05010112 (3) CITY OF CUPERTINo r �' ''° ^� �'+ "' `� •.'
BUILDING DIVISION PERPCONTRACTORdINFORMON -
. m :nom . ,p :
BUILDING ADDRESS: ALLEN SIGNS INC PERMITN"65010112
15 ERS NAME: PERMITISUEDATE
BAGEL STREET CAFE 1982 STONE AVE 01 /20/2005
PHONE: SANITARY NO. CONTROL NO,
(408) 280-6500
ARCH TEC?/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB METH
+00 LICENSED CONTRACTOR'S DECLARATION' Job DESCrIpt100
LL Fp 1 hereby affirm Thal 1 am licensed under provisions of Chapter Y(commencing
[iW with Section 7W).rDivisioa Sof iheBusinessand Professions Codc.andmylimnsis
infull force anaerr3 SIGN
LiccnscCu Lic.4
F-� DCunua<tnr
Dat
j ARC used
DECLARA ION
E�� I understand my plans shall
all be he reed as public rccnNs
eea �/`00 Licensed Professional
g OWNER-BUILDER DECLARATION /
'est a p I hereby affirm that 1 am exempt fmm the Contractor's License Lew for the y
p O following reason.(Sadun]031.5.Business and Professions Code:Any city Or county O�
`<m which requires a Permit hs construct.alter,improve,demolish,or repair-any somolne r
°iy prior outs issuance,also requires the applicant forxuch permiuufde asignedstaurenl
a thatheisliccnudpursmnuotheprovisions OflhcCimticmr'sLicense Low(ChapmrY Sq. Ft. Floor Area S Valuation
eFo (commencing with 5cnion2000)nf Division]of the Basturavnd Professions Codc)ur
that he is exempt therefrom and the basis for the alleged exemption,Any violation of
Section 7031.5 by any applicant for a pelmil subjects the applicant to acivil Penally of 3 2/GPWI9L5t'( c 0 0 Occupancy Type.
not more than five hundred dollars(S500).
❑I,a owner of the property,Or my employees with wages as their sole compensation,
Will do the work,and Ne s Wctum is not iml"ded or offered for sale(Sore.7044,Business
no Professions Code:The Commcmri License Law dors not apply to an owner of Required Inspections
property who builds or improves Hereon.and who doesauch work himself or through his
own em ploycex,provided that such improvements arc non intended o offered for sale,If,
box awl.the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not Wild or improve for purpose of
sale.).
0 1,as owner of the Property,am exclusively contracting with licensed contractors to
construct the project(See 9044,Busi norm and Professions Code:)The Conlracmri Li-
cense taw does not apply to an owner of property who Wilds or improves thereon.and
who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's
License taw.
❑I am exempt under Sec. ,B&P C for this reason
at Data
WORKER'S COMPENSATION DECLARATION
1 hereby alMn under penalty of perjury ore of the following declarations:
❑I have and will maintain a Cenificum of Consent m self-insure for Worker's Cam ion-
sation,as provided for by Section JTW of the labor Code.for the performance of the
work for which this Permit is issued.
have and will maintain Workers Compensation Insurance.as rtyuiled by Section
von 7/00.17 Be tabor Code.far Ne per7mmanceiR he work for which this permit is issued.
/11 My Worker's Compensation Insurance a../rt�ier and Policy number am:
Carrier: �fV IntGSiLTL4-�Pnli,No.:�dCi —b0>/RZ _
CE IFICATEOFEKE PTION FROM WORKERS'
COMPENSATION INSURANCE
(Thisscoion need not Be completed if the pefmil Is for one hundred dollars(SIM)
or lass)
I eenifs that in the performance of the work for which this Permit is issued.l shall not
employ any figmentany manner m as to Become subject to the Workers Compensation
L4wx of CaliforniDate
Applicant
NOTICE TO APPLICANT.If,after making this Cc nifientc of Exemption,you should
become subject to the Worker's Comps mention provisions of the tabor Coda you must
Oforthwith comply with such provisinm or this Permit shall Be deemed evoked.
