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08040217BUILDING DIVISION PERMIT BUIL91 ApD0.E55: lyg7U5 STEVENS CREEK BLVD HENRY'S DESIGN & SIGN CO PERMIT NO. 08040217 R'S NAME: PERMIT ISSUE DATE YAMAOKA COMPANY 04/30/2008 PHONE: SANITARY NO. CONTROL NO. (408)269-0888 ARCHTIEC (ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB - MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION ]b Description o licensed under Provisof Chapter 9 (commencing 1 Malty of lmt Nu I am ion P with section 7000) of Division 7 of for Business and Proessiow Code, and my licensee CHANNEL LETTERS In full forte end effect. License Clua 1 =gZzi L1.1 n Dam Conuanor 7� ARCHf ecrs DECLARAT ON 1 underwnd my plans shall M used as public recorea Licensed Professional OWNER -BUILDER DECLARATION 1 Mrthy aRnn that I am attempt [rum the Commences License Law for 0m following mason. (Section 7071.5, Business and Plofesdow Cade: Any city or county which t mA. a Permit in conune4 alcor, improve, demolish, or repair any swmurt Prior in its iou tr m. alts requires the applicant forsuch permit m file a signed ummcnt that M m licensed mlire n or the contractor's U== Law(ehapter9 Sq. Ft. Floor Area Valuation pursuant provisiom 2700 Rear encingoes.{ with sdmi 1000) of Division S of the Business and Rofcsimts Cod u or that he Is eWnpt uCmfmm Nd VC Wam far the alleged caenlpdpL Any Aol.d. of W LT Occupancy Type Section 7@31.5 by airy applicant fora permit subjects the Applicant to • civil Penalty Ofumber tet come than five hundred dollm (500). 31620083 . Q I,nw oratepmpcny,mmyemployeewithwagesudohtomcmnpenseumi, Required Inspections willdc, Newark and the uuctum m rot Gunned orolficam forsake (Sec. RN4, Badtm and Profession Cade The Camraclor's License taw does net apply m an owner of property who Mildsorimprovee thercan.andwho dues suchworkhi amifor Waugh his own employers, provided that such imprawmms..at intended oraRered fmsma. If. however, the building or Improvement lasold within am year ofcompletion. the Owner. ' builder will Mve the burden of proving that he did not Mid or Improve for purpose of um.). Q L as Owner of the Property, am mGusively contracting with licensed contract. to construct the project (Sec. 7044. Bummers and Profcsalons Cade:) The Conuaemr's U. coma Law docs ani apply to in owner Of propemy who builds or improves Merton. and whocontracu nonsuch projects with •contracmRa) licensed pursuant m the Combactoes License Law. am umapl undo See s B k P C far Nb reason Data WORKER'S COMPENSATION DECLARATION 1 thereby affirm under pmairy of perjury one of the following declarauan: VMve and will mmnuin a Cault Of Consent m self -inure fm WorkefaCompn- se mi, u provided fan by section 37M of the Labor Cann. far the performance of tM work for which this permit in lensed. ❑ 1 Mve and will mainuie WorkeYs Compewtion Ituur . as u q.tred by Section 3700.17ft lsbm Come far the pedo.. Of the work for which this Permit is cooed. . My Waimea Compoutiom Werarum carrier and Policy mouser art: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE rntGsectlmi need nottecompleted Ban permit la formic hundred dollen ($100) or mss) 1 ceNfy Net In the Performance of use wart for which this Permit is hound, l shall not employ anyPesaan In any man �mMcome sebjwID the Worken'Comprnntlan In mct� a�c!Msubjcct LawnofnyNnal NO ICEtTO APPUCANrS If, 1 n= 2 m7Cenil%lR e(.GcmPuan, you mould become subject in the workers Compmadon pmv sho, of lite Mbar Codc, you mum foMwith comply with inch proviainn or this Permit shall be demand rocked. CONSTRUCTION LENDING AGENCY I thereby affirm that then U n construction landing agency far do performance of sire work for which th s pomp Is issued (Sec. 3097, Civ. C) Leader's Name Lermea Address 1 cattily that 1 have rod this application and sum that the aMve Information Is comm 1 agree an comply Mut an city and county ordinances and sum laws reading m building construction. atW hereby osmesis