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08020148 CITY OF CUPERTINO BUILDING DIVISIOtO PEIFMT k Ct'0 NIRA.0 (.TR INFOI.tMATrON, `",_ u>+ ..y+ ;`N_c BUILDING ADDRESS: PERMIT NO. 11691 TIMBER SPRING CT CASTILLO' S ROOFING 08020148 OWNER'S NAME: PERMIT ISSUE DATE SWEE LIN 1703 CATHAY DR 02/22/2008 ONE: SANITARY NO, CONTROL NO. ARCHrrECrIENGINEER: BUILDING PERMIT INFO TEAROFF EXISTING COMP. BLDG ELECT PLUMB MECH .0, LICENSED CONTRACTOR'S DECLARATION ]O Descri tion rd� IhertbyafRm Nallamlimnudunderpmvisionsof Chapar9(wmmencing - ^^ --^ ^^••^ ^---•-^- p with Section 70M)afDivialon 3 afth,Basin.and Pmfc dumn Code,and my license is ^oH in full forte and effac �Ro Wcenu Clw Lk.N 3 F Dew Contractor ARCHITECTS DEC ON I uedcrstand my plans Mall be used u public swords NU 50 Licensed Professional Oat I am caempt fa DECLARATION C O E I panty a(Em on 1 1. exempt from she CmoamCo License c taw for tie iOO follwhop ng reamd ,Perm. mit W3lABuntsmpr and nee,donons Cade:archr y smausuty $pi which wqubu•e.Oce a manummumthe aper.Improve,rumoiW, B eFair ed urmum prior to its emounte,Oce to Me,movishApplicant;of Me Contractor's remit toiecruit m Lnetl statement < (that ara itRemountpamt.ntmthe of vroom of the cawaemrauaawssws(Charter Code)or Sq.F[. Floor Area Valuation x�s thameis as rp,witSection7")the Division of the egdnevand e.Any Cede)or that k h exempt thert(rom and Ne basis fa Ne alleged!emmptioa Any Notation of Section 70314 by acy,applicant fora permit subject the anficm,to a civil penalty of APN Number Occupancy T, trot mom Nan Rw hundred dollars(S500L p y +]pe ❑I.uownerof Nepmpem/,mmyemploymawiNwa udw ora eampewdon, will Fr id work,and the ahumom a miinrdnded oro w do d,set a(Sm.]Oa4.Bwinw and Pmrexsians case The Conoacton .)cense law alma not apply lf an toner Required Inspections mpe ,arfirmseves liescon,arel who easachimulfnd Nmughhis ahoemployebs.prmided suchinprovemcohmnot tendeedmd for 1 1. however,Meuildingmimprroneemet]a Di"complealm.builder will low drd buNen of proving that he did act build w improve forpurpose of tile,). ❑1.as owner of Ne propenY,am exclusively consuming ming wish licensed caatrsmon in crostmm she Mica(Sec.1011,Business and Professions Cade:)The Comrsctofa Li- [eve lbw alcea not apply to an caner of Property who build,or ire cern,Quarter.and, who contracts for such jackets with a camuacmta)licensed Paramus to the ConuamoYs Licence Lassa. ❑luneacmptunder See .B&PCfor Mi..n Owner DataWORKERS COMPENSATION DECLARATION 1 hereby amtm under peaty or Perjury ane of Ne fanwing aaclarulons: ❑Ihawandwilt.mmJnaCenlRcae of C^ventmself-1.me(orWantonCompca- utian,as provided for by Section 3700 of the Labor Code,for Me performance:of tie want for which this permit is issued. ❑I have and will maintain Workers Compensation Insurance,as required by Section 37t00 or the Mbar CWc.for the performance of Ne wont for which this permit Is issued. ' My Warkee,,CC.. thoad Inwrsnce m/trier and Policy number art: Carrier'. .;7�;7; Policy No..103t* CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thhumlm nand not M compleed if the Format is forma,hundred dollars(SIM) or lits) 1 cenifv Not in am performance of Ne work for which this Permit is imm d,I Mail not _ employ any Fame in any meaner an as to became subject to tie Worker'Compensation Laws of Califomla Data Applicant NOTICE TO APPLICANT.If,altar making this Comficaw of Exemption,you should became aobjea to the Workers Compensation provisions of the fAMr Cade,you mum .JO forthwith comply with such rovisions or this permit Mail be rumored remittal. z CONSTRUCTION LENDING AGENCY t-m 14 1 hemby of irre that Nem i,a consuucdn^leading agenry,for the Fmfmmuxe of fYa > Ne work rue which this permit is issued(Sec.3091,Civ.C.) aOLandes Name z Landes Md. U O I mairy that I have man this application and surd Nu Ne above information is IT4 E correct.1.