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12050215CITY OF CUPERTINO BUILDING PERMIT I I BUILDING ADDRESS: 10101 N WOLFE RD I CONTRACTOR: RAGO NEON I PERMITNO: 12050215 1 I OWN'ER'S NAME: SEARS ROEBUCK AND CO 1 235 LAUREL AVE, I DATE ISSUED: 05/30/2012 1 OWN'ER'S PHONE: 8472867538 TAT LICENSED CONTRACTOR'S DECLARATION /ILicense Class Lic. N -5'R S 6 2-y Contractor Date I hereby affirm tat 1 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. 1 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 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. QAV 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. �r► Signatu Date ❑ OWNER -BUILDER DECLARA'T'ION 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: I, 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 construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under penalty of perjury one of the following three 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 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. I certify that in the performance of the work for which this permit is issued, l 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. 1 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 HAYWARD, CA 94541 PHONE; NO: (510) 537-1903 BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH r RESIDENTIAL r COMMERCIAL JOB DESCRIPTION: SEARS - INSTALLATION OP THREE (3) INTERNALLY ILLUMINATED CHANNEL LETTER SIGNS READING "SEARS" 8/14/12 REVISION 91 ADD BACKER TO PREVIOUSLY PERMrrrED SIGN ON FIRS f & GROUND FLOORS, ADD WALL. MOUNTED SEARS SIGN TO PARKING ENTRANCE -ISSUED 8/14/12 Sq. Ft Floor Area: I Valuation: $7500 APN Number: 31620080.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAY RO LAST CALLED INSPEPCTION. Issued by: Date: RE -ROOFS: All roofs shall be inspected prior to any rooting material being installed. Ira roof is installed without first obtaining an inspection, I agree to remove all new materials Ibr inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETI'ER HAZARDOUS MATERIALS DISCLOSURE. 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should 1 store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance ol'work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professiona CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10101 N WOLFE RD CONTRACTOR: RAGO NEON PERMIT NO: 12050215 OWNER'S NAME: SEARS ROEBUCK AND CO 235 LAUREL AVE DATE ISSUED: 05/30/2012 OWNER'S PHONE: 8472867538 HAYWARD, CA 94541 PHONE NO: (510) 537-1903 ❑ LICENSED CONTRACTOR'S DECLARATIONF F BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class CLK- Lie. M 31 !� L ZZ) MECH i RESIDENTIAL r— COMMERCIAL Contractor FoRd Joan. kAe Date 1 hereby affirm t t 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION: SEARS - INSTALLATION OF THREE (3) INTERNALLY (commencing with Section 7000) of Division 3 of the Business & Professions ILLUMINATED CHANNEL LETTER SIGNS READING "SEARS" Code and that my license is in full force and effect. 1 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 which this permit is issued. Sq. Ft Floor Area: Valuation: $7500 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. APN Number: 31620080.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs, and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. 