rtpresmutives of this City m seta upon f above -menu med Property for inspection Purport - (WO) agree to save indemnify and keep harmless site City of Cupertino againn Ilabilidn.jud{menu. cam and erpemu which may in any way scone against said City in consegwnce of the swung of this Permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date—// SOURCE RECULATI Re -roofs Type of Roof Signature of App lcant/Cantrecmr Dem HAZARDOUS MATERIALS DISCLOSURE WIII do apPlieant ver fattens building aceupanl antro orhannla harallow maurid fined by the Copanine Municipal Com, Chapter 9.13, and the Health and Safety Sec0 an zs53z(.)7 ❑Yn 14No All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove WIII the applicant or future building occupant lire equipment or mvicea which colt havANous dr contaminants as defied by the Bay Ama Air Quailty Management all new materials for inspection. District? ❑Yes flu I have read timhuaNausO daUmquimmrmmummr Chaplcr6.95ofWCalifor- nWli,A]"Saimy Cam,Smtiw355I15.25533and2553d.lur4.0 WmmifNc Gilding does Out currently ban a 4YIanl that it 4 my responsibility m wily dC accupanl of dC rt mmmenm which mull be met pion he a f. Caditnmaroceulraney. Signature of Applicant Date All roof coverings to be Class'¢" or better Owner or authmind agent Dam CITY OF CUPERTINO BUILDING DIVISION PERMIT CVT'It�iCTC1RItR1it1OiN, :a BUILDING ADDRESS: 19705 STEVENS CREEK BLVD HENRY'S DESIGN & SIGN CO PERMIT NO. 08040217 OWNER'S NAME: PERMIT ISSUE DATE YAMAOKA COMPANY 04/30/2008 PHONE: SANITARY NO. CONTROL NO. (408)269-0888 ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION I hereby licensed Chapter 9 Job Description p affirm that I am under provisions of (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is CHANNEL LETTERS S IZ,,`7 in full force and effect License Class ^ r Lie. k 0 Date 6 Contractor ARCHITECTS DECLARATION I understand my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractors License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 Sq. Ft. Floor AreaValuation (commencing with Section 7000) of Division 3 of the Business and Professions Code) or $2700 that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of �pj�j_Number L Occupancy Type P Y not more than five hundred dollars (5500). 31620083 .`1i1�� YP ❑ 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, Business Required Inspections and Professions Code: The Contractors License Law dors not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner - builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:) The Contractor's Li- cense Law docs not apply to an owner of property who builds or improves themon, and , who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. ❑ I am exempt under Sec , B & P C for this mason Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: have and will maintain a Certificate of Consent to self-insum for Workers Compen- satton, as provided for by Section 3700 of rhe Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Codc, for the performance of the work for which this permit is issued. ' My Worker's Compensation Insurance carrier and Policy number am: . Cartier. Polity No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (3 100) or less.) 1 cenifv that in the performance of the work for which this permit is issued, I shall not employ any person in any man r1e soda to become subjtY the Workers Compensation Y– Laws of Californf Datc � --� — B Applicant 7 NOTICE TO APPLICA . If, atter ng fhrs cThRea mpuon, you should become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.) Lender's Name Lenders Address ' 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 in any way accrue against said City in consequence of the gtaming of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT [� Issued by: Date SOURCE REGULATI Re -roofs SignazureofApplicanVContractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant stom or handle hazardous material as defined by the Cupertino Municipal Codc, Chapter 9. 