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B-2016-1169 CITY OF CUPERTINO BUILDING PERMIT BUII.DINGADDRESS: CONTRACTOR: P�RMIT NO;B-2016-ll69 19429 STEVENS CREEK BLUD COPERTINO,CA 95014(316 20 115) (5 B C C INC) CAMPSELL,CA 95008 OWNER'SNAME: MAINSTREBTCUPERTINOAGGREGATORLLC DATE ISSUED:O]/13/2016 O WNER'S PHONE: PHONE NO; 7•ICENSED CONTRACTOR'C DE.CLARATION BUILDING PERMIT INFO: �Lioense.Class Lic.# � 33�0���� Conhactor(S B C C INC)Date �- �3-- �6 X BLDG _ELECT _PLUMB T hereby affirm that I am licensed under the provisious of Chapter 9(commencing —�CH_RESIDENTIAL X COMMERCiAT with Sectlon 7000)of Dtvlsion 3 of the Business&Professions Code and tLat my license is in full force and ettect. JOB DESCRIPTION: � Install footing and pedeslral for Rotary Club Clock I�hereby affirm under penalty of perjury one of the following two declarations: - i, I have and will maintain a cer[ificate of consent to self-insure for Worker's . Compensation,as provided fox by Sectian 3700 of the Labor Code,for the � performance of lhe work for which this permit is issued. I have a¢d will maintain Worker's Compeusation Insuea¢ce,as provided For by Section 3700 of the Labor Code,for the perFormance of the Work for Which this permit is issued. Sq.Ft FloorArea: ValuaHon:$]0000.00 APPLICANT CERTIFICATION I certify that I have read this applicalion and state that the above information is correct.I agree to comply with all city and county �N Number:� occupancy Type: ordinances and state laws relating to building consiruction,and hereby 316 20 115 A-1 authorize representatives of this city to enter upon lhe above mentloned �property for inspection purposes. (We)agree to save indemnify and keep harmless the Ciry of Cupertino against lia6ilities,judgments,costs,and pERMIT EXPIRES IF WORI{IS NOT STARTED expenses which may accrue against said Gty in consequence of the WITIIIN 180 DAYS OF PERNIIT I�SSUANCE OR granting of this permit. Addidonally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal 180 DAYS FR 'I LED INSPECTION. Code,Section Issucd by: 1445 Signature Dale '_13— '/. Date: r//'3��.� N1 OWNER-Bim�DF.R DErLARATiON RE-ROOFS: I hereby affirm that I am ccempt from the Contractor's Licenae Law for mie of the All rooFs skiall be iuspeeted prior to any roofing materisl being installed.If a roof is following hvo reasons: �ns(alled without first obtaiuing an inspection,I a��ee to rcmove all ncw materials for i. I,as owner of lhe prope�Ty,or my employees with wages as their sole inspection, compensation,will do the work,and the sfructure is not intended or offered for salc(Sec.7044,➢usiness&Profcssions Codc) Signature ofApplicant: ' z. I,as owner of[he property,am exclusively conteacting with licensed Date: conhactors to conshuct thepmject(Sec,7044,Husiness&Professions Code). I hereby affirm under pcnnity of perJm�y one of U�e following Flrcec declarations: �L ROOF COVERIlYGS TO BE CLASS"A"OR BETT�R . _ . i..- Ihase_andwillmaintain.aLertificateof_Consen[_toself-insiu'eforWorkee's . _. ._ .__. _ _— _..___ _._ .