BLD-2020-0386BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 19376 STEVENS CREEK BLVD Cupertino
APN:
375 01 018
PERMIT NO: BLD-2020-0386
CONTRACTOR:
VIKING SIGN INSTALLATIONS INC, 1 164 BESSEMER AVENUE, SUITE 1 MANTECA
CONTRACTOR PHONE:
DATE ISSUED 3/12/2020 1:1 1:12 PM
ISSUED BY: HALEYM
VALUATION: $10868
JOB DESCRIPTION
(1) ILLUMINATED MONUMENT SIGN (89 SF); (2) ILLUMINATED CHANNEL LETTER SIGNS (150 SF); (8) REGULATORY POLE SIGN (2 SF); (1) DIRECTIONAL SIGN
VINYL SIGN
BANK OF AMERICA - INSTALL
(3 SF); (1) SET IDENTIFICATION/HOURS
LICENSED CONTRACTOR DECLARATION
9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
VIKING
LICENSED
C45
LICENSED
963816
EXP
09/30/2021
I hereby
force
I hereby
SIGN INSTALLATIONS INC
CLASS:
ELECTRICAL SIGNS
NO:
DATE:
affirm that I am licensed
and effect.
affirm under penatly
I have and will maintain
for which this permit
I have and will maintain
I certify that in the performance
laws of California.
with such provisions
under the provisions of Chapter
of perjury one of the following three declarations:
a certificate of consent to self -insure for
is issued.
Worker's Compensation Insurance, as provided
of the work for which this permit
If, after making this certificate of exemption,
or this permit shall be deemed revoked.
Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the
work
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
is issued, I shall not employ any person in any manner so as to become subject to the Worker's
I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith
V
issued.
Compensation
comply
HAZARDOUS MATERIALS DISCLOSURE
Chapter
& Safety
as defined
Sections
for this
6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance
I have read the hazardous materials requirements under
the Cupertino Municipal Code, Chapter 9.12 and the Health
V
with
equipment
Municipal
Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use
by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino
25505, 25533, and 25534.
project.
Firm Certification No:
or devices which emit hazardous air contaminants
Code, Chapter 9.12 and the Health & Safety Code,
An EPA Lead -Safe Certified Renovator will be responsible
Firm Name:
No EPA Lead -Safe Certified Firm is required for this project.
Certified
v
CONSTRUCTION LENDING AGENCY
lending agency for the performance of the work which this permit is issued (Section 3097, Civil Code).
Lender's Address:
I hereby
Yes
affirm
under penalty of perjury that there is a construction
No
V
Lender's
Name:
APPLICATION CERTIFICATION
information
to enter
and
is correct. I agree to comply with all city and county ordinances and state laws relating to building
upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep
expenses which may accrue against said City in consequence of the granting of this permit. Additionally,
Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 365 days after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period
of 365 days after the time the work is commenced.