05010036 CITY OF CUPERTINO WABUILDING DIVISION PER
of rCONTRAC1r£®R�INFOR ,I®S,N
BUILDING ADDRESS: ALLEN SIGNS INC PERMIT NOD5010036
ER'S NAME: PERMIT ISSUE DATE
LITTLE MUSTARD SEED 1982 STONE AVE Q1/06/2005
PHONE: SANITARY NO. CONTROL NO.
(408) 280-6500
ARCHITECpENGINEER: - BUILDING PERMIT INFO
I BLDG ELECT PLUMB MECH
0 0 0 0
+bo LICENSED CONTRACTOR'S DECLARATION
£mF 1 hereby affirm that 1 am licensed Bri antler provisions of,Cmdc. v(commencing lob Description
roti with Ili yt of Division 3ofthcBusincsx and Prufmsinm Cndc.end myliccnscis
mranmrc1essanderrac4 CHANNEL LETTER SIGN .
Licensc�C s.v Contract.,_ '
�Fp Datc - Cunfractor
to ARCHITF,CrS DECLARATION
w I understand my plans shall be used as pa
ublic mides
U
'o't; Licensed Professional
OWNER-BUILDER DECLARATION
a y I hereby affirm that I am exempt from the Contractor's License Law for the
O O following reason.(Section 9031.5.Business and Professions Calc:Any city cr eounly
m whim requires a Pcnnit to construct.alter.improve,dcmollxh,or mpairany swcturnO O
Poore its issusrmc.also mgotra the applicant forsuch Permiuo filea.signed statement
a [hat he is licensed pursuant o the provisions(if the Contractor's License Law(Chapter 9 Sq. Ft.Floor Area Valuation
(commit acing with Section 7 W(bor Division 3 or the B usincxs and Professioor
that he u exempt therefrom and the basis for the alleged exemption.Any=of
Section]031.5 by any application for a permit subjects the applicant o a civil Penalty of 3�k®&31LpIl3er00 Occu ane Type
not moreban fivahundred dona.(SSW). Occupancy
I
❑I,as owner of the property,u my employees with wages az their sole compensatim. '
will domework,andec his COn isnmsLicensoroffereds notapplyt an,Business
and rty.hom Code:The Conoectm's Liao..Law docs not apply lf an owner of Required Inspections
own employe,proviid tiavexlh rain ntlwhn dmssucM1wmkh.fficor through his
however.thecx,ping Or lbutmchimpwvcmrnain ne year of omd
mpletieJ roe sale. r,f.
�/
however.the building or improvement is sold within one year of complctian,the owner,
builder will kava the burden of proving that he did not build or improve for purpura of /
Wo.). O
❑1,as owner of Bre(Sec.
.B exclusively Proeea:ng Cod:)tamed ntrxoh ors i
cone La Inc es not (Sec.9014,Business and Professions Cotler)The Cs damem'x and
witha of property who sed pursuant
improves lhemon.and
.he contracts for such Projects wih a eonaamor(s)licensed pursnam m the Contractor
s License Law.
Iem exempt under See .B&PCfor this..on
or Date
Our exam
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penally of pin my one of into following declarations:
❑I have and will maintain a Ccnifcmc of Consent to self-insure for Worker's Cumpem
aatiun,as provided for by Section 3908 of the labor CWc,for he peefoemance of he
work for which this permit is issued.
'�{I I have and will maintain Worker's Compensation Insurance,as required by Section
3 of the labor Code.for um pe,dormanec of the work for which this Permit is issued.
My Worker's Compenead on Insurance carrier and Policy number am:
tamer: „Z7 i/j icy NOSWO
IFICATEOFEXE ONFROMWORK RS'
COMPENSATIONINSURANCE
Qhs section need not M completed iflho Permit is for one hundred dollars($100)
or Itis.)
I Curdy that in tire performance of the work for which this permit is issued.I shall no,r
employ any person in any manner sou to become subject to the Worker)Compensation
taws of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Ceniacate of Exemption,you should
become subject to the Workers Compcnsnion provisions of the labor Code,you must
�z forthwith comply with such provisions or this Permit shall pot dccmedinvoked.
ZC
CONSTRUCTION LENDING AGENCY
1 Herby which
thi that there is a e d s cit.3 lending7,Cagency for the Performance of
x the work fur wnicA this permit is issuctl(Sec.l09),Civ.C.)
41 Lendc`s Name
z is d 's AdJrras
J Q 1 canny that I have read his application and some that the awvc information is
]. ,r cores.1 agree to comply with all city and county ordinances and sate laws misting to
Z)U building consmuction,and hereby authorize reprcacnativm of this City to enter upon the
W above mentioned properly for inspection purposes.