__ _ . _. . . . .. _ _ _. . , Compensation,es provided far by Section 3700 of the Lahor Cade,for the HAZARDOUS MATERIALS DISCLOSIIRE perfoemance of ihe work for which this pecmit is issued. I Lave read the hazardous materials requirements m�der Chapter b.95 of[he z. I have and will main[ain Worker's Compensation Ii�surancq as provided for Cnlifarnia Hea1tL&Safety Code,Sections 25505,25533,and 25534. I witl by Sec[ion 3700 of lhe I,abor Code,fm�the performance of the work for which mxintniu compliance with the Cupertino Municipal Code,Chapter 9.12 and the [his pecmit ls iasued. Health&Safety Code,6ection 25532(a)ahould I store or handlo Lazardous a. I certify tha[in[hc perPormance of the work for which this permit is issueQ 1 �naterial. Additionally,should I use equipment or devices which emit hazardous shall not employ any person in any mazmer so as to beoome subject to tlie air wntaminants as deSned by the Bay Area Air Quality Management District I will maintain compliauco with tho CuporH�m Mnnicikal Code,Chap[er 9.12 aod Worker's Compensation laws of California. If,atter making this certificate of the Health&Safety Code,S tion 25505,25533,and 25534. exemption,I become subject to the Worker's Compensation provisions of the I,abor Codq I mus[forlhwilh comply with such provisions ox this pennif shall Owner or authorized agent: be deemed revoked. Date: i�(3//_ APPLICANT CERTIFICATION 'Y CONSTRIICTIONLEIYDINGAGENCY I certify that I have read this applicalion and state that the above information is �hereby aNrm that there is a construction lending agency for the pertormance correct.I agree to comply with all city and county ordinances and state laws of work's for which this permlt is issued(Sec.3497,Civ C.) relating to 6uilding construcfion,and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspectlon purposes. (VJe)agree to save indemnify and keep harmless the City of Cupertino againsl liabilities, Lender's Address judgments,costs,and expenses which may accrue against said City in consequence of the grantlng of this permit Additionally,the applicant ARCHITECT'S DECLARAT1oN understands and will comply with all non-point source regulations per the I understand my plans shall 6e used as public records. Cupertino Municipal Code,Section 9.18. Licensed Professional � �Signature Date - CONSTRUCTION PERMIT APPLICATION � COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO �408) 777-3228• FAX (408)777-3333 • buildinp(a�cupertino.orq � ,_n�f�, I� �� ❑NEWCONSTRUCTION ❑pADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINALP�TIN PRWLCTADDRESS I�/�q� �L�t'�neA APN# '.� I(,7 `'� '- II � •'IL. "� V�itvt OWNER NAME H�MAIL - �H —/Sb0 trntl.C.faM S � .J- �,r f CI Y, STATE,Z1P O �^ ��P� :y�_ „T C TACT NAM O O � y� H�AIL�� STREETADDAE C1TY,STATE, ZIP FAX OWNLR ❑ OWNGR-➢�II.DLR ❑ OWNERAGENT ❑ CONTRACTOA ❑CONTAACTORAG9NT ❑ ARCHITeCT ❑HNGINE92 ❑ DEVELOPER ❑ TENANT CONTRACTORNAME.� � �L/�r� L[CHNSENUMBER �?/�Q�./�I LICHNSETYPE (J DUS.LICp S/�� �� ��� � T �� 6 COMPANYNAME � E-MA7L FAX �c„� � n dr�-�cca-r C° S(�cl.cart STRGBTADDRPSS '�� Ir ��p JG CFc�T^�.ZI ��� / A ^ ��Q� PHONG �� /�r'O, ((��/ � � c_ C_1t "'� 1911 / ARCHI7'ECT/ENGINEEILNAME� LICHNSENUMBER ➢US.LICA COMPANYNAME &MAIL FAX STRBET ADDRESS CI7'Y,S'CA1'H,ZIP PHONG DESCRIPTION OP WORK - S� EXISTINGU58 PROPOSEDUSB CONSTR,TITE NSTORI6$ - USE TYPE OCQ SQ.FT. VALUATION($) EXISTG NEWFLOOR D6M0 TOTAL ARHA AREA ARHA NBTAREA BATHILOOM KITCHGN OTHER APMODELARCA RCMODGLARGA REMODLLARCA . - . _....