13070164SIGN PERMIT APPLICATION
l113COMMUNITYDEVELOPMENTDEPARTMENT•BUILDING DIVISION "
1
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO
408)777-3228•FAX(408)777-3333•building(cDcupertino.org
PROJECT ADDRESS
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OWNER NAME T!/
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PI-IO E-MAIL
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STREET ADDRESS
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CITY,STATE,ZIP FAX
CONTACT NAME (
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STREET ADDRESS CITY,STATE,ZIP FAX
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OWNER OWNER-BUILDER OWNER AGENT CONTRACTOR CONTRACTORAGENT ARCHITECT ENGINEER DEVELOPER TENANT
CONT OR NA LIaNNLr ` LICEE TYPE
s
BUS.LIC#
COMPANY NAME E-MAIL
G
FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORKN C \ Pew
USE OF SFD or Duplex Multi-Family ILLUMINATED SIGN TYPE NO.OF SIGN AREA VALUATION
STRUCTURE:Commercial Y/N) CODE) SIGNS SQ.FT.) M
SIGN TYPE CODES: GQ 2 Sd
B - BANNER SIGN M - 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
RECEIVED BY:jik 1 TOTAVALUATION:, $-
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By my signature below,I certify to each of following: I am the property owner or an o' ed agent to act on the property owner's behalf. I have read this
application and the information I have pro d d is correct. I have read the Description of W and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to buil g onstructi I authorize representatives of Cu rtino to enter the above '-iden ed proper y for inspection purposes.
Signature of Applicant/Agent: Date: -7 *0
SUPPLEMENTAL YORMAfION RE UIRED OFFICE USE ONLY
Site Plan P_JAKCHECK TYPE ROUTING SLIP
Elevations OVER-THE-COUNTER BL PLAN REVIEW
Sign Details-including UL listing(s)applicable El EXPRESS PLANNING PLAN REVIEW
Structural Calculations(if applicable)STANDARD OTHER:
Copy of Planning Approval Letter or Meeting with Planning prior to LARGE
submittal of Building Permit application.
MAJOR
SignApp_2011.doc revised 03/31/11
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 20813 SCB DATE: 07/25/2013 REVIEWED BY: Mendez
APN: BP#: VALUATION: $2,55p
PERMIT TYPE: Building Permit MAN 1°YTE
PRIMARY PENTAMATION
1 CEAP5
USE.
Sign PERMIT TYPE:
WORK BROMIUM- INSTALL SINGLE FACED MONUMENT SIGN
SCOPE
SIGN TYPE FEE ID QTY SIGN FEE
Ground Sign 1SIGNGR/RF 1 349
TOTALS: 349 00
h
C
1'ech. Phm('he(.k 1'ou;rrh.I kvr (,'beck Branch Circuits 0 0.00
klech,lerm;f fire:Jlarpb? J'>rrrit 7 i e:Elec.Permit Fee:
flake> :l t4i'ir. tr=,k;. Other F hw,-b frsz>. Other Elec.Insp. 0.0 0.00
Pluitib.ImP.F<,e:
NOTE.This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). These ftes are based on the prellmina information available and are only an estimate. Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E . 7ff /1/12)FEE QTY/FEE MISC ITEMS
Plan('heckbee:
Suppl.PC Fee: (j) Reg. 0 OT0.0 hrs 0.00
Permit Fee: 349.00
Suppl. Insp.Feer Reg. ®OT 0,0 hrs 0.00
PME Unit Fee: 0.00
PME Permit Fee: 0.00
rara,trt t°tiara i x:
4(kninistr ative Fee:
Work Without Permit? 0 Yes (E) No 0.00
Sign Master Plan:0 Yes No 0.00
Travel Documentation Fee: ITRA,VDOC 47.00
Strong_Motion Fee: IBSEISMICO 0.54 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC 1.00
397.54 0.00
y
E_397.54
Revised: 07/01/2013
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Sheet No.:
FOUNDATION
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20813 STEVENS CREEK BLVD Th E M E9f Now.E.1o" 9M•.
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CUPERTINO,CA A,Eb Ybhmnhga MYE
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design Pr mium 51231 Aluminum construction monument sign
I; with internal frame, reveal and aluminum base
Kath C 523-13
f Paint sin - Matthews MP18073 Pal ver Metallicgr
SUILDNG DIVlsOO MENT DEPARTN-CUP MNO ENT
V Logo 1/8" aluminum with Digital 0dnt*d.h 1 /1ami ate.
2'-8n
lur,rg constructioncatiOns MUSTApplytosignpanel.S9s or It is unlawful too kept at the9 ,cl'.an
alferEtE• 3'-10" j, thl rt fmr,.I ations°n same,or todeviatelake any
WfTOMEAAPPROVAt 6 Bromium Bromium - 1/8" ALUMINUM painted satin black. Stud
mouJ'
8h 8b oOfficial.PRINT NAME
specifications SHALL NOT 'I
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provisio ;. an approval of the violSIGNNAME
ns°f anY Ciry Ordin violation
ance or State Law.
DATE ALUMINUM BASE PAINTED MATTHEWS BREY
HUPPSTAFFAPPROVAI
PRINT NAME
CUPERTINO et.
a Buildinq DepartmentCTMCid
DATE 3ff
pole 18"
JUL 2 4 2013 OATS
REVIEWtD FOR CODE COMPLIANCE P l
1 1-AXV BVI 4 o PA L-
Reviewed By, C- 5 t 3 ~i
1»` CONCRETE
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