00030207 (2) CITY OF CUPERTINO -
L ' BUILDING DIVISION PERMIT " CONTRACTOR INFORMATION: PERMIT No.7jJ 2 � O.
,BUILDING ADDRESS: - _ - , • .V OO ,/ O�'�J7 Y
/0/�9��i - f�VS. (� 1 PQrQ yl,n Services Cyt SANITARY NO. AVPLCATION SUBMITTAL DATE
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` I r's.�19 Oen (Z'R- D��✓` NIC CONTROLN
PHONE , ❑
04IIas. TX '7S22a
ARC,HITECf/ENGINF.F.R . EULDING I'IiitMITINPp
100 . -
60 Si�M2 &;5406 a Zry— 35—a — 3X910
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F j LICENSED CONTRACTOR'S DECLARATION -
O Z.= 1 herby eNrm Nat 1 w littnved undo Provisions a Chapter 9(commencing '
F_`—' wil�serionmoo)OfD;vision3ofN Bu>.K.,W f� onaenm.elmmyhaKei. 'Job . . -
y in run force and effect.
u License Class Lic.N
Date Conuacmr
ARCHITECLS DECLARATION
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