___ _- _ -.- ..-_..._- ..__.__-____ _.._ _ _—__.- __. _ . ._ ._- .. . _._- __ POACHAREA OECKAREA TOTALDeCK/PORCHNtLA GARAGeARHA: O9TACH ATTACH #DWeLLINGONTTS: ISASECONDUIiIT ❑YES SECONDSTORY �YLS . BLINGADDED? �NO ADDTTION? �NO PRE-APPLICATION QYES Q+YLS,PROVIDCCOPYOF ISTIIIIBLDGAN �YES RECEIVED �� .A�VALUATION: PLANNINGAPPlk �NO PLANNINGAI'PROVALLBTTER EICRLCRI[OMC? �NO ,e.,� �� By my signffiure below,I certify to each of the following: I am the pmperty owner or authorized agent to act on t6e prope ner's belial£ I have read this npplication and the informntion I hav rovi led is ri�r6t. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local - ordinances and state Iaws relalin o buil ' c �fction. I ai orize representatives of Cupertiuo to enter the abo e-i n[/ified proper[y for inspection purposes. SignntureofApplicantlAge : Date: b SUPPL�MCNTAL INFORMAT{ON REQUIR�D rLaN cxEcx rvee xouTiNc sc�r New SFD or Multifamily dwellings: Apply for demoli[ion permit for ❑ ovea-�courvres ❑ suau�xc r�nn xev�ew existing building(s). Demolition permit is required prior to issuance of building permitfornewbuildi�g. ❑ exeness � ❑ PLANMINCPLANREVIEW Comme�cial Bldgs: Provide a compiefed Hazardous Materials Disclosure ❑ STANDARD ❑ roeuc woaxs form if any Hazardous Materials are being used as part oPthis project. ❑ �,�ce ❑ FixE nerr Copy of Planning Approval Letter or Meeting with Planuing prior to � ry�pJOR ❑ SANITARY SEWERDISTRICT submitta]of Building Permit application. ❑ ENVIRONhIENTALIIEALTH BldgApp_2011.doc revised 06/2//ll � CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION ADDR�SS: 19429 DAT�: 01108/2016 R�VIEWL�D BY: Phuong APN; BP#: "VALUATION: $10,000 *P�RMITTYPE: BUIIdI1lgP2fl711t PLAIVCHECi{TYPC: T2nan[ IYi1pI'OV@Y11BIlf PRIMARY PENTAMATION osE: Commercial Building P�RMITTYPE: 1GENCOM� WORK Install N Site Clock in front of Marriott Hotel SCOP� ��ec;x 7'Icra f e:eck .'luraf> Prctrr Ctre°c6� I-1ec 1'far�Clreck lf ^Y t`crr,n�tl=ee: 7l�.rrG P�rrreil'ree , a_ Ye�rrial'��nr: €Jc?.er 3�kii:. 7;;_c,n. t)r?�ar/'lumti�IasR tlt7rer t;l,�,:�.I�:s�r_ � ,S:ar.f�.ln:;p.Z�a�r i'7ruiib.1rrsF�_P��e: f:!arc ln:7�. Fer�: NOTL:TGis esfisnate does not d�tclude fees due ta ofF�er Depnrtments(�e.Planning,Publtc Worlcs,Fire,Sanitary Sewer District,School District,etc. . Tlrese ees m•e bnsed ott t/ze re[imrrtnr informaHon avtdlnble and are onl ars es8mnte. Cnntact tEte De t m�arldrt'I dn o. FEE ITEMS (1_ee Ite,solunon 1)-OS3 6;{} 7/I/13) F�E QTY/FE� MISC ITPMS Plan Check Fee: Hourly Only? �Yes � No $0.00 2 l�ours P�an Check,Hourly Sttppl.PC Fee: � Reg. � OT p.p lirs $p.00 $2$6.00 IS1YLNCK PME P1an Cheele; $0:00 Perntit Fee: Hourly Only? �Yes Q No $0.00 Suppl. Insp.Fee:Q Reg. Q OT p,p hrs $0.00 PME Unit Fee: $0.00 PMF Permit Fee: $0.00 � C�r�ri.y�trr�crin�a 3"�r: � �Idtr:irristre;trtc 1'r�e: � Work WithoutPermiti7 � Yes � N'o $0.00 � Aclvanced Pfanning Fee: $0.00 � hours Inspections � 'l'r�cra�etl'3ocu�natrraFie�n7�e�s: $286.Q0 7s'PIrosP Inspection,I-IourJy � S�aon�n!lotton�e; IBS�SM1Co $2.80 Select an Administ��ative Item I31d�T Stds Commission Fee: taCasC $1.00 SUBTOTALs: l $3.80 $572.00 = T`oT��,P���.'