE
performance of the work for which this permit is issued.
I have read the hazardous materials requirements under Chapter 6.95 of the
2. I have and will maintain Worker's Compensation Insurance, as provided for by
California Health & Safety Code, 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 Cupertino Municipal Code, Chapter 9.12 and the
permit is issued.
Health & Safety Code, Section 25532(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 the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
Worker's Compensation laws of California. If, after making this certificate of
the Health & Safety Code, Sections 25505, 25533, and 25534.
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
r
Owner or authorized ageta�. Q°''—
be deemed revoked.
Date• 9/1.9/2016
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is
I hereby affirm that there is a constructionlending 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 issued (Sec. 3097, 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
RATION
consequence of the granting of this permit. Additionally, the applicant understands
A HITECT'S D
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.
Licensed
Professional
Signature Date 9/19/2016
SIGN'PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • build in cu pertino r
PROJECT q D, 0 0 4:A i_� c
APN #
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FAX
❑ OWNER ❑ OwNER-B=ER fl OWNERAGENT ❑ CONTRACTOR CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
COMPANY NAME e.
E-MAIL e
FAX
STREET ADDRESS o �p�
2CSITY, STATE, ZI�Pa GG
PRONE ry f a t
ARCHITECT/ENGINEER NAME
LICENSE XMBER
BUS. LIC #
CZQNIPAN�YN NAME �g
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DESCRIPTION OF WORK
Q wA S L. 4, 'f a C C S3 5/ 1 rt 'q Viar in " ',.,7 f- 4r- Ij
USE OF E]SFD or Duplex F-1Multi-FamilyILLUMINATED
SIGN TYPE NO. OF
SIGN AREA
VALUATION
-STRUCTURE: . Commercial '.
(Y / N)
(CODE) SIGNS
(SQ. FT.)
(S)
SIGN TYPE CODES:
�"
��
1
a ere
B - BANNER SIGN M - MONUMENT (GROUND) SIGN
BL - BLADE SIGN P' - PROJECTING SIGN
D;? DEVELOPMENT ID SIGN SP - SPECIAL EVENT BANNER
DI - DIRECTIONAL SIGN v0"" T - TEMPORARY
E - ELECTRONIC W - WALL SIGN
READERBOARD WI - WINDOW SIGN
C
V TION:
By my signature below, I certify to each of the following: aur the property owner or uthonzed gent to t on! property owner's behalf. I have read this
application and the information I have provided 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 construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date: �E� t
SUPPLEMENTAL INFORMATION REQUIRED
OFFICE USE ONLY
PLAN CHECK TYPE
ROUTING SLIP
Site Plan
❑ OVER-THE-COUNTER
%PT BUILDING PLAN REVIEW`��9
Elevations
Sign Details - including UL listing(s) applicable
El EXPRESS
PLANNING PLAN REVIEW �.�1 O
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
2001 Crow Canyon Road, Suite 100
San Ramon, CA 94583-5387
CONSOLIDATED ENGINEERING Tel. 925 314-7100 Fax. 925 855-7140
—R R I ' 3 www_ce-lab-_com
Nineteen 800
19600 Vallco Parkway L E
Cupertino, CA 9501/4 , 7 rcr,
mit B-2016-2695
L# 1032162
In accordar>ce with Section 1704 of the California Building Code, Consolidated Engineering Laboratories has provided
the requested special inspection and testing on the subject project as listed below:
1. Proofloa&torque testing of installed wedge anchors
These inspections were performed by personnel under the general supervision of a Registered Civil Engineer in the
State of California. Details of our work on this project are contained in our testing and inspection report, issued during
the course of construction.
Based solely upon the inspections and tests performed and upon our substantiating report, it is our professional
judgment that the inspected work was performed substantially in conformance with the approved plans and
specifications, approvals by the Engineer of Record and the applicable workmanship provisions of the California
Building Code.
Special inspection and materials testing is the observation of construction for general conformance with the approved
design drawings and specifications. It should not be relied upon by others as acceptance or as a guarantee of work, nor
should it in' any manner relieve any contractor, or any other party, from their obligations and responsibilities under
either the construction contract or generally accepted industry custom/practice.
We appreciate the opportunity of working with you. If you have any questions or require additional information, please
feel free to contact us at your convenience.
CC: I Reviewing Engineer: Chris Kavalaris, PE
Arrow Sign Company (ER)
City of Cupertino) (P)
All reports are submitted as the confidential property of clients. Publications of statements, conclusions, or extracts is reserved pending our written approval.