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08080092BUILDLYG'DIVISIGN PERMIT BUILDING ADDRESS: reamu nu. .1157 CANDLELIGHT WAY ALLIED AIRE SERVICE INC 08080092 OW NER'S NAME: PERMIT ISSUE DATE DINGER GARY M AND CAROL A ET 661 SINCLAIR FRONTAGE RD 08/13/2008 ONE: (408)934-8844 SANITARY NO. CONTROL NO. LILCIVaCV LVnnIrtRFIVna VCIaARX11V1Y "may affirm Wt I am limned under Provisions of Chapmr 9 (rommcncing Job Description wit Scemn 7") of Division 3 of Ne Byynaaa aod��'omc 3.aosdm_yBocnacia REPLC EXSTNG FURNACE in full forte and ccL License us Dale L Contractr g y Licensed Prefeuional OWNER -BUILDER DECLARATION i 1 hereby IT,,. that 1 am exempt from to Contranors License Law for Ne ❑ O following reason. (Section 7031.5. Business and Pmfeatioos Code: Any city or county K $ V which requires a permit te cnnslmcL alter, improve, dcmolim. or repair any atrmture 0 prior in its iuuaMc. also requires the applicant for such permit to file a signed stammcnt ££ that he is licensed pursuant m IW provisions of to Contmew'3 Littre , Law (Chapter 9 Y1- (commencing wit Section 70DO) of Division 3 o to Business and Professions Codc) or that he is exempt dmrtfmm and Ne basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not mote Nan fin hundrad dollars (5500). ❑ L o ownm of Ne ampmty, rt my emmmudedwit weed u dmir seee Business will do to work and Ne he Com is nm s Livens or a w do s Out a(Sec. 7014, diner of and ertywho ns Code: The Contracmh License Law deo Inst apply m an owner is own emywhe Wilmrided rowthimprand who amssuchwde oroffendNmugh his however, the building tat suchimps sold wiitarene Year fcmolfered me mater- builder ater- however, Ne building or impmvemml'u surd within one year of c improve r Ne owmr- W lldm will have to burden Of proving Nat he did not Wild or improve (ver Purpose of ssI.J. 1, as Owner of the propony, am exclusively conducting with licensed canuxmrs on consumer the pmloet (Sec. 7054, Business and Pmfeuiotu Cade:) The Contractors U. came law does not apply to an owner of property who Wilds or improves timrnon. and who contacts for such projects wit a conlractuRs) licensed pursuant b the Contractor's License Law. ❑ lemexammader See ,B&Pcilmdrureasun Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury arm of the following declarations; I haw and will maintain a Cmditcate of Consent m.1Nan. for Wmkcrs Compen- ution, as provided for by genion 37W of to Lahor Code. for to peRormenm of the work for which Nis permit is issued. ❑ 1 have and will me -Und, Workers Composition Insurance, as required by Section 3700 of Ne Labor Code, For to performance ofto w for which Nis permit is issued, My Wm!e Fc. I mnee carrier and Policy number :� Cartier. .r f"rl oils Poli, No.: 4C CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Olds second Used ambecmmplemd if the permit is for enc hundred dollars (5100) nr ldsc) I cerdfv Nm in to perfmm Seca of to work for which Nis permit is issued. l shall not employ any person in any mennerm o m become subject to the Workers' Compensation Laws of California. Dam Applic ret NOTICE TO APPLICANT. If, after making this Canifcam of Eacmptimn, you should become subject to the WorW1'3 Compmwtion provisions of to labor Code, you must wJ ,z fie twiN comply with such provisions m tis permit shall be deemed revoked. 'Z O CONSfRUCr10N LENDING AGENCY [-� 1 hereby affirm Nat there is a construction lending agency for Ne performance of C „>,r to work for which this permit is issued (Sec. 3097, Civ. C.) �W 0 Lenders Name z Landers Andress U 0 1 conffy Nat 1 have read this apPlicadon and scam Net to shove ioinnormon is PcorrecL 1 agree m comply wit all city and county ordinances and sum laws mlating to, QU Wilding construction, and hereby interim repmsenddim of Nu city m comr open Ne W above-mentioned property for inspection purposes F 6a (We) agree to sew, indemnify add kecp harmless the City of Cupertino against fA Iiabilidn,Judgments, costs and expeew, which may in my way acrnm against and City V z in consequence of to granting of Nis poeth, APPLICANT UNDERSfAD'B3 O WILL COMPLY WITH ALL