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07060216CITY OF CUPEx11 . BUILDING DIVISION BUILDINGADDRESS:___ PERMIT S CREEK BLVD OWNER'S NAME: EVERSHINE GROUP NE: ARCHITECT/ENGINEER: p LICENSED CONTRACTOR'S DECLARATION U I hereby affirm that I am licensed under provisions of Chapter 9 (commencing z W with Scction 70(10) of Qivision 3 of dtc Business and Professions Cod , and in license is m = w in full force and of $ �l /ri.1L11e /s'O�J License CI Lic. # u(� p Date Contractor F w R HITECTS DECLARATION 2 a < 1 understand my plans shalt be used as public records >yU U. in Licensed Professional O e OWNER- BUILDER DECLARATION a1 hereby affirm that 1 am exempt from the Contractor's Liccnsc Law for time 20 following reason. (Section 703 t.5, Business and Professions Code: Any city or county < m f which requires a permit to construct, alter, improve, demolish, or repair any structure u ' y prior to its issuance, also requires the applicant for such permit to file a signed statement ? e that he is licensed pursuant to the provisions of the Contractor's Uccnse Law (Chapter 9 rt=- (commencing with Section 7000) of Division 3 of the Business and Professions Code) or y that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). ❑ I, as owner of the property, or my employees with wages as their sole compensation. will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If. however, the building or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑ 1, as owner of the property. am exclusively contracting with licensed contvctors to construct the project (Sec. 7044, Business and Professions Code:) The Contactors Li- cense Law does not apply to an owner of property who builds or improves thereon. and. who contracts for such projects with a contractor(s) licensed pursuant to the contractors License Law. ❑ I am exempt under Sec B & P C for this mason Owner Date WORKER'S COMPENSATION DECLARATION �z 0 z� W? aA 0z U0 w F. �U Uz I hereby affirm under penalty of perjury one of the following declarations: J I have and will maintain a Certificate of Consent to self - insure for Workers Compen- ation, as provided for by Section 3700 of the Labor Cod. for the performance of the Nork for which this permit is issued. -1 1 have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Cod, for the performance of the work for which this permit is issued. My Worker's Com rmsati Insurance ca . an d-R lity numbe �y D� Carer.. R Q � � "" Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (SI00) or less.) I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.) Lender's Name Lender's Address I certify that I have read this application and state that the above information is correct 1 agree -,comply with all city and county ordinances 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 City of Cupertino against liabilities. iudemcn1SQes[5`Al1aTXPMKs which may in any way accrue against said City in conseq of the granting of this P&mit. APP NT UNDERSTANDS AND WILL COMPLY SUCCESS SIGN INC 2812 PECK RD (626) 444 -8181 PERMIT NO. 07060216 PERMIT ISSUE DATE 06/25/2007 SANITARY NO. CONTROL NO. BUILDING PERMIT INFO BLDG ELECT PLUMB MECH Job Description ILLUMINFTED INDIVIDUAL CHANNEL LETTERS. ,,q. Ft. Floor Area 3690600'1 SO ONS. Signature o or Date I HAZARDOUS Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino MuniciW Code. Chapter 9.12, and the Health and Safety Cod, Section 25532(a)? ❑ Yes No Will the applicant or future building occupant use equipment or devicct which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District? ❑ Yes Jd tvo I have mad the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health & Safcty bons 505.25533 and 25534.1 understand that if the building does not curmnWfiave a tenant, thal it is my responsibility to notify the occupant of the requiremen ich must be met priok to issuance of a Certificate of Occupancy. Owner or Date Issued by Valuation $1800 occupancy Required Inspections Type of F.00f All roofs shall be inspected prior to any roofing material being installed. If a roof s installed without first obt 'ning an inspection, I agree to remove all new mal_, a for insp ' n. C_ Signature of Applicant Date All roof coverings to be Class "B" or bett r CITY OF CUPERTINO CITY OF CUPERTINO aA PERMIT APPLICATION FORM 076�, - 021 APN # Date: Building Address: wb 9 rt S Owner's Name: _ Phone Contractor: �� License #: ` BUILIDNG Contact: f Phone #: Applicant /Contractor: Building Permit Info: Bldg 1ec Plumb Mech Job Description: Residential: L(4vl.��i l �� a,lb� ������V Commercial: Sq.Ft. Floor Area: $ /Sq.Ft.: Architect/Engineer: Cost of Project: 8 �� Type of Construction: Occupancy Group: Qty. if Applicable Fee ID Fee Description Fee Group / BENERGY Energy BUILIDNG BPERMFEE Bldg Permit Fees BUILIDNG BPLANCHK Plan Check Fee BUILIDNG BSEISMICOM Seismic Commercial BUILIDNG EPERMITFEE Elect Permit Issuance ELECTRICAL BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Rmdl Signs, Marquee ELECTRICAL BUSLIC Business License BUILIDNG VA LP CITY OF CUPERTINO BUILDING DIVISION PERMIT Ct7I 'I'I2A TO IN.t1kt1� ATI�N. BUILD[ G ADD ESS: PERMIT NO 175 STEVENS CREEK BLVD SUCCESS SIGN INC 07060216 OWNER'S NAME: PERMITLSSUEDATE EVERSHINE GROUP 2812 PECK RD 06/25/2007 PHONE: SAMTARY NO. CONTROL NO. (626) 444 -8181 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 00 LICENSED CONTRACTOR'S DECLARATION U affirm F 1 hereby arm that I am licensed under provisions of Chapter 9 (commencing Z w with Section 7000) of Division 3 of the Business and Professions Code. and is < � in full force and c � eQ Q n� � 'Q�J ti ? Liccnsc CI lJ f F, a Datc Contrp actor R HITECI -S DECLARATION a I understand my plans shall be used as public records yU U. y Licensed Professional y J OWNER- BUILDER DECLARATION < � I hereby Affirm that 1 am exempt from the Contractors License Law for the C) 0following rason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement ?