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04020148 CITY OF CUPERTINO BUILDING DIVISION PERMIT rCONTRA �OR nYFU�i .TtUN.�.. BUILDING ADDRESS: PERMITNO. CALIFORNIA NEON 04020148 OWNER'S NAME: PERMIT ISSUEDATE E: SANITARY 0 OL NO. ARCHITEC(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LOp LICENSED CONTRACTOR'S DECLARATION IobDescri tion 1 hereby ocean that 1 am licensed under previsions M Chapter 9(commencing p with Smdo 70(10)of Division Sof WCBusineas rad Professime Code,and my license is pppp df andaflm. G4� T"�stulp SIGN--3 BEADS �1VALIE® yn Z Lice Class Lic. ss� Dote, ContL, AlleffrI[EIZO QRCLARATION a rp a um pumicomomis MAR 0 5 2004 3O� Licenseesaion.I OWNER-BILDERD ARATION BUILDING <I 1 herchy am.that 1 am a Contractor's License Law for the D O following mason.(Section 703 1.5,Business and Profceshms Cods:Any city or m.my I�i which mquirca a permit to enmwct alter.Improve,demolish,or repair any stmetbm Fi' prior in its issuance,also requires the applicantorsuch permit to file a signed statement 290 FP a NatWislicensed pursuant tothsprevisionaofde,ConuacweaLee.Law(Chapter 9 Sq.Ft. Floor Area Valuation es�$ (commencing with Section7000)of Division 3 of the Business and Proressions Code)or .. Nat he is exempt therefrom and the basis for the Waged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a cidl penalty of 3��DT�jy erp p Occupancy Type not mom Nan fin hundred dollars(g500k ❑Luownm of Ne property.mmy employers with vngesu Neinolc compensation, will do Newark,and Ne shbcuu is notinunded oromemA tarsale(Sm.7044,Business and Professions Code:The CmmncurY License Law does not apply to an"net of Required Inspections propeny w Ise builds or improves thercnn,and who does such work himself or through his own employees,provided that such improvements arc not intended m offered forsala.If, however,the building or improvement is mid within tome year of completion,the owner. builder will have the burden of pmving Net he did not build or improve for purpose of talc.). ❑1.as owner of the property.am exclusively contracting with licensed commerce,to convect the project(Sec.70m.Business and Professions Cade:)The Contractor's Lt. come law does not apply to an owner of property who Eui16s or improve demon,and who contracts for such projects with a contrutor(s)Iicemed pursuant in the ConuanoM1 Lie W Law. I am exempt under Sac. .B&P C for this mason Owner Data WORKER'S COMPENSATION DECLARATION I hereby atom,under penalty of perjury me of the following declarations: I hive and will maintain a CaNfinas of Convent a self-imum for Workae,Compen- ution.as provided for by Section 3]00 of Ne labor Code,for the perform irm of the work for which this permit is issued. of, f have and will maintain Worker's Compensation Insurance,as required by Section 3]OO of the Labor Code.for du performance of the work forwhich this permit is Ismad, My Wmkeeb Comiumsed n lmurams sorrier and Policy nbmber - Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE CThis section need not be completed lithe permit Is fmonehundreddollan($100) leu.) I certify that In the performance of the work for which this permit is imbed,l shall not amployany person in sey rearm.,an, bre ecomesubiectuthe Worken'Compensatlon Laws of Califoroia,Dam �'- /�C �J Ap is t .X� �+ bRTO APPLI A afar g r Exemption,you should .E.bject m the WeA ComPewtian ,Iain a Lahnr COM,ynu muaI O foMwith comply with such provisions or this permit shall M deemed mvokcd. 'Z CONSTRUCTION LENDING AGENCY Ihcrebyamrm Nat then 4.evaretmctinn lending agency for the perfmunmee of !Yi> the work for which this permit is issued(Ser.3097,Civ.C.) 4 Q Lender's Name z Lender's Add. U Q 1 cenify that I have mad this application and state that the above information is F correct,I agree to comply with all city and county ordinances and state laws relating to 0 building consrmmion,and hereby authodu representatives or this city to enter upon the [f] above-mentioned property for inspection purposes. gy On)agree to save,indemnify and keep harmless the City of Cupertino egaimt liabilities,judgments.costs and npcmcs which may in any way accrue against old City t.j z in eomequem0 of the ranting of this permit `�T APPLICANT WILL COMPLY WITH ALL NON-POINT Issued by: Date {� URC G I Re-roofs mgnature of App] toe Data HAZ DO DISCLOSURE Type of Roof