! $575.80 � Revised: 01/01/2016 .= DC1 � - - _ '�. E !l G 1 fl E E R 5 ��Seattle ; Portland �' ISpokane � � San Diego ���. ��I AusUn '"'�e Structural Calculations � $ � San Prancisco � Anchorage Main Street Cupertino Clock Footing ��`�;,Y-^- �`RTIIV� �����`3 ��P Cupertino, CA ,�� �3uiidlrrg� �5��p��m�nt �;., �'�'� J��J 1 _ � Z�i16 REVI�W�a F0� GOb� CQ�PLIANC_ �eviewedey; �a �CI JOb Number 15081-0143 November 6, 201�i�; �, i � � � L,,�� o�h�Frvr ���,�Rr�,��rvr ��N - ��PERTINO � '��'�'h�OVEU ��� ��� vR..��a� r�a �F1 '.;�r�l S7 � ���PC-� ;dfln�Sh1��5`j'�@k „ � .g..,,Y b s e�`;u r � r r�c, ept at(he � ` �}�F9 a�14),"r��jw�` na ,��s , on It is unia,�fu.l lo � �,,,�,a � or �i ��ra,f�ns on make any ,�: �`, ,���p, 6�� '�'�� e°rom, �,ti�r a sa' �e, or to deviate f'Ke:"f��°�''� �4' '�mpir, .h.,a an an�'rom r e guilding Of/icial. ,fj. �� pCr ������s SHALL NOT f �' an ,:,s ,_ a� of ihe violation < @ t, �3o Ib _ state �aw. --_ _ _-- - -- -- — — s:�����`�.r.kUG't'��'�`a. .� ��r# _ !2.6 /6 _ s �,� � , , /r a «;�.�. � � .'y' '�y„.�t"� �c �:Lt �`'^�:..,.�""'w�-, Prepared for: 1'L,OT , Sand Hill Construction Management S E(;KED C�y 2gg2 Sand Hill Road, Ste. 241 DA ,E Menlo Park, CA 94025 NG �p�- CUPERTINO One Pos[Street, Suite 1050 San Franasca CA 94104(415)781-1505 (Service � Innov�a�tlo�n Value � � � �� . 5f8"(6 ANCHOR BOLTS ' (Fy=36 ksl MIN) #4 RECTANGULAR r� j HOOPS @ 8"OC � ! �--- CLOCK ASSEMBLY „ � ' i & CONN TO FfG BY OTHERS M � -- i . T/FfG �„--_--_ : =D�I Project No. Sheet No. ' Eft GIflEERS Project Date CU�� , I��;.o �Y,�„a �; a✓f.,:, � 1���� f-� ta..�. ��/ 6/�5 Subject BY � ,�' �„�, ,.,�� ���� . - �e �� /15Cf t I, �3 . � Jr��,✓ c � �� � CJ Lln� St•>5 t✓f _--.�_._ � I12 �� ) _ G,4rl, � h ���� Ib � O, SZW � 2U� il, j;r - �. -.-..�.. � ..,, j�: �( SS�.,,.c r..p/ f'�. : i.c �r...� �erv�. �'�'e'1 / ; , _ i � — �F _ . . �`= � �. _; � /� o �� � �, , . � .,.�,rr� ,�;j I i.rF,-_ j yy t t, _; �` Sor 4�� 1i .�ns : r. ; .; . , c�._, r. � � �__ _ _ i �.�-�1o.r.,L,�e �e�.rn < Prry„re.: ' . .f �°pPS�PwSS:�.A. p7lC-54.,�c (�a.f 9t�irrla f�t�.!'� . . . ___ � .. /' � -j .� . 3co -�, .(- x c�G�,���,a��„ �r ��c 5� > 4�'��. .yC.C(�4`/� .. I N _��.._ = P - �__. 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[0.56 M] � REAR ILLUMINATION 4 FACE WITH "SPADE" HANDS. ALUMINUM POST t u WEATHER PROOF in ,� �i FINISH COLORS OPTIONS AVAILABLE _ � ����� o "ACCESS PANEL" - REMOVABLE d TWO SIDE FOR ACCE55 FOR d' �' MOUNTING POST (BY GEN. o CONT'R.) AND ELEC. "HOOK-UP" . . _ _ . . . -_._ _ _ _. . _u_. - -.._ .. _ _ _ _ _ - _ __.__ _ ._. _.__(BY-ELEC.-EONT'R.-): _ _ _ .. ._ _._. _ .. _ _ . _.. _ _ _. •ALl PANELS HAVE � ro m TAMPER-PROOF SCREWS AS � o REQ'� w/ TOOL BY VERDIN. � 1 N iq � 11�" [0.29M] Sq. Baee I � p �� � V�RDIN DFSIGN GROUP THE VERDIN COMPANY MODEL No. 4MST II CORPORATEHEADQUARTERS 444 READING ROAD q CINCINNATI,OHIO 45202 Scale: Y2"— I ' ��� 1-800�543-0488 sales@va�din.com www.verdin.com THIS UESIGN CONCEPT IS TiE EXCWSIVE PROPERtt OF THE � VEROIN COMPANY, AN� MPY NDT BE CO%ED� REPROOOCEO, MANUFACTIIRED, MARKEfEU, OR SOLD IN WHOLE OR ANY PART TNEREOF NITHOUT THE E%PRE55 WRIiTEN CONSENT OF TNE VERDIN COMPANY. 444 RFADING ROAD.CINCINNAT, OHIO. 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