26601 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO "'R"il I" rD L+ C O Z
BUILDING DIVISION APPLICATION/PERMIT .PLUMB OJEC ECx&recC L U O
(•.g..a}r-; BUILDING PROJECT IDENTIFICATIUNrry, '.-
BUIIDING ADDRESS: SANITARY NO. APPLICATION SUBMITTAL DAT4
WUTIMN LOT, U` 0
WNERS NAME: PHONE CON .TRACTORNAME LI NO: / L
L L' NIC COMROLI
'`y�ARCHI CT INCFIb LIC NO: DRESS: L ❑
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•� CONTACT: PHONE: amrN,xvnv�vAn�D: ,,g 3I: -'-%?;VL,� BUTLDBJG PERMIT INFO
l�9 LL Y Qi,Y. + EEBCIRIC PPRABT.a.�<ry.Y —i� h,, BLDG ELECT PLUMB Mf CH
wit� Y 90, PFIU+IR ISSUAN'ws' �`4 Y�'eiG +�•SS
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LICENSED CONTRACfOR'S DECLARATION APPIJANCES-RPSIDFNTIAL
OZZ 11a=by affirm Bur I smlia uMn poviaiau of Chap,9(cmmvwingwiN 1 DESCRIPHON
''-00 Section T000)of Division 3 of Oe Bu..,ane fessi OC yli.isin PANELS
full finec effm. Ossa �T0300 AAfP5 �y./�,
yZw Him, Class _Lie.. //
!!<y Due Con.CT'SD yl l-1000 AMPS SQ.FT.FLOOR ARG $/SQ.FT.
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ARCHITECT'S DELI-ARATON OVER IOOOAMJPS
l udcnund my Mem shill be osel as public oxords.
SIGNS ELECTRICAL
ry4< Vamd itofesumlU OWNFR-BUILDER DECLARATION SPECAI.CIRCUTIMISC
�� 1 hereby affirm that 1 am eacmp from list, mna
Cve 'a I.icae mLaw fa ftrs�i
�';—)N fidb ring..(Sn'don 70313.Bvavw W P l f rssions Code:Any cit,or county TEAff.METER OR POLE INST.
v� ph t its is • .aho romnunst..Fc,improve,d ptrmil ,mreq'vanyavunwe
..<= that he iuietrool<.LLaoul to th Ncvosimsntf dsa Cone II carman W(CbxNiamant POWER DEVICES
xz�� Nub ulianrd prnuantwdc porisimu of she Comacbr'a lJreae l�w(Glaq,
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