&rte to comply with all city and county ore name and surd laws misting m (] 4C1: building construction.and hereby euNonm representatives of this city to emm upon dor w ahow-menuoned Property t Tar impaction which es LL (we)same to caw,indemnify and keep hamless the City of Cupertino against p) in consequence ce or the hestand and espnms which may In anyway acnm against said City U z in comswgmne,o(the LnnunL of Ni,peril APPL ANT UNDERSTANDS AND WILL COMPLY WITH L NO POINT Issued by: Date 50 CER U IN �� �� Re-roofs cart of App onow" Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof WIR the applicant w Tatum Wilding ocempantuom a handle huudaw mawrist u deRned by Ne Coastline Mumeipl .Chapter 9.12,and she Health and Sarely Com,Seeders 25s3z(.)1 All roofs shall be inspected prior to any roofing material being installed. ❑m m WIII do eppllcaut ar futurt buildinL M Vat equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove ,mh bv�rdn.air emu sa=ri u def y the Bay Am Air Quality Management all new materials for inspection. Disuictl ❑Yca ON. I have mad the hmaadoss materials requirements candor Chaplemi.95 of ace Califon his Health&Saiety Cada.Sceuoma 25505,25533md 25531.1 understand NulTthe Wilding does not cummly haw a tarsal that It is my responsibility to unify de occupant of numbs 'topic mw IpdortoismamceoraComftcamoftYet " D Signature of Applicant Date -mrwa homuul em m F All roof coverings to be Class"B"Or better CITY OF CUPERTINO BUILDING DIVISIOtO PEIFMT k Ct'0 NIRA.0 (.TR INFOI.tMATrON, `",_ u>+ ..y+ ;`N_c BUILDING ADDRESS: PERMIT NO. 11691 TIMBER SPRING CT CASTILLO' S ROOFING 08020148 OWNER'S NAME: PERMIT ISSUE DATE SWEE LIN 1703 CATHAY DR 02/22/2008 ONE: SANITARY NO, CONTROL NO. ARCHrrECrIENGINEER: BUILDING PERMIT INFO TEAROFF EXISTING COMP. BLDG ELECT PLUMB MECH .0, LICENSED CONTRACTOR'S DECLARATION ]O Descri tion rd� IhertbyafRm Nallamlimnudunderpmvisionsof Chapar9(wmmencing - ^^ --^ ^^••^ ^---•-^- p with Section 70M)afDivialon 3 afth,Basin.and Pmfc dumn Code,and my license is ^oH in full forte and effac �Ro Wcenu Clw Lk.N 3 F Dew Contractor ARCHITECTS DEC ON I uedcrstand my plans Mall be used u public swords NU 50 Licensed Professional Oat I am caempt fa DECLARATION C O E I panty a(Em on 1 1. exempt from she CmoamCo License c taw for tie iOO follwhop ng reamd ,Perm. mit W3lABuntsmpr and nee,donons Cade:archr y smausuty $pi which wqubu•e.Oce a manummumthe aper.Improve,rumoiW, B eFair ed urmum prior to its emounte,Oce to Me,movishApplicant;of Me Contractor's remit toiecruit m Lnetl statement < (that ara itRemountpamt.ntmthe of vroom of the cawaemrauaawssws(Charter Code)or Sq.F[. Floor Area Valuation x�s thameis as rp,witSection7")the Division of the egdnevand e.Any Cede)or that k h exempt thert(rom and Ne basis fa Ne alleged!emmptioa Any Notation of Section 70314 by acy,applicant fora permit subject the anficm,to a civil penalty of APN Number Occupancy T, trot mom Nan Rw hundred dollars(S500L p y +]pe ❑I.uownerof Nepmpem/,mmyemploymawiNwa udw ora eampewdon, will Fr id work,and the ahumom a miinrdnded oro w do d,set a(Sm.]Oa4.Bwinw and Pmrexsians case The Conoacton .)cense law alma not apply lf an toner Required Inspections mpe ,arfirmseves liescon,arel who easachimulfnd Nmughhis ahoemployebs.prmided suchinprovemcohmnot tendeedmd for 1 1. however,Meuildingmimprroneemet]a Di"complealm.builder will low drd buNen of proving that he did act build w improve forpurpose of tile,). ❑1.as owner of Ne propenY,am exclusively consuming ming wish licensed caatrsmon in crostmm she Mica(Sec.1011,Business and Professions Cade:)The Comrsctofa Li- [eve lbw alcea not apply to an caner of Property who build,or ire cern,Quarter.and, who contracts for such jackets with a camuacmta)licensed Paramus to the ConuamoYs Licence Lassa. ❑luneacmptunder See .B&PCfor Mi..n Owner DataWORKERS COMPENSATION DECLARATION 1 hereby amtm under peaty or Perjury ane of Ne fanwing aaclarulons: ❑Ihawandwilt.mmJnaCenlRcae of C^ventmself-1.me(orWantonCompca- utian,as provided for by Section 3700 of the Labor Code,for Me performance:of tie want for which this permit is issued. ❑I have and will maintain Workers Compensation Insurance,as required by Section 37t00 or the Mbar CWc.for the performance of Ne wont for which this permit Is issued. ' My Warkee,,CC.. thoad Inwrsnce m/trier and Policy number art: Carrier'. .;7�;7; Policy No..103t* CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thhumlm nand not M compleed if the Format is forma,hundred dollars(SIM) or lits) 1 cenifv Not in am performance of Ne work for which this Permit is imm d,I Mail not _ employ any Fame in any meaner an as to became subject to tie Worker'Compensation Laws of Califomla Data Applicant NOTICE TO APPLICANT.If,altar making this Comficaw of Exemption,you should became aobjea to the Workers Compensation provisions of the fAMr Cade,you mum .JO forthwith comply with such rovisions or this permit Mail be rumored remittal. z CONSTRUCTION LENDING AGENCY t-m 14 1 hemby of irre that Nem i,a consuucdn^leading agenry,for the Fmfmmuxe of fYa > Ne work rue which this permit is issued(Sec.3091,Civ.C.) aOLandes Name z Landes Md. U O I mairy that I have man this application and surd Nu Ne above information is IT4 E correct.1.