08080143 CITY QF CUPERTINO4,
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION
BUILDING ADDRESS: PERMTT NO.
996 CRANBERRY DR WESTSHORE ROOFING INC 08080143
OWNER'S NAME: FERMTT ISSUE DATE
CIIENG WI.N-SI"IENG AND JUI-YUEN 2814 AIELLO DR C 08/19/2008
NE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
RE-RF RMV 2LYR WDSHK INSTL BLDG ELECT FLUME MECH
O o LICENSED CONTRACTOR'S provisions DECUBATION 8EF-ARB efffii Mit 85,
4UE Iiothereby a,OfDivthat w3ofthe licensed Buinds andPrienrs Code. 9 myliceme is -�_ .._ Job Description
tt�� wife Secuon'/Ogl)of Division Sof dm Business and Professiwu Cade.and mylicenc is
^Od in fell fora aM cfr
j�? License C Lk.a "
Co.
A S DECLARATION
sI understand my pita shall be used as public records
Ddu
g G Licensed Profcssioal
OWNER-BUILDER DECLARATION
.� f I hereby affirm that I am exempt from the Contractors License Law for the
C
00 following reguin.(Section]031.5.Busiimss and Pmfcauons Cade:My city or county
$ which ox,res a permit to convect.alms.improve.amalish,or-poi,any grump
a y prior m ita issuance,also require On applicant for such permiva file a signed statement
S< thin be ishconsed pursant w tier nevisioncof the Cimsamu's U.nate Law(Chapter 9 Sq.Ft. Floor Area Valuation
yk-g (commeneing with Section 7(00)of Division 3 of to Business and propasiou Code)or
that he u exempt therefrom and Ne basis for dm Wlcged exemption.Any violatlan of
Section 7031.5 by any applicvn for a permit Mbjccla the applicant m a civil penalty of APN Number Occupancy Type
om N
Out man five hundred dart.(Ss110). P Y YP
❑i,u owner of tis pmpeny,sir my employees wife wages u they rete compensation,
will a the work,and dmawaup u notinanded monemA tarsale(Sec.1044,Busi^a..
arta Pooressiml,Cade The Contractors Liar¢Law does Out apply to an.of Required Inspections
property who builds or improves Hereon,and who does such work himself or Through his
own employee,provided dor such improvements as not intenJed moRemd for axle.ff.
however.the Wilding or improvemat is std within one year of oompicuon,the owmr-
Wilar will have the W Wa of proving cast he did not Wild or improa for purpose of
sale.).
❑1.as owner of fee property,am exclusively convening with licensed censors in
construct Ne project(Sec.1004,Business atm Profasiau Cade:)The Convecmts V- .
cense Law dao not apply to an wmer of property who Wilda or improm thereon,and,
wW contracts for such projC=with a conuanar(,)licenced puragm,he the Conuanara
License taw. -
❑I am exempt under Sec ,B At P C for this moon
Ower Data
WORKER'S COMPENSATION DECLARATION
1 hereby ave tactor pwhy of perjury one of the following dalaruionc
I have and will maintain aCrrufimm ofCansnt to selNimum for Wurkces Compen-
sation,u provitrd fa by Section 3700 a the labor,Code.for use performance of the
wart for which this permit is issued.
0 j have and will msinWn Wofkers Comperagi I.,u squired by Section
3100of the Labor Code,fa fee pcdormmen of Ne wort forwhiclt dda permit is Issued.
Mywor�sC4am-perraumm lulLlpnceanim and Policy num ram: {
Cartier: 5rK f7 f t,/ Policy Nu.: 760 7 6
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thusnim Imed not beeunpk if the permit It Image hundred aBan(SIM)
or loss)
1 Certify that in the pc lormarce or the work fm which this permit is issued.)shall nm
croploy any perm finny mender s as m beechen subject N the WorkcWcompewum .
Laws of California.Dam
Applieant
NOTICE TO APPLICANT:It,arm,making this Ccniria¢of Exmnption,you should
become Subject in the Warkcra Compensation provisions of dm labor Code.you mug
.,O forthwith comply with such provisions or this permit shall a deemed molcd.
Z '-' CONSTRUCnON LENDING AGENCY
[-+� I hereby Orion thm them I..Construct..lendingagemy for the perfonnameuf
l5: the wish for which Nu permit a issued(Sec.3 .Civ.C.)
GQ Lenders Nene
.7. z lectors Address
U O 1 certify that 1 have rad this applicuion W sum Chas the above information is
Ila E comem I agree to comply with all city and county ordinances and state laws plating as
.C) building congmnian.and hemby auNarim mpoesaudm of this city in cater upon use
yabove-menuasd propcny for inspection puryaea
(We)agree to give,indemnify and kap halrllleas to City of Copenioa against
IA liabilities,jWgmenl,,coal,and Capering which may in any way same against said City
U,'Z in consequence of the grarrinz of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATION'%%;
S7gnarutc o�licrgContromr _� I Dam Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof G�—
WinNe Cupertino
future Wildinga.Chaptgoremand to Hcardoanmaterial
u alined by Oe Cupenina Municipal Cade.Chapter 9.12,and the HcaIN and Safety
Coda.Section 25532(11? All roofs shall be inspected prior to any roofing material being installed.
