BLD-2022-1932_Request for Extension Revised 7/25/2017
REQUEST FOR PERMIT EXTENSION
Please e-mail the completed form to
permitcenter@cupertino.org
Under Plan Review Process Issued Permit
Building Address: ____________________________________ Permit Number: _______________
Owner Name: ________________________________________________________________________
Owner Address: ____________________________________ Phone: __________________________
Contact Name: _______________________________________________________________________
E-mail Address: ______________________________ Phone: _________________________________
Reason(s) (please be specific): __________________________________________________________
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Signature: __________________________________ Date: _________________________________
(CITY OF CUPERTINO USE ONLY)
Yes No
Approval: Expired Date: ___________________ Fee: $ _______________
10415 Moretti Dr. Cupertino BLD-2022-1932
Yoon, Haksoo
10415 Moretti Dr. Cupertino 650-223-1527
Garcia, Katrina
admin@homenes.com 408 254 4663
Our administrative assistant is no longer with us and we are doing an audit
of our installations and noticed that this permit was never completed.
11/29/23
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