08070120 CITY OF CUPERTINO
BUILDINGDIVISION
PERMIT CON+TRACTS.TRI1�)I''ORMt�x';IE .1�F`
Bu1LL31gc�3pgRFsN PERMITNO.
WALNUT CIR R A CONSTRUCTION 08070120
OWNERS
S NAMEE: PFRMIr ISSUEDATE
PAVAN BAYYAPU 3851 R. CHARTER PARK DR 07/16/2008
PHONE (408) 559-1877 SANITARY NO. CONTROL NO.
ARCHITECTfENGINEER: BUILDING PERMIT INFO
BLDG
l� O PLUMB MECTI
IC [�
u o o LICENSED CONTRACTOR'S DECLARATION l IOb Description
iF i hereby affirm that 1 aro licensed under provisions archaisms 9(commencing p
M with section 70(Xr fDhrkdn3aftheBusinessandProfessdouCode,andmylicenser RE-RF T/O OLD RF INSTL OSBPLYWD INSTL 50YR GAF RF
< n full fares and Uf
-=K Lt..daa Lk.g ASPHLT SHNGLC CLS A 29SQ. RA CONSTRUCTION PD FOR
=—F Dam xnEci s DECLARATION BSL RENEW 7/16/8
W'i 1 undersand my plans mull W used mo public records
IatG L.iccued professional
5OWNER-BUILDER DECLARATION
E I hereby oRrm Not I am exempt from the Convectors License Law for me
Coe following mama.(S motion 71311.5.Business and Pmfcssiom Codc:Any city or county
which requires a permit Of comtruc4 alter.improve,demolish,nr mpair any swclure
poor in its issuanco.oho requires lWappliaat formch pmmilto Rte asignd saumat
< deehoislicenxdpumoanuothepmvisiomofduConwcwr'sUiceesclsw(CTapur9 Sq.Ft. Floor Area Valuation
pp 9980
YF^e3 that he ndngwith Seetion30m)nfDivisionr of theeged essuWon.Anyavi Cadc)on
.. that io r 7031J
b M applicant
and Os,beer for Ne alleged ca=ption.a civil
l violation of
Out
3ma, by artyapplicants(apermitmbjccts Ju applicant in'civil penalty of
net roam man BK Wndred dollars(swan. 35 7 0 3 0 4 8 .M*XU$tber Occupancy Type
❑I.uowm of the Propury,mmY mopioyms with mgesuthe4 mW campeuWon,
will do she work and the smuclum r u
notinnded oroffernd forsar(Sec.30N,Butlrcu
and Pmfe m code:TW contraerars I usesse Law does an[apply to an owner of Required Inspections
property who Wilds orimproves lhatean,and who duessuch workhimselfortlerough his
arm employ=.po tided matsuch improvements are vat intruded molreled fwule if.
however,me building or improvement)amid within one year of compledon.the owner-
Wilder will haw due Wrdut of proving that W did Out MW or improse far Worm of
sale.).
❑1.u owner of the property.am exclusively cmnuacling wide Besmed ronaxlm.to
construct me project(Sec.3044.Busnm and Professions,Cade:)TW Conmmors Li-
.Law does mot apply to an..fp.,.,who Wilds ar improves theaon.and.
who contacts forstch projects with acontractor(s)licensed pursuant in dee Conuaetors
Liomm loo
w.
❑lam exempt under See ,B@PCformisomeen
Owner Date
WORKERS COMPENSATION DECLARATION
I hereby of irm under parully of perjury one of the fallowing declarations-
1 have and will maintain a CeniBam ofCouent to x11-imus,for Workers Compcn.
axion,as provided fm by Sacuan 3300 of the Mbar Cade,far the part...of W
wall for which this permit is issued.
1 haw and will maintain Workers Cmmpars,aJon lesurance,as related by section
3300 of the Labor Code.for the performance of ore work forwhlch this permit is lasned.
