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11030050CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 19068 STEVENS CREEK BLVD I CONTRACTOR: DIABLO VALLEY SIGNS I PERMIT NO: 11030050 I 01 "NTER'S NAME: UNITED POLARIS INC 0- iER'S PHONE: 4082553999 E] LICENSED CONTRACTOR'S DECLARATION License Class C- (y 1 � / „ Lic. # G G WS Contractor . Date L I I hereby affirm that I am licensled un er 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. 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 Section 3700 of the Labor Code, for the performance of the won$ for which this permit is issued. 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 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 accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all no 7o source regulations per the Cupertino Municipal Code, Section 9.18. Sia -ature Date �Z ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, I shall 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 the above mentioned property for inspection purposes. (We) agree to save .nify and keep harmless the City of Cupertino against liabilities, judgments, co:.ts, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point soyrce regulations per the Cupertino Municipal Code, Section 9.18. Date YZ ( 1 PO BOX 452 SAN LORENZO, CA 94580 DATE ISSUED: 03/16/2011 PHONE NO: (510) 333 -5483 BUILDING PERMIT INFO: BLDG f— ELECT r— PLUMB MECH r— RESIDENTIAL COMMERCIAL JOB DESCRIPTIONA L WALL SIGNAGE, INDIVIDUALLY ILLUMINATED CHANNEL LETTERS @STORE FRONT Sq. Ft Floor Area: Valuation: $1300 APN Number: 37507046.19068 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued b Date: Z� 7 RE- ROOFS: 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 all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owne b ized agent: Date: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of Wrk's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional �. 5 SIGN PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION j 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333• buildingO cupertino.org i PROJECT ADDRESS / ^ APN# aa 4a C1 X✓ OWNER NAME -MAILQJIVNE /?Gir� E '711 41 1 6 KS STREETADDRESS 'LC ,(%STATE,ZIP .i 1 FAX �� z P� - v %I . art APPLICANT NAME Com`'r HONE / E-MAI J " / ( UJ" STREET ADDRESS /� (� / .,� '� CITY, TATE, ZIP�Vr �f FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME ) LICENSE NU BERJ, , LICENSE TYPE ,.r-- BUS.LIC# V ! � 1 G�S COMPANYNAME \ (( / E-MAIL FAX STREET ADDRESS ;� (r/ CITY, ATE,ZIP ��J.� ( PHONE,�__ !1 4 �0. Afir �,� i �� I��Q ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE 1 DESCRIl' ONW .01 ORK r l _ TI ` trV1, USE OF BUILDING ❑ Residential Kcommercial ILLUMINATED SIGN TYPE NO.OF SIGN AREA VALUATION (Y/N) (CODE) SIGNS (SQ.FT.) (s) SIGN TYPE CODES: 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 VL T�IQN: 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 h 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 to ildi.g nstruction_. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes, Signature of Applicant/Agent; �� - Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY" _Site Plan PLAN CHECK TYPE ROUTING SLIP _Elevations 1 E,XPItESS E]�„B�U'�ILDING PLAN REVIE)Y Sign Details-including UL listing(s)applicable ❑-_sTANnaxD 1-I PLANNINGPLANRFVIE,V - Structural Calculations(if applicable) ❑-LARGE = ❑ OTHER. _Copy of Planning Approval Letter or Meeting with Planning prior to ❑= W_0_R- - - - submittal of Building Permit application. - - - - - - SignApp_2011,doc revised 03/02/11 I i I i jT CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION DRESS: 19068 stvns crk blvd. DATE: 03/10/2011 REVIEWED BY: bob s.N: BP#: "VALUATION: 1$1,300 rPERMIT TYPE: Building Permit P1i : s-- C ! 's£:Tt 7 ;' PRIMARYSi PENTAMATION Sign 10EAP5 USE. g 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 r hmi t 1,,z,_ 1'ir,,,,7t. E"7r�r� #Branch Circuits 1 $42.00 f £ IESIGN Elec.Permit Fee: IEPERMIT -1kch.frdsjr. >r,'��u ,, ., ,,:;;. Other Elec.Insp. 0.0 $42.00 f h"-wh. NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resohition 09-051 E '. 711/IOZ FEE QTY/FEE MISC ITEMS Suppl.PC Fee: G Reg. 0 OT 0.0 hrs $0.00 'Tyt 3 Ppp y .3 Permit Fee: $253.00 Suppl.Insp.Fee:O Reg. 0 OT F0.0 hrs $0.00 PME Unit Fee: $42.00 PME Permit Fee: $42.00 t,-"rts�„"Pi-7�,;7frt177 1 C1,� Sign Master Plan: 0 Yes (D No $0.00 Work Without Permit? 0 Yes G) No $0.00 Travel Documentation Fee: 1TRAVDOC $42.00 Strom Motion Fee: IBSEISMICO $0.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 i SUBTOTALS: $380.50 $0.00 TOTAL FEE: 1 $380.50 Revised: 01/15/2011 I r i f ILLUMINATED INDIVIDUAL CHANNEL LETTERS I Approved Channel Letter Layout y LETTER SECTIONPCL-LED LI INTERNALLY ILLUMINATED PAN CHANNEL LETTER e .040ALUM. RETURN ILLUMINATED INDIVIDUAL CHANNEL LETTERS srucco AND 1/4"DIA.31[211 EXTERIOR SCREW PLYWOOD WALL FACE WHITE ACRYLIC (4) PER LETTER WITH#14 ANCHOR RETURN : D/BRONZE MIN.21/2"IN TO MASONRY 4"Deep X S"H TRIM CAP : 3/4"SILVER WITH 112"DIA.STAND OFF RACEWAY LEDs : WHITE s GTO CABLE THRU 1/2"DIA. �) FLEXIBLE SEAL TIGHT CONDUIT DISCONNECT SWITCH W LEDs ILLUMINATE® LOGO BOX LOW VOLTAGE POWER SUPPLY z o � U o-cg FACE WHITE ACRYLIC IMAGING PRINTING RETURN : WHITE TRANSPARENT ACRYLIC I R)TO PS"1JiVHu:NiFG UL IvsT.w ui/cTCMm"�/el"" TRIM CAP : 3/4"SILVER LEDs : WHITE 20' Typical LED M®untl g De tail not to scale x I� TOTAL STORE FRONT LINEAR =20' TOTAL PROPOSE® SIGNAGE SQ FOOTAGE 30 sqf „ I LA 1 ` z 1 04 � loom 009 f 11 -6 ADS 13,®®„ 0��,�-f,� � S-o L I