06030064 Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
;C10F Fax(408)777-3333
OUPERTINO
Building De artment
OB DR�SS: PERMIT#
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OWNER'S NAME: frY1 Iv2 PHONE # — Q —
GENERAL CONTRACTOR: FAX # —
I am not using any subcontractors:, G3 -T O
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Please check applicable subcontract rs lete the followinginformation:
60 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 Date