&rte to comply with all city and county ore name and surd laws misting m (] 4C1: building construction.and hereby euNonm representatives of this city to emm upon dor w ahow-menuoned Property t Tar impaction which es LL (we)same to caw,indemnify and keep hamless the City of Cupertino against p) in consequence ce or the hestand and espnms which may In anyway acnm against said City U z in comswgmne,o(the LnnunL of Ni,peril APPL ANT UNDERSTANDS AND WILL COMPLY WITH L NO POINT Issued by: Date 50 CER U IN �� �� Re-roofs cart of App onow" Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof WIR the applicant w Tatum Wilding ocempantuom a handle huudaw mawrist u deRned by Ne Coastline Mumeipl .Chapter 9.12,and she Health and Sarely Com,Seeders 25s3z(.)1 All roofs shall be inspected prior to any roofing material being installed. ❑m m WIII do eppllcaut ar futurt buildinL M Vat equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove ,mh bv�rdn.air emu sa=ri u def y the Bay Am Air Quality Management all new materials for inspection. Disuictl ❑Yca ON. I have mad the hmaadoss materials requirements candor Chaplemi.95 of ace Califon his Health&Saiety Cada.Sceuoma 25505,25533md 25531.1 understand NulTthe Wilding does not cummly haw a tarsal that It is my responsibility to unify de occupant of numbs 'topic mw IpdortoismamceoraComftcamoftYet " D Signature of Applicant Date -mrwa homuul em m F All roof coverings to be Class"B"Or better • CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36654086 . 00 DATE ISSUED. . . . . . . : 02/22/2008 RECEIPT # . . . . . . . . . : BS000004009 REFERENCE ID # . . 08020148 SITE ADDRESS . . . . . : 11691 TIMBER SPRING CT .SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . : OWNER SWEE LIN ADDRESS . . . . . . . . . . : 11691 TIMBER SPRING CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5145 RECEIVED FROM . . . . : JOSE CASTILLO CONTRACTOR . . . . . . . : JOSE CASTILLO LIC # 25850 COMPANY . . . . . . . . . . : CASTILLO'S ROOFING ADDRESS 1703 CATHAY DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95122 TELEPHONE . . . . . . . . : (408)251-3565 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 7, 500. 00 0.80 0 . 00 0. 80 0. 00 1REROOFRES SQ FEET 20. 00 260. 00 0. 00 260 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 260 .80 0. 00 260.80 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 260. 80 14951 --------------- TOTAL RECEIPT 260 . 80 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- --------------------------- ------ ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS 605 FINAL REROOF i CITY OF CUPERTINO � • REROOF • ocuPr�Tinio PERMIT APPLICATION APN# � � O p Date: v Building Address: U im be 1~ S rtn C4 , Owner's Name: Phone #: q 4a ;2 (o & Sme L n Contractor: Phone #: io I - �• r,2 � 1� 3SS"' TI I I U S �b Di7l�C Fax #: sa3 e Cupertino Business License #: MID Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Guilt-Up Roof ❑ Built-Up roof al Asphalt Shingles uXAGphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: _TeA Y D P_ X i3) i I i.c� C , (L Corn ? SI-� )e-s C Residential Commercial Commercial Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation: 1 2 5_Z�,� Q c,2 O S(k I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Si re CITY OF CUPERTINO REROOF •CUPS' TINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FC0M Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 6 1REROOFRES Re-roof Residential B 1SFDWLROOF / 1BSEISMICRE Seismic Residential B 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B • Community Development Department Building Division City of Cupertino • 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to any roofing installation. 4. To receive a final sign off from the City,the following steps are required: 1) Pre-inspection and/or tear off approval. 