CONSTRUCTION LENDING AGENCY
1 Bemhy alfrm that there Its construction lending agency bring Performance of
Z 7 the work for which this permit is issued(Sec.3099.Civ.C.)
:177 Lendeis Name
Lender's Address
D
7.J 0 1 certify that 1 have read this application and state that the above information is
f•" bonm ding I agree comply with all cityty and couo nty uNinameef and sat 1 laws relating e
�U abovebuildingcotioned construction.and hembyauthoriaerposes, anivu of cars City 10 enter upon the I
aborad-mcein gree to averty for i Indemnify
an Purposes.
I,
We)agree m cast,indemnify and keep harmless the City of Cupertino against 2�kL
Z in
oftherossang espnsPe which may in any way acerae against said City
:) z A APPLICANT
NDIb RSTANDfthis permit.
APPLICANT UND RS'TANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Dale
v SOUR ER UL DNS��.JpJ ,� _
i/i� 0Ot Re-roofs .
Signature of Appban Cummoor 'Date
ZARDDUSMATERIALS DISCLOSURE Type of Roof
Will Be a Cupertino
nr fMuni ipal Code,
Chapter
amrc or handl[ Health and
dcfinbd by the Cupeninn Municipal Codc,Chapmr 9.13,and the Ilcahh vnJ Safcny
de,Section 25532(a)7 All roofs shall be inspected prior to an roofing material beim Installed.
❑res �fi+. P P Y g g
Will the applicant or future building Occupant use equipment no devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit ha,todmus air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection.
District?
❑Yes �[x N. 1
I have mad Ne hamodnus materials requirements under Chapter 6.95 of the Califon
nim Health&Safety Code.Sections 25505.25533 and 25534,1 understand that if the building — OS
does net gently have a tenant.that in is my responsibility m nod ly the oaeupanl of the YL
nen, rd dswbi moa met prior,.issuing,of a certificate Of Oaupancy Signature of plicant Dale `
owner.ra.m.riac ag nn )��Da� All roof coverings to be Class"B" or better
® CITY OF CUPERTINO
Item 1 of 1 PERMIT RECEIPT OPERATOR: conniew
COPY # 3
Sec : Twp : Rng : Sub : Elk: Lot :
APN . . . . . . . . : 32610054 . 00
DATE ISSUED. . . . . . . : 01/20/2005
RECEIPT # . . . . . . . . . : 28320
REFERENCE ID # . . . : 05010112
SITE ADDRESS . . . . . : 10591 N DE ANZA BLVD
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : BAGEL STREET CAFE
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : K LIN
CONTRACTOR . . . . . . . : ALLEN LIN LIC # 22174
COMPANY . . . . . . . . . . : ALLEN SIGNS INC
ADDRESS . . . . . . . . . . : 1982 STONE AVE
CITY/STATE/ZIP SAN JOSE, CA 95129
TELEPHONE : (408) 280-6500
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
-- - ------ -------- ---- ------ - --- -- --- - -
BPERMFEE VALUATION 4 , 000 . 00 104 . 76 0 . 00 104 . 76 0 . 00
BPLANCHK PERMIT FEE 104 . 76 139 . 80 0 . 00 139 . 80 0 . 00
BENERGY PERMIT FEE 104 . 76 50 . 28 0 . 00 50 . 28 0 . 00
BREMSIGNAD NO. CIRCUITS 1 . 00 4 . 80 0 . 00 4 . 80 0 . 00
EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
BREMSIGNS NO SIGNS/MARQ 1 . 00 23 . 98 0 . 00 23 . 98 0 . 00
BSEISMICOM VALUATION 4 , 000 . 00 0 . 84 0 . 00 0 . 84 0 . 00
- - ------- --- ----------
TOTAL PERMIT 362 . 83 0 . 00 362 . 83 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
------- - --------- - -- --------- ------- -----
OTHER 362 . 83 AMEX
TOTAL RECEIPT 362 . 83
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
--101--- FOUNDATION__ ==103-=- UFER---==___________________
104 REBAR 105 ANCHOR BOLTS
304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL
514 FINAL PUBLIC WORKS
,� • CITY OF CUPERTINO* o
SIGN S�
T
bF
OCUPERINO PERMIT APPLICATION FORM
APN# Date: II//
3Z6� 10-l�S� f2o DS
Building Address:
(OS9 I J- 0& Anza 'Blud.
