B-2016-1842 •
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1842
10869 N WOLFE RD CUPERTINO,CA 95014-0614(316 05 052) ARROW SIGN CO
OA
4436
OWNER'S NAME: CUPERTINO DATE ISSUED:06/29/2016
•
OWNER'S PHONE:650-946-9503 PHONE NO:(510)533-7693
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-45 Lic.#314794
Contractor ARROW SIGN CO Date 10/31/2018 X BLDG _ELECT _PLUMB •
MECH RESIDENTIAL X COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
9 FREE STANDING MONUMENT SIGNS(CUPERTINO VILLAGE).
I hereby affirm under penalty of perjury one of the following two declarations: ELECTRICAL UNDER SEPARATE PERMIT.
a. 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 REV#1 (1/18/17)RELOCATE(2)SIGNS;CHANGE FOOTING DETAIL
'Jerformance of the work for which this permit is issued. -ISSUED 1/26/2017
I have and will-maintain Worker's Compensation Insurance,as provided for by REV#2 CHANGE TO STRUCTURAL FOOTING-ISSUED 11/16/2017
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$164506.00
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 316 05 052 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 regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
i tDate 11/16/2017 Issued by:Abby Ayende
Date:06/29/2016
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
t. I,las 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.
sale(Sec.7044,Business&Professions Code)
2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date: 11/16/2017
•
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
a. 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 which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials 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. I will
permit is issued.' maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Health&Safety Code,Section 25532(a)should I store or handle hazardous
• a. I certify that in the performance of the work for which this permit is issued,I material. Additionally,should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensatio ia. 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,Sections 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
•
be deemed revoked. • er or authorized agent:
APPLICANT CERTIFICATION ate:11/16/2017
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,Civ 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 DECLARATION
Code,Section 9.18. 1 I understand my plans shall be used as public records. '
•
•
Licensed
Signature Date 11/16/2017 Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1842
10869 N WOLFE RD CUPERTINO, CA 95014-0614 4-0614 (316 05 052) ARROW SIGN CO
OAKLAND, CA 94601-
4436
OWNER'S NAME:
OWNER'S PHONE:
LICENSED CONTRACTOR'S DECLARATION
License Class C-45 Lic. , 14794
Contractor ARROW SIGN CO Date 10/31/2018
I hereby affirm that I am licensed under the provisions of Chapter 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:
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 of the work for which this permit is issued.
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
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application.and state that the above
information is correct. 1 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 indemnify and keep harmless the
City of Cupertino against liabilities, judgments, costs, and expenses which
may accr st sarlpily in consequence of the granting of this permit.
Additi
upertino Municipal Code, Section 9.18.
Date 1/26/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
t. 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)
2. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
[ hereby affirm under penalty of perjury one of the following three declarations:
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 of the work for which this permit is issued.
2. 1 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
permit is issued.
3. 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, atter making this certificate of
exemption, I become subject to the Worker's Compensation provisions of the
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
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 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 indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
Signature Date 1/26/2017
DATE ISSUED: 06/29/2016
NO: (510) 533-7693
PERMIT INFO:
BLDG —ELECT —PLUMB
MECH _ RESIDENTIAL X COMMERCIAL
JOB DESCRIPTION:
9 FREE STANDING MONUMENT SIGNS (CUPERTINO VILLAGE).
ELECTRICAL UNDER SEPARATE PERMFF.
REV # 1 (1/18/17) RELOCATE (2) SIGNS; CHANGE FOOTING DETAIL
- ISSUED 1/26/2017
Ft Floor Area: I Valuation: $164506.00
APN Number: Occupancy Type:
316 05 052 1 A'(Tenant Improvements)
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Abby Ay—ende
RE -ROOFS:
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.
Signature of Applicant:
Date: 1/26/2017
TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as
Date: 1/26/2017
CONSTRUCTION LENDING At ENCY
1 hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
1 understand my plans shall be used as public records.
