11030049 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19082 STEVENS CREEK BLVD CONTRACTOR:DIABLO VALLEY SIGNS PERMIT NO: 11030049
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OWNER'S NAME: UNITED POLARIS,INC. PO BOX 452 DATE ISSUED:03/16/2011
OWNER'S PHONE: 4082553999 SAN LORENZO,CA 94580 PHONE NO:(510)333-5483
LICENSED CONTRACTOR'S DECLARATION r r r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class /1'4 Lic.4 0�lo
MEC / RESIDENTIAL COMMERCIAL
Contractor '4if l�j� lei, iu ).`u _Date Sv E �G �/IGl i/77Cc�/fir!`
JOB DESCRIPTION"POT"S'Tl '=WALL SIGNAGE,INDIVIDUALLY
I hereby affirm that I am licensed under the provisions of Chapter 9 ILLUMINATED CHANNEL LETTERS @STORE FRONT
(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:
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 Sq.Ft Floor Area: Valuation:$2300
Section 3700 of the Labor Code,for the performance of the work for whicl).this
permit is issued.
APN Number:37507046.19082 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:
Signature Date "
❑ OWNER-BUILDER 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.
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)
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
HAZARDOUS MATERIALS DISCLOSURE
declarations:
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
contaminants as defined by the Bay Area Air Quality Management District I will
permit is issued. 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 Owner,o)authorized agent: w r
become subject to the Worker's Compensation provisions of the Labor Code,I must i t_ r Date
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-viork'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 ARCHITECT'S DECLARATION
granting of this permit.Additionally,the applicant understands and will comply
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
SIGN PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION y
10300 TORRE AVENUE• CUPERTINO, CA 95014-3255
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CUPERTINO (408)777-3228• FAX(408)777-3333• buildinaCa.cupert!no.org
PROJECT ADDRESS APN#
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OWNER NAME 0 �I -MAILj q
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STREET ADDRESS �, CITY, AR'E,ZIP °' FAX
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APPLICANT NAME ' `- PHONE ,_ 1 `l.y _ E-MAI1 l i
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STREET ADDRESS CITY,STATEFAX
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❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT •'E CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME I LICENSE NU BE' ` LICENSE TYP BUS.LIC#
COMPANY NAME ` E-MAIL,,k ` (l ) �/ FAX
STREET ADDRESS t CITY,S ATEeIP ' 24
//� _ PHONE (�
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ARCHITECT/ENGINEER NAME LICENSE NUMBER 0 BUS.LTC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK t ✓ r 1 ( -:. - �l j ! .,..
ham' s
USE OF BUILDING ❑ Residential Er-co-mmercial ILLUMINATED SIGN TYPE NO.OF SIGN AREA VALUATION
(Y/N) (CODE) SIGNS (SQ.FT.) (S)
SIGN TYPE CODES: ` K/ 31, - � (yao
B - BANNER SIGN M - MONUMENT(GROUND)SIGN
BL - BLADE SIGN P - PROJECTING SIGN
D - DEVELOPMENT ID SIGN SP - SPECIAL EVENT BANNER
DI - DIRECTIONAL SIGN T - TEMPORARY
E - ELECTRONIC W - WALL SIGN
READERBOARD WI - WINDOW SIGN
RECEIVED BY: : TOTAL VALUATION:
> JO
By my signature below,I certify to each of the following; I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I a e provided is correct, I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating o »Iding construction.-I""authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
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Signature of Applicant/Agent; c Date: 4)
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
Site Plan PLAN.CHECK TYPE ROUTING SLIP
Elevations ® EXPRESS I—I BUILDING PLAN REVIEW
Sign Details-including UL listing(s)applicable ❑- STANDARD I!rPLANNING PLAN REVIEW
Structural Calculations(if applicable) 1:1 ❑ OTHER:
Copy of Planning Approval Letter or Meeting With Planning prior to ❑ MAJOR
submittal of Building Permit application.
SignApp_201 1.doc revised 03/02/11
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WAPN:
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
DRESS: 19082 stvns crk blvd. DATE: 03/10/2011 REVIEWED BY: bobs.
BP#: "VALUATION: $2,300
PE: Building Permit f:.
PRIMARY Sign PENTAMATION 10EAP5
USE. PERMIT TYPE:
WORK install illuminated channel letter sign for comm. storefront.
SCOPE
SIGN TYPE FEE ID QTY SIGN FEE
Wall Sign,Electric 1SIGNWELEC 1 $253
TOTALS: 1 $253.00
#Branch Circuits 1 $42.00
IESIGN Elec.Permit Fee: IEPERMIT
Other Elea Insp. 0.0 $42.00
law, Fee: ph"U;d" b)t�,',
NOTE. These,fees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 09-05I Eff. 7/1/10) FEEQTY/FEE MISC ITEMS
f'ry) eck.77 I
Suppl.PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00
1Tf111r ::t{c 111
h(.r",i';
Permit Fee: $253.00
Suppl.Insp.Fee:O Reg. 0 OT 0.0 his $0.00
PME Unit Fee: $42.00
PME Permit Fee: $42.00
Sign Master Plan: 0 Yes E) No $0.00
Work Without Permit? 0 Yes E) No $0.00
Travel Documentation Fee: ITRAVDOC $42.00
Strom Motion Fee: 1BSEISMICO $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
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SUBTOTALS; $380.501 $0.00 TOTAL FEE:" $380.50
Revised: 01/15/2011 j
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T's :. ILLUMINATED INDIVIDUAL CHANNEL LETTERS
Approved Channel Letter Layout LETTER SECTIONLI
n INTERNALLY ILLUMINATED PAN CHANNEL LETTER
® ILLUMINATED INDIVIDUAL CHANNEL LETTERS 040ALUM. RETURN
FACE WHITE ACRYLIC 1/4"DIA.31/2"EXTERIOR SCREW STUCCO AND
RETURN : D/BRONZE (4) PER LETTER WITH#14ANCHOR i PLYWOOD WALL
TRIM CAP : 3/4"WHITE MIN.21/2"IN TO MASONRY 4"Deep X 8"H
LEDs : WHITE WITH 1/2"DIA,STAND OFF RACEWAY
DIA.
FLEXIBLE
0
GTO CABLE THRU 1l2" I
FLEXIBLE SEALTIGHT CONDUIT
DISCONNECT SWITCH o w
ILLUMINATED LOGO BOX LEDs—
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FACE RED/GREEN ACRYLIC LOW VOLTAGE POWER SUPPLY a w z
RETURN : D/BRONZE wzo
moo
40" TRIM CAP : 3/4" RED/GREEN a U
LEDs : WHITE/RED
;1-0 (-0 GAG to
NFiIOtlAL EIECINCFIt
TOTAL STORE FRONT LINEAR= 40'
TOTAL PROPOSED SIGNAGE SQ FOOTAGE = 58
Typical LED Mounting Detail not to scale
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4'4"
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P1,0"F PLANS
00 D p ®
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0 0 0
16' 3" Av0
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