� that he is licensed pursuant to the previsions of the Contractor's License Caw (Chapter 9 t=- m (commencing with Section 70D0) of Division 3 of the Business and Professions Code) or 3 — that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (E500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered forsale. If, however, the building or improvement is sold within one year of completion, the owner- builder wi0 have the burden of proving that he did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:) The Contractors Li- cense Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractors License Law. [] I am exempt under Sec , B & P C for this reason Job Description ILLUMINATED INDIVIDUAL CHANNEL LETTERS. Sq. Ft. Floor Area $1800 Valuation 3 6906009 qiq Number Occupancy Type Required Inspections Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a Certificate of Consent to self - insure. for Workers Compen- sation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued ❑ I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Worker's CCoompensatK`isurance carriyr an"olicy numbe are ` L �Y r l Carrier.- Policy No.: 1 l CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (5100) or Icss) 1 certify that in the performance of the work for which this permit is issucA. I shall not employ any person in any manner so as to become subject to the Workers' Compensaton Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the worker's Compensation provisions of the Labor Code, you must Z forthwith comply with such provisions or this permit shall be deemed revoked. 7 CD CONSTRUCTION LENDING AGENCY �-+ 1 hereby affirm that there is a construction lending agency for the performance of x the work for which this permit is issued (Sec. 3097, Civ. C.) Ll ~n Lender's Name Z Lcndei s Address � J Q 1 certify that I have read this application and state that the above information is L — corrccb I agree to comply with all city and county ordinances and state laws relating to D U building construction, and hereby authorize representatives of this city to enter upon the W above- mentioned property for inspceuon purposes. Ls. (We) agree ho save, indemnify and keep harmless the City of Cupertino against in liabilift&judgmcn n sc` which may in any way accrue against said city J z in consequ�u of the granting of this permit. APPI� A�" t1T UNDERSTANDS AND WILL COMPLY WITHALL/bN-PXYT Issued by Signature o or Date HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Euturcobuilding Code. Chapter 9.12, and the Health and Safety Code, Section 25532(a)? ❑ Yes Will the applicant or occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District? C3 Yes )d'IVu I have read the hazardous materials mquirements under Chapter 6.95 of the Califor- nia Hcalth &SatetyC ections 505.25533 and 25534 .1 understand that ifthebuilding does not current ave a tenant, (ha it is my responsihility to notify the occupant of the requirement. hick must be met prix, to issuance of a Certificate of Occupancy. Owner or 2uthori7�d agent _,Y Date ' R-e -roofs Type of Roof Fnlrjr�Ai� Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obt 'ping an inspection, I agree to remove all new for insp Lion. i Signature of Applicant Date All roof coverings to be Class "B" or bett r city "OF CUPEI�TINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777 -3228 Fax (408) 777 -3333 Building Department JOB ADDRESS: c � 7s -s, —, S iw �� crz -<& PERMIT # d,3 0 z (�r- OWNER'S NAME: sZ �`(1�4� �:���T / PHONE 4+K4 ` ZIF GENERAL CONTRACTOR: 5 Gz.% - FAX # iEc�� -- (,6 ` I am not using any subcontractors: grta —� ate Please check applicable subcontractors an ete the following information: r Owner /Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile r Owner /Contractor Signature Date . 16 "� W� IN 1 160" Sign Type: (1) Internally illuminated individual Channel Letters Halo Glow Blue at Night Sign for SUSHI TATSUMI fetter Face: 1/8" thick acrylic face orange Letter Returns: 5" Bronze OR Dark Brown 0.40 Aluminum Sheet Trim Cap: 314" Bronze ,s ks RacewayEiousirg —4 Fasteners as Required Connection between Letters Disconnect Switch ig on Transformer �-4 .:.8-- , w... Access Panel Power Source - -- LED Transformer ce ANIL WW cation) nated Channel Letters Typical Storefront Success Sign Group 2812 Peck Rd unite A, El Monte, CA 91731 (408) 306- 9521sean (626) 444 -8181 19754 Stevens Creek Blvd, Cupertino, CA 95014 V a A LU 0- LLJ IL LLJ 0 LLJ < U) 10 < < 17 FT -IT I T_ 1' 1-17 F 1-17, as :1 Th 7� N'T C3 Ul R-41 A, Q) Z t. Ul u I _0 114" x 2" Lag Screw Into Wood Beam Top & Bottom Trim Cap 3/4; ❑� fT 3" Space Sheet Metal Raceway For Electrical Wiring Clear Lexan 12 volts LED Lighting LED Junction Wiring Disconnect Switch on Transformer Acrylic Face 1/8; 4----Power Source T LED Transformer #10 x 112" Screw For Raceway cover Paint To Match Wood Beam Per Landlord (installer to find suitable location) < INSTALLATION DETAIL > i2N - CL N.- 5 #ff q! on 12 nll.; 4) Cr M A— TT uj O'l -51 nm- j — t I t F I 21-f-22 %1! 1�'! 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