The URL can be used to link to this page

B-2017-1821 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1821 19505 STEVENS CREEK BLVD UNIT,102 CUPERTINO,CA 95014(316 49 009) YADA SIGNS HAYWARD,CA 94545 OWNER'S NAME: CHEUNG ROLAND F AND JENNY TRUSTEE&ET AL DATE ISSUED: 10/25/2017 • OWNER'S PHONE:408-401-0227 PHONE NO:(510)828-9354 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-45 Lic.#958377 Contractor YADA SIGNS Date 03/31/2019 X BLDG _ELECT _PLUMB MECH.7RESIDENTIAL 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: (N)•WALL SIGN-ILLUMINATED-T4 I hereby affirm under penalty of perjury one of the following two declarations: 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. opI 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:$1600.00 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 316 49 009 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 regula .'ns per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. 11' c aturego- ,-4Date 10-25-2017 Issued by:Jasmine Archbold Date: 10/25/2017 OWNER-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:10-25-2017 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 z. 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 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 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall / .�' be deemed revoked. Ow r authorized agent: � . APPLICANT CERTIFICATION 0- 5-201 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 ereby 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 10-25-2017 Professional \\I /, SIGN PERMIT APPLICATION t :& • COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ,i''''s, 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildingt cupertino.orq CUPERTINO i • PROJECT ADDRESSsf 5f. J_Vo661 APN# t( G` /h O° Lt OWNER NAME PHONE . E-MAIL V r L -GFoI JO�.1' STREET ADDRESS 1 41"CC c ctt !An QA 12` CITY, STATE,ZIP /J- 1�n' i OD FAX CONTACT NAME Q. ��A CAUL PHONE a--- f Ne E-MAIL U STREET ADDRESS CITY,STATE,ZIP 9d t 4- 4s--- FAX `'? )L .Q 'w) kolk pk�z - Y1010 1 (4. 14 45 , OWNER 0 OWNER-BUILDER 0 OWNER AGENT &CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NAME 5. ( �. LICENSE NUMBER�� LICENSE TYPE _ BUS.I#` .414 i`—�lM' 1 X E-MAILFAX COMPANY NAME ` lJ ` 1 k, (4,4.L. DIV.S. I/kJ...0 i nil-ely A-0( v-_)-°fc a ,.....__ STREET ADDRESS . ?f ' ``1 I !� CITY,STATE,ZIP Pj Al-, /� _ PHONE ` )7,9+ til) 1140-- Auz, rt AI war), / "(q-S-i's� ' (G' CS�-S , , q- ARCHITECT/ENGINEER NAME ; ' , LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK kJ4 ' i it/t4 J41 1 I, ytt i ii,,f eql (4.—,reµvlY1 (/ ,iii . - USE OF SFD or Duplex ❑ Multi-Family ILLUMINATED SIGN TYPE NO.OF SIGN AREA VALUATION STRUCTURE: COmrnerCial (Y/N) (CODE) SIGNS 1(SQ.FT.) ($) SIGN TYPE CODES: � Ili ( c --).-- - 'V 0 Cr.---- . B - BANNER SIGN M - MONUMENT(GROUND)SIGN BL - BLADE SIGN P - PROJECTING SIGN D - DEVELOPMENT ID SIGN SP - SPECIAL EVENT BANNER Dl - DIRECTIONAL SIGN T - TEMPORARY E - ELECTRONIC W - WALL SIGN READERBOARD WI' - WINDOW SIGN 1' \ n RECEIVED B e !A-!'lY1' TOTAL V UATIO�-- 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 ha 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 to6 *:,construction. I authorize representatives of Cupertino to enter the above-identified roperty for inspection purposes. Signature of Applicant/Agent: ' < Date: (0(2—S- iSUPPLEMENTAL;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