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15110081 - SIGN CITY OF'CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMITN0: 15110081 19349 STEVENS CREEK BLUD CUPERTINO CA 95014(3l6 20 112) (rll2120W SIGN CO) OAKLAND,CA 94601- 4436 OWNER'SNAME: � DATE ISSUED; 1V12/2015 OWNER'S PHONE: raoNE No: LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: � License Class Lic.# 3�� y 1� Contractor(ARROW SIGN CO 1 Date Q S�-�Z—� w _BLDG _ELECT _PLUMB I hereby affirm that I am Iicensed under the provisions af Chap[er 9(cammench�g —MECH_RESIDENTIAL_COMMERCIAL witN Section 7000)of Division 3 of H�e Business&Professions Code and t6at my Iiceuse is fn full force and effect. JOB DESCRIPTION; INSTALLATI9N OF(2)WALL MOUNTED SIGN5 WITH ELEC I herehy afflrm under penalty otperjury one of the following bvo declarations: FOR AMERITRADE. t. I have and will maintain a cerlificale of consent to self-insure£or Worker's Compensation,as provided for by Seclion 3700 of Ihe Labor Code,£or the _ p perfo�mance of tlie work for which this permit is issued. � �I have and will maintain Worker's Compensa$on Insurnnce,as provided For by Section 3700 of the Labor Code,for the pedaanance of the work for which this permi[is issued. Sq.Ft FloorAreflt Valuation:$10000,00 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 APN Number; Oceupancy Typc; ordinances and state laws relating to building construction,and hereby 31C 20 112 authorize representatives of thls city to enter upon the above mentioned ' � property for Inspectlon purposes. (We)agree to save Indemnify and keep harmless the City of Cupertino agalnst liabllities,judgments,costs,and PERMIT�XpIRES IF WORI�IS NOT STE�T�D expenses which may accrue against said City in cansequence of the �7ITHIN 180 DAYS OF PERIVIIT ISSUANCE OR granting of this permit. Additlonally,the applfcant understands and wlll comp� ' n-point so ce tegulations per lhe Cupertlno Municipal 180 DAYS FROM LAST CALLED INSPECTION. Cotl Section 9.18. IsenaU by:-1 Signature "^�'' �ate��'��L"��} Date: OWIVER-BOILDER DECLARATION RF,-ROOFF: I heroby afllem tLat I am eaempt frmn the ContracCor's Licm�ea Law for one of tl�e Al]eoofs aliall bo inepected prioc to auy rooSng matecial baing installod,If a roof is following hvo reasons: installed without flrst obtaining an inspoction,I agree to cemove all new materials for � i. I,as owncr oC lhe property,or my employees wi[h wagcs as thcir sole inspectian, compensation,will do the work,and Uie strvcture is not intended or oH�ercd � for sale(Sec9044,Business&Professions Code) Signature ofApplicant: z I,as owner of the prope�Ty,am exclusively conhacting with liceused Dete: conhactors to construc[the project(SeC.7044,Business&Pxo£essions Cade). -Iherehyatfirmundcr-penalty�ofperjury-oneofthefollnwingthrendeclarations; �LROONCOVCRINGSTOBECI.ASS"A"ORBETT�R . - ..—__- ._ __. _ _ __. i, I have and will maintain a Certificate of Consent tn selF-insure for Worker's Compensation,as provided for by Section 3700 of tl�e Labor Codc,For the HA2ARDOUS MATERIALS DISCLOSl1RE performance o£t6e work for which this permit is issued. . I have read the liazardou�mateiials requiremen[s m�der Chapter 6.95 of the s. I have and will maintain Workcr's Compensa[ion Hisurance,as pmvided for California Health&Safety Code,Seclions 25505,25533,and 25534. I will by Section 3700 ofthc Labor Code,for the petfoimance of the work for which �aintain compliance w�th the Cupertino D4unicipal Code,Chapter 912 and the Ihis pumit is issued. Health&Safety Code,Section 25532(a)ahould I store or Naudle hazardous a, I certify that in the perfomiance of the work for which this pe�mit is issued,I �naterial. A�ditinnally,should I use equipment or devices which emit hazardous air contaminan[s as daflnad by the BayArea Air Quality Managemon[Distrlet I shall no[employ any person in auy manner so es to become subjec[[o Ihe �y��maintain enmplinnce i �t�o erHn MmdcipRl Code�CM1apter 9d2 and . Woxker's Compensalion lawe of Cali£omia. If,after making this certificate of �]�¢Hea1tL&Sa ty Code,S �tio 5505,25533,and 25534. exemptioiy I bccome suhject[o We Workex's Compensation provisions o£&c �i L¢bor Code,I must Corthwith wmply with such pravisions or this permit shall Owner or autharized gent: hedeemedrevoked. Date; �\«�'L.-��t eiPpLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read lhls appllcation and state that the above informatlon Is I hereby affirm.that there is a constructlon lending agency for the perlormance corred.I agree to wmply with all city and county ordinances and state laws of work's for which this permlt Is Issued(Sec.3097,Civ C.) relating to building constructlon,and hereby authorize representatives of this cily Lentler's Name lo enter upon the above menlioned property for Inspection purposes. (We)agree to save Indemnify and keep harmless the City of Cupertino againsi liabilities, Lender's Address judgments,costs,and expenses which may accrue against said City in consequence of the grantlng of this permit. Additionalty,the appllcant ARCInT�CT'S DECLARATION understa s and wlll co y with all non-point source regulations per lhe I understand my plans shall be used as public recortls. Cuperti .Muni C de ttsfi�9.18, Licensed ' �--� Professlonal Slgnature� Date T H U M A � � J YY A N � � a � � To: Neal Duffy Arrow Sign Company 105146Ch Avenue Oaldand, CA 99•601 Re; Signage Permie for tlmeriCrade,Cupertino,CA Date Issued: 11/12/2015 Receipt# 55000028714 Reference [D #15110081 This letter is to authorize Arrow Sign Company to assume responsibilities and transfer name on permit fi•om Thomas-Swan Sign Company for the Ameritrade project. Sincerely, ''l;�2�tr�,. Date: 1J7/2016 Scott Sanderson Thomas-Swan Sign Company 2717 Goodricic Avenue Richmond, CA 94801 510.232.9610 THOMAS�SWAN 51GN CO.,ING 277� GOODRIC�K AVENUE. RACHMOND, CA �J4801, 510.232.96i0, FA% 510.232.9611, LIC. NO. 269069