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. _ Issued by: Date: 30 l� Signatur�.0Date _JC9N%G� ❑ OWNER -BUILDER DECLARATION RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is 1 hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection, I agree to remove all new materials for the following two reasons: inspection. I, 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, Signature of Applicant: Date: Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1 hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 1 have and will maintain a Certificate of Consent to self -insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation, as provided for by Section 3700 of the Labor Code, for the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & I have and will maintain Worker's Compensation Insurance, as provided for by Safety Code, Section 25532(a) should I store or handle hazardous material. Section 3700 of the Labor Code, for the performance of the work for which this Additionally, should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued, I shall Health & Safety Code, Sections 25505, 25533, and 25534. 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 Ow CDP become subject to the Worker's Compensation provisions of the Labor Code, I must Date:0?Z forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of "ork's I certify that I have read this application and state that the above information is for which this permit is issued (Sec. 3097, Civ C.) correct. I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save Lender's Address 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 ARCHITECT'S DECLARATION with all non -point source regulations per the Cupertino Municipal Code, Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION SIGN TYPE ADDRESS: 10101 N Wolfe Road DATE: 08/14/2012 APN: BP#: 12050215 REVIEWED BY: Sean 'VALUATION: 1$2,000 PERMIT TYPE: Building Permit I'L,4N C/l;:'(`tr' T)'I'E` PRIMARY USE: Sign IESIGN PENTAMATION PERMIT TYPE: 10EAP5 WORK Revision #1: Add backer to previouslypermitted signs on first and round floors; add wall mounted SCOPE Sears sign to parking entrance. SIGN TYPE FEE ID p1runn. Plurl C'acek QTY SIGN FEE IESIGN Wall Sign, Electric 1SIGNWELEC Elec. Permit Fee: IEPERMIT 1 (7NwrPtr�nr1>rr,,:,,. $266 p:; -...b. lriwy;. r:.t- 1'h:1)11). ru,ep. ret': F'"T.Insp. Poo: Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $45.00 PME Permit Fee: $45.00 ""Co, Work Without Permit? 0 Yes 0 No $0.00 TOTALS:}\�?aii $0.00 _ ,:.>.Y. its $266.00 .....,.>:.r �:i�" tb�. �ai7 ''i k I � • L ( ,S i•I. •fisc' r .i. .f.r'.: •7 [it / t i I ?.- \ .1:.;"r.... Z[:• -,•r .x{...s..r Vii} ��...> >I. �] �i .�- .1 •%\�/:.� rel i�j>%':�•:^•.a `::[,)�=fir.;. C•.'i� ! 7 � l I'`� T•T it �•..•, 's�'� �.�-� �rst.. rr� �.S 1?;�.. �s i ^u• r. sir.. �/.d'3%<i.`i ��:%i-'.;:i'iitit?i�;', r = n f. (Sfi it?•% ].' s:..k4 . } I£f��:� .a ..S 1 �I'( -c1 s :..'r..-_ eh r:.��..� r� L.. .e ..� : �.::t , .rG. ��i.� ^ ,:�9 ;•; i;-..1 ::4s,a C'tis,:. p1runn. Plurl C'acek # Branch Circuits 1 $45.00 IESIGN ..... .,..: !`. , . P(rwlj ,. Permf7 Fee: Elec. Permit Fee: IEPERMIT $0.00 (7NwrPtr�nr1>rr,,:,,. Other Elec. Insp. 0.0 $45.00 p:; -...b. lriwy;. r:.t- 1'h:1)11). ru,ep. ret': F'"T.Insp. Poo: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These tees are based on the nreliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/11) FEE QTY/FEE MISC ITEMS Suppl. PC Fee: Q Reg. Q OT 0.0 1 hrs $0.00 Permit Fee: $266.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $45.00 PME Permit Fee: $45.00 ""Co, Work Without Permit? 0 Yes 0 No $0.00 Sign Master Plan: 0 Yes (E) No $0.00 Travel Documentation Fee: ITRA VDOC $45.00 Strong Motion Fee: IBSEISMICO $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 ,.5 . � l..' i'J " is S,:.r':- x..ii. 1�.. �.3 "'-?. !. zri t;r ;:r:.. ���; • I ....--. ., ,... rr.., .. x•�•: -int:. .........�. w•.i..� ., .�.:=-T �....i..:...::��... .. ...........'i :...:............ r...t.::..i:...•..1. 3f.1..C.rr..n.i..,:. r....5�}.n.:i ........ 402.0 i1�: ' /3l%=: .iCi:?'. \. t1.�• ::f =-- .!, "' 0.00 ,_,.. �;�>�>:�;�:;;_�; � .... .: ., .- i`�--•i:\::1F.�.51�'r}:e:-ii::i%:..'�•.i....�.I.........