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08050210CITY OF CUPERTINO BUILDING BIVISTON • PERMIT MONTRACTORjNFURMATIO BUILg16e�DTy�eTA RODA DR A PERFECT CLIMATE gg 08050210 W NER'S NAME: PERMrr ISSUE DAIS , MANDY YANG 8375 BRENTWOOD BLVD STE B 05/27/2008 HONE: SANITARY NO, CONTROL NO. (408)861 9545 ARCHITECT/ENGINEER: BUILDING PERMIT INFO s BLDG ELECTPLUMB MECH 0 0 0 LICENSED CONTRACTOR'S DECLARATION Chapter OBSCrIP Job Description under provisions of 9 (c acneing 1 hcRm ny afBthat 1 am licensed a with Secure 7") of Division J of the Busmen aha Pmfeabms Code, atud my'icomm. RMV/RPLC AC UNIT 3 TON SAME LOC in cull foRe+5,ln�d ercecy. Z�� lY. g 7 I Cl . Do. l ^J L LtinlT Coonan, 1 ^✓ L LAtBC'tHI ECI-SDECLARATION I uncle Mand my plans Nall be used a Public tecortle Licensed Pofcstlanel OWNER-BUIIDER DECLARATION 1 hereby .Nina that I am exempt from the Contractors License Law far the following mason. (Section 7031.5, Business and Professions Code: Any city Or county which requires a permit to construct, alter. improve, demolish, or repair my structurn prior to is issuance. also nalums the applicanl for such permit to rile a signed ankmca that he is licensed M the of the Contractors Liecnx Law (Chapter 9 Sq. Ft. Floor Area Valuation pursuant provisions $4058 (commencing with Section 7000) of Division l Or the Business and Professions Cade) or that he u exempt thmefrom and the hand fa the alleged exemption My violation of um Occupancy Pane Y Type Sagan 703IJ by dry applicant far a permit subjects the applicant to a civil penalty ofNber am mote than Eve hundred dollars(S-IM36933024. I,uownv of Ne propttty.amY moPloyw with wagauthev role compewdm, will the wort and ra ed o for Required Inspections ,' The Cmc oil and Professions Crile: Law dA r Conmcmh Lim Out Fredtor'. U Law doh oat apply lf an owmr ser apply.t owns, propenywh0 bands ori mpr h andwht euehwoted oro lrmrthmvgh his ids mea d darsu Improvements °toneer.the not neededmplcu dthe Wiprovidedthasmhimpravedms,te however. the Wilding within am year of owner. for the hrimpomnentlshat improv osn of builder will love Ne burden of proving that K did not build or improve far Putpox of sok.). 1, as owner of the propen,, am exclusively convecting with licensed mnt19L7om ur Construct the project (Sec. 7044. Business ad Prorucsi°a Code:) The Commissars U. corm Lew does not apply to an owner of property who builds or improves thereon, and who contracts fm such pmjees with a conductorial licensed pursuant k the contractors License law. ❑ I,muemptunder See ,BdPCrorths Resod Das WORKERS COMPENSATION DECLARATION 1 hemby aline under penalty of perjury arc or the following decluuirrsc ❑ Iham and will murine Cerurtave of Covent to self-insumfurWarteesCompen- sallon, as provided fur by Section 3700 of the labor Code, for the performance of the wart for which this permit is issued. have and will maintain WOrt es Compensation Insunnce, as tequbcd by Section 3700 of Lha labor Code, forNe performance of the work for which this permit is issued. ' My W°ricers. Caa1pevatim food. carrier and Policy auaber ate: Carrier. J65/:L riFfi Policy N�Ql%UO�.