My Wartrls Com,cro.u/r.�n hrenante arner and Policy nu��a`x/:/p
Comer. �4'yTY �Uw� Policy Na.: 7
'21CAFE OFIPIION FROM WORKERS'
COMPENSATION INSURANCE
(This xNrn need net hocomplcted if Jc permit is forma,hundrW dallass($100)
or leu)
I certify that in the performance of the work for which this permit is issued.I shall not
employ any permn in any mauurm u m haeme xbjat tome Workers'Compensation
Lam of Caltfomia.Dau
Applicant
NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should
become subject to the Workers Compceskdan i mrisioru of the LOU,Cada,you atm -
.J O forthwith comply with such previsions a this permit shall W dccmed mooted.
d."' CONSTRUCTION LENDfNG AGENCY
(•+vN. 1 hereby affirm this thea is a construction lending agency forme performance of
ai w�-t
the work for which this permit is issued(Sm.3097,Civ.C.)
6Wi Q Landers Name
Loafers
ers Address
U O 1 esrtify vel 1 haw rho JJs application and mote Ihu the show irufinehomm is
if, comm..I agrace to comply with all city and county ordirmuces and sure laws relating to
.C) Wilding conswnion.and herby xthorim rtpmxnutiws of der city toenur upon Je
[Il show-mentioned property,for inspection puryoxs
6e (We)agree to more.indemnify and keep harmless the City of Cupertino agaim
tF•rZ in consequence
of the ratsand expenses thissoWhich may In any myacrneagsnntseid City
U,Z AcPLIC NT of the UNDERSTANDS
of thispermit,
APPLICANT UNDERSTANDS A LL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS. 7
Sigvuurt of All.. amnr • p�t Re-roofs
H DOUs MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wilding ampantswc on handle havNous material
as defined by Use,Cupertino Municipal Code.Chapter 9.13.and the Health and Safety
Cale.Section 35532(.)7 C—_ All roofs shall be inspected prior to any roofing material being installed.
❑Yes T'yiam
Will the applicant or ffuture Wilding occupant use equipment or dcsuces which If a roof is installed without first obtaining an inspection,I agree to remove
haysrdou it contaminants as dcfncel by tW Bay Area Air Quality Management all new materials for inspection.
clT
❑Yes Nu
I haw mol the hosrJousmauriab xquiremenu undcrch.purh.95ofthe Cslifm.
nixHalthkS.f,LYCade,Seeuana25505.25533u Z534.lundemandmasifthe Wilding
does net torrenJy how a torrent,that it is my ressomA lily to notify site occupant of the
rcyuirtmcts nw prior to fuusrue of a Cmtifcau of Qempancy.
Signature of Applicant Date
iota risaagenl Dam All roof coverings to be Class'W'or better
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: pdtg
COPY # 1
Sec : Twp: Rng: Sub: B1k:. LOt:
APN . . . . . . . . : 35703048 .APTA&B
DATE ISSUED. . . . . . . : 07/16/2008
RECEIPT # . . . . . . . . . : BS000005490
REFERENCE ID # . . . : 08070120
SITE ADDRESS . . . . . : 22480 N WALNUT CIR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : PAVAN BAYYAPU
ADDRESS . . . . . . . . . . : 22480 N WALNUT CIR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : R A CONSTRUCTION
CONTRACTOR . . . . . . . : ANDREWS, RON LIC # 21382
COMPANY . . . . . . . . . . : R A CONSTRUCTION
ADDRESS . . . . . . . . . . : 3851 R. CHARTER PARK DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95136
TELEPHONE . . . . . . . . : (408) 559-1877
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
-- ------------- ---------- - ---- ---- ----------
1BSEISMICR VALUATION 9, 980 . 00 1 . 00 0 . 00 1. 00 0 . 00
1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00
1REROOFRES SQ FEET 29 . 00 377 . 00 0 . 00 377 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 488 . 00 0 . 00 488 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER '
--------- --------------- --------------------
CREDIT CARD 488 . 00 VISA
---------------
TOTAL RECEIPT 488. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- - ------------ --- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