Licensed
Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1842
10869 N WOLFE RD CUPERTINO, CA 95014-0614 (316 05 052)
ARROW SIGN CO
OAKLAND, CA 94601-
4436
OWNER'S NAME:
DATE ISSUED: 06/29/2016
OWNER'S PHONE:
PHONE NO: (510) 533-7693
LICENSED CONTRACTOR'S DECLARATION A_RATION
BUILDING PERMIT INFO:
License Class CONVEYORS - CRANES HOISTING EQUIPMENT DOCK
X BLDG —ELECT _PLUMB
LEVELERS, MATERIAL Lic. #314794
ContractorARROW SIGN CO Date 10/31/2016
MECH_RESIDENTIAL X COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business & Professions Code and that my
JOB DESCRIPTION:
license is in full force and effect.
9 FREE STANDING MONUMENT SIGNS (CUPERTINO
VILLAGE).
ELECTRICAL UNDER SEPARATE PERMIT.
I hereby affirmunder penalty of perjury one of the following two declarations:
i. 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 which this permit is issued.
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
Sq. Ft Floor Area:
Valuation: $164506.00
permit is issued.
APPLICANT CERTIFICATION
ATN Number:
Occupancy Type:
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
316 05 052
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 indemnify and keep harmless the
PERMIT EXPIRES IF WORK IS NOT
STARTED
City of Cupertino against liabilities, judgments, costs, and expenses which
may accrue against said City in consequence of the granting of this permit.
WITHIN 180 DAYS OF PERMIT ISSUANCE
OR
Additio
�-�-- Date 6-29-116
Issued by SEANHATCHSignature
Date: 06/29/2016 7 v h
OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of the
All roofs shall be inspected prior to any roofing material be
g installed. If a roof is
following two reasons:
installed without first obtaining an inspection, I agree to remi
ive all new materials for
r. I, as owner of the property, or my employees with wages as their sole
inspection.
compensation, will do the work, and the structure is not intended or offered for
sale (Sec.7044, Business & Professions Code)
Signature of Applicant:
2. I, as owner of the property, am exclusively contracting with licensed
Date: 6-29-16
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A"
OR BETTER
r. 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
HAZARDOUS MATERIALS DISCLOSURE
performance of the work for which this permit is issued.
I have read the hazardous materials requirements under
Chapter 6.95 of the
2. -I have and will maintain Worker's Compensation Insurance, as provided for by
California Health & Safety Code, Sections 25505, 25533,
and 25534. I will
Section 3700 of the Labor Code, for the performance of the work for which this
maintain compliance with the Cupertino Municipal Cod(,
Chapter 9.12 and the
permit is issued.
Health & Safety Code, Section 25532(a) should I store
or handle hazardous
3. I certify that in the performance of the work for which this permit is issued, I
material. Additionally, should I use equipment or device
which emit hazardous
shall not employ any person in any manner so as to become subject to the
air contaminants as define
APPLICANT CERTIFICATION
CONSTRUCTION ENDINAGEAGEN
CY
I certify that I have read this application and state that the above information is
I hereby affirm that there is a construction lending agency
for the performance
correct. I agree to comply with all city and county ordinances and state laws
of works for which this permit is issued (Sec. 3097, Civ
C.)
relating to building construction, and hereby authorize representatives of this city
Lender's Name
to enter upon the above mentioned property for inspection purposes. (We) agree
to save indemnify and keep harmless the City of Cupertino against liabilities,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
ARCIIITECTIS DE LARA TIO
and will comply with all non-point source regulations per the Cupertino Municipal
I understand my plans shall be used as public records.
Code, Section 9.18.
