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B-2017-1033CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1033 19725 STEVENS CREEK BLVD CUPERTINO, CA 95014-2405 (316 20 083) S J P SIGNS INC SUNNYVALE, CA 95131 I OWNER'S NAME: 650-919 forkl- Aa;sa z,,4 (DATE ISSUED: 06/28/2017 OWNER'S PHONE: 650-919-3459 1 I PHONE NO: (408) 971-6643 N mix" tolms 03 License Class Q4�j Lie. #945852 Contractor S J P SIGNS INC Date 04/30/2018 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. I hereby affirm under penalty of perjury one of the following two declarations: r. 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. /2,. /LI have and will maintain Worker's Compensation Insurance, as provided for by \ Fra Section 3700 of the Labor Code, for the performance of the work for which this 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 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, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Dupe-d-itg Municipal Code, Section 9.18. BUILDING PERMIT INFO: BLDG —ELECT —PLUMB MECH _ RESIDENTIAL X COMMERCIAL JOB DESCRIPTION: CUPERTINO MARKET - (I) ILLUMINATED SIGN (1) (46.06 SF) Sq. Ft Floor Area: I Valuation: $5000.00 APN Number: Occupancy Type: 316 20 083 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar Date: 06/28/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the 1LL=nLRIP 0: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 1. 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) z. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 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. 2. I 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 permit is issued. 3. 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 Worker's Compensation laws of California. If, after making this certificate of 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 be deemed revoked. 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 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, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 06-28-2017 Signature of Applicant: Date: 06-28-2017 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Munici al Code, Chapter 9.12 and the Health & Safety Code, Sectio 255P5, 2 3, and 25534. Owner or authorized agent: Date: 06-28-2017 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION understand my plans shall be used as public records. Licensed 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 a-cupertino.org b ")n f -q- - I ()?) 3 PROJECT ADDRESS 19725 Stevens Creek Blvd - APN# OWNER NAME PHONE E-MAIL Saara Diaz 650-919-3459 cu ert'inomarket@gmail.com STREET ADDRESS 19725 Stevens Creek Blvd CITY, STATE, ZIP FAX Cupertino Ca. 95014 CONTACT NAME Saira Diaz PHONE 650-919-3459 E-MAIL cupertinomarket@gmail.com STREET ADDRESS 19725 Stevens Creek Blvd CITY, STATE, ZIP Cupertino Ca. 95014 FAX ❑ OwNER ❑ OwNER-BUR.DER ❑ OwNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER TENANT e❑ 4�2�r CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BU/ Harry Singh 945852 C45 T COMPANY NAME E-MAIL FAX SJP Signs, Inc harry@sjpsigns.com STREET ADDRESS CITY, STATE, ZIP PHONE 1752 Junction Avenue.. Unit C San Jose, CA 95131 408-971-6643 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK W-4, �— J -� USE OF ❑ SFD or Duplex ❑ Multi -Family ILLUMINATED SIGN TYPE NO. OF SIGN AREA VALUATION STRUCTURE: ❑ Commercial (Y / N) (CODE) SIGNS (SQ. FT.) (S) SIGN TYPE CODES: 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 RECEI T By my signature below, I certify to each of the following: I am the property owner ora orized agent to act on the 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 bd ding constr thorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature ofApplicant/Agen i ��---�� Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY PLAN CHECK TYPE ROUTING SLIP Site Plan ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW Elevations _ Sign Details - including UL listing(s) applicable ❑ EXPRESS ❑ PLANNING PLAN REVIEW 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