12. and the Health and Safety Code, Section es 25532(a)? Yes Qd No All roofs shall be inspected prior to any roofing material being installed. Will If a roof is installed without first obtaining an inspection, I agree to remove the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑ YC 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&SatctyCode,Scctions25505.25533and 25534.1understand that ifthc building does not currently have a tenant that it is my responsihilfty to notify the occupant of the requirements which must be met prior to issuance of a Certificate of Occupancy. Signature of Applicant Date t � 14 All roof coveringso be Class".. ., or better Owner or authorized agent Date � CITY OF CUPERTINO SIGN CUPEI�IFINO PERMIT APPLICATION FORM APN # (,,) Date: Building Address: I gjo5 S 11 v H 5 Cl��=�1� B w9, Mllf*Mo, rA Mailing Address (if different from building address): . 10m �,uu-m-, kVA 16o CUV'�KTO� , (4_ J Owner's Name: ,4 CZj Phone #: 3 Contractor: }j r �` ISS r�l\1 /' Phone #: q g Fax #: Contractor License #: Cupertino Business License #: \ 71�- �� o Contact: Phone #: �{ o g 3 6$ X 0 "l U- q ) Fax #: �09 �-� 6 Py Building Permit Info: Bldg �. Elect Monument ❑ Mounted on Building Residential ❑ Commercial Job Description: Valuation (cost of project): Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set & the sheet index. CITY OF CUPERTINO ZSIGN OF CUPEVIINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit 'Type 1SIGNDIRECT Directional B 1SIGN/RF Ground/Roof/Projecting Signs B 1 SIGNMASCK Master Plan Sign Check B 1 SIGNREWRKG Rework of any existing Ground Sign B 1 SIGNOTHER Other Sign B 1 SIGNREINSP Re -inspection Fee B 1 SIGNWNONEL Wall/Awning Sign, Non- Electric B _ 1 SIGNWELEC Wall, Electric E IESIGN Sign, Outline Lighting. System or Marquee supplied from one branch E 10EAP5 IESIGNADD Additional Branch Circuit on Same Sign, Outline System or Marquee E 10EAP6 1 ELCPLNCK Plan Check Fee E EPERMITFEE Electric Permit Fee E / BSEISMICOM Seismic Commercial B BSEISMICRE Seismic Residential B TRAVDOC Travel & Documentation B f BUSLIC Business License B 5 1 CITY OF CUPEQ'INO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: 9 ) , PERMIT # OWNER'S NAME: PHONE # -fe-o a 0 8 8 GENERAL CONTRACTOR: FAX # <-. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: Owner/ Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork ar Cement Finishing Electrical S� 'S s> Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/ Contractor Signature Date File Edit Actions Details Links Favorites Help JW 4 Permit Number " 08040217 APN 31620083.DNTL NO INPSECTIONS ^f Overrides Status F E - Expired Unit Master Number FILMED 5/2011 Notes 0 e Project Fees Apply Date " 04/30/2008 Operator patg Permit Issue Date 04/30/2008 Operator patg yl...� Inspections Address Certificate Issued Operator Certificate Type I� Print Permit CitylState/Zip Certificate Number Adjustments Permit x Property Zoning Applicant Contractor x Defined Fields Permit Details Permit Type " 1 CEAP5 QI SIGNS, OUTLINE LIGHTING & MARQ Usage Class x N/A IQI NON APPLICABLE Applied Value x 2700 SQUARE FT. 0 Calculated Value 0 ISI US C-404 Type 437 IQI ALT: NON -RES, NON-HSKPG Permit Form " AUTOPERM - PERMIT Ownership I 1 - Private f Project Size Permit issued 0413012008 Enter the purpose or any special conditions for this permit Address x I 19705 STEVENS CREEK BLVD I a/OK City/State/Zip CUPERTINO CA 95014 I4* Back APN 31620083.DNTL NO INPSECTIONS ^f Overrides PERMIT EXPIRED 10/30/08 Jr- Contractors Unit Supplement FILMED 5/2011 Fees Attachment: (Owner Name xI YAMAOKA COMPANY (;,Plan Review Use Default yl...� Inspections Address Other - 20200 LUCILLE AVE #60 I� Print Permit CitylState/Zip CUPERTINO CA 95014 Adjustments Purpose/Special Conditions L:opy Hermit ILLUMINATING SIGN CHANNEL LETTERS I Close Permi NO INPSECTIONS ^f Overrides PERMIT EXPIRED 10/30/08 Supplement FILMED 5/2011 Notes Attachment: ILW' -- - -.--.. .