NON -POINT ...'enure or nppneanvcont se. Dem HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building mxupsutsmro or handle hevrdom material as deftncd by the Cupertino Municipal Code, Chapter 9.12, and the Halt and Safety Code, Schon 25532(a)? OY Will the applicant or future building occupant an equipment or devices which Ink hazardous air contaminants u defined by to B, Area Air Quality Management Gotta? ❑Ye No I have read Ne haaardous materials m uimments under Chapter 6.95 of to Calife, ria Hcallh& SafctyCede, Secdmu 25505.25533 and 25534.1 Understand that if Use Wilding does out c.nd, have • mnanl Nmar ilk my moodusti,hy m nedfy due occupant of me $1200 36224045: Required Inspections Issued by: Re -roofs Type of Roof n VILVIIVIa'C.tvua InFU Date a- - - I( 3 � $ 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 'W' or better • 6 ITEMS OF 6 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36224045.00 DATE ISSUED.......: 08/13/2008 RECEIPT #.........: BS000005776 REFERENCE ID # ...: 08080092 SITE ADDRESS .....: 1157 CANDLELIGHT WAY SUBDIVISION ..... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: patg COPY # : 1 OWNER ............: DINGER GARY M AND CAROL A ET A ADDRESS ..........: 1157 CANDLELIGHT WAY CITY/STATE/ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM ....: ALLIED AIRE SVC INC CONTRACTOR .......: STEINER, ARNOLD R LIC # 19207 COMPANY ..........: ALLIED AIRE SERVICE INC ADDRESS ..........: 661 SINCLAIR FRONTAGE RD CITY/STATE/ZIP ...: MILPITAS, CA 95035 TELEPHONE (408)934-8844 • FEE ID UNIT QUANTITY AMOUNT. PD -TO -DT THIS REC NEW BAL IBSEISMICR VALUATION 1,200.00 0.50 0.00 0.50 0.00 1EPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 1MPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 1MRRAA UNITS 1.00 61.19 0.00 61.19 0.00 1PPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 1TRAVDOC FLAT RATE 1.00 40.79 0.00 40.79 0.00 TOTAL PERMIT ---------- 224.85 ---------- ---------- 0.00 224.85 ---------- 0.00 METHOD OF PAYMENT --------------- CHECK TOTAL RECEIPT AMOUNT --------------- 224.85 --------------- 224.85 VOICE ID DESCRIPTION -------- ---------------------------- 505 FINAL ELECTRICAL 508 FINAL MECHANICAL • REFERENCE NUMBER -------------------- #20170 VOICE ID DESCRIPTION -------- ---------------------------- 507 FINAL PLUMBING Olt# •CUPEkTINO CITY OF CUPERTINO FURNACE/AC PERMIT APPLICATION FORM oXU8U`CIA APN# 3aa 6 Building Addressi/S -�-G / eL 16 q Gt/ Owner's Name: L A1i'DL ��.vl wiz08 Pho e #: S �,-? SSS j. Contractor: �%le4614lwe-Azv16eZ,- c Phone #: /� 7 Fax #: ZID9 493Y ?ff -/'Q Contractor License #: Cupertino Business License #: o?�OD3,S Contact: Phone #: �108 6y0 i8L'� Fax #: V081 Building Permit Info: Elect ❑� Plumb ['� Mech "9 Residential Commercial Job Description: For Residential Installations: Attic ❑ 1" floor 2"a floor ❑ Adhere to minimum setback requirement ❑ For Commercial Installations: Replacement same weight ❑ Structural Calculations required for new installation Additional weight (structural calcs) ❑ ❑ New installation Planning Approval Required ❑ Cost of Project: Type of Construction (Usage Class): IaZDD Strapped On Platform Bonded New Location ❑ Replacement Project Size: Express ❑ Standard Large ❑ Major ❑ Valuation: Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set & the sheet index._ Revised 6/16/08 aCG CUPEkTINO CITY OF CUPERTINO FURNACE/AC FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group FURNACE FURN/AC 1MCRAA Commercial-Repair/Alteration/Add to M ca heating appliance,refrigeration unit, cooling unit,absorption unit,or ea heating,cooling,absorption or evaporative cooling system;incl installation of controls regulated by this code. IMCREPALT Commercial for the repair of alt/add to M ea heating appliance,refrigeration unit,cooling unit,VAV boxes, absorption unit or ea heathing, cooling absorption,or evaporative cooling sys, incl install of controls regulated by this code. IMCSUSHTR Commercial Install/Relocate ea M suspended heater,recessed wall htr, or floor mounted unit heater. 