12060087CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20750 STEVENS CREEK BLVD
CONTRACTOR: VIKING SIGN
PERMIT NO: 12060087
INSTALLATIONS
OWNER'S NAME: BYER PROPERTIES LP
1164 BESSEMER AVE APT 1
DATE ISSUED: 06/14/2012
OWNER'S PHONE: 4156262937
MANTE CA, CA 95337
PHONE NO: (209) 239-3339
❑ --LICENSED -L-ICENSED CONTRACTOR'S DECLARATION
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BUILDING PERMIT INFO: BLDG ELECT' PLUMB
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License { l s
1\ -,
Contractor' - ' Date �P `► 01—
MECH RESIDENTIAL COMMERCIAL
I hereby of it m t I a ice d� t er th provisions of Chapter 9
JOB DESCRIPTION: THE ISLANDS - INSTALL 3 INTERNAL, I EXTERNAL
(commencing-wi i ed r 7600) of ►vision 3 of the Business & Professions
ILLUMINATED SIGNS
Code and that my license is in full force and effect.
I 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: $9500
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.
APN Number: 35908013.00
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 eypenses�h h' may accrue against said City in consequence of the
180 DAYS FROM LAST CALLED INSPECTION.
granting.of`this permit. ddi 'Dually, the applicant understands and will comply
with aJl non -point so gulati s, er t c upertino Municipal Code, Section
9.18. (l
Issued bye — Date:y—�l
//
Signat�r Date
❑ OWN , BUI ER DECLARATION
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
I 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.
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,
Signature of Applicant: Date:
Business & Professions Code)
I, 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
I hereby affirm under penalty of perjury one of the following three
declarations:
HAZARDOUS MATERIALS DISCLOSURE
I 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
District I
permit is issued.
cppritaminants asd cared by the Bay Area Air Quality Management will
finaintain complia c wit th��Cup re fo 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 & Safe_ e, S ions255Q5, 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 rize'` en
become subject to the Worker's Compensation provisions of the Labor Code, I must
! Date: 41�
forthwith comply with such provisions or this permit shall be deemed revoked.
UCTION LENDING AGENCY
APPLICANT CERTIFICATION
I hereby affirm that there is a construction lending agency for the performance of Nwrk'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
1 W-0 FEE ESTIMATOR — BUILDING DIVISION
iaADDRESS:
20750 SCB
DATE: 06/14/2012
REVIEWED BY: Sylvia
APN:
BP#:
*VALUATION: w500
PERMIT TYPE: Building Permit
PLaAr C/11sc7i TYT E:
PRIMARY
USE: Sign
PENTAMATION
PERMIT TYPE: 1 CEAP
woRlc
The Islands- install 3 internal 1 external illuminated signs
SCOPE
SIGN TYPE
FEE ID
QTY
SIGN FEE
Wall Sign, Electric
1SIGNWELEC
4
$1,040
TOTALS:
$1,040.00
A-l"'ch. Plan ('heck
Plw;)b. Plate Cbeck
# Branch Circuits 1 $44.00
ri,fecli. Perl)?ii Fee'•
1,111 b. Pe�ml Tee:
IESIGN Elec. Permit Fee: 1EPERMIT
t)rhe, Alech, 7,r.�h.
DiIwr P/rri,�b 7,�.tP.
Other Elea Insp. 0.0 $44.00
A'lcch' lap. Fee'
PFrnub. lav), Fee:
Elec. Insp. Fee:
NOTE: This estimate does not include fees due to other Departments (i.e. Planting, Public Works, Fire, Sanitary Sewer District, School
District. etc). These fees are based on the vrelintinary information available and are only an estimate. Contact the Devt for addn'I into.
FEE ITEMS (Fee Resolution 11-053 Ef : 7f 11111)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
i
Suppl. PC Fee: (S) Reg. 0 OT
0.0
hrs
$0.00
Plrill rh.IjIjech./Elec
Permit Fee:
$1,040.00
Suppl. Insp. Fee:Q Reg. 0 OT
p p
hrs
$0.00
PME Unit Fee:
$44.00
PME Permit Fee:
$44.00
—F—T
Coirsiruclion Tax'
Work Without Permit? 0 Yes (j) No
$0.00
Sign Master Plan: 0 Yes 0 No
$0.00
Travel Documentation Fee: ITRAVDOC
$44.00
Strong Motion Fee: IBSEISMICO
$2.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC 1
$1.00
SUBTOTALS;`
$1,175.00
$0.00 TOTAL FEE:
I $1,175.00
Revised: 06/05/2012