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B-2018-0380 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO;B-2018-0380 19550 VALLCO PKWY CUPERTINO,CA 95014(316 20 118) VIKING SIGN INSTALLATIONS INC MANTECA,CA 95337 OWNER'S NAME:MAIN STREET CUPERTINO MULTI-FAMILY PROPERTY DATE ISSUED:07/06/2018 OWNER'S PHONE: PHONE NO:(209)239-3339 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C45 Lic.#�8 B Contractor VIKING SIGN INSTALLATIONS INC Date 09/30/2019 X BLDG ELECT—PLUMB MECII RESIDENTIAL X COMMERCIAL I hereby affirm that I nm licensed under the provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is fn full force and effect JOB DESCRIPTION: LOFTS-INSTALL I ILLUMINATED WALL SIGN AND I 1 hereby affirm under penalty of perjury one of the following two declarations; ILLUMINATED BLADE SIGN 'rave and will maintain a certificate of eousent to self-insure for Worker's mmpensation,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 Insnronce,as provided for by '-Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Flan-Arca: Valuation;$8850.00 APPIJ122 CPRTIFPCATION 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 20 118 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 pe th Cupertino Mugjcipal Code, ction 9,18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 07/06/18 Issued by:SEAN HATCH Date:07/06/2018 RATE I hereby affirm that I am exempt trmn the Contractor's License Law for one at'theRE-ROOFS: following two reasmas: All roofs shall be inspected prior to any roofing motefial being installed.If.roof is r. 1,as owner of the property,or my employees with wages as their sole nutalled 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(Sce.7044,Business&Professions Code) hsmwncroftl pmpertr,-arrr elusively-contractingwith liecnscd�—Sigamme-of-Applicant. contractors to construct the project(See.7044,Business&Professions Cade). Date:07/06/18 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER n, 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 die 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 or the Section 3700 of the Labor Code,for the performance of the work fnwhich this California Health&Safety Code,Sections 25505,25533,and 25534.1 will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the a. 1 certify that in the performance of the work for which this permit is issued,I Health&Safety Coda Section 25532(a)should I store or handle hazardous shall not employ n in an manner so as to become subject to the material.Additionally,should 1 use equipment or devices which emit hazardous I y an y person y 1 atr 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,Secktanss 25505,255, and 255 Labor Code,I must forthwith comply with such provisions or this permit shall �//' be deemed revoked. - Owner or authorized agentY�` — APPLICANT CERTIFICATION Date:07/06/18 1 certify that I have read this application and slate that the above information is CONSTRUCTION LENDING ACL Y 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.) toenter 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-polnt source regulations per the Cupertino Municipal ARCHITECT'S DECI,ARA'f10N Code,Section 9.16. I understand my plans shall be used as public records. Licensed Signature Date fliztffij 8 Professional