%i' k_ - CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE rlhissectlea cad not Wcomplexd irthn permit ls far oncloommal dollan(SIM) ' or less.) I certify dot in the performance of the work fur which Nis permit is issued. I Nall not employ any person in my mamerx a k become mbjxr an the Workers' Compensation Laws of Califomia. Dau Applicant NOTICE TO APPLICANT: If. after making this Certificate of Exemption, you Nould Woman subject an the Woherl Compensation provisions of the tabor Cod, you most forthwith comply with such provisions or this pcnTiL shall be dccmed revoked. CONSTRUCTION LENDING AGENCY 1 har by affirm dor dten k. construction lending.gete, ser the arcorm,am of the wart for which thio Permit is issued (Sec 3097, Civ. Ca Leaders Name Lender, Mdoa 1 certify Nu 1 have rad this application and sok this dtc above: information is CmrmcL I agRe to comply with all city and courtly ONinmRa and utak lawn tetanal as Wilding eoasuo union, and hereby anthmine Rpaamutives Of this city m enkr upon the atpM-men imMd p diany rar inspection purposes. (We) agree to save, indemnify and kecP haemes Iha City of Corpenim against liabilities. Judgments, costs and I.N. which may to my we,.. agadho said City in crusegoenee Of the granting of this permil. APP NT UND}/EEjRSfW'TTt�66AAJ�NDSSffAND WITH ALL NON �2� COMPLY -POINT SO REGULAi_Y6N'S__l. Issued by: Date -c.,� ��WILL �7-2�9 Re -roofs �--- Sgnuumo(ApplivHAZAR horOU U Data HAZARDOUS MATE RIALS SCLOSURE Type of Roof WIII the applicant or (arum Wilding aapaptnoRorand hauAovmateria a dcRSed ate Cupertino Municipal Code. chapter 9.11, and ate HeuN and Safety. t Section . Se0y. )9110 ction zss3z(.)7All roofs shall be inspected prior to any roofing material being installed. use equipment em m Awim which WIII the applicant orfuturedefined If a roof is installed without first obtainingan inspection, I agree to remove P by0. B eFadicO nua air contaminants s defined by the Bey Area Air Quality Managcmem all new materials for inspection. ❑Yes 1 have mad the haardoua materials requiamens under Chapter 6.95 of the Calif°r- nkHcolth&Safety Code. Sesvov13505,15377 and 25534.1undesknd thuirthe building ,- dons not currently have . knanl this it a my responsibility a noury the occupmt of the _ �� °e�l - S L/ a W� Z>7- RgalRments which must be mm prior to issuance ser, eerurkate aramapaney. Signature of ApplicanY U Date . All roof coverings to be Class'R" or better — Como,crmlhoNrdagerl Dow • 6 ITEMS OF 6 • • CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN 36933024.00 DATE ISSUED.......: 05/27/2008 RECEIPT #.........: BS000004903 REFERENCE ID # ...: 08050210 SITE ADDRESS .....: 10553 LA RODA DR SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: patg COPY # : 1 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 224.85 --------------- 224.85 VOICE ID DESCRIPTION -------- ---------------------------- 505 FINAL ELECTRICAL 508 FINAL MECHANICAL REFERENCE NUMBER -------------------- MC VOICE ID DESCRIPTION -------- ---------------------------- 507 FINAL PLUMBING OWNER ............: MANDY YANG ADDRESS ..........: 10553 LA RODA DR CITY/STATE/ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM ....: EDWARD A GREGORY CONTRACTOR .......: SMITH, BYRON E LIC # 21144 COMPANY ..........: A PERFECT CLIMATE ADDRESS ..........: 8375 BRENTWOOD BLVD STE B