26486 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
BUD, ;N -ELb 1'R1 AL PERMIT NO.CPPY OF CUPERTINO PMECHANICAL BUILDING DIVISION APPLICATION/PERMIT BUILDING PROJECTIDENIIzICATI(N
26486
BUILDING ADDRESS: SANITARY NO. APPLICA'TON SSUUBMH I'AL DAIIi
6 UNIT. LO]It 1�
SNAME: .. PHONE: CO ACT R'SN ME: LICNO:
N/C CONTROL.
•A CIII I LC I'/1: GINF.F:R: IC NO: Z DRESS: ❑
i�
I CONTACT: P E' QTY. ELECTRIC PERMIT FEE BUILDING PERMIT INFO
BLDG ELECT PLUMB MITCH
PIiRMIT ISSUANCE, 1:1 El El
LICENSED CONTRACTOR'S DECLARATION APPLIANCES-RESIDENTIAL JOB DESCRIPTION
CCZ l herebyaffimt that l am licensed underprovisions of Chaper9(commenciagwith
VJ00 Smdon 180(pot Division 3ol'the Buainex,mal professions Code,and my liecrae is in PANELS
wJ Fj, fon force and effeet.
.cense Claes Lich UPT0200AMPS -�
yQy Mir Contractor 201.1000 AMPS
F'yZ ARCHITECTS DECLARATION OVIiR I"AMPS SQ.FT.FLOOR AREA b/SQ.FT.
ZOy—
OG—❑ I understand my plan%shall be usedse.public records.
F y F-; SIGNS ELECTRICAL fy�a*1I
Q i--1 Licensed Professional
'ac=< - OWNER-BUILDER DECLARATION SPECIAL CIRCUIT/MISC. f _ 11 (� to Lw
XOi