12030069CITY OF CUPERTINO BUILDING PERMIT ` 9 __4 W-�-
BUILDING ADDRESS: 2 RESULTS WAY
OWNER'S NAME: ECI TWO RESULTS LLC
OWNER'S PHONE: 6502924101
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. 4 2LU� Zu
Contractor wC,_kA�3(?'47 Date l.V► (y I L C_
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.
1 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 work 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
� Date 44LL
❑ OWNER -BUILDER DECLARATION
1 hereby affirm that 1 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, l 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
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 non -point source regulations per the Cupertino Municipal Code, Section
9.18.
CONTRACTOR: VALLEYCREST — PERMIT NO: 12030069
LANDSCAPE MAINT CO
24151 VENTURA BLVD DATE ISSUED: 06/01/2012
CALABASAS, CA 91302 PHONE NO: (408)453-5904
BUILDING PERMIT INFO: BLDG F ELECT F PLUMB r
MECH r RESIDENTIAL r— COMMERCIAL r—
JOB DESCRIPTION: INSTALL 2 MONUMENT SIGNS AND PEDESTAL FOR FUTURE
SCULPTURE AND CONTSTRUCT BASES FOR 2 MONUMENT AT
THE FRONT ENTRANCE 6N14112-REV#I REVISE SIGNAGE CONSTRUCT BASES FOR TWO MONUMENT SKNS AT ENTRANCE,
SIZE OF SIGN- 6114112 REV# I ISSD
Sq. Ft Floor Area: I Valuation: $10000
APN Number: 35720042.2 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS M LAST CALLED INSPECTION.
Isb Date:
T
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.
e
LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of Hork's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Date I Licensed
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 2 RESULTS WAY
CONTRACTOR: VALLEYCREST
PERMIT NO: 12030069
LANDSCAPE MAINT CO
OWNER'S NAME: ECI TWO RESULTS LLC
24151 VENTURA BLVD
DATE ISSUED: 06/01/2012
OWNER'S PHONE: 6502924101
CALABASAS, CA 91302
PHONE NO: (408)453-5904
❑ LICENSED CONTRACTOR'S DECLARATION
r F r
License Class 2 Lic. # V0110Z l 1
BUILDING PERMIT INFO: BLDG ELECT PLUMB
MECH r— RESH)ENTIAL r— COMMERCIAL �
Contractor & Date
1 hereby affirm that 1 am licensed under the provisions of Chapter 9
JOB DESCRIPTION: INSTALL 2 MONUMENT SIGNS AND PEDESTAL FOR
(commencing with Section 7000) of Division 3 of the Business & Professions
FUTURE
SCULPTURE AND CONTSTRUCT BASES FOR 2 MONUMENT AT
Code and that my license is in full force and effect.
THE FRONT ENTRANCE
1 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 work for which this
Sq. Ft Floor Area:
Valuation: $10000
permit is issued.
APPLICANT CERTIFICATION
APN Number: 35720042.2
Occupancy Type:
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,
PERMIT EXPIRES IF WORK IS NOT STARTED
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non -point source regulations per the Cupertino Municipal Code, Section
180 DAYS FROM LAST CALLED INSPECTION.
9.18. _
—
Issued by: �C,/V �i�%l/� Date: I l�
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
RE -ROOFS:
the following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
I, as owner of the property, or my employees with wages as their sole compensation,
installed without first obtaining an inspection, I agree to remove all new materials for
will do the work, and the structure is not intended or offered for sale (Sec.7044,
inspection.
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
Signature of Applicant: Date:
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
declarations:
l have and will maintain a Certificate of Consent to self -insure for Worker's
HAZARDOUS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance, as provided for by
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
Section 3700 of the Labor Code, for the performance of the work for which this
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
permit is issued.
Additionally, should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued, I shall
contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Compensation laws of California. If, after making this certificate of exemption, I
Health & Safety Code, Sections 25505, 25533, and 25534.
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
CONSTRUCTION LENDING AGENCY
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
I hereby affirm that there is a construction lending agency for the performance of %ork's
to building construction, and hereby authorize representatives of this city to enter
for which this permit is issued (Sec. 3097, Civ C.)
upon the above mentioned property for inspection purposes. (We) agree to save
Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Lender's Address
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
ARCHITECT'S DECLARATION
9.18.
1 understand my plans shall be used as public records.
Signature Date
—
Licensed-PTofessional _........_.. _ .. ---- .---
rM---,7
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
iaADDRES
results way
DATE: 03/15/2012
REVIEWED BY: bobs.
APN:
BP#:
'EVALUATION: $10,000
PERMIT TYPE: Building Permit
PRIMARY
USE: Sign
PENTAMATION
PERMIT TYPE: 1 CEAP5
WORK
install 2 monument signs and pedestal for future are sculpture at front entrance of existing commercial
SCOPE
site.
SIGN TYPE
FEE ID
QTY
SIGN FEE
Other Sign
1SIGNOTHER
3
$981
TOTALS:
$981.00
# Branch Circuits 1 $44.00
lESIGN Elec. Permit Fee: IEPERMIT
Other Elea Insp. 0.0 $44.00
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, eta). These lees are based on the prelim inary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (fee Resolution 11-053 £'ff 711.111)
FEE
QTY/FEE
MISC ITEMS
Suppl. PC Fee: 0 Reg. 0 OT
0.0 1
hrs
$0.00
Permit Fee:
$981.00
Suppl. Insp. Fee-.0 Reg. Q OT
0,0
hrs
$0.00
PME Unit Fee:
$44.00
PME Permit Fee:
$44.00
Work Without Permit? Yes (F) No
$0.00
Sign Master Plan: Q Yes (F) No
$0.00
Travel Documentation Fee: ITRAVDOC
$44.00
Strong Motion Fee: IBSEISMICO
$2.10
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$1,116.10
$0.00 TOTAL FEE:
1 $1,116.10
Revised: 1 /19/2012
FM_7
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 2 RESULTS WAY
DATE: 06/14/2012
REVIEWED BY: SYLVIA
APN:
BP#:
'VALUATION: Iso
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY
USE: Commercial Building
PENTAMATION
PERMIT TYPE: 1GENC0
WORK
Revision #1- Revise si na e- construct bases for two monument signs at entrance size of sign
SCOPE
Xlech. Mara ChECA.
V,,ch. 1''� rn :
PfJJmh. ; , l' r.
lilac. Rrrnirr Ft
')rfx r i1 x ': ,
Emlif
.,'Umfi Im
(i ,:. r <. Insp.
I i11.. f'r'r;:
!'frvlob, fu.ip. Fey.'
r, ,
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District. eta). These lees are based on the Dreliminary information available and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes 0 No
$0.00
F-27 hours Plan Check, Hourly
$260.00 1STPLNCK
Suppl. PC Fee: Q Reg. 0 OT
0.0 1
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee-.0 Reg. 0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
0
0
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential 0
Building or Structure 0
l l-cJ1C'.l L)i]CIl II'J t'nlLlt 11 rl7 /'eF�:S:
Strong; Motion Fee:
$0.00
Select an Administrative Item
Bldg Stds Commission Fee:
$0.00
SUBTOTALS:
1 $0.001
$260.00 TOTAL FEE:
$260.00
Revised: 06/05/2012