CITY/STATE/ZIP ...: BRENTWOOD, CA 94513 TELEPHONE ........: (408)861 9545 FEE ID ---------- UNIT QUANTITY ----------------------- AMOUNT PD -TO -DT THIS REC NEW BAL 1BSEISMICR VALUATION 4,058.00 -------------------- 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 IMRRAA UNITS 1.00 61.19 0.00 61.19 0.00 IPPERMITFE 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 ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 224.85 --------------- 224.85 VOICE ID DESCRIPTION -------- ---------------------------- 505 FINAL ELECTRICAL 508 FINAL MECHANICAL REFERENCE NUMBER -------------------- MC VOICE ID DESCRIPTION -------- ---------------------------- 507 FINAL PLUMBING LI WC -114F CUPERTINO CITY OF CUPERTINO FURNACE/AC PERMIT APPLICATION FORM o05 oai � APN# C).2-' 2 (P 2 � Date: Building Address: Owner's Name: Phone #: Pr �Y ��`•c`G �l0-3�1— 6331 Contractor: ^ ^ ` y er er,� L" le - Phone #: -o-d„ Ji6/_ Fax #: y/Olf Contractor License #: .. Cupertino Business License #: 7Z 3/Sg _ -7, �l Contact: Phone #: Fax #: ko'?-006/- 9SY6 Building Permit Info: Elect ❑ Plumb ❑ Mech Residential Commercial ❑. Job Description: i U Aj 704 10a For Residential Installations: Attic ❑ 1st floor 2"d floor ❑ Adhere to minimum setback requirement For Commercial Installations: Replacement same weight ❑ Additional weight (structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: r S 8 Type of Construction (Usage Class): 7 �Fu Strapped ❑ On Platform ❑ Bonded ❑ New Location Replacement I Valuation: Green Building: Must attach Green Building Check list to this application CITY OF CUPERTINO (� ' FURNACE/AC CITY CUPERTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group FURNACE FURN/AC IMCRAA Conmiercial-Repair/Alteration/Add to M ea heating appliance,refrigeration unit, cooling unit,absorption unit,or ea heating,cooling,absorption or evaporative cooling system,incl -installation_ of controls.regulated b_y_this code. 1MCREPALT 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. lMCSUSHTR 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 113PGAS 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 &riot incl in an appliance permit. 1BSEISMICO Commercial Seismic B IMRRAA Residential Repair/Alteration/Add to M ea heating appliance,refrigeration unit, cooling unit,absorption umt,or ea heating,cooling,absorption or 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. :exp" CITY OF CUPERTINO FURNACE/AC • cMoF CUPERTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type 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 1BSEISMICR Residential Seismic B 1MECPLNCK Mechanical.Plan Check M 1MFR=<100 Furnace BT install S st <=100k y U is all or relocate ea forced-air/gravity type famace/bumer, incl.ducts/vents attached to such appliance up to and include 100,000 Btu/h M 1MFRN>100 Furnace Syst > 100k BTU install or relocate ea forced-air/gravity type furnace/burner, incl ducts/vents attached to such appliance over 100,000 Btu/h M IEPERMITFEE Electric Permit Fee E 1M2ERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit P 1TRAVDOC Travel Documentation B 1BUSLIC Business License B 0 �. CITY OF CUPERTINO CITY OF CUPERTINO FURNACE/AC • FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type AIR CONDITIONING FURN/AC 1BCAIRHAN Commercial A/C Units <= 10k CFM B 1MCRAA Commercial Mech Repair/alt/add M IBSEISMICO Seismic Conunercial B IPGASCOM Commerical for ea gas piping System 1-4 outlets P . 