03070083 CITY OP CUPERTINO '�"" ;v
HULI,DINC DIVISION PERNO UCO NTRACTOR�INFARiVL�ON ,,•:
BUILDING ADDRESS: TROJAN REMODELING & DESIGN PM�ND03070083
OWNER'SNAMI. 681 ELDEN DR PERMITLSSUEDATE
NE: (408) 371-9179 SANITARY N0. I I CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
JOO LICENSED CONTRACTOR'S DECLARATION
f GU. 1 h=rtbyyyy farm mm 1 am rmen.sed ander�g,,,vismna n1 chapter 9(enmmeming lob Description
withscaion7, fDMsimr3.f the Businres;hd Professions Code.and my license is
Le�1.
Cmcsn IT ✓/ LO Z �/, REPLACE 2 PATIO DOORS W/ HEADER
j i Licenforce
d Lic,x 3
,I n Dale Cunuacto
ARCIII'IECTS D[CLARA N
iH crsuna my Plansfiall be used es public remrJs
Q Licensed Professionalt(-A
g OWNER-BUILDER DECLARATION V �7
2 P 1 hereby affirm that I am exempt from the Contractor's License Low for the
0 o following reason.(Section 7031.5.Business and Profession Cods:Any city or county Y
5 m which requires A permit m ern ameL cher,improve,demolum.or repair Any sumdus,
_ZQ prior In its issuance,also requires the applicant for such permiuu rile asigoedstammem innn
g
that he isl;cenredpursuant it)dteprovisions oftbcContractor's Lo,mseLaw(Chapter 9 Sq. Ft. Floor Area Valuation
y�0 (commencing wi IS Section 70f)D)of Division Sof the Business and Professions Code)or
i $ Nat M1e is eacmpl chcrefmm and the basis for the alleged exemption.Any violation of 35928032 . 00
Section 7031.5 by any applicant for a Permit subjects be applicant to a civil penally of APN Number Occupancy Type
not mom than rive hundred dollars($500).
❑ I,As owner of the Pmpcny.or my employees with wages as their sols compensation, 7�T
will do the work,and the svuctum is not intended offered for sale(Sec.1044.Business - 17Cd Inspections
and Professions Th
sions Code: e Contractor's License License Law not apply to an owner of ns p
property who builds or improves thereon,and who dues such work himself or through his 102 — PIERS
own employees.provided that such improvements see not intended or offered for sale.If, 103 - UFER
however.me building or improvement is sold within ane reef of completion.Ne owner-
builder will have the burden of Proving that M1<aid not baud or improve for Purpose of 104 — REBAR
Ask.). 105 — ANCHOR BOLTS
CD 1.as owner of the properly,am exclusively contracting with licensed contractors to
epaslm=l the project(Sec.70a4,Business and Professions Code?The COn03e1o,3 U. lO6 - SEWER & WATER
ecru law docs not apply w An Owner of propady who holds ar impmws Reason.And 202 — UNDERFLOOR PLUMBING
who contracts for such pmjccts with a Contractors)licensepursuant d pursuano dm Contractor's
License Law. 203 — UNDERFLOOR MECHANICAL
❑l am exempt uodet sec. .B At P C dor this mason 204 — UNDERFLOOR FRAME
Owner Dam 205 — UNDERFLOOR INSULATION
WORKER'S COMPENSATION DECLARATION
1 hereby affirm ander Recopy of perjury one of the following declamdona: 3 01 — ROUGH PLUMBING
IhaveandwillmaintainaCenireueofConaenlI.self-inumhorW°,kerscompcn- 302 — TUB & OR SHOWER
7[U3:1i�
tion,u pmvidcd for by Section 3700 of the Latin,Code.for the pedormancc of me 3 03 — ROUGH MECHANICAL
ork for which This permit is issued.