Ya No
Win the applicant r rum"Wilding occupant us equipment or avires which If a roof is installed without first obtaining an inspection,I agree to remove
pit baramms air Cml,miruna as afned by to Bay Arta Air Quality Managcmat all new materials for inspection.
Uisufctl P
Yo
I have mad the board mmerialsoupimemcnl,under ChapmrG95ofNeCalifor-
niallalNg:SdctyCao.Secant235115,25533 and25534.1 orWCmnod thatifde Wilding
dna ret cmrendY have a enema that it u MY rapmuibilitY In redly the occuPam of the //�� . V
regmoursou lc .. 0 met prmriniuuvueof.Cenirramof"'O t� Sgn�ueofApplLcant _ Dat
8 All roof coverings to be Class'W'or better
wtmr or auNarir<d agent Dam' '
CITY OF CUPERTINO
• 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lotr ..
APN . . . . . . . . .. 36202004 . 00
DATE ISSUED. . . . . . . : 08/19/2008
RECEIPT # . . . . . . . . . : BS000005832
REFERENCE ID # . . . : 08080143
SITE ADDRESS . . . . . : 996 CRANBERRY DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CHENG WIN-SHENG AND JUI-YUEN
ADDRESS . . . . . . . . . . : 996 CRANBERRY DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4756
RECEIVED FROM . . . . : BEN FOWLER
CONTRACTOR . . . . . . . : PAUL FOWLER LIC # 21417
COMPANY . . . . . . . . . . : WESTSHORE ROOFING INC
ADDRESS . . . . . . . . . . : 2814 AIELLO DR C
CITY/STATE/ZIP . . . : SAN JOSE, CA 95111
TELEPHONE . . . . . . . . : (408) 694-0060
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ----- --- ----
1.13SEISMICR VALUATION 15, 000 . 00 1 . 50 0 . 00 1 . 50 0 . 00
1REROOFRES SQ FEET 28 . 00 364 . 00 0 . 00 364 . 00 0 . 00
---------- -------- ------ ----------
TOTAL PERMIT 365 . 50 0 . 00 365 . 50 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ----- --------------- -------- ---------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
-� CITY OF CUPERTINO
REROOF
•CUPERTINO PERMIT APPLICATION
APN # 3 U v , / o � Date:
Building Address: c�Q /_ C elan ( e(y y/ Jr.
F' / d�
Owner's Name: Phone #:Cq ov
Wive Ckekl) 1(16 - x(3,3)
Contractor: Phone #:(yo y56 v �Z
Fax #: koS 56 - OZ5.3
Cupertino Business License #: �j/ L// �J Contractor License #: Z�
0 ( / f
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
Wood Shakes ❑ Wood Shakes
v, Wood Shingles ❑ Wood Shingles 51vv� coated we.tal
❑ Other (Specify) /< Other (Specify) C-2Prov-J CitnyV✓I 5h-IM
Number of existing coverings 7A-Provide I.C.B.O. Report# 55�- 1`ic11
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: RDtmJve I lovv wood SHct IGf- 1 V-7,1 5jq k1
c,e✓uvd co 176V1 50clKe Cjays �►
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation:
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
CITY OF CUPERTINO
�d:' REROOF
CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
2 P 1RER00FRES Re-roof Residential B 1SFDWLROOF
1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
•
Community Development Department
Building Division
City of Cupertino
• 10300 Torre Avenue
Telephone: (408)777-3228
Fax: (408)777-3333
Building. Department '
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards
and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino
municipal code 16.04.080.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to any roofing installation.
4. To receive a final sign off from the City, the following steps are
required:
1) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
• a) Spark arrester installation.
5. If plywood is installed,a plywood nail inspection is required.
6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re-inspection fee of$176.18. The re-inspection fee must
be Raid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs must have a minimum of /a "per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: W I✓1 C�� p s7 9
Job Site Address: ��(7 C ru 1h Ile rrV
Roofing Company Name: WP5�500vlp F!Cx�fiYiq inc—,
• Applicant's Signature�/j� ��/� Date:
Greg Casteel
Building Official
Revised 07/30/08
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
a
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points
11. Permeable Paving, Note L-1 2 points
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 point's
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points
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 oints
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refrigerator, (Note/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
R_PRIEBE= TOTAL POINTS 40 paints
•
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 AQIHealth
rte
1.Recycle Job Site Construction 8 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 8 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
Design Resource-Efficient 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=yes 0
1 1 1
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 pts0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0
1 1 1
C.Structural Frame
r.-Substitute Solid Sawn Lumber with Engineered Lumber _I 3 Resource
Pis y--yes 0
2.Use FSC Certified Wood for framing
(For every 1096 of FSC lumber used=2 points,up to 10) up to 10 Resource pts. 0
3.Use Wood I-Joists for Floors and Ceilings "2 Resource pts y=yes 0
4.Use Web Floor Trusses 2 Resource pts y=yes 0
5.Design Energy Heels on Trusses 6"or more 2 Energy pts y=yes 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yes 0
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0
B.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes 0
b.Wall 3 Energy pts y=yes 0
c.Roof 3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes 0
122.Use OSB__ - - - - - -- - -
a.Subfloors 1 Resource pt y=yes 0
• b.Sheathing !