1PGASCOM Commerical for ea gas piping System P 1-4 outlets 1BPGAS For each gas piping system of 5 or P more per outlet. 1MCAPPVNT Commercial for the install/relocate/ or M replacement of ea appliance vent installed & not incl in an appliance permit. 1BSEISMICO Commercial Seismic B 1 MRRAA Residential Repair/Alteration/Add to M ea heating appliance,refrigeration unit, cooling unit,absorption unit,or ea heating,cooling,absorption or 1/ evaporative cooling system,incl installation of controls regulated by this code. 1MRSUSHTR Residential Install/Relocate ea M suspended heater,recessed wall htr, or floor mounted unit heater. 1MRAPPVNT Residential for the install/relocate/ or M replacement of ea appliance vent install & not incl in an appl permit. Quantity Fee ID Fee Description Fee Permit Type rm 0 • • Cin o •CUPEkTINO CITY OF CUPERTINO FURNACE/AC FEESCHEDULE is I Quantity I Fee ID Fee Description Fee Permit Tvne Group FURNACE FURN/AC 1PGASRES• Residential for ea gas piping system of 1-4 Outlets P 1BPGAS For each gas piping system of 5 or more per outlet. P IBSEISMICR Residential Seismic B 1MECPLNCK Mechanical Plan Check M 1MFR=<100 Furnace Syst <=100k BTU install or relocate ea forced-air/gravity type fumace/bumer, incl ducts/vents attached to such appliance up to and include 100,000 Btu/h M 1MFRN>100 Furnace Syst > I 00 BTU install or relocate ea forced-air/gravity type fumace/bumer, incl ducts/vents attached to such appliance over 100,000 Btu/h M ,IEPERMITFEE Electric Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit P 1TRAVDOC Travel Documentation B 1BUSLIC Business License B is I Quantity I Fee ID Fee Description Fee Permit Tvne Uz Acl r CUPEkTINO CITY OF CUPERTINO FURNACE/AC FEE SCHEDULE 0 • 0 Group AIR CONDITIONING FURN/AC 1BCAIRHAN Commercial A/C Units <= lOk CFM B 1MCRAA Commercial Mech Repair/alt/add M 1BSEISMIC0 Seismic Commercial B 1PGASCOM Commerical for ea gas piping System 1-4 outlets P 1PGASRES Residential for ea gas piping system of 1-4 Outlets P 1BPGAS For each gas piping system of 5 or more per outlet. CommfResid P 1BREMAIRHAN Residential A/C units <= IOk CFM . B 1MRRAA Residential Mech Repair/alt/add M 1BSEISMICR Seismic Residential B IEPERMITFEE Electric Permit E 1MPERMITFEE Mechanical Permit M 1PPERMITFEE Plumbing Permit P 1TRAVDOC Travel Documentation B 1BUSLIC Business License B 0 • 0 r L • • Plan Review Process Work Book Page -12-Revised 3/25/08 Green Building Plan Check Index of Green Building Points/Categories A. Category Example of an Index or Table of Green Plan Sheet or Page Points Building Points Categories that must be shown and referenced on the Project Plans See below B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 paints 11. Permeable Paving, Note L-12 Lints C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 points D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 __j 2 paints 5. Use Truss with heels, (detail) S-2 2 points 6. B. OSB Sheathing, detail S-2 2 oints E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points 4. B. Fiber Cement Siding, (Note/Spec.) A-4 2 Dints F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points 5. Tankless W.H., (Note/Spec.) A-2 2 points 11. A 2500 Gal. Tank, (Note/Spec) L-1 10 aints G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 paints H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point 3. Energy Star Refrierator, (Note/Spec.) A-3 1 Dint P. Other 1. List Green Features on Plans A-1 1 point TOTAL POINTS1 40 points • • Plan Review Process Work Book Page -12-Revised 3/25/08 Green Points Rating System for Remodeling Projects Due to the diversity of remodeling project types, assigning a "total points" value to a project to be considered environmentally friendly is • not feasible. However, 25 measures have been highlighted to signify that every effort should be made to incorporate them into your projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with ease of implementation and relative low cost. These measures can be used as a starting point for 'greening' your project. INPUT ReSDurces Energy AQ/Heafth A. Site 1. Recycle Job Site Construction & Demolition Waste 65%=1 point; 75%= 