I haw and will maintain Workcfs Compensation Imuran¢,As myuimd by Section 3 04 — ROUGH ELECTRICAL
W or me labor Code,for me Performance of doe work for whim this loonit is issued. 305 - FRAME _
y Worker's�Compeynsa(ion lnsumncec mics nd Policy number Am: 3O6 — HOEDOWNS
`' roelly"°'7gS K "o?4 307 — INSULATION
CERTIFICATED EMM FROMWORKERS'
COMPENSAT4 INSURANCE 308 — SHEETROCK
(rhisseclinn neuJ nm hccomPlcmJ if the permit isfm one M1unJred dollars(SIIX)) 309 — EXTERIOR LATH
oneas.) 310 — INTERIOR LATH
I certify that in the Performance of doe work for which this Permit is issued,1 shall nut
employ any lierso u m M1m
any manner ccome subject the Workers Compensation 311 — SCRATCH COAT
Laws of California!Dam
Applicant 313 — ROOF NAIL
NOTICE TO APPLICANT.If.after making chis Ccoif=am of Emmption.you should 501 - FINAL ELECTRICAL ENERGY
become subject to the Worker's Com persauon Provisions of the Labor Code,you mus
Z Forthwith comply with such provisions or this Permit shall IN,deemed revoked. 502 — FINAL PLUMBING ENERGY
Z O CONSTRUCTION LENDING AGENCY 503 — FINAL MECHANICAL ENERGY
EIhembyaffirmdoor Rem isaeonuomnnlending agency fonhcperfurman¢of 504 — FINAL BUILDING ENERGY
CV > the wurk dor which this Permit is issued(See.3M7.Civ.C.)
al Lordc,ANumc 505 — FINAL ELECTRICAL
7 nZ <naer,Aadess 506 — GAS TEST
U C) 1 certify that 1 have read this application and ..,bar the above information is 507 — FINAL PLUMBING
correct.1 agree to comply with all city and County ordinances and state laws relating to
O U building construction,and hereby aumo,iae repreecntazives of this city to enter upon the FIN MECHAN CAL
Cq above-mentioned Property for inspection purposes.
(~ Q, (we-)agree m sate,indemnify and trey harmless the City of Cupertino against 0 9 F I N
fq Babilitits,judgmcn¢costs Andcxpcnus which may in anyway action,againssaid City 5 NG
t� Z in ennuquenc 1 egranling seri this permit.
r-i
APP ICA UN ERSTA OS AND WILL COMPLY WITH ALL NON-POINT Issued by:5 I C WORKS Dat
SOURCE R
.{,461A.��L�-!T Re-roofs
signaom PR anYCommcmr /pit
HAZARDOUS MATERIALS DISC60SURE Type of Roof /
Will me applicant or future building occupant store or handle harardaus maudal
a defined by the CuNnino Municipal,Code.Chapter 9.12,and the Health and Safely
Code.Section25532(a)? (�/G/['+ All roofs shall be inspected prior to any roofing material being installed.
Will thea applicant o,future building am,use equipment or devices whim If a roof is installed without first obtaining an inspection,I agree to remove
np sby mp
.mil hvaranus air contaminants u defined by the Bay Area Air Quality Management all new materials for inspection.
DIMIII=11
❑Yes 'RIZ, '
1 have read to haaamous materials requirements under Chapter 6.95 of me Califor-
niaH.ImMclyC c.Scmons25505.25533nnd25534.Itolemlan mal cbuilding
dMS m,l currently a mnanl,mat f is my maponrimur to nUdfr 1 eupanl nr me
wmmentswhr vus'lemet'runtoisman=eofacentfeamif =r' Signature of Applicant Dale
re ///Irl
0 retortion Dale All roof coverings to be Class "B" or better
r �
v T Square Consulting Group, Inc.
3319 Pinnacle Drive
• !.'3 SY-Cheng Tsai,Architect San Jose,CA 95132-2434
Jing-Chen Tsai,SF Tel: (408)926-8790
James Y.Liang,Architect
C I U !? A L P L A fl IJ I II C- Fax: (408)926-8190
• E II G 41 E G R FI G MAN A G E bi @'ll T
BUILDING INSPECTION DIV. i \/
CITY OF CUPERTINO II �f,�' I r.1,�,J U
Re: MARDESICH PROJECT t� P
CUPERTINO, CA
July 11, 2003
Dear Sir,
This letter is to confirm that I have calculated the header beam design for the above
project. By using 4x 14 DF#1 header beam or use same size Glu-Lam beam, the
header will be adequate to carry the load.