Willtheapplicant or rat store of handle hustomus material as defined by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety ode.Sccdon 255320)? ❑Yea All roofs shall be inspected prior to any roofing material being installed. N Ino Will Nc applicant or(uturc building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove it hazardous air contaminants as defied by the Bay Arca Air Quality Management all new materials for inspection. District? ❑Yes A§yn 1 have mad the hasardnusmateriais mquiremcnrs under Chanter 6.95 of the Califory nu Health&SdNyCodc,Smtions25505,2a533ud25534.1unk. ndthatifd¢building Jura not cmmmly he n t.N respomibility in roufy the amupmt of do require sw ' must be dors cc of.cenlfmcatearOccup mry. SignatureofApplicant Date _.C1 `12 -Z2/'V'I Owneror aathan igen Dom All roof coverings to be Class "B"or better CITY OF CUPERTINO BUILDING DIVISION PE BUILDING ADDRESS: CALIFORNIA NEON PERMIT NO.04020148 PERMIT 1$UEDATS OWNER'S NAME: SANITARY 140 'dO'kthOL NO. NE: BUILDING PERMIT INFO ARCHITECnBNGINBER: BLDG ELECT PLUMB MEOCH s: LICENSED CONTRACTOR'S DECLARATION Job Descripti n �i 'd 1 xmbYr^�Nat 1 sin licensed under,Peviaioes of Chapter 9(commencing with Snedo 7M)nfDividon3ofdte BWnmand Pro��sILLtp licenuiA hn fril I arta erten. C L4� SIGN——3 BEADS MAR JS 2004 g? Lice Clus f•i^• tp•q'�` Dale ComilbgtoruRAT10N 5yi a yp uuDPubliemenrds BUILDING WU W Licenu esaiwnel OWNER-B ILDERD ARATION I I hereby aRrm that 1 am Consoemea Licenu Law for Ore 0 o following roman.(Section]031.5,Business and Prefesdues Cade:My city m county g, which requires a Permit 10 construct,atter.improve,demolish.or repair any structure Pdm to its Woucc•al..requires the applicant fm such permit m file a signed rukmem Sq,FI.Floor Area Valuation €e that he oRcenud present,todm provishom of de Commover's Use=Law(Chapter 9 ' $ (commencing with Section]000)of Division 3of On Business and Profeasima Code)or basis r fin Section TO LS by Any Applicant far a permits bjeea Ne applumO to A dvil timnally of ffifi,b,is sump, 3 Did iY1R$er0 0 olation Of Occupancy Type Am am than five hundred dollar($300L ❑1,As owner of the property,army employees wish"gnu their Sole compensstion, will do me work and Nesm,fic 6 not intended reoffered forsalc(S.c.70/4,Business Required Inspections and Professions Code:The Consommes Limine Law does nal apply to An own"of property wbo builds or improves memon,and who does such wink 6imael f m shr^ugh his roam employnes,provided shatsech irepovemenuae ra tin ended araReeed fmsam.IL however,the building or improvement is sold within one year of comPI000n,the owwr- builder will haw tie burden of peWng that he did net Wild w improve for purpose of Asia.). ❑1,as mover of she property,am exclusively contracting with licensed cobacmn In construct the pmject(Sec.7044.Business and Professions Cade:)The Comraemes LI- ceoe Tsw does not apply m in owner of property who builds or improves thrown.and who convects for such propcta with a conueetm(s)Remand pursuant to the Commences tic Law. I Am exempt under Sm. ,B&P C for this reason caner Date WORKER'S COMPENSATION DECLARATION 1 hereby a0bm under penalty of perjury one of she following declarations: ❑I have and will maintain aCeedOcate of Comseat to ul6insu a fm Wmke"Com en- sarion,a provided for by Sedan 37M of the Isar Code.Ire she performance of dm work for which this permit is issued ❑I have and will maintain Worker's Compensation Insurance.As required by Section 37M of site Labor Code,for the performance of the work for which this permit Is bound. My Workee.Compmudon Insurance rani"and Policy number am: Carder. Policy No.: CERTIFICATE OF EXEM MON FISOM WORKERS' COMPENSATION INSURANCE (TMs uctlon need not x completed ifthe Permit Isforomo hummed dollars(SIM) or less.) 1 certify that in the performance of the work for which this permit Is Wood,I shall not employ any person in any mannerunm Mcomaiuhiecuo the Workers'Compewdon Laws of Calif^ ie ao�/�� Apalicpt - vLTbTOAPPLI A ,efmr gtly v stfau.Qf Laborempoom.rodyoumould become subject y it Worker's Come or this rsio pLMs Labor Cade,you men �O COMwim comply with ouch prwvitlnes or this Punmlt shall x domed reeked. CONSTRUCTION LENDING AGENCY .