2) In-progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. • 5. If plywood is installed, a plywood nail inspection is required. 6. Any roofing which is applied without first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/4" per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: /S�tve Pte_' L i n Job Site Address: (o�1 "l! in her �7y1/ j7Gl ��j / n Roofing 7-- Roofing Company Name: / Applicant's Signa ✓l Date: Z 2 *? • Greg Casteel Building Official Revised 11/2/04 Community Development •"°J 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 QCITY OF Fax(408)777-3333 UPERTINO Building Department JOB ADDRESS: PERMIT # 1 -T, m ,beP Spri-nel C4 . 6'22 OWNER'S NAME: 6W L-'i PHONE # 01 to Sq GENERAL CONTRACTOR — p phi) FAX # 25135-&s— am 1- am not using any subcon Z 0V Signature Date Please check applicable subcontractors and complete the following information 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 • CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36654086 . 00 DATE ISSUED. . . . . . . : 02/22/2008 RECEIPT # . . . . . . . . . : BS000004009 REFERENCE ID # . . 08020148 SITE ADDRESS . . . . . : 11691 TIMBER SPRING CT .SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . : OWNER SWEE LIN ADDRESS . . . . . . . . . . : 11691 TIMBER SPRING CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5145 RECEIVED FROM . . . . : JOSE CASTILLO CONTRACTOR . . . . . . . : JOSE CASTILLO LIC # 25850 COMPANY . . . . . . . . . . : CASTILLO'S ROOFING ADDRESS 1703 CATHAY DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95122 TELEPHONE . . . . . . . . : (408)251-3565 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 7, 500. 00 0.80 0 . 00 0. 80 0. 00 1REROOFRES SQ FEET 20. 00 260. 00 0. 00 260 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 260 .80 0. 00 260.80 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 260. 80 14951 --------------- TOTAL RECEIPT 260 . 80 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- --------------------------- ------ ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS 605 FINAL REROOF i CITY OF CUPERTINO � • REROOF • ocuPr�Tinio PERMIT APPLICATION APN# � � O p Date: v Building Address: U im be 1~ S rtn C4 , Owner's Name: Phone #: q 4a ;2 (o & Sme L n Contractor: Phone #: io I - �• r,2 � 1� 3SS"' TI I I U S �b Di7l�C Fax #: sa3 e Cupertino Business License #: MID Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Guilt-Up Roof ❑ Built-Up roof al Asphalt Shingles uXAGphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: _TeA Y D P_ X i3) i I i.c� C , (L Corn ? SI-� )e-s C Residential Commercial Commercial Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation: 1 2 5_Z�,� Q c,2 O S(k I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Si re CITY OF CUPERTINO REROOF •CUPS' TINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FC0M Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 6 1REROOFRES Re-roof Residential B 1SFDWLROOF / 1BSEISMICRE Seismic Residential B 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B • Community Development Department Building Division City of Cupertino • 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to any roofing installation. 4. To receive a final sign off from the City,the following steps are required: 1) Pre-inspection and/or tear off approval. 2) In-progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. • 5. If plywood is installed, a plywood nail inspection is required. 6. Any roofing which is applied without first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/4" per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: /S�tve Pte_' L i n Job Site Address: (o�1 "l! in her �7y1/ j7Gl ��j / n Roofing 7-- Roofing Company Name: / Applicant's Signa ✓l Date: Z 2 *? • Greg Casteel Building Official Revised 11/2/04 Community Development •"°J 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 QCITY OF Fax(408)777-3333 UPERTINO Building Department JOB ADDRESS: PERMIT # 1 -T, m ,beP Spri-nel C4 . 6'22 OWNER'S NAME: 6W L-'i PHONE # 01 to Sq GENERAL CONTRACTOR — p phi) FAX # 25135-&s— am 1- am not using any subcon Z 0V Signature Date Please check applicable subcontractors and complete the following information 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