1PG7ASRES -ResidentiaFfTr ea gas piping ern of 1-4 Outlets —P— IBPGAS For each gas piping system of 5 or more per outlet. Conun/Resid P IBREMAJRHAN Residential A/C units <= 1 O CFM B . IMRRAA Residential Mech Repair/alt/add M IBSEISMICR Seismic Residential B / 1 IEPERMITFEE Electric Permit E / IMPERMITFEE Mechanical Permit M ' 1PPERMITFEE Plumbing Permit P / 1TRAVDOC Travel Documentation B IBUSLIC Business License B G • Single Family GreenPoint Checklist date: S--- Z7-0 ? The GreanPoim Checklist is basad on the various green features incorpoatad into the home and is the basis for the GreenPoint Rated program. A home can ba considered green It t fulfills the prerequisites, eams at least 50 points, and meets the minimum points Per category. Energy (30), Indoor AIF Quality/ Health (5), Resources (6), and Water (9). Please contact Build It Green for a list o1 qualified GreenPoint Raters if you are interested In pursuing third -parry, verificatlon. The green building practices listed below are described in the New Home Construction Green. Building Guidelines, available at www.builtlitorean.ora. Cil Build ItGreeri SmanSoludans From fie Ground Up E E n- R_ F1 H. FOUNDATION - uuaauon=o Points Available Per Measure Points Available Par Measure 1. Replace tl Cement in Concrete with Recycled Flynn or Slag a. No Invasive Species Listed by Cal -IPC Are Planted b. No Plant Species Will Require Hedging C. 75% of Plants Are Drought -tolerant Deform Naives, Meddenansan, or Difer Appropriate Species 2 Use Fire -Safe Landscaping Techniques 3. Minimize Turf Areas in Landscape Installed by Builder 0 —❑ a. Minimum Flyashor Slap m 20V20% __ 0 0 0 1 El b. Minimum 25%Flash or Slag0�- ❑ El ❑ ❑ ❑ 1 ❑ 2 Use Frost -Protected Shallow Foundation in Cold Areas (D.ED. Climate Zone 16) _3U. 0 I r ❑ Radon Resistant Construction On At -Risk Locations Only) 0 3 f ! 1 2 4. Design and Build Structural Past Controls r— Z 3 2 ❑ El LJ ❑ ❑ a. Install Termite Shields 0 Separate All Ei arior Wood -to -Concrete Connections by Metal or Posts FastenersMviders 0 2 0 a 0 0 0 1 Is. All New Plants Have Trunk. Base, or Stem Located W Least 36 Inches from Foundation 1 C. LANDSCAPING - 1. Construct Resource -Efficient Landscapes uuaauon=o u I Points Available Par Measure ❑ El El El a. No Invasive Species Listed by Cal -IPC Are Planted b. No Plant Species Will Require Hedging C. 75% of Plants Are Drought -tolerant Deform Naives, Meddenansan, or Difer Appropriate Species 2 Use Fire -Safe Landscaping Techniques 3. Minimize Turf Areas in Landscape Installed by Builder 0 ! 1 0 __ 0 0 0 1 0 1 3 ❑ El ❑ ❑ ❑ a. WI Tod Will Have a Water Requirement Less than m Equal to Taa Fescue(50.0 plant fa.