CITY OF CUPERTINO (_-4 7012- o
la
REROOF
CITY OF
CUPEVINO PERMIT APPLICATION
APN # O LI
Building Address: 2zy0 N !/UhbWr�2 ( V
Owner's Name: Phone #:
1*04v V 134wi 0(l :5�;) 3 -/032,
Contractor: Phone #:
x 4. Ccw5r Fax #:
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
• t, 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: 7� O/—F
/
Residential Commercial ❑
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index. E}-
Valuation:
Have Read, Understand and Wi#Cly with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
n}d CITY OF CUPERTINO
REROOF
CITY 0
CUPER,TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B ICOMMLROOF
1BSEISMICO Seismic Commercial B
2 1RER00FRES Re-roof Residential B 1SFDWLROOF
/ 1BSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B •
1BUSLIC Business License B
Revised 6/16/08
•
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: 41
Job Site Address: 0q). U ��
Roofing Company Name:
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04
Green Building Plan Check
Index of Green Building Points/Categories
• A. Category Example of an Index or Table of Green Plan Sheet or Page Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points
11. Permeable Paving, Note L-1 2 Dints
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 Dints
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 __jpoints
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11. A 2500 Gal.Tank, Note/S ec L-1 10 points
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refrigerator, (Note/Spec. A-3 1 Dint
P. Other 1 1. List Green Features on Plans A-1 1 paint
TOTAL POINTS 40 points
Plan Review Process Work Book Page-12-Revised 3/25/08
Green Points Rating System for Remodeling Projects
Due to the diversity of remodeling project types,assigning a"total points'value to a project to be considered environmentally friendly is
not feasible.However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for"greening"your project.
INPUT Resources Ener�y' ADIHealih
.Site
1.Recycle Job Site Construction&Demolition Waste 4
65%=1 point;75%= 2 points;80%=4 points ! up to 4 Resource pts D
2.Salvage Reusable Building Materials J) 4 Resource pis y--yes 0
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pts y--yes 0
4.Protect Native Soil 2 Resource pts Y--yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt Y--yes 0
6.Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
8.Design Resource-Efficient Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse Matedals/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes 0
10,Install High-Efficiency Irrigation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0
B.Foundation Id
1.Incorporate Recycled Flyash in Concrete
• 25%Recycled Flyash=2 points;Add 1 point for every 10%
increase of flyash,up to 5 points up to 5 Resource pts 0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes[;F p
1 1 1
C.Structural Frame
L.Substitute Solid Sawn Lumber with Engineered Lumber 3 Resource pts y=yes D
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pis. D
3.Use Wood I-Joists for Floors and Ceilings 2 Resource pts y--yes D
4.Use Web Floor Trusses 2 Resource pts y=yes D
5.Design Energy Heels on Trusses 6"or more 2 Energy pts y=yes 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pis Y--yes 0
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0
B.Use Recycled Content Steel Studs for Interior Framing 2 Resource pis y=yes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pis y=yes 0
b.Wall 3 Energy pts y=yes 0
c.Roof 3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pis y=yes 0
11,Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes 0
1 Resource pt y=yes 0
a.Subfloors
• b.Sheathing 1 Resource pt y=yes 0
1 1 0
INPUT RESDUTces Energy ADHEalth.
D.Exterior mtsh
1.Use Sustainable Decking Materials
a.Recycled content 3.Resource pts y=yes 0 .