Owner's Name: Phone#:
'e.
Contractor: License#:
S' I n 3 -
Contact: Phone #:
Applicant/Contractor:
All-em Ac .
Building Permit Info:
Bld lec Plumb Mech
Job escription:
Residential: C ommercial:
Sq.Ft. Floor Area: f $/Sq.Ft.:
Architect/Engineer: Cost of Project:
46 /a
Type of Construction-
Occupancy Group:
Qty. if
ApplicabIg, Fee ID Fee Description Fee Group
BENERGY Energy BUILIDNG
( BPERMFEE Bldg Permit Fees BUILIDNG
J BPLANCIIK Plan Check Fee BUILIDNG
J BSEISMICOM Seismic Commercial BUILIDNG
( EPERMITFEE Elect Permit Issuance ELECTRICAL
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
J BREMSIGNS Rmdl Signs, Marquee ELECTRICAL
BUSLIC Business License BUILIDNG
z
BAGEL STREET CAFE BUILDING SIGN ELEVATION: 10591 N.DE ANZA BLVD. CITY OF CUPERTt
_31'-6"
5TORE FRONTAGE STORE FRONTAGE
PROPOSE TWO NEW SIGNS INSTALL®NORTH&SOUTH BUILDING NEW 51GN LOCATION NEW 51GN LOCATION
i
�p RACEWAYPAINTED �-_ _ t� -
DUNNEDWARD#5P4036ANGEL'5HAIR .g-=T
R A_-G---EV'S T,R_-E-,f--Tu
5"THICK INDIVIDUAL CHANNEL LETTERS,NEON FOR INTERNALLY ILLUMINATION. _— _ _ - - _ -
AFN
314"RED COLOR TRIM-CAP,RETURN PAINTED BRONZE COLOR,
LETTER5 WILL 6E#2793 RED COLOR WITH 15mm RED COLOR NEON - - --- - - - old
SCALE:1/4'=1'-O" DATE:OCT-06-2004 901_TH BUILDING ELEVATION: NORTH BUILDING ELEVATION:
BAGEL STREET OFFICE COPY
10591 N.DE ANZA BLVD.LVD.
-�7 CITY OF G� 2TINO
5- 5HEET METAL RACEWAY \ –w
1/4"LAG 5CREW INTO
BUILDING WOOD MEMBER
TOP&BOTTOM®4'-O"O.C. t— VALLEY GREEN DRIVE —► RECEIVEp
1.5"x1.5"METAL BRACKET m
DISCONNECTED SWITCH \ °A3 �" z �4 N 2 C 205
#10x1"5CREW MINI PER LETTER
g c is II Q O
°I
1/47x1"60LT&NUT
4 BUILDING BACKGROUND ? I a PLOT PLANS
a�
/ Gi < GHE(X BY.
TRANSFORMER p /j�
, � '� I
CHANNEL LETTER _- ./„/ DA
INSTALLATION DETAIL L---------__—__—__—__—__—__—__—__—__--- LANNING EPT.
DATE
NEW SIGNS LOCATION
C
fL408/280-8500
W408/280-8700
APPROVAL: DATE: PROJECT.- All deoign5 &art works belong to Allen 5ign6, Inc. Any duplication i5 prohibited. COPY RIGHT 2004 1982 SCONE AVE
SAN,JOSE, CA. 95125
State Lic.#834580