2 points; 80%= 4 points up to 4 Resource pts 0 2. Salvage Reusable Building Materials 4 Resource pts y=yes 0 3. Remodel for Mixed Use, Adaptive Reuse, and Historic Preservation 4 Resource pts y=yes 0 4. Protect Native Soil 2 Resource pts y=yes 0 5. Minimize Disruption of Existing Plants & Trees 1 Resource pt y=yes 0 6, Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0 7. Protect Water Quality with Landscape Design 2 Resource pts y=yes 0 F8. Design Resource--Esicient Landscapes and Gardens 4 Resource pts y=yes 0 9, Reuse Materials/Use Recycled Content Materials for Landscape Areas 2 Resource pts y=yes 0 10, Install High -Efficiency Irrigation Systems 2 Resource pts y=yes 0 11. Provide for On -Site Water Catchment / Retention 2 Resource pts y=yesl 0 B. Foundation 1. Incorporate Recycled Flyash in Concrete •25% Recycled Flyash = 2 points; Add 1 point for every 10% increase of flyash, up to 5 points up to 5 Resource pts 2! Use Recycled Content Aggregate 2 Resource pts y=yes 3. Insulate Foundation/Slab before backfill 3 Energy pts y=yes C. Structural Frame SSubstitute Solid Sawn Lumber with Engineered Lumber 3 Resource pts y=yes 2. Use FSC Certified Wood for framing (For every 10% of FSC lumber used = 2 points, up to 10) up to 10 Resource pts 3. Use Wood I -Joists for Floors and Ceilings 2 Resource pts y=yes 4. Use Web Floor Trusses 2 Resource pts y=yes 5. Design Energy Heels on Trusses 6' or more 2 Energy pts y=yes 6. Use Finger -Jointed Studs for Vertical Applications 2 Resource pts y=yes 7. Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 8. Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 9. Use Structural Insulated Panels (SIPS) a. Floors 3 Energy pts y=yes b. Wall 3 Energy pts y=yes c. Roof 3 Energy pts y=yes 10. Apply Advanced Framing Techniques 4 Resource pts y=yes 11. Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes 12. Use 0SB — --" -- a. Subfloors 1 Resource pt y=yes • b. Sheathing __ __ _ 1Resource pt y=yes 11. Use Sustainable Decking Materials a. Recycled content 3 Resource pts y=y( b. FSC Certified Wood 3 Resource pts y=y( 2. Use Treated Wood That Does Not Contain ChromiumlArsenic 1 IAQ/Health pt y=ys 3. Install House Wrap under Siding 1 IAQ/Health pt y=ys 4. Use Fiber -Cement Siding Materials ^ _ 1 Resource pt y=yes E. Plumbing 1. Install Water Heater Jacket 1 Energy pt y=yes 2. Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 3. Retrofit all Faucets and Showerheads with Flow Reducers j a. Faucets (1 point each, up to 2 points) b. Showerheads (1 point each, up to 2 points) 4. Replace Toilest with Ultra -Low Flush Toilets (1 point each, up to 3 points) 5. Install Chlorine Filter on Showerhead 6. Convert Gas to Tankless Water Heater 7. Install Water Filtration Units at Faucets (2 points each, up to 4 points) 8. Install On -Demand Hot Water Circulation Pump P. tiecmcar 1. Install Compact Fluorescent Light Bulbs (CFLs) (6 bulbs=2 points, 10 bulbs =3 points, 12 bulbs = 4 points) 2. Install IC -AT Recessed Fixtures with CFLs (1 point each, up to 5 points) 3. Install Lighting Controls (1 point per fixture, up to 4 points) 4. Install High Efficiency Ceiling Fans with CFLs (1 point each, up to 4 points) G. Appliances 1. Install Energy Star Dishwasher 2. Install Washing Machine with Water and Energy Conservation Features 3.Install Energy Star ReMgerator 4. Install Built -In Recycling Center H. Insulation 1. Upgrade Insulation to Exceed Title 24 Requirements a. Walls b. Ceilings 2. Install Floor Insulation over Crawl Space 3. Install Recycled -Content, Fiberglass lrisulation witli No Added Formaldehyde 4 Use Advanced Infiltration Reduction Practices 5. Use Cellulose Insulation a. Walls b. Ceilings 6. Alternative Insulation Products (Cotton, spray -foam) a. Walls o.cemngs Up to 2 Resource pts Up to 2 Resource pts Up to 3 Resource pts 1 IAQ/Health pt y=yes 4 Energy pts y=ye Up to 4 IACJHealth pts 4 Resource pts y=ye Up to 4 Energy pts. Up to 5 Energy pts. Up to 4 Energy pts. Up to 4 Energy 1 Energy pt 1 Energy pt 1 Energy pt 3 Resource pts 2 Energy pts 2 Energy pts 4 Energy pts 31AQ/Health pts 2 Energy