B-2018-1103 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1103
20080 STE'VENS CREEK BLVD STE 106 CUPERTINO,CA 95014(369 03 010) MCHALE.SIGN CO INC
REDDING,CA 96002
OWNER'S NAME: DATE ISSUED:08/08/2018
OWNER'S PHONE: PHONE NO:(
LICENSED CONTRACTOR'S D RA110 BUILDING PERMIT INFO:
License Class C-45 Lic.#703137
Contractor MCHALE SIGN CO INC Dale 03/31/2020 X BLDG ELECT—PLUMB
I hereby effirm that I am licensed under the provisions of Chapter 9(commencing —MECH_RESIDENTIAL X COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license Is in full farce and effect. JOB DESCRIPTION:
CURRY PIZZA-NEW SIGNS-INSTALL 1(N)CHANNEL SIGN
I hereby affirm under penalty of perjury one of the following two declarations; ILLUMINATED;(1)ALUMINUM PAN SIGN;(1)ALUMINUM PANEL
1. 1 have and will maintain a certificate of consent to self-insure for Worker's VINYL SIGN-NON-ILLUMINATED
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft floor Area: Valuation:$6000,00
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 36903 010 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 regulatio/yns�s per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature �- 08-08-2018 Issued by:Kim Dunbar
Date:08/08/2018
OWNER-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of theRE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being Installed.fro.of 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.
auto(See.7044,Business&Professions Code)
z. I,as owner of the property,am exclusively contracting with licensed Signature ofApplicant:
connectors to construct the project(Sce.7044,Business&Professions Code), Date:08-08-2018
I hereby affirm under penalty of perjury one of flue 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 ofthe work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE
z. 1 have and will maintain Worker's Compensation Insurance,as provided for by I have rend the hazardous materhds 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 25534.1 will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
s. 1 certify that in the performance of the work for which this permit is issued,l Health&Safety Code,Section 25532(x)should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the nuuertal.Additionally,should I use equipment or devices widch emit hazardous
air contaminants as delined by the tiny Area Air Quality Management District I
Worker's Compensation laws ofCalitbmia.If,eflor making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,I become aubject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,said 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Date:OB-08-2018
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,Clv 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 DECLARA'ITON
Code,Section 9.18. 1 understand my plans shall be used as public records.
Signature .�� Date 08-08-2018 Licensed -
Lice"Professional