Loading...
06090929/5 (2) CITY OF CUPERTINO 0 QGq()Q� REROOF /4 — • CUPERTINO PERMIT APPLICATION FORM APIC# Date: °J - j% -M I ff-p-op Building Address: /036 1"^ t,7/ems C+re e-A-- P4 Owner's Name: Phone #: �te,t Gha� & 5"0 Contractor: Pbane# License#: n oal-f v$ a-86 -Qs90 6-;z f/fa Contact: Phone#: Cupertino Business License #: cz 8 to -?9fo Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles _'_,4r—Asphalt Shingles Wood Shakes o Wood Shakes O Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# 9 To be Removed ❑ Provide Mfgr.Installation Specs. • I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: rc,*"wu, 0-a in.cS a/11rti z psl3W►*�1 ('Gtd�rw�-8>rnd.- p� � cwr�l, l�t�-fin.► D�rn�r,Ston�P Gov. .p -bio;, Sl� Residential IR, Commercial ❑ L(69. — Fire Zone: Yes ❑ No a Confirmed with Planning Dfft. if there are any restrictions: lJ Cost of Project: Type of Construction: OccupancX group: p r e --no a-�c S'r [c_ Qty. if Applicable .Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING •