08060043 (2) CITY OF CUPERTINO
BUILDING DItiISION PERMIT CONTRACTOR*INEORMATZON
BCILTTGgp`6"dPLAND WY SHADOWFAX ROOFING PER08060043
OWNER'S NAME: PER ITT`SUE OATS
Dt�N LAUBER 1366 SANTA FE DR 06/05/2008
NE: SANITARY NO. CONTROL NO.
ARCHRECfr6NGINEER: BUILDING PERMIT RE—RF RMV SHK RF APPLY BLDG ELECfPLUM00 MECH
O 0 O O
o p LICENSED CONTRACTOR'S DECLARATION
u - I bunchy grim that 1 an licensed under provisions of Chapter 9(communing Job Description
with Section 7")rfDivision 3 ofthe Business and Professiolu Code,and my liecrse is
„ Amufpnxande _ ��y
�q� t.icenm class L"c.« '
Dam Con.'n
ee ARCHI'IERSDECIA ON
? u 1 nimyplans"Iheusetlu Publicreenrds
6
tat'„ Licensed Praiuional
M OWNER-BUILDER DECLARATION
s�f I March,aRrre that I am exempt from to Cmuamunes License Law for the
CO following noon.(Section 703 I.S.Business and Pmfeadov COx:My city Or county
K S M which requires a permit in convect,alar,improve,demobh,or repair my svucwm
u i'o prior m a reires its issuanam.,lsquPa applicant for such permiuo file a signed suumem
a< Oat he i licensed pursuant to the pmvisiov of the Contractors Licamse Law(Chaper9 Sq.Ft. Floor Area, Valuation
iF$ (commenting with Section 7")of Division 3 of On Business and Pmfmiov Code)or
— Nat W is exempt thcre(rom and to basis for the dinged exemptom Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant in a civil penalty of APN Number Occupancy Type
rpt mom than five hundred relics(M). p y yp
❑I.Y pWMl of On properly,M my employees with wages as their role comperLLL em,
will do the work,and theavuctum is not Intended or offered for salt(Sec.7W,Business
aha Pmfmiov Coda,The Contractors Lim.Law does rot apply a an owner of Required Inspections
property who builds or improves thereon,and who does such work himsel f or through has
own employees,provided Nat such improvements art not intended proffered for sale IL
however.the building or improvement isold within one year of compleum.the owner-
builder will have On b rdm of proving Nat he did not build or improve for purpose of
.in.).
1,as owner of the property am exclusively convecting with liaved contractors to
construct the project(Sec]Das.Business and Professions;Code:)The Consumers U. .
more law does not apply e m owner of property who builds or improves thereon,and.
who contracts for such projects with a monochromic)lieeved pursuant in the Contractors
License taw.
❑I am exempt under Sec ,B&P C for this reason
Owner Dan
WORKER'S COMPENSATION DECLARATION
40 1 heroby ace under pevhy of perjury sun of the following declarsuov:
C]1 haw aha will mainuin a Cerufine of Conserv m ulr-insure for Workcla Compcn-
.1i.n.u pmvixd for by Section 3]08 rf the labor Core,forthe performanneof the
work for which this permit is issued.
❑1 have and will mainum Workers CpmperuNon lvurance,as horsed by Section
I700 of the talon Core.(Or Ne pcRarmmce of the wank for which Nu permit Is nation. '
My Workers C c tion In nue caMandl Policy number art:
camera Policy Nol1f�7LS7f0/oJf�U
OFEX PfIONFROMWORKERS'
COMPENSATION INSURANCE
(Thusecuon need not be compknd iDh Permit Oformse hundred dollar($IM)
or less)
1 untify 021 in On performance of the wank for which this Permit u issued,1 shall not
employ any person in my summer an as a become subject to the WorkmsCornpevaton
Laws of California.Dan
Applicant
NOTICE TO APPLICANT:If,-fur making this Ccnifwu of Exemption.you.Amid '
become Subject an the Worked Compensation prevlsmars or to IabIX(.'ode,you most
.J z forthwith comply with such Imbrium.or,this permit shall be dcemed rewkcd.
,Z.,h CONSTRUCTION LENDING AGENCY
[--� I hemby 1111m,Oat Vert is a convection lending agency for to performance of
aNe work for which this permit is issued(Sec.3097,Civ.C.)