• Attached please find the,header calculation. If you have any questions regarding the
above conclusion please contact me at (408) 892-7680, thank you.
tzo Es O APPROVED
Sincerely, C,HE/v Nq� '\ IN ACCORDANCE WITH THE CITY of
CUPE TIN ,ODESS, ND ORDINANCES
No. S 4210 A I DATE_
Exp. 6/30/0/Y SIGNEDT
J s� Tsai >q�TRUCTORP���Q This set o' plans 7and speclticationo ifl1IR
Structural Engineer rFOF CA tie oe kept on Vx ;ah at sll h'n� ail 111'; nn
lawful to make DAY chan CS rri 0111oloW
on same without wrttcn r"'nti alga from
the building Dept., City d Oupc,tmo,
The stamping of this plan and ',pnrif1c,1001's
SHALL NOT be held to permit or to IJs ar.
approval of the violation of any provisions
of any City Ordinance or State Lew.
I
r T Square Consulting Group, Inc. 3319 Pinnacle Drive
Sy-Cheng Tsai,Architect San Jose,CA 95132-2434
• t",p� ling-Chen Tsai,SE Tel: (408)926-8790
James Y.Liang.Architect Pax: (408)926-8190
A R C H I 1 E C T U R A L P L A 11 FI J I G E II G I IJ E E R I II G D E V E L O P IA E it t ;,; A IJ A G E M E N T
BUILDING INSPECTION DIV.
CITY OF CUPERTINO
Re: MARDESICH PROJECT
CUPERTINO, CA
1
July 11, 2003
F, s�
Dear Sir,
This letter is to confirm that I have calculated the header beam design for the above
project. By using 4x 14 DF#1 header beam or use same size Glu-Lam beam, the
header will be adequate to carry the load.
• Attached please find the header calculation. If you have any questions regarding the
above conclusion please contact me at (408) 892-7680, thank you.
Sincerely, h����GGHE/v rs�Fc�
z
—? xp. S 010,
210
Exp. 6/30/0
l `P'RUCTWRP���P/
J ss§e Tsai 9TFOF CHE�E%�
Structural Engineer
•
T SQUARE CONSULTING GROUPB INC SHEET NO.
• DATE: 07/10/03 BY: 1CT PROJECTNO.
>TYPICAL ROOF FRAMING DESIGN• HEADER BEAM DESIGN
BEAM DESIGN SPAN 14'-S" USE 4x14 DF#I
CLEAR SPAN(L)= 14.70 FT
UNIFORM LOAD(W)= 60 PLF
POINT LOAD(PI)= 2604 LBS S = 102.41 IN^3
DIST.TO SUPPORT(XI)= 7.35 FT A = 46.38 IN^2
POINT LOAD(P2)= 0 LBS 1 = 678.48 IN^4
DIST.TO SUPPORT(X2)= 0 FT
M(MAX) = 11190 FT-LB
R(MAX) = 1743 LBS
DEFLECTION(D)=L/240= 0.735 IN Fb(ALLOW)= 1150 PSI
S(REQ'D)=M/Fb/LDF= 93.42 IN^3 Fv(ALLO W)= 95 PSI
A(REQ'D)= 1.5 R/Fv/LDF= 22.02 IN^2 E= 1800 KS]
I (REQ'D) =M x L^2/E/D= 272.7 IN^4 L.D.F.= 1.25
MOMENT DIAGRAM SHEARAGRAM
12000 - - 2000 ���j IS ,�1'DIL� C�Oo p
g 6000 \
E 6000 1000-
e 4000 Seriesl a
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0 -1008.
a a- 06•0' Off• 9ry
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*CITY OF CUPERTINCO
CITY OF PERMIT APPLICATION FORM
CUPERTINO
A OIL
PN # Z�P 6,? 2, Date:
Building Address: Mailing Address (if different from building address):
t N Z q �
Owner's Name: Phone#: yo t -27-7- 7 2 4'b
ontractor: License #: 7 G p 8 Z I r3
wnc
Conta P e.'Z5 Cupertino Business License#:
Fax: s6 /
Bu mg Pe it Info:
i
Elect ❑ Plumb Mech ❑
Job De ption:
esidential LY/Pf 'rw s7.o ,� w �.., 14, Commercial ❑
Sq.Ft. Floor Area: S/Sq.Ft.:
Cost of Project: Occupancy Group:
P e7
Type of Constructio : 4 Please check this box r Iect is a
second-storyaddition: ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to 1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
BELEC1000 Elec 600V<= I OOOA ELECTRICAL
BELEC1001 Elec 600V > 1 OOOA ELECTRICAL
BELEC200 Elec Svcs 600V <= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
BMITIGATC Comm. Housin Mit. Fee BUILDING
22 �L6s!