-toq b. Turf Shall Not Be Installed on Slopes Exceeding 10% or in Aran Less than B Feet Wide c Tud is 533% of Landscaped Area f glal2 points) d. Tud is 90% of Landscaped Area (total 4 points) 4. Plant Shade Trees 5. Group Plants by Water Needs (Hydrozoning) S. Install High -Efficiency Irrigation Systems 0 2 D t 2 2 2 0 0 0 r— Z 3 2 ❑ El LJ ❑ a Si Uses Only Low -Floe Drip, Bubblers, or Low -i Sprinklers b. System Has Small Conhdlare ]. Inwrpo ste Two Inches of Compost in the Top 6 to 12 Inches of Soil 8. Mulch All Planting Betla to the Greater of 2Inches or Local Water Ordinance Requirement 9. Use 511% Salvaged or Recycled-0oni Materials for 50% of Non -Plant Landscape Element 10. Reduce Light Pollution by Shielding Pictures and/or Directing Light Downward _ T- 0 2 0 a 0 0 0 1 r h ! 3 ! 3 2 1 D. STRUCTURAL FRAME & BUILDING G ENVEIAPE i. Apply Optimal Value Engineering ❑ a. Place Rafters and Studs at 24 -Inch On Center Framing El b. Size Door and Window Heatlars for Load ❑ e Use Only Jack antl Cripple Studs Required for Loatl - 2 Use Engineered Lumber ❑ a. Beams and Headers ❑ b. Insulated Engineered Heatlars ❑ C. Wood 4Joist or Web Trusses for Floors ❑0 d. Wood 6Joists for Roof Raters ❑ e. Engineered or Finger Jointed Studs lot Veri-al Applications ❑0 (.Oriented Shand Board for Euolloor ❑ g. Oriented Strand Board for Wall and Root Sheathing 3. Use FSC-Certiged Wood ❑ a. Dimensional Lumber, Studs and Throar Minimum 4D% ❑ b. Dimensional Lumber, Studs and Timber Minimum 70% ❑ C. Panel Prodrts: Minimum 40% ❑ d. Panel Products: Minimum 70% Total Pomts Available In Lantlscapm =31 0 Points Available Per Measure 0 1 0 ! 1 0 1 0 0 ! T- 0 L 1 r— ' 0 1 0�— 2 0 j ! 1 0 _ T- 0 2007 Build It Green Single Family GreenPolnt Checklist 2007 Version Page I of 4 ENTER , PROJECT points Available Par Measure' LJ RecycledContent (No Virgin Plastic) or PSCCertified Wood Decking 0 1 1 2 1 ll a Rain Screen Wag System H n a u u Q 3 Durable and Noncombustible Roofing Materials 4. Use Solid Wall Systems gncludes SIPS, ICFs, & Any Non -Stick Frame Assembly) I 1 2 1 ❑ Total Points Available in Exterior Finish 7 D D ❑ a. Floors 0 ! 1. Install Insulation with 75% Recycled Content ❑ a. Walls an Nor Floors —Ob -Ceilings 0 --'—-- 1 : ❑ b. Walla0 _ 1 1 2 1 0 1 — ❑ C. Rohs 0 — 2 .--i2� 1 3 I ❑ b. Use Duct Mastic m All Duct Joints and Seams S. Reduce Pollution Entering the Home from the Garage ❑ c. Instal Ductwork under Attic Insulation(Buried Ducts) 0 ❑ a. Tightly Seel the Air Bader between Garage and Living Area 0 0 1 ❑ ❑ b. Install Garage Exhaust Fan OR Build a Detached Cara e D 1 0 1 6. Design Energy Heels on Treses V5% of Attic Insulation Height at Outside Edge of Exterior Wall) 0 1 1 t 1 ❑ 7. Design Roof Trusses W Accommodate Ductwork 0 1 & Install Effective Exhaust Systems in Bathrooms and Ktehens &. Use ReCtoledCordent SLYJ Surds for 9D% of interior Wall Framing 0 0 1 6. All Bathroom Fans Are on Timer or Humidl 9. Thermal Mas Walls: 5l ri Drywall on All Interior Walla or Walls Weighing more than 401Wcu.IL 0 1 c. Install Kitchen Range Hood Vented to the Oulsitle 0 - 1 1 10. Install Overhangs and Gusers 9. Insall Mechanical Ventilation System for Cooling (11aximum4 Points) ❑ ❑ a. Minimum 16 -Inch Overhangs and Gutters r t b., Install Whole House Fen with Variable Speeds 0 ❑ b. Minimum 24 -Inch Overhan s and Guldens 0 1. ❑ Total Points Available in Structural Building Frame and Enve me=361 0 1 R FINLSH points Available Par Measure' LJ RecycledContent (No Virgin Plastic) or PSCCertified Wood Decking 0 1 1 2 1 ll a Rain Screen Wag System H 0 2 Dumble and Noncombustible Siding