27998APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
CITY OF CUPERTINOBUILDING- P,LECTRICAI. I PERMITNO.
APPLICATION/PERMIT PLUMBING -MECHANICAL 9 7Q Q ^
BUILDING DIVISION no air,..............,,.......... TS
LICENSED CONTRACTOR'S DECLARATION
Oa'z Ihereby affrtm Nat l mars licensed under provisionam'CTader9(commencing with
tQOO Section 9001 Division 3nnhe ImeinCxsand Pmfexsinns Cade, and my license is in
tFy�F full farce and effect.
FZ w License Class Lim. a
IoQe. Date Contractor
1—,z ARCHITECTS DECLARATION
ZO/ N O 1 anderntnnd my plans %hall he used as public records.
ad
Qfi , Licensed Professionnl
Cya%Q OWNER -BUILDER DECLARATION
0 W U 1 hereby in Finn that I am exempLfrom the Contractor's License Law for the
Say following reason.(Setion 9031.5. Business and Professions Code: Any city or county
[—�• C);