�::::�i::: :�\::::... ... i.. 02. Revised: 07/01/2012 CITY OF CUPERTINO FM77, FEE ESTIMATOR - BUILDING DIVISION SIGN TYPE ADDRESS: 10101 No. Wolfe Rd DATE: 05/30/2012 REVIEWED BY: Sean # Branch Circuits 1 $44.00 APN: I BP#: *VALUATION: 1$7,500 *PERMIT TYPE: Building Permit il;7,14 tv, ("i U"( 1K T)'Ph- PRIMARY Sign USE. Car: t,h PENTAMATION 1 CEAP5 PERMIT TYPE: WORK Installation of (3) internally illuminated channel letter signs reading "Sears." SCOPE bf.qj, Teo. SIGN TYPE FEE ID QTY/FEE QTY # Branch Circuits 1 $44.00 SIGN FEE Wall Sign, Electric 1SIGNWELEC hrs 3 Car: t,h $780 Other Elec. Insp. 1 0.0 $44.00 Permit Fee: Ife,!"-q. bf.qj, Teo. 0.0 hrs $0.00 PME Unit Fee: $44.00 PME Permit Fee: $44.00 --- — -------------------- - J i Work Without Permit? 0 Yes E) No $0.00 TOTALS: $0.00 I I .............. . $780.00 Strong Motion Fee: IBSEISWCO Jf., f� % . . . . . . . . . . . . ? QTY/FEE MISC ITEMS # Branch Circuits 1 $44.00 IESIGN 0.0 hrs Elec. Permit Fee: IEPERMT Car: t,h Li Other Elec. Insp. 1 0.0 $44.00 Permit Fee: Ife,!"-q. bf.qj, Teo. NOTE: This estimate does not include fees due to other Departments (Le Planning, Public Works, Fire, Sanitary Sewer District; School District. etc). These fees are based on the Preliminary information available and are only an estimate Contact the Dent for addnl info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/11) FEE QTY/FEE MISC ITEMS Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 Permit Fee: $780.00 Suppl. Insp. Fee.0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $44.00 PME Permit Fee: $44.00 --- — -------------------- - J i Work Without Permit? 0 Yes E) No $0.00 Sign Master Plan: 0 Yes (j) No $0.00 Travel Documentation Fee: ITRAVDOC $44.00 Strong Motion Fee: IBSEISWCO $1.58 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 W� $914.581 —T—$911�.58 $0.00 Revised: 05/01/2012 CUPERTINO SIGN PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255EVISIoIY / (408) 777-3228 • FAX (408) 777-3333 • buildingecupertino.org PROJECT ADDRESS 0 I / 9' A'V I' WO rC n j �(•(� APN 11 /`n h O 0 (, O`) C OWNERNAME PHONE E-MAIL SrREEr�DD&ESS fd_?/3 Cif STATE ZIP// FAX / CONTACT NAME NE E -Mt f,V STREET ADD I f cnY' ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT 11KCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHrM T ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR q0411E LICEN NUMBER LICENSE TYPE BUS. LIC 0 COMPANY NAV, E- rX r STREET ADDRES CITY, ST ZIP 4 P r r) -no 3 ARCHrrECT/ENGTNEER NAME LICENSE NUMBER BUS, LIC 0 COMPANY NAME E-MAIL FAX SPREE[' ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK f \. ✓ d Pt n my r 4ro_c -i_4 n USE OF ❑ SM or Duplex ❑quIti-FamilP ILLUMINATED SIGN TYPE NO. OF SIGN AREA VALUATION STRUCTURE: Commercial (Y/N) (CODE) SIGNS (SQ. Fr.) (S) SIGN TYPE CODES: W p 0 U B - BANNER SIGN M - MONUME rr (GROUND) SIGN BL - BLADE SIGN P. - PROJECTING SIGN - - D - DEVELOPMENT ID SIGN SP - SPECIAL EVENT BANNER DI - DIRECTIONAL SIGN T - TENIPORARY E - ELECTRONIC W - WALL SIGN READERBOARD WI - WINDOW SIGN TOT '" I'All' . By my signature below, I certify to each of the following: I am the property owner or autnOrizeti agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description df Work and v"ify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bui c I authorize representatives of Cupertino to enter the above-identifie property for inspection purposes. oo Signature of ApplicanUAgent:� Date: SUPPLEMENTAL INFORMATION REQUIRED Site Plan Elevationsa . Sign Details - including UL listing(s) applicable T Structural Calculations (if applicable) s - _— Copy of Planning Approval Letter or Meeting with Planning p riot to submittal of Building Permit application. -• w SignApp_2011.doc revised 03/16/11