10090278 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 18850 NEWSOM AVE CONTRACTOR:ADAMS GLOBAL PERMIT NO: 10090278
CONSTRUCTION
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Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
1;j C O P E RT I N O Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: f $ C ��' �' PERMIT
OWNER'S NAME: :�22
PHONE# t4a6 ` 4 6 � ti��
GENERAL CONTRACTOR: f&&wVNs �"1 _1�, 'h' car BUSINESS LICENSE#
ADDRESS: 1 J 1.1 � ,
CITY/ZIPCODE: ,v
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
EULED
NO BUILDING FINAL OR FINAL OCCUPANCYINSPECTION(S)
HAVE OBTAINED AHCITY OF CU ERTINO
UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS
BUSINESS LICENSE.
I am not using any subcontractors: Si,nature 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
Painting/Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
it
Date
Owner-rContractor Signature
CITY OF CUPERTLNO
-M
R/MAIN
SERVICE
REPIPE/SENVE
CITY OF
CUPEKTINO PERMIT APPLICATION FORM
Date:
C,
APS 7BuildingAddress:
Owner's Name: Phone#: 4 IVT
#.
Contractor: #.
�:Aa yn 1'."n Phone#:
Fax
Phone#:
Contact:
Fax #:
Contractor License#: -1
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Cupertino Business License#:
Job Description:
Residential Commercial
❑
Valuation: J Major L_J
TC
Project Size: Express tandard Large
Green ding: Please complete relevant portion of the Green Building Checklist & attach it to the
application or if applicable, include in plan set & the sheet index.
Green Building Points:
Fee Description Fee Permit Type
Quantity Fee ID Group
IPCSEVvrER Commercial biuldingg P 1CPSS
sewer/sanitary,sewer .2n J
—---------
1BP E Commercial r�-pipe per fixture P 1CPPIP
IPGASCOM Commercial (Jas Piping System
1-4 Outlets ALL PERMIT
1BCBSC Cal Bldg Standards Co mission.. B TYPES
Fee
IBSEISMICOM Seismic Commercial P
Revised 01/07/09