(We)agree to save,indemnify and keep hum less the City of Cupertino against 4
tq liabilities,judgments,costs cad eapenus which they in any way accost against said City
j Z in emosequenee of the granting of Permit.
F-t APPLICANT UNgERSTANOS AND WILL COMPLY WITH LL NON-POINT Issued by: Date
SOURC4J,[,pULAT%ON v (/) J I
r. .' T Data
Re-roofs '
Signaof Appb'ca tic vapor
IAZARDOUS MATERIALS DISCLOSURE Type Of Roof
W;I ec app)cam orfuture building occupantstore or handle Ouardoes material
defacd by the Cupsninn Municipal Coda.Chapter 9.12,and the Health and Safety
e.oy,zss3z(a)2n All roofs shall be inspected prior to any roofing material being installed.
Will the appbmma,future Wilding meupintaxeegmpmcutordevices whim If a roof is installed without first obtaining an inspection,I agree to remove,
mit haramdous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection.
Oierictl
❑Yes g7No - l/
Ihavemad thchvaN///aux\\\materials rtyuircments under Chapmr b.YS ofthe Califon
nia Heele Js SafetyCwc,Sceuuns 25N15.25533 and 25534.1 undershot that ifthc building
ams ret eurtenlly nave tenant.tam it is my rmponsihility lis nrulY Ire rceuPant of the
rcyuir me hflkhmu tem poor to issuance of a Cenificae of Occupancy.
i — Signature\f Applica [ Date
orae a aathorizc agent , All roof coverings to be Class "B" or better
• CITY OF CUPERTINR
• mssr r SIGN
CUPEkTINO PERMIT APPLICATION FORM 6 sb/bD�3
APN# Date:
326- 3- oZ.
Building Address:
D e r . q-60
Owner's Name: Phone#:
Contractor: License
/ #:
( � Sim /7G•
Contact: U Phone #:
Li h
App licant/Contractor
I/7C _ lf-
Building Permit Info:
Bldg - Elect Plumb Mech
Job Description:
Residential: Ar ercial:
Sq.Ft. Floor Area: $/Sq.Ft.:�
rchitect/Engineer: ost of Project: \,
Type of Construction: Occupancy roup:
Qty. .
A icable Fee ID Fee Description Fee Group
BENERGY Energy BUILIDNG
BPERMFEE Bldg Permit Fees BUILIDNG
BPLANCHK Plan Check Fee BUILIDNG
BSEISMICOM Seismic Commercial BUILIDNG
EPERMITFEE Elect Permit Issuance ELECTRICAL
/ —-BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
/ REMSIGNS Rmdl Signs, Marquee ELECTRICAL
BUSLIC Business License BUILIDNG
LITTLE MUSTARD BUILDING SIGN ELEVATION: 10455 B.4NDLEV DR Suite#400 CITY OF CUPERTINO
IN ACCORD NCE WITH T'7 iY Of
GsiPFrRTiv' -- N.-/rcDiNAN"
DA-r
50'-0"151ALDING FRONTAGE
NEW SIGN LOCATION $ISti:.D
T`s set = a,-, :i-:wvdfl-jOS
in = �F—_– "►,R- \'•" - .n• ` Ce k?-,t lk)t- i.:r"i and j
1 l�►, K l
tLITTLE V_ST DEED- = � � I � � '� �
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- + 1 LRTLE MUSTAAr
D SEED05M Fes- --
5"THICK INDIVIDUAL CHANNEL LETTERS,NEON FOR INTERNALLY ILLUMINATION. --- - - 1
3/4r'WHrrE COLOR TRIM CAP,RETURN PAINTED WHITE COLOR.
LETTERS WILL BE RED COLOR -
-
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BUILDING ELEVATION:
OFFICE copy
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IRIJbISERE medbrm«et1Y11'NiMnaI9,Ycumi LMLE MUSTARD
i.Betaenrcmhn.IBowrlwowMolwll.la,...lwla. 10455 BANDLEY DR. Suite 11400
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brmml«Yw m,wMbitlo«aett sMii bMvirm•ghllmmmm S9A) 1WImS990 12ileh 12inch mN 3Nin t I _ .�S ti
afa9!18MM mry MMepely I 's,
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C E'408/280-0500
A408/280-8700
APPROVAL: DATE: PROJECT: All designs&art works belong to Allen Signe, Inc. Any duplication is prohibited. COPY RIGHT 2004 1982.STONE AVE.
SANJOSE, CA. 95125
swe ma#834580