1 of
S, *ITY OF CUPERTINO*
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
Quantity Fee ID Fee Description Fee Group
BMITIGATR Res. Housing Mit Fee BUILDING
BMNEWMULTI New Multi-Family Res MECHANICAL
BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL
BNEWMULTI Multifamily Res ELECTRICAL
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BNUMULTI New Multifamily Res PLUMBING
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bidg Permit Fees BUILDING
BPFIXTURE Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Ind Waste Interceptor PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinklerBackflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER Install/Alter Water Pie PLUMBING
BPWHEATER Water HeaterNent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 ctin MECHANICAL
BREAMRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREWURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Fumace> l OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
2 of 3
ti( OITY OF CUPERTINO
CUP kTCITY OF
O PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
BREMTHEATR Theatrical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Inspection BUILDING
BSWW1 Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
13TENTPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issuance PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
ZADDCHG Address Chane BUILDING
3of3
CI'T'Y OF CUTER r1NO
HUILDING DIVISION pFg CONTRACTORINFQRM.�pN ;
BUILDING ADDRESS: TROJAN REMODELING & DESIGN PM�NQ03070083
owNER's NnmE: 681 ELDEN DR PERMIT ISSUE DATE
-0N.E (408) 371-9179 SANITARY NO. 9 CONTROL NO.
ARCHITECfIENGINEER: BUILDING PERMIT—INFO
BLDG ELECT PLUMB MECH
L�
+00 LICENSED SED CONTRACTOR'S DECLARATION
us ATION 111 {{{,,,
fw❑ 1 hcrtbJJ)Y'' firm that 1 am lemma under`a visions of Chapter 9(commencing ascription
iW with Section] fDi i.ion 3efthe Businexe ghd Prufeuions Code.and my license is
)j2= in full fm man ff ✓ Lo REPLACE 2 PATIO DOORS
Liccnx Clara Lk.N
ac Da¢ C'S DEo
ARCf11TF.CTS DECLARA N MAR 1 5 2004
��U ler rstanJ my plans shall he used as Public rcnxds
Licensed Pmfcssional p
`Og OWNER-BUILDER DECLARATION 19UjOtl ®B®VAIL
a I hereby aBUm Conroe...
that I am eac.,,fru.the Conactor's License raw for the s
0 o following mason.(Section 7031.5.Business and Professions Code:Any city or county
<m which requires a permit Or construct.alter,improve,demolish,or repair any structure
uai prionnils issuance.als�.quiru the apPlicam for such Krmiuo Ek aaigneJ suilemem
a that he is licensed Pursuant it)the provisions of the Contractor's License Law(Chapter 9 Sq. Ft. FloorAreaValuation
�Fo (commencing with Section 7(koR Of Division 3 of the B udders and Professions Cwc)or
i that he is exempt therefrom and de bene for the alleged Compton.Any violation of 35928032 . 00
Section 7071.5 by any applicant for a Pother subjects the applicant to a civil penalty of ccu ane APN Number OType
nm...thanrKhundreddollars(S5Oo). Occupancy YP
❑ 1,ss owner of the pm,,,,,or on,employees with wages as their sole comPensatton.
