B-2017-1682 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1682
10465 S DE ANZA BLVD CUPERTINO,CA 95014-3011(359 17 019) ALLEN SIGNS INC
SAN JOSE,CA 95125
OWNER'S NAME: BDC HAYWARDLP DATE ISSUED:09/28/2017
OWNER'S PHONE:925-588-2213 PHONE NO:(408)280-6500
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-45 Lic.#834580
Contractor ALLEN SIGNS INC Date 03/31/2018 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:
CATHAY BANK-SIGNS;(2)ILLUMINATED CHANNEL LETTER
I hereby affirm under penalty of perjury one of the following two declarations: SIGNS;(1)REFACE EXISTING MONUMENT SIGN
t. I have and will maintain a certificate of consent to self-insure for Worker's
pensation,as provided for by Section 3700 of the Labor Code,for the
X11 ,performance of the work for which this permit is issued.
j I $ 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. Sq.Ft Floor Area: Valuation:$8600.00
- 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 ordinances APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 359 17 019 A(Tenant Improvements)
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 t`zn ino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Sig -� Date 9/27/2017 Issued by:Jasmine Archbold
Date:09/28/2017
NER-BUILDER DECLARATION
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
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)
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:9/27/2017
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. 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 Air Quality Management District 1
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Munici I Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections , 5533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Ow z rj ,.horized agent:
APPLICANT CERTIFICATION '';14/20
I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
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. I understand my,plans shall be used as public records.
Licensed
Signature Date 9/27/2017 Professional •
\\I S/, SIGN PERMIT APPLICATION
/' COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
,,Si.lys, 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•buildinq(a cupertino.orq
CUPERTINO
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CONTRACTOR NAME /1`{& L; r^ LICENSE NUMBER Rs if;RI, LICENSE TYPE C ` if 5- B4Lo3 53'',
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USE OF ❑ SFD or Duplex ❑ Multi-Family ILLUMINATED SIGN TYPE NO.OF SIGN AREA VALUATION
STRUCTURE: ❑ Commercial (YIN) (CODE) SIGNS (SQ.FT.) (5)
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SIGN TYPE CODES: 2. yr ZS O LO 0 0 4.
B - BANNER SIGN - MONUMENT(GROUND)SIGN I r V, r'�
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BL - BLADE SIGN P - PROJECTING SIGN l J r C
D - DEVELOPMENT ID SIGN SP - SPECIAL EVENT BANNER
DI - DIRECTIONAL SIGN T - TEMPORARY
E - ELECTRONIC V�- WALL SIGN
READERBOARD WI - WINDOW SIGN `
RE�EIVI�B y�sirst ate2 TOTAL V pgl/"U8iTtNr:(g
By my signature below,I certify to each of the following: I am the property owner or authorized 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 building constructs authorize representatives of Cupertino to enter the ter- �above-identified property for inspection purposes.
tq 2C', ,el
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
Site Plan PLAN CHECK TYPE ROUTING SLIP
Elevations 0 OVER-THE-COUNTER 0 BUILDING PLAN REVIEW
Sign Details-including UL listing(s)applicable 0 EXPRESS 0 PLANNING PLAN REVIEW
Structural Calculations(if applicable) 0 STANDARD 0 OTHER:
Copy of Planning Approval Letter or Meeting with Planning prior to 0 LARGE
submittal of Building Permit application.
0 MAJOR
SignApp_2011.doc revised 03/31/11