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