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S 2050 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY ,. (JG.0 ��(�/yti CI TY OF CUPERTINO • BUILDING-ELECTRICAL,' Ii I'I'NO.BUILDINui DIVISION APPLICATIONIPERBIIT PLUMBING.-MECHANICAL V 2050 _ BUILDING PROJF,C'T IDENTIFICATION BUTLDINGADDRESS: Q.f SANITARY NO. APPLICATION SUBMITTAL DATE Co38a �n' w�� <� R SO j4 ��l OWNERS NAME: 111IONII: CONTRACTOR S NAME: LIC NO'. • S lit— NIC CONTROL# ` ARCHITECUENGINEER: LIC NO: ADDRESS: *Vt ❑ CONTACT: PHONE: - BUILDING PERMITINFO ❑ Consultant Fees Paid by Applicant(Initial) BLDG ELECT' PLUMB MliCH �2' ❑ ❑ ❑ LICENSED CONTRACTOR'S DECLARATION QTY ELECTRIC PERMIT FEE CIZZI hereby affirm that 1 am licensed under provisions of Chapter 9(commencing JOB DLSCRIPTION wo, with Section 7000)of Division 3 ofthe Business and Professions Cale.and my license is W adO PERnfIIISSUANCF. RESIDENTIAL: CWF in full farce and eke . layg � _ ❑til'DWI. f� ❑KITCHEN REMODEL QU[) Latera Class Lica APPLIANCES-RIiSIDF.N'I'IAh ❑ADDITION } ❑PLUMBINGRIiPIPE F W 111 a� Cunoa•sr