01060173 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS'. PERMIT NO.
20300 STEVENS CREEK BLVD STOP SIGNS INC 01060173
OWNER'S NAME: APPLICATION SUB DATE
SYMANTEC 3193 BELICK ST 37 06/29/2001
PHONE: (408) 988-7867 SANITARY NO, CONTROL NO,
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woo ARC HITECIENGINEER: BUILDING PERMIT INFO
to— BLDG ELECT PLUMB MECH
,cut L -1 1._I I___I CI
Z S vols j CONTRACTOR LICENSED CORACTOR'S DECLARATION Job Description
c i_G 1 hereby affirm an,I am licensed under provisions of Chapter (commencing
a, simIdiun70001ufDirisiun3oftheBusinessunJrae,.imp 'ewe.andmylicen=< HALO CHANNEL LETTERS
a Y Lech full force amt<B _ (
case z License Class Lic.ro SSL F�
3 i Datc Comrucmr
v. ARCH R'S DECL A ON
xg I undcmund my plans shall be used as pub is retold
or are—.7 O Licensed Pndessione.
OWNER-BUILDER DECLARATION
w 1 hereby affirm that I a empt from the Contractor's License Law for the
z< following«amt.(Section 7031 5.Business and Profession,Code'.Any city or cannt,, $10000
Z x e whim somatic.renames a penh to son.are,improve,demolish,or repair any amcmm
citprint to assmance.a6naqaimsdnnppl-ru fmsoob lxnuWo file a aigrwel staemm�t.
c:= . . ..._ _.. ...Liss
hufle 'I'' s"dI If ll p of. Id C f"r 2'1' Liw(Chapmo9 [�� �y1di )r a. - Valuation
(aa cingwhh Seclmn7"hisfEask i3ofine Bastne'-a JP feasiona Cale) I I,' 3tJ;jO-1 tfj� .,eV :•-I t,J ��d•."
or that he is eierhpt domprom and the basis for the alleged exemption.Any violation `
of Sectio 7031.5 by any applicant man permit subjects the applicant m n civil penalty
.feet reamthan remndreddo0ara(5580), 103APN t Occupancy Type
01,us owner of me pnspeny,ser my empbyees wan wages as Meir sole compensation,
will do the work.and the structure is not intended*or offered ler sale(Sec.70,14.
Business and Pnvfessions Code:The Contra ror's License Law docs not apply to an 505 - FINAL ELF$ VR(J JAaActions
owner of property Who builds or improves thereon,and who does such work himself
or through his own employees idthat mer mems are not;mender m
offered for sale.If,hmscvc,the building m impmventem"_sold within oeyeld of
„
on,the ownersalcr will have the blydrn of proving that he did not buil)m '
improve
Ip rya fr sale.).
01 f the property. exclusively contracting with licensed contractors to
constiont the project(Sec 70W4Business and Prat .ons CWe:)Thr,C naas+or s
License Law does not applyt r ofp peny who builds or impthereon,
and.who contracts for h projects with a centimeters)licensed pursuant to the
Contracto License Law.
01 apt under Stir. B&PCT flakod m / "fl "
Owner are
f WORKERS COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
0 1 have and will maintain'z Certificate of Consent on self-immne f«Worker's
_ Compensation, as provided for by Section 37M of the Labor Code, for the
performance of the work for which this permit is issued,r
01 have ase will maintain Woion x Comped tion Incamrece,its renulm l by gen ion
37M of the Labor Cade,for the pc,f..c of are work far which this permit is
kau,d.My Workers Compensation Insurance carrier:md Policy number are:
- .................._-._..._........ ......... _...._ .,.....
Corsica: ' Policy No.:
CERTIFICATION OVEXEMPTION FROM,WORKERS'I" - + *• t v• (�. \zss - �'
COMPENSATION INSURANCE' ; •"" _ .._......-...._..,..
(Th11 section need let be completed if the permit is for one hundred dollars
(S IBB)or le".)
'1 tardy that in the performanceuaof the work forwhichthis permit c issued,1 ,
-Com notma employ any person in any nannaa sat as m become subject m the Workers' -
Applic psaion laws or Calil'omia.nam
Applicant
NOTICE TO APPLICAN"1':If,after making this Certificate of Exemption,you should
be"noths the worker's Compensation previsions of the Labor Code,yna mast
0 bjeci m forhwltcomply with such provisions or this permit shall be deemN revoked. ,
E r CONSTRUCTION LENDING AGENCY .
I hereby affirm that then Is a construction lendlag agency for the performance
of the work for which this Permit is issued(Sec.3097.Civ.C.)
Lender'sName -..:. .... -..._.. . . .._.
TI" LeaderAress
, dd
1.7-'Z ,. ... .t
U O 1 evrtifv leaf(h:we head dd.nnpreamm ase xtae mat me aha�e mram,afmn is
. t*+.[... emren.I agree m eampfy wim all ity and coumy mdinancu ane xtae laws relining
Q I.V to building consauction.and hereby ammirim representatives f,hi,city to eater upon
�,'Ow the nhove(Wc)agrenede to save,
indemnity
for inspection ty andkeep
purposes. _ �
F'.1. ("Vitt agree tisleve,InJcmnily vnd keep M1annlexv the City of Cnpetiino against ILJ- r
y IiubJm�es�' rc costs and expenses which may in any way amine against said
f>.Z Cerin ennseyuenceo t f - omit.
.len
r\PP LIC ANT UNDI;I . IIS An 'ILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIU
r —
Signamrc or plicanVGWil
CL,and me flc J e Re-roofs
LOSUREsera nitappbcaf ure m hawle haraNws ma¢dal Type of Roofas defined Is _ alth and SafetyCode:Section 255._a. ON. ..�.. .,i,.
Oys, 1 ' " f ' . . All roofs shail.be.inspected.prior.to any roofing material being installed.. .- .....
Will ma ups,'art
art"' mor,building rccapam ase equipment or des __ices which If a roof is installed without first obtaining an inspectiod;1 agree.to remove
emit hazardous air contamin ons is defined by the Bay Asea Air Qualify Management
District? - all new materials for inspection. Applicant understands and will comply with..-
1:1 ye, ❑No all non-point source regulations.
I.1 have read the hwasdous materials requirements under Chapter 6,95 of the
California Heahr&Salty Code.Section,'505.25533 and 25534.I unde,smnd shat
if the building does not cu marlY have a tenant,that it is my resprnsibdily to notify he (
scup meats which must be mei prior to issuance of a Cenificam of
OccDate
upancy.
—7 9_01 Signature of Applicant . _ _ _
Cars,nr,B e agent Dale All roof coverings to be Class "B" or better
. ... .. . _ '_. . OFFICE _. . ..
t .. Ices