WM Q Lendera Name
7 z Lenders Address
U Q I Cereify Nu I have rad this application and sou that the above infor comm is
Is,P cortex I agar to comply with all city and county ordinances and son law mlaung th
0U Wilding convection.and hereby mutative icincsenwives ofthu city to enter upon the
r W a1mve-mentioned property for ivpeetim purposes
(~ LL (We)agree to ave,indemnify and keep hartnlm On City of Cupertino against
to Iiabiliuepanim,of
and expevel which may in any wyaccrue against sed City
U z A PLIC me of to granting of N' Permit. ,/
.. SOURIC EGUfATI0N5.NDS WILL COMPLY WITH ALL NON- INT Issued by: Date 'e5'—
Suit
� ^
Re-roofs
Sig rAppl'anUC trmtor an
RDOU ATERIALS DISCLOSURE Type of Roof
Will to applicant or future building ompantuom or handle heandous material
u defm l by to Cupeninyy}x+unicipal Code.Chapter 9.12,and the Hnith and Safety
tax,Section ns3xa>y� ' All roofs shall be inspected prior to any roofing material being installed.
Yes a
If a roof is installed without first obtaining an inspection,I agree to remove
Will the,Pnbe t or roam Lauding arapant vc cgdpment m xvim wnich g P
I hvasdnus air cone �n cats as defined b Area Air Quality Management all new materials for inspection.
Dissier?
❑Yes
l have maJ the nv anrialsrtquimmenu unxr Ceamoul di5ofNe Califon.
nu HcalthkSarcty Code,Sreu ND,25577 mdyS53a.lund:rsund thcirthc building
d currency bast a t it u my respovihilitY a mtifY the oaupmt of tic
menmw wMmn conn i was an certfe,npfacnmccum Signature of Applicant Date
nerarmt 'mdagcm Dam- All roof coverings to be Class'"Or better
CITY OF CUPERTINO
• 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36603034 . 00
DATE ISSUED. . . . . . . : 06/05/2008
RECEIPT # . . . . . . . . . : BS000005014
REFERENCE ID # . . . : 08060043
SITE ADDRESS . . . . . : 11790 UPLAND WY
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : DAN LAUBER
ADDRESS . . . . . . . . . . : 11790. UPLAND WAY '
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : JERRY L SHAFFER
CONTRACTOR . . . . . . . : JERRY SHAFFER LIC # 27342
COMPANY . . . . . . . . . . : SHADOWFAX ROOFING
ADDRESS . . . . . . . . . . : 1366 SANTA FE DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95118
TELEPHONE . . . . . . . . : (408) 265-2490
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 24, 800 . 00 2 . 50 0 . 00 2 . 50 0 . 00
1REROOFRES SQ FEET 57 . 00 741 . 00 0 . 00 741 . 00 0 . 00
-- ------ ---------- ---------- ----------
TOTAL PERMIT 743 . 50 0 . 00 743 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 1, 082 . 50 MC
---------------
TOTAL RECEIPT 1, 082 . 50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
Oyoia C>O`f.3
CITY OF CUPERTINO
REROOF
CUPEkTINO PERMIT APPLICATION
APN # 3 G (,o 0S D J 2 L1' v v Date: i i
Building Address: S
Owner's Name: Phone#:
4dy-.7si- SQ��
Contraaccttor: Phone #•
Fax #: - �6
Cupertino Business Li ense #: Contractor License #:
Z
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles � Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
Wood Shingles ❑ Wood Shingles
❑ ther (Specify) ❑ Other (Specify)
Number of existing coverings ,� ❑ Provide I.C.B.O. Report#
%To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: � i
C ( csrF- ,, 7
Residential/5-1, Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the there are any restrictions: ❑
application or if applicable, include in plan
set & the sheet index.
Valuation: 4r, OQ
• I Hav ad, Understan d Will Comply with Cupertino's Tear-Off Policy:
Si re
CITY OF CUPERTINO
S112- REROOF
OF
PCUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
r 1REROOFRES Re-roof Residential B 1SFDWLROOF
•7 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:
Job Site Address: U
Roofing Company Name:
Applicant's Signature: Date:
��y it
• 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
a
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 7points
11. Permeable Paving, Note L-1 C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 5. Use Truss with heels, (detail) S-2 6. B. OSB Sheathin detail S-2
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points
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/Spec 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 point
P. Other 1. List Green Features on Plans A-1 1 point
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.
A.Site
1.Recycle Job Site Construction&Demolition Waste —�
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materials _ 4 Resource pts 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 yryes 0
B.Design Resource-Efficient Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse Materials/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y--yes 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts yryes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes D
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 p
3.Insulate Foundation/Slab before backfill 3 Energy pts Y--yes _ p
1 1 1
C.Structural Frame
1.Substitute Solid Sawn Lumber with Engineered Lumber 3 Resource pts yryes 0
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pts. 0
3.Use Wood I-Joists for Floors and Ceilings 2 Resource pts y=yes 0
4.Use Web Floor Trusses 2 Resource pts y=yes 0
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 pts Y--yes 0
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0
8.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts yryes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes
b.Wall 0
3 Energy pts y=yes 0
C.Roof 3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes 0
12.Use 0S8 --, ---
a.