b.FSC Certified Wood 3 Resource pts y--yes 0
2.Use Treated Wood That Does Not Contain Chromium/Arsenic j 1 IAO Heath pt y=yes 0
3.Install House Wrap under Siding 1 IAQ/Health pt y=yes 0
4.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
E.Plumbing
1.Install Water Heater Jacket J� 1 Eneray pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y--yes 0
3.Retrofit all Faucets and Showerheads with Flow Reducers
a.Faucets(1 point each,up to 2 points) Up to 2 Resource pts. 0
b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0
4.Replace Toiled with Ultra-Low Flush Toilets
(1 point each,up to 3 points) _ Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showerhead 1 IAQ/Health pt y=yes 0
6.Convert Gas to Tankless Water Heater 4 Energy pts y=yes 0
7.Install Water Filtration Units at Faucets
(2 points each,up to 4 points) Up to 4 IAQ/Health pts. 0
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 01 1
1 1 1
. .. r.ttectncai -----
1.Install Compact Fluorescent Light Bulbs(CFLs)
(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) ) Up to 4 Energy pts. 0 •
2.Install IC-AT Recessed Fixtures with CFLs(1 point each,up to
5 points) Up to 5 Energy pts. 0
3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pis. 0
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up to 4'points) Up to 4 Energy pts. 0
1 1 1
G.Appliances
1.Install Energy Star Dishwasher 1 Energy pt y=yes 0
2.Install Washing Machine with Water and Energy
Conservation Features 1 Energy pt y=yes 0
3.Install Energy Star Refrigerator 1 Energy pt y=yes 0
4.Install Built-In Recycling Center 3 Resource pts Y--yes 0
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pts Y_—Yes 0
b.Ceilings 2 Energy pts yeses 0
2.Install Floor Insulation over Crawl Space 4 Energy pts Y--Yes 0
�3.Install'Recycled-Content,Rberglass Insulationwitli
Lo Added Formaldehyde j 31AQ/Health pts y=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes 0
5.Use Cellulose Insulation
a.Walls 4 Resource pts y=yes0
b.Ceilings 4 Resource pts y=yes 0 •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
D.�eumgs 4 Resource pts y=yes 0
i 1 1
INPUT Resources Energy ]ACIBealth
.Windows
F1.'Install Energy-Efficient Windows
a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y--yes0
c.Low.Conductivity Frames �j 2 Energy pts y=yes 0
2.Install Low Heat Transmission Glazing 1 Energy pt Y=yes D
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Duct Mastic on All Duct Joints 2 Energy pts y--yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts Y=yes D
3.Vent Range Hood to the Outside 1 IAQ/Health pt y--yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 7
0
5.Install Solar Attic Fan 2 Energy pts y=yes 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts Y=yes D
B.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heaters 3 IAQ/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Heater with
Through-the-Wall Heat Pumps 3 Energy pts y=yes D
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes D
11.Install AC with Non-HCFC Reirigerants 2 Resource pts yryes 0
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pis y=yes 0
• 13.Retrofit Wood Burning Fireplaces
a.Install EPA certified wood stovesBnsarts 1 IAQ/Health pt y--yes D
b. Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt y=yes 0
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 4 IAQ/Health pts y--yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAO/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3IAQMealth pts y--es 0
K.Renewable Energy and Roofing
1.Pre-PlumtYforSolar Water Heating 4 Energy pts y=yes 0
2.Install Solar Water Heating System 10 Enarcy pts y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points) Up to 18 Energy pts 0
6.Select Safe and Durable Roofing Materials — 1 1 Resource t – as 0
� -------- – — — – P Y=Y
7.Install Radiant Barrier 3 Energy pts y=yes 0
I 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts Y=yes 0
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes 0
3.Plant Deciduous Trees on the(Nest and South Sides 3 Energy pts y=yes 0
1 1 1
•
M.Indoor Air Quality and Finishes "
1 Use LowMo-VOC Paint 1 IAQ/Health pts y=yes D
2.Use Low VOC,Water-Based Wood Finishes _ 2 IAQMealth pts y=yes 0
3.'Use Low/No VOC Adhesives 3 IAQfHealth pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y--yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 6IA0/Health pts y--yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
I7.Setl allall Exposed Particleboard or MDF _ 4 IAQ/Health pts y=yes D
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yesD
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y--yes 0
10.Install Whole House Vacuum System 31A0/Health pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 6 Resource pts y--yes D
2.Use Rapidly Renewable Flptng Materialss — _ 4 Resource pts y=yes D
3.Use Recycled Content Ceramic Tiles 4 Resource pts Y--yes 0
4,Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes D
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 i 1
Total Points A 1 1401 130 57
Total Points Project Received: 1 01 0-7-01
•
G:dafalprogsigmenbuil3ngguidelinesfremodelem/greenpoin6f na12.12.04prNeNedxls
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
� CUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
02Wo b d o -1
OWNER'S NAME: A ✓ PHONE # 3_ 3
GENERAL CONTRACTOR: - FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors4ffG 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
P astering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
er/Contractor Signature Date