Licensed
Professional
Signature Date 6-29-16
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1842
10869 N WOLFE RD CUPERTINO,CA 95014-0614(316 05 052) ARROW SIGN CO
OAKLAND,CA 94601-
4436
OWNER'S NAME: DATE ISSUED:06/29/2016
OWNER'S PHONE: PHONE NO:(510)533-7693
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class CONVEYORS-CRANES. HOISTING EQUIPMENT,DOCK
LEVELERS,MATERIAL Lic.#314794 X BLDG —ELECT —PLUMB
Contractor ARROW SIGN CO Date 10/31/2018 MECH_RESIDENTIAL X COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing
with Section 7000)of Division 3 of the Business&Professions Code and that my JOB DESCRIPTION:
license is in full force and effect. 9 FREE STANDING MONUMENT SIGNS(CUPERTINO VILLAGE).
ELECTRICAL UNDER SEPARATE PERMIT.
I hereby affirm under penalty of perjury one of the following two declarations:
have and will maintain Worker's Compensation Insurance,as provided for by REV#3 MOVE(2)FREE STANDING ILLUMINATED MONUMENT
Section 3700 of the Labor Code,for the performance of the work for which this SIGNS TO NEW LOCATIONS;CHANGE FOOTINGS ON(2)FREE
permit is issued. STANDING ILLUMINATED MONUMENT SIGNS;REMOVE SIGN
APPLICANT CERTIFICATION AB2 FROM SCOPE OF WORK-ISSUED 3/18/19
1 certify that I have read this application and state that the above Valuation $164506.00
information is correct. I agree to comply with all city and county ordinances Sq.Ft Floor Area:
and state laws relating to building construction,and hereby authorize
representatives of this city to enter upon the above mentioned property for APN Number: Accu anc p y Type:
inspection purposes. (We)agree to save indemnify and keep harmless the
31605052 A(Tenant Improvements)
City of Cupertino against liabilities,judgments,costs,and expenses which
may accrue against said City in consequence of the granting of this permit.
Additionally,the applicant understands and will comply with all non-point
source regulations
3/18/19 180 DAYS FROM LAST CALLED INSPECTION.
OWNER-BUILDER DECLARATION Issued by:Abby A,ende
I hereby affirm that I am exempt from the Contractor's License Law for one of the Date:06/29/2016
following two reasons:
i. I,as owner of the property,or my employees with wages as their sole
RE-ROOFS:
compensation,will do the work,and the structure is not intended or offered for All roofs shall be inspected prior to any roofing material being installed.If a roof is
sale(Sec.7044,Business&Professions Code) installed without first obtaining an inspection,I agree to remove all new materials for
2. I,as owner of the property,am exclusively contracting with licensed inspection.
contractors to construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations: Signature of Applicant:
i. I have and will maintain a Certificate of Consent to self-insure for Worker's Date:3/18/19
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
2. 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 HAZARDOUS MATERIALS DISCLOSURE
permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
3. I certify that in the performance of the work for which this permit is issued,I California Health&Safety Code,Sections 25505,25533,and 25534. I will
shall not employ any person in any manner so as to become subject to the maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Worker's Compensation laws of California. If,after making this certificate of Health&Safety Code,Section 25532(a)should I store or handle hazardous
exemption,I become subject to the Worker's Compensation provisions of the material. Additionally,should I use equipment or devices which emit hazardous
Labor Code,I must forthwith comply with such provisions or this permit shall air contaminants as defined by the Bay Area Air Quality Management District I
be deemed revoked. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
the Health&Safety
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is ,
Owner or authorized agent:
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 Date:3/18/19
to enter upon the above mentioned property for inspection purposes. (We)agree CONSTRUCTION LENDING AGENCY
hereby affirm that there is a construction lending agency for the performance
to save indemnify and keep harmless the City of Cupertino against liabilities, of work's for which this permit is issued(Sec.3097,Civ C.)
judgments,costs,and expenses which may accrue against said City in Lender's Name
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal Lender's Address
Code,Section 9.18.
ARCHITECT'S DECLARATION
Signature Date 3/18/19 1 understand my plans shall be used as public records.