'a.Subfloors 1 Resource pt y=yes 0
b.Sheathing
__ 1 Resource of y--yes
0 mckow
INPUT Resources Energy [ADIHealth
xtenor Fins
!1.Use Sustainable Decking Materials j •
a.Recycled content ` 3 Resource pts y--yes 0
It.FSC Certified Wood I 3 Resource pts y--yes 0
2.Use Treated Wood That Does Not Contain Chromium/Arsenic ( 1 IAQ/Health pt y--yes D
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
— --- ---- -- 1 1 1
E.Plumbing
1.Install Water Heater Jacket 1 Energy pt Y_-Yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts yryes 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 Toilesf 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
8,Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
. .. r.riecmcar -----
1.Install Compal Fluorescent Light Bulbs(CF'
(6 bulbs=2 points, 10 bulbs=3 points,12 bulbs=4 points) Up to 4 Energy pts. D •
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 pts. 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
F.Install Energy Star Dishwasher i 1 Energy pt y=yes 0
2.Install Washing Machine with Water and Energy
Conservation Features 1 Energy pt y=yes 0
�3.lnstall Energy Star Refrigerator 1 Energy pt y=yes 0
14 Install Built-In Built-In Recycling Center 3 Resource pts Y--yes D
i 1 1
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pis y=yes 0
b.Ceilings 2 Energy pts y=yes 0
2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
3.Install Recycled-Confeni,Fiberglass Insulaton with
No Added Fo maldehyde — _ 3 IAQ 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=yes 0 •
b.Ceilings 4 Resource pts y=yes 0
6.Alternative Insulation Products(Colton,spray-foam)
a.Walls 4 Resource pts y=yes 0
o.Ceilings 4 Resource pts y=yes 0
1.Windows
(1.Install Energy-Efficient Windows
a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0
c.Low.Conductivity Frames 2 Energy pts y=yes 0
2.Install Low Heat TransmissionGlazing 1 Energy pt y--yes 1 0
1 11
J.Heating Ventilation and Air Conditioning
,1.Use Dud Mastic on All Duct Joints _— � 2 Energy pts y-yes 0
2.Install Ductwork within Conditioned Space 3 Energy pis y=yes 0
3.Vent Range Hood to the Outside 1 IAO/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts yq es 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 pis y=yes D
8.Install Sealed Combustion Units
a.Furnaces 31AQ/Health pts y--yes 0
b.Water Heaters 3 IAQ/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Healers with
Through-the-Wall Heal Pumps 3 Energy pis y=yes 0
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes 0
11.Install AC with Non-HCFC Reirigerants 2 Resourcepts y=yes D
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 stovesInserts 11AQ/Health pt y--yes 0
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 pis y=yes 0
15.Install High Efficiency Filter 4 IAQ/Health pts y=ye_ 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pis y=yes c
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes 1 p
I I 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pis Y--yes 0
2.Install Solar Water Heating System 10 Energy pts y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes p
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 p
S@ ect Safe and Turable Roofing Mate als _ 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pis y=yes p
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts . y=yes p
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes p
• 1 1 1
M.Indoor Air Quality and Finishes
1.Use LowRJo-VOC Pant 1 IAO/Health pts y=yes D •
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
f3.Use Low/No VOC Adhesives 31AQMealth 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 61AO/Health pts y--yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes D
7.Seal all Fxposed Particleboard or MDF _ _ _J 4 IAO/Health pts y=yes D
S.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
1 { 1
N.Flooring
1.Select FSC Certified Wood Flooring 6 Resource pts y--yes D
2.Use Rapii Renewable Flooring Materials 4 Resource pts y=yes 0
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 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
Total Points 1 1401 1301 57 •
Total Points Pro'ect Received: 1 01 01 0
G:dadprogsrgreenbuilr ingguidellneshemodelersrgreenpointsfina2.12.O4proteped.xls
Community Development
e 10300 Torre Avenue
J Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
SCUPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
//714) o(5,aa�cX—
OWNER'S NAME: PHONE # o k • � 3-so/L
GENERAL CONTRA OR FAX # d7 -c)or- .a7�
I am not using any subcontractors:
Signature 4W ate
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
•
oY
6r/C actor Signature Date