B-2016-2681 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2681
20684 HOMESTEAD RD CUPERTINO,CA 95014-0451(32610 066) SIGN OF LIGHT
ROSEVILLE,CA 95678
OWNER'S NAME: SOBRATO INTERESTS 1 ETAL DATE ISSUED:0910812016
OWNER'S PHONE:408-446-0700 PHONE NO:(916)797-9445
LICENSED ONT TOR' DECLARATION BUILDING PERMIT INFO:
License Class C=10 Lie.4906191 4
Contractor SIGN OF LIGHT Date 11/30/2017 X BLDG _ELECT _PLUMB
_MECH_RESIDENTIAL X COMMERCIAL
I hereby affirm that I 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. JOB DESCRIPTION:
INSTALL 1(I)ILLUMINATED WALL SIGN-YAYOI
I hereby affirm under penalty of perjury one of the following two declarations:
1. Lhave 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.
2./ 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. Sq.Ft Floor Area: Valuation:$2500.00
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 32610 066
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 PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and will comply with all non-point
source regulatignsppr the Cupertino Municipal Code,Section 9.18. 180 DAY_ S FROM LAST CALLED INSPECTION.
r Sighature 4-<,A t D�a ' "M Date 9/8/2016 Issued by:AbbAyende
a Date:09/08/2016
OWNER-BUH;DER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
-following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for inspection.
sale(Sec.7044,Business&Professions Code)
2. 1,as owner of the property,am exclusively contracting with licensed Signature ofApplicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:9/8/2016
I hereby affirm under penalty of perjury one of the following three declarations: ALL•ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. 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. HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
a. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
material. Additionally,should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. r'
Owner or authorized�gent. -i ••--•�..-._
APPLICANT CERTIFICATION Date:9/8/2016 a
I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.)
to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLAMATION
I understand my plans shall be used as public records.
Code,Section 9.18.
Licensed
Signature Date 9/8/2016 Professional
�4_ae Z1 5 r, I I�Z_ Ulu
SIGN PERMIT AP ICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION Cjgfjj,
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333•building(?-cupertino.org
91 f6 - Iq 7,-Ci
PROJECT ADDRESS - � APN#
OWNER NAME ® PHONE
IVN E-MAIL
111i S t � "� �,� ! 6i�
STREET ADDRESS � Y, STATE,ZIP v -g FAX
1 l3{I/� yv e3�v ICA
l /�� l>r6 ? �6
CONTACT NAME PHONE - -
p e
STREET ADDRESS �. Y,STATE,ZIP FAX
i k- �
I13OWNER 13OWNER-BUILDER ® OWNERAGENT CONTRACTOR ®CONTRACTOR AGENT ® ARCHITECT ®ENGINEER ® DEVELOPER ®TENANT
CONTRACTORNAME LICENSE NUMBE LICENe2YPE� BUS.LCOMPANY NAME
` ' E �� n @ FAX
STREET ADDRESS /� CITY ,ZRIP� _ [�cif
1091. C ! —us-C-1 Ie r.. s mg/0
HON / //7"7 d`r
ARCHITECTIENGINEER NAME - LICENSE JrdR, BUS.LIC# -
.. COMPANY NAME .. IL u� �. . FAX
STREET ADDRESSPHONE p' /�
CITY,S IP=o -.i✓tli C_1 -C,Vi
DESCRIPTION OF WORK
TI�e64" aSr� fit #` LA--
USE.OF ❑. SFD or Duplex ❑ Multi-Family ILLUMINATED SIGN TYPE NO-OF SIGN AREA VALUATION
STRUCTURE: ❑ Commercial (YIN) (CODE) SIGNS
SIGN TYPE CODES: LO 941;:k7o
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
C� READERBOARD WI -WINDOW SIGN
RECEIVED BY: TOTAL VALUATION.
By my signature below,I certify to each of the following: I am the property owner or authorized agent to aJt on the property owner's behalf. I have read this
application and the information I have 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 to dmg construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant(Agent: \>i� Dater t�
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
Site Plan PLAN CHECKTYPE ROUTING SLIP
?'! _Elevations ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
Sign Details-including UL listing(s)applicable ❑ E%PREss ❑ PLANNING PLAN REVIEW
jStructural Calculations(if applicable) ❑ STANDARD ❑ OTHER:
'opy of Planning Approval Letter or Meeting with Planning prior to ❑ LARGE
bmittal of Building Permit application.
❑ MAJOR
` SignApp 2011.doc revised 0"