will do the work and the almcw.is not intended or offered for sale 70W,Business _
and Professions Cede:The Contractors License Law dors not apply to an owner of d Inspections
property who builds or improves thereon,and who does such work himsdfm through his 102 - PIERS
own employees.provided that such improvements ase not intended or offered for sale.If, 103 — UFER
however,the building or improvement is sold within one year of completion,the owner
builder will have the burden of roving that he did not loud or improve for purpose of 104 _ REBAR
"'I`')' 105 - ANCHOR BOLTS
❑I,as owner of the property,am exclusively confessions with Code:)The
to
cottswn the projcn(Scc.7oa4,Business and Professions Cwe:)The Contractor's Li106 — SEWER & WATER
anis Law does not apply to an owner of property who Wilds or improves thrown.and 202 - UNDERFLOOR PLUMBING
who contracts for such projects with a contnctor(s)licensed pursuant to the Contractor's
Liceno,Law. 203 - UNDERFLOOR MECHANICAL
❑ I con cacmp,under See. .B&P C for this..on
204 - UNDERFLOOR FRAME
Owner °at= 205 - UNDERFLOOR INSULATION
WORKER'S COMPENSATION DECLARATION
I hereby am.t under penalty of perjury one of the following declarations: 301 — ROUGH PLUMBING
�aKadd will
7--m a Certificate of Consent to self-insure forWorkerseompen- 302 - TUB & OR SHOWER
as prodded for by Section 37W of the Labor codefor the Perf.mtanot of the 3 03 - ROUGH MECHANICAL
K for which this permit is issued.
❑I have and will maintain Worker's Compensation Insurance,as requited by Section 3 04 - ROUGH ELECTRICAL
37130 of the Labor Cwe,for the performance of One work for which this permit is issued. 3 05 — FRAME
My Workers Compensation InsuranceHier d orcynumner am: 306 - HOLDOWNS
CPoli No:7g3 fi 00694 It
a 'e
CERPIFICATEO (EM n FROM WORKERS' 307 — INSULATION
COMPENSATa<INSURANCE 308 - SHEETROCK
r
less)Oris section nem not he completed if the permit is for one hundred dollars ISIBIB 309 — EXTERIOR LATH
m 310 - INTERIOR LATH
employ
any
or the performance anyneof the work for Subject
this permit is issued,I shall not
employ anypcaon in any manncrsoumIecome sobjeu tmM1e workeri Compensation 311 — SCRATCH COAT
Lawofon cabman,.O'tc
npvO313 — ROOF NAIL
NOTICE TO APPLICANT:IC after making this Certificate of Exemption.you should 501 - FINAL ELECTRICAL ENERGY
become subject to the Worker's Compensation provisions or the labor Code,you must
.JZ forthwith Comply with such powisumsOrthis pc,.hsh.11Wdeemed nevokw. 502 - FINAL PLUMBING ENERGY
z CONSTRUCTION LENDING AGENCY 503 — FINAL MECHANICAL ENERGY
F-' IherebyaffirmNatthereisaemiswetinnlendingagencyIn,thepnormanemof 504 — FINAL BUILDING ENERGY
Od > the work for which this p.it isur.d(Site.3W7,Civ.C.)
W 505 — FINAL ELECTRICAL
Q Lender's Namc
� z tnder'sAwru 506 — GAS TEST
U O 1 ecody,that 1 have read this application and suite that the above information is
correct.1 agree to comply with all city and county on inures and stale laws misting to 507 — FINAL PLUMBING
0 U building Construction.and hereby aulhorin representatives Of this City to enter upon the FI"MECHAN
CAL
r W abovcmeminnud property for inspection purposes.
t1 (We)agree to save,indemnify and keep harmless the City of Cupcni no against 0 9 F I N liahililies,judgmcnts.costs and caPcnses wM1ich may in any way ascus against saidCity C, NG
UZ in conuquene c gmnling oflhis Permit.
^' APPLICAN UN
ERS TA OS AND WILL COMPLY WITH ALL NON-POINT Issued by:5 C WORKS Dat
SOURCE R
Re-roofs
SlgnatufanVCnnlra'(or
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or from building occopanl sore 6,handle harardous material
u defined by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety
Code.Oyez25532(.)?r All roofs shall be inspected prior to any roofing material being installed,
Will the applicant o�building Occupant use equipment or devices whim If a roof is installed without first obtaining an inspection, I agree to remove
hazardous air contaminants as retired by the Bay Area Air Quality Management all new materials for inspection.
el?
p Yee
1 have mW the haraNnrs materials.goim.cnts under Chapter 6,95 of the Califon
ria Health&SafetyC ,Secdow 25515,25533 and 25534,1 udders overt Width,
Jses nal cm.nlly a Omant.Na it is my resPomibility m noufy Pant of the
. uimot wni fest la met pr`ur:,1,mmtsoraceni0camor ancy. Signature of Applicant Date
O nc or awhr ao pa.
All roof coverings to be Class "B" or better