08090103CITY OF CUPERTINO
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CR:�iCTORINF1'MMA'�I0N_`N�;
BUILDING DIVISION PERMIT
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Bu1Lq�IdP�3DD,ttE TEVENS CREEK BLVD
S
ITAL CUSTOM SIGNS INC
PERMIT NO.
08090103
VERS NAME:
PERMIT ISSUE DATE
EVERTRUST BANK
9868 KALE ST
09/17/2008
PHONE:
SANITARY NO. CONTROL NO.
(626) 444-6027
ARCHIIEC (ENGINEER:
BURRING PERMIT INFO
BLDG ELECT PLUMB MECH
p LICENSEDCONIRACTOR'S DECLARATION
9
Job Description
C 1 hucby affirm ihu 1 w licensed under Provisions of Chapmr (mmmuein
Lt
wlNscetion]qMl)orDimmor3ofdxBusiKssuditlestlomCade_and mylcenau
INSTL 1 SET CHNL LTRS INTNLY ILMNTD BY
H ease metWerceu� Us.a ^^L
? License Class C 4
L
LEDLIGHTNG, LTRS ARE 2'4" HEIGHT&1/2" THCK ACRYLIC
'p Dae p ARCHITECTS DDECLARATI N
FAC&BLK RETURN
1 undcrsund my plus.N+ll M uxd u publlc rem is
6
U
IScensed Professional
3 OWNER-BUILDERe..DECLARATION
f 1 hereby aRrm I .Bumped from 0e Cssions ins Lkenx Law for the
on
a (Section land, Budncss and Professions Cade: My city or
O fallowing 1
der, impmw, demolish. fie any nmctent
which Rquirus permit m omme
rueful.
issuance. uimds he a sig
y priorm its endpursunt to the the of for such pertor's fticasLaw aaemcm
thnhc is licensed pursuant to the the Comranoarrllaense4w(Chapav9
Sq. Ft. Floor Area
Valuation
(u Of Dis hu0)r
codc)ted
of the Bualncssand Proon.
crumig pet
$6500
.2 t W In
ft basis for Any
and exemption. Any NUI+Oun of
u esemp therefrom and the bur for the of
Nn doter.
3 5908018� Number
Occupancy e
P Y�'P
subjectsthe
io arty applicants fon a permit mbjecu the appllunl m a civil pmdty of
Seton ID313
wy
ml wort than fiw haddRd dollam (S5W).
❑ i,uowrerofthepmpenymmYeraploycuwithwgau Neirxlecompenndon,
Required Inspections
d1C m
aMtlnWlensor Lawdoror+ala($CC. Of
he Ci
and code The Conase70rs License law dam not apply 70 an awrcr
and Pr lle slum Co
_
is
property who Wo ugh his
wpenrwyees,
twmmkAimselfm
pdaonimpmwch unpr vemmus.whoclanot maRered for Mall,
Own smhimissold our
wthvenal
lmwnM.lme Wilding imp o(cded
hunkler Ne buil dingaimpmmovinmold withinoroyear of comPkuon. the owrcsf
builder MB Nw Ue burdut of poring Nat K tli0 Out build or improve for purpose 0)r
sale.).
❑ 1, as ownm of the pmpeny, w uclusinlY conhxdng wild Ecessed mnlncmu to
wuwct the Mjm (Sec. ]OSA, Budden and Pmfuetiom Cade) The Covuxmfs LI.
mus Law does not apply in an owner of property who Wilds of Impmwa thsomtr, and
who comom forsuch projects with a comm r(U Iicatsed purnunt to the Comme70r','
License law.
lamexemptummor Sett .B&PCfuthismason
re Dslc
WORKERS COMPENSATION DECLARATION
I hereby affirm under prsulty of perjury ore of 070 following declamations:
❑ T haw wEl dtdna Se Ceru3ue ofConse Wortrra
of
utron, u provided for Laborthe ce the
Section 3'!Oo of 00) labor Code, for the perfamtanee of the
pet Code,
mi
work far which Ni, pemtids is is,uM
I nave and will mdmain WarWs Compawuan Indvance. as required by Section
37W.fthe labor Code, for the pedmmanc.or Ute wort for which this permit is issue&
'
My Worker's Compensation lnasurana�^carrier and Policy number art:
Carrier. 5;W'?
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
Mm section reed the completed Ifthe Permit is, foram hundred dollars ($I00)
nr ku)
1 comfy thus in Ue Mr.. or the wart For which this permit is iaseod, I shall ml
.raploy myperxn I. any manrer m as to become subject 70 th. WortG,'Gampe11ea0W
Laws of Celifomia. Date
-
Applicant
NOTICE TO APPLICANT. If, aver making dust Cenifinte of Exemption, you should
bawd. mbjem m the Wortera Compemid. pmvisioM of the lalmr Cade, you must
Oforthwith comply with such provisiom or this Permit hall be dmmcd re hied.
h CONSTRUCTION LENDING AGENCY
I hereby affnm due mem r+ eomuuction lending agenry, for the terim once or
.
.. the work for which this permit r issued (Son. 3097, Civ. C.)
-
r, Landers Name
Z 4n&es Address
1 cedry that I have Rad this application and rule than the anew id ..do. r
c rmoct 1 siren m comply wind dl city and county on imdecs and sate laws relating in
r% wildi....nswetion,andherebydolumsereprOsomvesofthincitytonowuponthe
+ItovC-menuoned for inspermav
property purpowhich
y (We) agree m saw. indemnify and kap harmless the City Cupertino
of against
A ospenmsmay in any way acm0)agalnusdd City
incoium,jed.oftheconseg
of thegranting of this Permit.
A APPLICANT
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
Issued by: 1
��
SOURCE
/ `^!/ W�/ Date z
RE DNS.
Re -roofs
Type Of Roof
moi
$1gnnYR 0)r AppllC]rl ama.mf Dam
US TERIALS DISCLOSURE
WTIIy ccupom erre mmaerid
future buildinge.cupanlvoreofand
tapplicantor
Bred the Cupertino Municipal Code. chapter 9.@. +M Ue Health and Safety
Health
Section e�STu')] �
El Yen Ne
All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipment Or dedces which
If a roof is installed without first obtaining an inspection, I agree to remove
emit hoodeldm no eundermads u defined by the Bay Amo Air Quality Management
all new materials for inspection.
P
Dismetl
❑Yes
I haw read thc hardmi—ro ed-ls requiRmctm muter Ch merd.95 of the calif.,.
-in Hulm&S fs,yCade, Sect 23505,25533 am125534. Itmeersand thuifNc building
does not currently haw 0).4 mads it is my responsibility to merry, the ocument of me
Rquiremenu which most 70 met prior at issuvtcc of a Cutiftmm of Occupord,
Signature of Applicant Date
_/ _o
All roof coverings to be Class '%W' or better
Ownera ori, Into 7070