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B-2017-0849CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0849 10088 N WOLFE RD CUPERTINO, CA 95014 (316 20 108) HERSCHEND CORP SAN BRUNO, CA 94066 OWNER'S NAME: CUPERTINO PROPERTY DEVELOPMENT, LLC DATE ISSUED: 05/30/2017 OWNER'S PHONE: 408-343-1088 EX 112 PHONE NO: (415) 360-5502 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-10 Lic. #1002588 Contractor HERSCHEND CORP Date 04/30/2019 X BLDG _ELECT —PLUMB 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 license is in full force and effect. JOB DESCRIPTION: INSTALL (2) SETS OF INTERNALLY ILLUMINATED LED WALL I hereby affirm under penalty of perjury one of the following two declarations: SIGNS - STEINS BEER GARDEN. t. 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 ! of the work for which this permit is issued. terformance have and will maintain Worker's Compensation Insurance, as provided for by ection 3700 of the Labor Code, for the performance of the work for which this Sq. Ft Floor Area: Valuation: $12000.00 permit is issued. 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 ordinances APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 31620 108 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, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and-will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. '- --- Date 5/30/2017 Signatre Issued by: ABBY AYENDE OWNER-BUILDER DECLARATION Date: 05/30/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is t. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date:/35 0/2017 1 hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER t. 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Mr Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety-Code, Sections 25,.545 5 , and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall f / be deemed revoked. Owner or authorized ag nt: APPLICANT CERTIFICATION Date: 5/30/2017 I certify that I have read this application and state that the above information is CONSTRUCTION LENDINGAGENCY correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 5/30/2017 Professional CUPERTINO SIGN PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building cDcupertino.orp 8 _6w7 Z)1?51y1 PROJECT ADDRESS APN i %I � — 2O Il I 10088 N. Wolfe Road -_ ✓ lVJ ` OWNER NAME ;;7�PHONE Cupertino Property Development. LLC 408-343-10088 ext.wokuboOl@sprynet.com STREET ADDRESS CITY, STATE, ZIP FAX 19620 Stevens Creek Blvd. Suite 200 Cupertino Ca 95014 408-343-1089 .CONTACT NAME Wayne Okubo PHONE 408-343-10 88 ext. 112 E-MAIL wokuboOl @sprynet.com STREET ADDRESS CITY, STATE, ZIP FAX 19620 Stevens Creek Blvd. Suite 200 Cupertino Ca 95014 408-343-1089 OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC Herschend Corp. 1002588 C-10 300832 COMPANY NAME E-MAIL FAX Herschend Corp. farid@herschendcorp.com STREET ADDRESS CITY, STATE, ZIP 1050 National Ave San Bruno Ca 94066 PHONE 415-360-5502 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY. STATE, ZIP PHONE yy DESCRIPTION OF WORK d Fabricate and lnstal!A sets of internally illuminated LED signs, per project sign program and tenant guidelines. USE OF ❑ SFD or Duplex ❑ Multi -Family ILLUMINATED SIGN TYPE NO. OF SIGN AREA VALUATION STRUCTURE: © Commercial (Y!N) (CODE) SIGNS (SQ. FT.) ($) SIGN TYPE CODES: i W 1 6000 y i W 1 6000 B - BANNER SIGN M - MONUMENT (GROUND) SIGN BL - BLADE SIGN P - PROJECTING SIGN D - DEVELOPMENT ID SIGN SP - SPECIAL EVENT BANNER DI - DIRECTIONAL SIGN T - TEMPORARY E - ELECTRONIC W - WALL SIGN READERBOARD WI - WINDOW SIGN J'� RECEIVED BY: p, 1 U TOTAL VALU TION: , i , e),�O By my signature below, I certify to each of t I am the property owner or authorized agent to act on the property owner's behalf. I have read t is application and the information [ provided is correc . I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws rel g to buildin cti I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Ag t: Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY PLAN CHECK TYPE ROUTING SLIP Site Plan OVER-THE-COUNTER BUILDING PLAN REVIEW al Nki , �Elevations _�/%Slgn Details - including UL listing(s) applicable EXPRESS PLANNING PLAN REVIEW C �(A v St Crural 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