11100130 I
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20387 STEVENS CREEK BLVD CONTRACTOR:SUCCESS GRAPHIC PERMIT NO: 11100130
SIGNS
OWNER'S NAME: W D V PROPERTIES 1744 QUEENS CROSSING DR DATE ISSUED:10/18/2011
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OWNER'S PHONE: 4087384444 SAN JOSE,CA 95132 PHONE NO:(408)667-1777
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIALS
COMMERCIAL
License Class Lie.# L(O CALI HAIR-INSTALL CHANNEL LETTER SIGN
Contractor. Date
I hereby affirm that I am licensed under the provisions of C apte 9
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
I hereby affirm,under penalty of perjury 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
performance of the work for whichthis permit is issued. Sq.Ft Floor Area: Valuation:$1100
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 APN Number:31626090.20387 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.I agree to comply with all city and county ordinances and state laws relating. WITHIN 180 DAYS OF 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 180 DAYS FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which in against said City in consequence of the
granting of this permit. ntionall ,the applicant understands and will comply Issued by: Date:
with all non-poi!n rce regulations per the Cupertino Municipal Code,Section
9.18. 10
RE-ROOFS:
Signature Date (l All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
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)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 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 9.12 and the
declarations: Health&Safety Code,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 A uality Management District I
performance of the work for whichthis permit is issued. will maintain compliance with th pertino Mum ipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Se ions 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Owner or authorized agent: Date: `
I certify 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 C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
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 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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs and expenses which may accrue against said City in consequence of the I understand m plans shall be used as public records.
P Y my
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.
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Signature Date
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SIGN PERMIT APPLICATION �
COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINQ (408)777-3228• FAX(408)777-3333-building@,cupertinomg y `
1 1
PROJECT ADDRESS 010 (�T�J6�s �le W9 APN# { / / ,I 0 �6 �e r �j�
OWNER NAME �� 1� J r� 0 V PHONE E-MAIL/ lJ �1 ® �(
{� . ��
STREET ADDRESS cl �,v W wcxf CITY,STATE,Z v a,` C4 FAX
CONTACT NAME CAg" w, PKONE j� `J -7 27 S- vt E-bJAIL
STREET ADDRESS CITY,STATE,ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAMED�N A w LICENSE NUMBER �r LICENSETiycBUS.LIC#
COMPANY NAbfE E-vG1IL FAX
STREET ADDRESS. �!! ,�j y� JSS r�G'n' ITY,STATE,ZIP �r PHONE n, /1
ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
USE OF ❑ rD or Duplex ❑ Multi-Family ILLUMINATED SIGN TYPE N0.OF SIGN AREA VALUATION
STRUCTURE: Commercial (Y/N) (CODE) SIGNS
(SQ.FT.) (S)
SIGN TYPE CODES:
B - BANNER SIGN M - MONUMENT(GROUND)SIGN
BL - BLADE SIGN P - PROJECTING SIGN
D - DEVELOPMENT ID SIGN SP - SPECIAL EVENT BANNER
DI - DIRECTIONAL SIGN T - TEMPORARY
E - ELECTRONIC W - WALL SIGN
READERBOARD WI - WINDOW SIGN
TOTAL VALUATION:
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.,LhavT-Mlad the Description of Work and verify it is accurate. I agree t compllip
th all applicable local
ordinances and state laws relating to building constru I authorize repres ntatives of Cupertino to enter the above-i ennytifie r p ction purposes.
Signature ofApplicant/Agent: Date:
SUPPLEMENTAL INFOP IYIATION REQUIRED r —
_Site PlanPLeI� o —
Elevationsa� - -�
� E4YERES _,r JUI)IIIlIPL1�3Aii`
—Sip Details-including UL listing(s)applicable
s�AND�xD--��G �i���etxx>•<v>�
Structural Calculations(if applicable) G -
Copy of Planning Approval Letter or Meeting with Planning prior toMrM
'NTT
o T �
submittal of Building Permit application.
Signftpp_2011.docrevised 03/16/11
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CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 20387 St. Creek Blvd DATE: 10/18/2011 REVIEWED BY: jsg
APN: BP#: "VALUATION: j$1,100
"PERMIT TYPE: Building Permit
PRIMARY Sign PENTAMATION 1 CEAP5
USE: g PERMIT TYPE:
WORK
SCOPE
SIGN TYPE FEE ID QTY SIGN FEE
Wall Sign,Electric 1SIGNWELEC 1 $260
TOTALS: 1 $260.00
#Branch Circuits 1 $44.00
1:r=r. ,,.r f�`£,r;, r=f.,F 1`£>F t. fr;tr, 1ESIGN Elec.Permit Fee: IEPERMIT
Other Elec.Insp. 0.0 $44.00
l avp' Fee,' t.'r.Ira,? 3 cr=>�
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . These ees are based on the prelinina information available and are only an estimate. Contact the De t or addn'l info.
}F/ 7
EE ITEMS (F .(Fee Resohitimi 11-053 E 7/1111, FEE QTY/FEE MISC ITEMS
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Suppl.PC Fee: (D Reg. 0 OT 0.0 hrs $0.00
Permit Fee: $260.00
Suppl.Insp.Feer Reg. 0 OT Q,Q hrs $0.00
PME Unit Fee: $44.00
PME Permit Fee: $44.00
ON -F7
Work Without Permit? Yes (D No $0.00
Sign Master Plan: Q Yes 0 No $0.00
Travel Documentation Fee: 1TRAVDOC $44.00 A
Strong Motion Fee: IBSEISMICO $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $393.50 $0.00 TOTAL FEE: $393.50
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Revised: 10/01/2011
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' Mag Tech Industries Corp,
COO J Anz#Z142D Efficiency 85%
(1)CIRCUIT 1
120 V6LT/20 AMPS'
Primary
P Electrical Source
-� (supplies by others)
(040
5"Aluminium Return , ) Junction Box
2s J;, it
#10 x 3 1/2"Drive screws
r minimum threes(3)per letter Class 2 Low voltage E-C�T- Fl-,
oras required per fieconditions Wirin
field g
w/sleeves for stand-off Note:No conduit or flex ' ' -
'. required per class 2 low
Rubber brushing
voltage wiring guideline
Acrylic Face—P
� Maxbrite LED
{ . . Power Supply `
, (120-277 VAC)
9
7]384444� i
Disconnected Switches
Trim Cap 3/4'--► Primary 412
-47 it conduit or flex
f 1/4"Drain Holea
130"
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21.5"
+
Sign Type, (1)Internally Illuminated L,E,D individual Channel Letters Sign.
Letter Face: 118"Thick acrylic face color as shown `
Letter Returns: 5"bi with,040 Aluminum
Trim Cap: 314' b>d I$/Q MtS: 9 r,
Mons=;
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" t m 1744 Queens Crossing Drive—San Jose—CA 95132
20387 Stevens Creek Blvd Cupertino
T.• (408)667-1777 E-mail:swu1966@gmail.com I
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