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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 # OWNER NAME �y � �� PHONE �3 °� � d fa 9 �'3 13 E-MAIL i' p - C'� . �t e S n, i4 C id'? c18fl K C STREET ADDRESS CITY, STATE, ZIP FAX COCT t4NAME y� e " 6 1 6 q t4 A RID Res ! C� PHONE t o r? "'�s�f+' E-MAIL STREET ADDRESS. e 44 v CITY, STATE, ZIP 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 E4,1AIL IS 10 1--"-4 �P- ''4 FAX, g er STREET RFCS Q. f� �p--_-2r6Cj CITY_, NATE, ZIP A. PHO -E 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.