14010138 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20620 HOMESTEAD RD CONTRACTOR:PACIFIC NEON PERMIT NO: 14010138
OWNER'S NAME: THE SOBRATO ORGANIZATION 2939 ACADEMY WAY DATE ISSUED:02/11/2014
O NER'S PHONE: 4083874933 SACRAMENTO,CA 95615 PHONE NO:(916)927-0527
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL [] COMMERCIAL
t_ Ja _ INSTALL 3 ILLUMINATED MONUMENT SIGNS
License Class'y Lic. 1
Contractor fauFrG J V Date :Q. /1-
I hereby affirm that I am licensed under the provisions of Chapter 9
(cammcneing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
1 hereby affirm under penalty of perjnry one of the following two declarations:
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
erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$68940
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 APN Number:32610066.20620 Occupancy Type:
permit is issued,
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.1 agree to comply with all city and county ordinances and state laws relating WITHIN 180 F PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 184 S FROM LAST CALLED INSPECTION.
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 Issued by: Date:
Lwilthhnon- source regular' ns per the Cupertino Municipal Code,Section
-�' RE-ROOFS:
r Date All roofs shall be inspected prior to any roofing material being installed. If a roof is
d re installed without first obtaining an inspection,1 agree to remove all new materials for
inspection,
❑ OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date:
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of tate 1
California Health&Safety Code,Sectious 25505,25533,and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.I2 and the
declarations: Health&Safety Cade,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued, will maintain compliance with the upertino M nicipal Code,Chapter 9.12 and
1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Se 125505,25 ,and 25534. �/�I�/
Section 3700 of the Labor Code,for the performance of the work for which this Or:'rar a uil�ck. I TL" r ;` _. :C I)atc:a' C''pvl�f
permit is issued, � "-
I eert4 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 CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ Q
Lender's Name
APPLICANT CERTIFICATION Lender's Address
I certify that I have read this application and state that the above information is
correct.1 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, ARCHITECT'S DECLARATION
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
r
l�
SIGN PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-32550
CUPSRTINO (408)777-3228•FAX(408)777-3333•building Cd)cupertino.org 1
PROJECT ADDRESS n U ��O / I��S � _f QGr APN ii �� O /i -6
0 N [7t r](, C] P+ NE E-MAI V
r 0 and * o • `tq3 r e ler 5a rQ�-a. Ibm
STREETADDRESS r• CITY, ATE,ZIP
YF
CONTACT NAME 111IONE E- L
s5he_ l o uv eua, a-r a 5a� s�ierlc p i neo evJ Z
STREET ADDRESS F
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR CONTRACTOR AGENT ❑ ARCHrrECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAMELICENSE NUMBER LICENSE TYPE BUS.LIC 0
iPaq i-Fl;r' ileoIn 303019 C- a
COMPANY NAME P G O kr� E he i G1 Gdl FAx
1[o-4
STREETADDRESSn�, C'`ZI aL u-))Cnto N- 25015- ll� -20 7,0521 x e
ARCHITECIIENGINECCER NAME LICENSE NUMBER BUS.LIC 0
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
�-ns-QI 3 mumi1la4-ed monumeo+ 5L ns -
USE OF ❑ SFD or Duplex ❑ Multi-Family ILLUMINATED S[GNTYPE NO,OF SIGN AREA VALUATION
STRUCTURE: ■ Commercial (YIN) (CODE) SIGNS (SQ.Fr.) (S)
SIGN TYPE CODES:
B - BANNER SIGN M - MONUMENT(GROUND)SIGN
BL - BLADE SIGN P - PROJECTING SIGN
D - DEVELOPMENT to SIGN SP - SPECIAL EVENT BANNER
DI DIRECTIONAL SIGN T - TEMPORARY
E - ELECTRONIC W - WALL SIGN
READERBOAILD WI - WINDOW SIGN
RECEI TOTAL.YALUATION:
By my signature below,1 certify to each of the following: I am the property owner or authorized agent to act On the p erty owner's behalf. I have'
jrea t Is
application and the information 1 have p vided is correct. I have read the Description of Work and verify it is ac e. I agree to comply with all applicable local
ordinances and state laws relating to I ng c n truction. 1 u orize representatives of Cupertino to enter the above-1 de flmF
rr inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFO TION REQUIRED OFFICE USE ONLY
Site Plan PLAN CIIECKTYPE ROUTING SLIP
Elevations ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
Sign Details-including UL listing(s)applicable ❑ EXPRESS ❑ PLAIYNINGPLAN REVIEW
Structural Calculations(ifapplicable) ❑ STANDARD 0 OTHER:
_Copy of Planning Approval Letter or Meeting with Planning prior to ❑ LARGE
submittal of Building Permit application.
❑ MAJOR
SrgnApp_201 Ldoc revised 03/31/11
t
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 20620 HOMESTEAD RD DATE: 01/24/2014 REVIEWED BY: MELISSA
APN: 326 10 066 BP#: D 'VALUATION: $68,940
*PERMIT TYPE: Building Permit PL4NC11EC:"K TYPE:
PRIMARY PENTAMATION
USE: Sign PERMIT TYPE: 7CEAP
WORK INSTALL 3 ILLUMINATED MONUMENT SIGNS
SCOPE
SIGN TYPE FEE ID QTY SIGN FEE
Ground Sign 1SiGNGR1RF 3 $1,047
TOTALS: $1,047.00
Mech.Plan Check Phemb.Plan Check #Branch Circuits 1 $47.00
:Vech.Permit Fee: Plamb.Pemil Fee: IESIGN Elec.Permit Fee: IEPERMIT
Other blech.Insp. =7— Other Plumb Insp. Other Elec.Insp. LLO $47.00
Akch.Lisp. Free. Phmah, Insp,Fee: Elec.Insp.Fee:
NOTE:This estimate does not include fees due to outer Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etG). Thesefees are based on the prelimina information available and are only an estimate. Contact lite De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff.' 7/1/13) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC Fee: Q Reg. O OT 0.0 hrs $0.00
Phimb./Alech.IElec
Permit Fee: $1,047.00
Suppl. Insp. Fee-.0 Reg. O OT 0,0 hrs $0.00
PME Unit Fee: $47.00
PME Permit Fee: $47.00
Consiruction Tax:
Administrative Fee:
Work Without Permit? Yes d No $0.00
Sign Master Plan: Q Yes (F) No $0.00
Travel Documentation Fee: InMVDOC $47.00
Strong Motion Fee: 1BSEISMICO $14.48 Select an Administrative Item
Bldfz Stds Commission Fee: 1BCBSC $3.00
SUBTOTALS: 1 $1,205.481 $0.00 TOTAL FEE-.T $1,20.5,481
Revised: 01115/2014