L 1 Resource pt y=yes p
1 1
INPUT Resources Energy JAG/Health
0.Zrtenor Fmsh
1.Use Sustainable Decking Materials- -
a.Recycled content 3 Resource pts y=yes 0 .
b.FSC Certified Wood 3 Resource pts y=yes 0
12.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAQ/Health pt y=yes 0
�3.Install House Wrap under Siding 1 IAQ/Health pt y=yes 0
4.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
E.Plumbing
1.Install Water Heater Jacket _ --- 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
3.Retrofit all Faucets and Showerheads with Flow Reducers
a.Faucets(1 point each,up to 2 points) Up to 2 Resource pts. 0
b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0
4.Replace Toiled with Ultra-Low Flush Toilets
(1 point each,up to 3 points) Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showerhead 1 IAQ/Health pt y=yes 0
6.Convert Gas to Tankless Water Heater 4 Energy pts y=yes 0
7.Install Water Filtration Units at Faucets
(2 points each,up to 4 points) Up to 4 IAQ/Health pts. 0
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y--yes 0
1 1 1
r.uecmcai
1.Install Compact Fluorescent Light Bulbs(CFLs)
(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) Up to 4 Energy pts. 0
2.Install IC-AT Recessed Fixtures with CFLs(1 point each,up to •
5 points) Up to 5 Energy pts. 0
3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pts. 0
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up to 4 points) Up to 4 Energy pts. 0
1 1 1
G.Appliances
1.Install Energy Star Dishwasher 1 Energy pt y=yes 0
2.Install Washing Machine with Water and Energy
Conservation Features 1 Energy of y=yes 0
3.Install Energy Star Refrigerator 1 Energy pt y=yes 0
4.Install Built-In Recycling Center 3 Resource pts y=yes 0
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pts y=yes 0
b.Ceilings 2 Energy pts y=yes 0
2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
13.Install RecycledContent,Fiberglass Insulationwit
No Added Formaldehyde _ 31AQ/Health pts y=yes 0
- --
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes 0
5.Use Cellulose Insulation
a.Walls 4 Resource pts y=yes 0
b.Ceilings 4 Resource pts y=yes 0 •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
D.uenings 4 Resource pts y=yes 0
1 1 1
INPUT Resources Energy IAO/Heafth
131endows
1'1.Install Energy-Efficient Windows
. a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0
c.Low.Conductivity Frames l 2 Energy pts y=yes 0
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
�.Use-Duct Mastic on All Duct Joints 2 Energy pts y=yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes 0
3.Vent Range Hood to the Outside 1 IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=-yes
5.Install Solar Attic Fan 2 Energy pts y=yes 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes 0
8.Install Sealed Combustion Units
a.Furnaces 31AQ/Health pts y=yes 0
b.Water Heaters 3 IAQ/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts y=yes 0
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes 0
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes 0
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
13.Retrofit Wood Burning Fireplaces
• a.Install EPA certified wood stoves/inserts 1 IAQ/Health pt y=yes 0
b. Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt y=yes 0
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 41AQ/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes 0
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes 0
2.Install Solar Water Heating System 10 Energy pts y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 0
4.Install Photovoltaic(PV)System -
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points)_ _ Up to 18 Energy pts 0
I6.Select Safe and Durable Roofing Materials ' 1 Resource pt y=yes 0
7.-Install Radiant Barrier --- -- - 3 Energy pts y=yes p
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes p
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes p
yes
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y= 0
1 1 1
•
4
INPUT Resources Energy 1ADIHeafth
. ndoorAir Quahty an lmshes
r Use LowMo VOb Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 •
CUse LowMo VOC It _ _ 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Interior Rnishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
LSeal all Exposed Particleboard or MDF _ 4IAQ/Health pts y=yes 0
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 31AQ/Heallh pts y=yes 0
1 1 1
N.Flooring `
1.Select FSC Certified Wood Flooring 6 Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials _ J 4 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y--yes 0
1 1
Total Points Available: 1 1401 130 57
Total Points Project Received: 01 OF-01
•
G:datalprogslgreenbuildingguidelineslremodelerslgreenpointsfinal2.12.04prolected.xls
•
Community Development
`i
100 pe
Crttino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
f6UPERTINO
Building Department
JOB ADDRESS: qq/ (VU ,rr y rr PERMIT # o P o/
l61%J d C-) 3
OWNER'S NAME: W i A ckevil PHONE # Lt 5 6 -ozoo
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors: 4;& / [�
Signature Date
Please check applicable subcontractors and complete the following information
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 bate