pts 4 Resource pts y=yes 4 Resource pts y=yes 4 Resource pts 4 Resource pts J is E � 0 � 4 Resource pts y=yes 4 Resource pts y=yes 4 Resource pts 4 Resource pts J is E -1.instill Energy-EtficientWindows y=yes 3 Energy pts • a. Double -Paned 1 Energy pt y=yes b. Low -Emissivity (Low -E) 2 Energy pts y=yes c. Low. Conductivity Frames 2 Energy pts y=yes 2.lnstall Low Heat Transmission Glazing -- - 1 Energy pt y=yes J. Heating Ventilation and Air Conditioning F1 Use butt Mastic on KI-1w6t Joints 2. Install Ductwork within Conditioned Space 3. Vent Range Hood to the Outside 4. Clean all Ducts Before Occupancy 5. Install Solar Attic Fan 6. Install Attic Ventilation Systems 7. Install Whole House Fan 8. Install Sealed Combustion Units a. Furnaces b. Water Heaters 9. Replace Wall -Mounted Electric and Gas Heaters with Through -the -Wall Heat Pumps 10. Install 13 SEER/11 EER or higher AC with a TXV 11. Install AC with Non -HCFC Refrigerants 12. Install 90% Annual Fuel Utilization Efficiency (AFUE) Furnace 13. Retrofit Wood Burning Fireplaces • a. Install EPA certified wood stovestinserts b. Install/Replace Dampers c. Install Airtight Doors 14. Install Zoned, Hydronic Radiant Heating 15. Install High Efficiency Filter 16. Install Heat Recovery Ventilation Unit (HRV) 17. Install Separate Garage Exhaust Fan K. Renewable Energy and Roofing 1. Pre -Plumb for Solar Water Heating 2. Install Solar Water Heating System 3. Pre -Wire for Future Photovoltaic (PV) Installation 4. Install Photovoltaic (PV) System (1.2 kw = 6 points, 2.4 kw = 12 points, 3.6 kw = 18 points) i6. Select Safe and Durable Roofing Materials 17.Install Radiant Barrier - — -�-- - -- --- L. Natural Heating and Cooling 1. Incorporate Passive Solar Heating 2, Install Overhangs or Awnings over South Facing Windows 3, Plant Deciduous Trees on the West and South Sides is 2 Energy pts y=yes 3 Energy pts y=yes 1 IAQ/Health pt y=yes 21AO/Health pts y=yes 2 Energy pts y=yes 1 Energy pt y=yes 4 Energy pts y=yes 31AQ/Health pts 31AQ/Health pts 3 Energy pts 3 Energy pts 2 Resource pts 2 Energy pts 1 IAQMealth pt y=yes 1 Energy pt y=yes 1 Energy pt y=yes 3 Energy pts y=yes 41AQ/Health pts y=yes 5 IAQ/Health pts y=yes 31AQ/Health ots v=ves 4 Energy pts y=yes 10 Energy pts y=yes 4 Energy pts y=yes Up to 18 Energy 1 Resource pt y= 3 Energy pts y= 5 Energy pts y=yes 3 Energy pts . y=yes 3 Enerov ots v=ves (1. Use Low/No-VOC Paint 1 1 IAO/Health pts 2. Use Low VOC, Water -Based Wood Finishes 2 IAQ/Health pts 3. Use LowMo VOC Adhesives 3 IAO/Health pts 4. Use Salvaged Materials for Interior Finishes 3 Resource pts 5. Use Engineered Sheet Goods with no added Urea _ 3. Use Recycled Content Ceramic Tiles Formaldehyde 61AO/Health pts 6. Use Exterior Grade Plywood for Interior Uses 1 IAO/Health pts �7. Seal all Exposed Particleboard or MDF _ _ __ 4 IAC/Health pts B. Use FSC Certified Materials for Interior Finish 4 Resource pts 9. Use Finger -Jointed or Recycled -Content Trim 1 Resource pts 10. Install Whole House Vacuum System 3 IAQ/Health pts N. Flooring 1. Select FSC Certified Wood Flooring 6 Resource pts y=yes 2. Use Rapidly Renewable Flooring Materials ^_ J 4 Resource pts y=yes _ 3. Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 4. Install Natural Linoleum in Place of Vinyl 51AQ/Health pts y=yes 5. Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 6. Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes Total Points Aval ab e: Total Points Project Received: • 1401 1301 57 01 • G:dalalprogsrgreenbuildmo3uidelines4emodelerslgreenpdntsfina1212.04prrnened.sls 0 Community Development a10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 CITY OF Fax (408) 777-3333 �UPERTINO Building Department JOB ADDRE S: � BUSINESS NAME PERMIT #��� OWNER'S NAME: i i 6C PHONE # GENERAL CONTRACTOR: o4lll, ; e J FAX # I am not using any subcontractors: T.-F�%.�l 2� /3 O Signature Date Please check applicable subcontractors and complete the following information: Owner/ Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing /-- Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/ Contractor Signature Date