Materials 0ct ❑ Durable and Noncombustible Roofing Materials 0 I 1 2 1 ❑ Total Points Available in Exterior Finish 7 D D F. INSULATION - - "" Points Available Per Measure 1. Install Insulation with 75% Recycled Content ❑ a. Walls an Nor Floors —Ob -Ceilings 0 --'—-- 1 : 2 Install Insulation that is Low -Emitting (Candied Section 01350) ❑ a. Walls ancilor Floors El b. Collings 0 o _ 1 1 ❑ 3. Inspect Duality of Insulation transliation before Applying Drywall 1 0 1 0 r G. PLUMBING - - - - Points Available Per Measure ❑ 1. Distribute Domestic Hot Water Efficiently (Mu¢imum 7 Points) . 0 1 4 I ❑ a. Insulate Hot Water Pipes from Water Heater to Khchen 0 ❑ ❑ b. Insulate All Hot Water Pipes 0 L 2 ❑ ❑ c. Use Engineered Parallel Piping D _ 2 1 ❑ d. Use Engineered Parallel Piping win Demand Controlled Cimulation Loop 0 __!__ _ 1 e. Use Structured Plumbing with Demand Controlled Circulation Loop E] 9. 0 1 7 2 ❑ L Use Central Core Pull 0 _ 1 1 I 2 Teal Points H. HEATING, VENTILATION & AIR CONDITIONING Points Available Per Measure ❑ 1. Design and Install HVAC System to ACCA Manual J, D, and S Recommendations 0 1 4 I 2, Install Sealed Combustion Units ❑ a. Furnaces 0 L 2 ❑ b. Water Heaters 0 _ 2 1 3. Install Zoned, Hydronic Radiant Heating with Slab Edge Insulation 0 4. Install High Efficiency Air Conditioning with Environmentally Responsible Rehigerants 0 1 i 5. Design and Install Effective Ductwork ❑ a. Install HVAC Unit and Ductwork within Condidoned Space 0 1 3 I ❑ b. Use Duct Mastic m All Duct Joints and Seams 0 ❑ c. Instal Ductwork under Attic Insulation(Buried Ducts) 0 ❑ d. Pressure Balance the Ductwork System 0 1 _ ❑ e. Protest Ducts during Construction and Clean All Ducts before Occupancy - 0 1 ! — 6. Install High Efficiency HVAC Filter (MERV 6+) 0 1 ❑ 7. Oonl Install Fireplace or Install Sealed Gas Fireplace with Efficiency Rating Not Less Than 60% 0 1 using CSA Standards & Install Effective Exhaust Systems in Bathrooms and Ktehens ❑ a. Install ENERGY STAR Bathroom Fans Verged to the Outside 0 ❑ 6. All Bathroom Fans Are on Timer or Humidl 0 E]' c. Install Kitchen Range Hood Vented to the Oulsitle 0 - 1 1 9. Insall Mechanical Ventilation System for Cooling (11aximum4 Points) ❑ a. Install ENERGY STAR Calling Fans & Light Kits in Living Areas & Bedrooms 0 r t b., Install Whole House Fen with Variable Speeds 0 C. Automatically Controlled Integrated System ❑ d. Automatically Controlled Integrated System with Variable Speed Control 0 10. Install Mechanical Fresh Air Ventilation System (Maximum 3 Points) ❑ a. Any Whole House Ventilation System That Moors ASHRAE 622 0 _ ❑ b. Insall Air-toAO Heat Exchanger that or ASHRAE 622 0 1 I 2 1 I L1 11. Install Carbon Monoxide Alarms) 0 ( ( 1 02007 Build It Green Single Family GrelmPoint Checklist 2DO7 V=_rsion Pace 2 of 4 n Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building Department JOB ADDRESS: / // /0 !�-53Lq Todq r(/i- PERMIT # Odv_�-U'Lf b OWNER'S NAME: o otq PHONE # r S ( f GENERAL CONTRACTOR: e��K �p FAX # J I am not using any subcontractors: LZWA�'aT- dao Signature Date Please check applicable subcontractors and complete the followinc infnrmatinn- � a7-ZcU� 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 gnk I tal ck � a7-ZcU� Date