�+ Ixmby affirm that inert is a construction lending agency for the Performance of y'> de work fm which this return u issued(Sec,3097.Civ.C) i7 QLender's Nam. ,a z Lenices Address . Q 1 mnify that I move teed this Application And tum that the above information Is L F mmecL 1 ages to comply With all city and county ordinances and Stale laws elating la 6.1 building c^nawee In.aveheebyarthodmepounativesaf this city menter upon the is u] above-mentioned property for impaction PerPous (W.)Agan m saw.indemnify and hep may i m the City of Cupertino id City yZ iliabilities.osjnce ol'he granting uind expenses which may in anymyaccee against said City .—T J'Z' in PLICA T of the Bunting of this permit Date �/ ^+ APPLICANT q A17P WILL COMPLY WITH ALL NON-POINT Issued by: URC Re-roofs Igm�A,�Ml_ onJ DO DISCLOSURE DamType of Roof or tattle"handle haesNous maadsl as acfen.d 11the Cupertino Municipal Code,Chapter 9.12.and tite Health and Safety Cade,Section 255324)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes Will the Applicant m future building occupant use equipment or devims which I. If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants As defined by the Bay Area Air Quality Management all new materials for inspection. District? - ❑YestlP 1 have read she mount.materials requirements under ChAmc,6.95 of theCalifor- reHceho&SafmyCode,Scetiom25505,25533 and25534.1 undersand thnifde building dins not curmmly he n Lot ' ' mspecompay m mufY de ecctmant or the require w murex dram' cooraC.nificateofOcmpency. Signature of Applicant Date 3 " j2--23-v-1 All roof coverings to be Class "B"or better Owner or authilffecTaperfir CDau �/ % . • Community Development 10300 Tone Avenue ;y Cupertino CA 95014 (•" Telephone(408)777-3228 CITY OF Fax(408)777-3333 �JPERTINO Building Department JOB ADDRESS: PERMIT O 206$0 . �i.lt�Ic J C2cc� Ril-VN OWNER'S NAME: PHONE # '107 qSo vh`1 GENERAL CONTRALTO G Au F02N L 0+- KJc-04j FAX # -70-7 I am not using any subcontractors: i 2--2 � - 6c( ianai 'e DJ ate Please check applicable subcontractors and complete the followinginformation: 60 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical 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 z-23 • oY Ow e o o ature Date 10/28/03 • 0 CITY OF CUPERTINO 0SIGN • CUPERTINO PERMIT APPLICATION FORM APN# Date: 2-22, - ay Building Address: Z D♦�jD `-�'TGJ LNS GR-ct�_ nj Lt/� Owner's Name:3 Phone#: B SDs Contractor: License#: GFrLi�—vava , ,�- N�-av -e- 4S 70S140 Contact: Phone#: �ff2J SwtL70- dol If302s((o-4- Ap licant/Contractlor: / �iA-vvi E Building Prmit Info: Bldg -Eke Plumb Mech • JotfD�ra ription: -Res dential: Commercial: Sq.Ft. Floor Area: $/Sq.Ft.: Architect/Engineer: Valu 'on: 1 A- P2 Type of Construction: Occup Group: PAN N AT�� Qty;-if A fable Fee ID Fee Description Fee Group BENERGY Energv BUILIDNG BPERMFEE Bldg Permit Fees BUILIDNG BPLANCHK Plan Check Fee BUILIDNG BSEISMICOM Seismic Commercial BUILIDNG •EPERMTTFEE Elect Permit Issuance ELECTRICAL BREMSIGNAD Rmd1 Signs Add Branch ELECTRICAL BREMSIGNS Rmd] Signs, Marquee ELECTRICAL BUSLIC Business License BUILIDNG 133" #1OX79CPk1N3 ® EIECIRO Blr 31r> CAP ED DcmNEON 24" LGLO.CAa3/16'PIFXFACE A40 AWM. RECENED WAIL SUM #10X7SCI�WS^ _ _ AILM MAMW Iw YY�R��'I1.U.S i�: .1 �.U�..`. _ M�mmm FEB 23 2004 Center on fascia s :._' CITY OF CUPERTINO 1: S t BUILDING DEPARTMENT J055COP� rr WEE 'Cap,V 24 LIOTEn � C�I�N N EL L�TTEI25 Center on fascia ZLTUP b: bronze -- - --- -- --- - TIZI M : bronze LOT PLANS • ��: �� r h/-\F CHECKED BY � DATE 2I a I LLU M I NOTION: Zed Neon 'P1' Bl"i DEPT. Cupertino Center Ir,mal� JOB# Lre , & t9V(TbNt9 co�cxs DATE g n7G�lJa� ADDRESS _\ Graphic: Ask 20680 Stevens Creek Blvd Landbrd Approval REVISION Date: 707-544-0140 FAX 544-2516 LICENSE# 450869 i • yp E NED 1.t € k f - 1150-107 , MEttwr� s FEB 2u 2u�4 22 CITY OF CUPERTI O X18 L9 BUILDING DEPARTP ENT 25 \StGNLOCATION i - • � u 2s MERVYN'S CUPERTINO CROSSROADS SHOPPING CENTER OFRT Cgpy 1. FED EX 6. THE LEARNING GAME 11. PIER ONE IMPORTS 17. TOMORROW'S TREASURES 23. MARIE CALLENDER'S 2. VACANT 7. McWHORTER&YOUNG 12. DRESS BARN 18. MOULIN ROUGE COFFEE 24. PIZZA HUT 3. FAMILY HEALTH CENTER 7. POST OFFICE EXPRESS 13.PENINSULA BEAUTY 19. LORAL WIGS 4. STARBUCK'SCOFFEE CO. g, GOLDEN PRO GOLF 14.VACANT 25• WHOLE FOODS MART 4. NOAH'S BAGELS 20. THE HAIRCUT 26. FONTANNAS ITALIAN 5. VACANT 9. HONG FU CHINESE CUISINE 15.THE UPS STORE 21. FOOTWEAR ECT. 10.AARON BROTHERS ART MART 16. LU'S WEDDING PHOTO 22. MERVYN'S