B-2016-2179i
CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-2179
19389 STEVENS CREEK BLVD CUPERTINO, CA 95014 (316 20 112)`
PETALUMA SIGN
COMPANY
PETALUMA, CA 94952
OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LLC
DATE ISSUED: 06/21/2016
OWNER'S PHONE: 408-813-7490
PHONE NO: (707) 322-0009
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C-45 Lie. #833377
Contractor PETALUMA SIGN COMPANY Date 03/31/2018
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) NON-ILLUMINATED BLADE SIGN - ROOTSTOCK
I hereby affirm under penalty of perjury one of the following two declarations:
WINE BAR
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.
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
Sq. Ft Floor Area:
Valuation: $2500.00
permit is issued.
APPi.I NT .RTiFiCATION
certify that I have read this application and state that the above
APN Number:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
316
31620 112
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 con o the granting of this permit.
WITHIN 180 DAYS OF FERMI ISSUANCE OR
Additionally, the applicant understa s and will comply with all non-point
source regu ' ns er a Cuperti u icipal Code, Section 9.18.
180 DAYS FROM LAS D SPECTION.
Signature Date 6/21/2016
Issued by: Alex Vallelung_a
Date: 06/21/2016
BUILD DECLARATIL
I hereby affirm thA I am exempt from the Contractor's License Law for one of the
RF ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
t. 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. I, as owner of the property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 6/21/2016
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
3. 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 & SafetyC ections 25505, 25 33, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent:
APPLICANT CERTIFICATION
Date: 6/2112016
I certify that I have read this application and state that the above information is
CONS UA04 LE A NCY
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a cons � u tion lending a ncy for the performance
relating to building construction, and hereby authorize representatives of this city
of work's for which this permit is is d (Sec. 3097, iv 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, casts, 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 DECLARATION
Code, Section 9.18.
1 understand my plans shall be used as public records.
Licensed
Signature Date 6/21/2016
Professional
CUPERTINO
SIGN PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(@_cupertino.org
S
PROJECT ADDRESS 19389 Stevens Creek Blvd
APN #
!�'`
OWNERNAME Rootstock LLC
PHO �� _gll �
1
E-MAIL
STREET ADDRESS 19389 Stevens Creek Blvd
CITY, STATE, ZIP Cupertino, CA95014
FAX
CONTACT NAME Jim Foley
PHONF408-813-7490
E-MAIL jimf@rootstockwinebar.com
STREET ADDRESS 19389 Stevens Creek Blvd
CITY, STATE, ZIP Cupertino, CA 95014
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER IXTENANT
CONTRACTOR NAME
John Ton
LICENSE NUMBER
833377
LICENSE TYPE
C-45
BUS. LIC #
40406
COMPANY NAME Petaluma Sign Company
E-MAIL john@petalumasign.com
FAX
STREET ADDRESS 90essie Lane
J
CITY, STATE, ZIP
Petaluma, CA 94952
PHONE
707-322-0009
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
Install one NON -ILLUMINATED blade sign for ROOTSTOCK WINE BAR, per sign criteria specs.
Subject property is located at "Pad #3" within the Main Street Cupertino development.
USE OF ❑ SFD or Duplex ❑ Multi -Family
STRUCTURE: ® Commercial
ILLUMINATED
(Y /?
SIGN TYPE
(CODE)
NO. OF
SIGNS
SIGN AREA
(SQ. FT.)
VALUATION
($)
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
N
BL
1
6
$2,500
F -F
[RECEIVEDBY:, 5
'42511\1 1
TOTALV ION:
oo
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 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 relaf bui I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicaut/Agent: Date: 6-1-2016
SUPPLEMENT INFORMATION REQUIRED
_ Site Plan
_ Elevations
Sign Details - including UL listing(s) applicableEXPRESS
Structural Calculations (if applicable)
Copy of Planning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application.
OFFICE USE ONLY
PLAN CHECK TYPE
ROUTING SLIP
OVER-THE-COUNTER
❑ STANDARD
❑ LARGE
❑ MAJOR
BUILDING PLAN REVIEW
PLANNING PLAN REVIEW
❑ OTHER:
SignApp_2011.doc revised 03/31111
CEIE
JU1v 2x16
BY
SHOP 9
- Sign location: North wall of "Pad 3"
(Rootstock Wine Bar),
Main Street Cupertino
S T E V E N S C R E E K B L V D
UPERTINO
Building Department
OF FiCE C `� i JUS 2 1206,
REVIEWED FOR GODS COMPLIANCE
Revlew0d By. �E-q,
Rootstock Blade Sign Permit Application - SITE PLAN - NO SCALE
submitted by John Ton / Petaluma Sign Co / 707-322-0009 /john@petalumasign.com
COMMUNITY-DRV5M,ENcT!DVRRT.,MENT
BUILD.ING DIVISION - CUPERTINO
v CuAefgkb��.cyse # 40406
This set of plans and specifications MUST be kept of the
job site during construction. It is unlawful to make any EU Y
changes or alterations on sane, onto deviate p►,�'T PLAN
therefrom, without approval from the Building Official.
The Stamping of this plan d specifications SHALL NOT ®ATE �P.T
be held to permit o o an approval of the violation PLANNI G
of any provisiors ity Ordinance or State Law. CUPF-RTINO
BY
DATE
PERMIT #. C-107 MIs il-
0
Existing frame wall
I
1/2" bolts through -bolted
through wall (TYP).
Nuts + foundation
washers (TYP)
Drawn by John Ton
707-322-0009
r
Existing stone veneer
Bracket is welded 1/4" plate steel
1/2 x 1/2 steel guy, welded to bracket
and to pole
2 in. sched 40 steel pole, all
intersections /.fillets welded
r
36 in
UP' NO
lei .> '` Building Depatnent I
g ``
Ems'
�f Jum ��9i >9 feet to fin. grade,
per MSC Sign Criteria
RE"VlEVVED AOR CODE: I.;C)MPLi,4NCE
Reviewet7 By: 17�iw'
scale: 1" = 12"
Double -sided blade sign, rusted steel letters.
Rusted steel bracket. Aluminum pole finial.
wood is reclaimed fir, stained / whitewashed to contrast with steel.
End straps encase all wood to ensure structural stability. welded to
chain hangers. Decorative steel rivets.
Letters attached with 2 inch threaded studs, holes filled with
foundation epoxy. Stand-off <1/2'in.
wood thickness = 2 inches.