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07110053 CITY OF CUPERTINO � ' BUPLDING [�it'ISION PERMIT ��t �.:�� ' ;: :.: :,.:, .. ,; :: .....:... . . ,,.::.. ... BUILDING ADDRESS: PERMIT NO. 22860 STONEBRIDGE ST TBD -'IO BE DETERMINED 07110053 . VER'S NAME: PERMIT ISSUE DATE AL & MARY ANN WEINGARTNER � 11/09/2007 PHONE: SAMTARY NO. CONTROL NO. ARCHI7ECC/ENGiNEER: BUILDING P£RM1T INFO BLDG ELECT PLUMB MECH 0 0 � 0 � o p UCENSED CONTRACI'OR'S DECLARATION � I hcrcby attirm that I am liccnscd undcr provisions oC Chaptcr 9(commcncing Job Description � z� wit6 Section 7000) of Division 3 of thc Busincss and Profcssions Codc, and my liccnse is KTC HN R MDL TO I NC LD L I GHTNG , NON - S TRUC T L. °< a in full focce and ef[ect ��z LicenacClas;, ��•+► ITCHEI� MASTERNS PD BSL #29591 11/6/07 y �:. C Datc �/' Y• '� Contncmr � ARCHITECI'S DECLA AT10N ��< I undcrstanJ my plans shall bc utcd as public recorda ��U L p y Liccnscd P�ufcssional y � OWNER-BUILDER DECLARATION 1 hcrcby aCGrtn U�at 1 sm excmpt Gum ihc Conuactor's Liccnsc Law for thc p O Collowing resson. (SccUon 7(Yi 1.5, Busincss md Profcssions Cak: Any ci�y or county K,°, Pi which requiccs s pem�it to conswct, alter, improvc, dcmolish, or repuir any swcw�c � Z y prior lo ils issusncc, also tcquires thc applicanl for such permit to filc a signcd summenl �_ � ma� �� u��a ��.�<<o m� �ro��s�o� or u� co��w��s u«� vW ccna�� e Sq. Ft. Floor Area Valuation y t- �(canmcnring wi�h Scction 7000) of Division 3 0( Ihc Busincss and Professiona Cadc) or $ 3 5 6 0 0 y �... �ha� he is exempt themftom md the batis for the sllcgcd eumption. Any vioiauon ot Secuon 7031.5 by a�ry applicant for a permit subjecu �he applicant to a civil penalty of � Number Oceupaney Type noi moro u,an rve n�na�ea aouars cssom. 3 4 213 0 3 9: i7 CJ' ❑ I, u owner o[ tl�e property, ar my employces with wages az their sole compensaUon, will do the work. snd ihe structwe is not intended or aRaed for sale (Sa. 7044, Business Re uired Ins ections and Protessions Cade: The Conuactors Lianse taw dae4 not apply in an owur of 9 P propeny who 6uilds or improves �hercon, and wM daes such work himaelf or tlwugh his own employces, providcd that such improvemenu ue no[ inten�d or o[(eced (or sale.lf, however, ihe building or improvement is sold within one year of rnmpledon, ihe owner- builder wiU 6ave the burden o[ proving iAa� he did not build or improve tor purpose of sakJ. y - - Q I. a� awner of [M1e property. am aeclusively conuacting wi�h lianaed rnnvactors to �� x consuuct the projea (Sec. 7044. Business and Professiom Code:)'ILe Conuacwrs Li- � ccnse Iaw does not apply w m owner of propeny w6o builds ar improves iheeeon, and , a'. who rnnvac�t for suc6 projec�s with a conuactar(s) licensed pursusnt to �he Convaaor's � I am uempt unda Sec. , B R P C for this rcason {._._ _ . .� Date WORKER'S COMPENSA170N DECLARATION 1 hereby �rm under penalty of perjury one o[ the foltowing dectuazions: luve and will mainuin a Certificale of Conaent to xlf-inswe for Worker's Compea- on, u provided for by SecUon 3700 of the Labor Code, for the pedormance of �he work for which Ihis peimit is issuM. ❑ I Aavc and will maintain Workc(s CompensaUon Insurana, u required by Section 3700 of the Labor Code. Cw �he pedormance of �he work for w6ich this peemit is istued. My Worker's Compensation Insurancc carricr and Poliry number a¢: Cartier. Policy No.: CERTIFICATE OF EXEMPfION FROM WORKERS' COMPENSATION INSURANCE • (7Lis section necd irot be completcd if the permit is for onc hundmd dallars (f 100) or Icss.) • 1 cenify that in thc perfamancc of thc work fw which Wis permit u issucd, t shall not employ any person in any man so � w becqmc wbject w �he Workccs' Compcnsation Laws of Cilif p� � � Applicanl �• N077CE TO APPLICAM: If, aMr making Ihis CcrtiCcate of Excmp6 n, you shoulJ bccane aubjctt to thc Workcr� Compcnsation provisions o[ Nc Labor Codc, you muu � O forthwiW comply with such provisions or this pecmit shall 6c dccmcd n.wokcd. z ""' CONSTRUCI70N LENDING AGENCY (.~-� ►�-� I hcreby a�rtn Uiat �hcro ia a consuuction knding agcncy (or thc perfarmancc uf a� �hc work [or which this permit is iuued (Scc. 3097, Civ. C.) W� Q Lendcr's Nunc • ] z L.cnder's Address V 0 I cenify Ihat I have rcad Uus appliw�ion and siam �Aat the above informatiun is w� corten. l agrce to comply wi�h all city and county ordinances and sute laws �elating m 0 U building conswction, and hereby authorin reprcsentaGvcs of U�is city w entcr upon thc � a aAme-mcntioned pmpcny (or inspenion purposea (Wc) agrce to save, indcmni(y and kecp harmless the City of Cupertino against „E" � liabilitiea,judgmcnts, cosLS and expenscs which may in any way acccuc againsl said City V z in conuquence ot thc granting of �his permiL ��2� � APPLICANT UNDERSTANDS AND WILI. COMPLY WITH ALL NON-POINT Issued by Date l/ SO(1RCE REGULATIO S. �� // .9�0 ) Re-roofs �v ignuu�cant/Conuactor Daic HAZARDOUS MATERIALS D[SCLOSURE Type of R oof w II Ihc spplicant w fuwts building accupant storc or handlc harardous matcrial efincd by Ihe Cupenino Municipal Codc. Chapmr 9.12. and thc Hcalth and Safcty :. Scction 25532(a)? All roofs �hall be inspected prior to any roofing material being installed. ❑ Y� �° Will �hc applicant or fu�wc building accupant usc cyuipmcnt or dcvices which If a roof i� installed without first obtaining an inspection, I agree to remove cmit ha•rardous air conuminanu az dcfincd by ihe Bay Arca Air Quality Managcmcm all new m aterials for inspection. a�� 0 Yes �u 1 havc rca�i the hvardous maicrials requiremcnu umicr Chap�cr 6.95 of �hc Cali(or• nia Hcalih & Sakry Codc, Secdau 25505, 25533 aru125534. I undcrsund ihat iCthc building daes not currently have a icnant, ihu it u my responsibiliry to noufy ihe occupani nf �he rcquiremc whice must be met �� or s c�r�� or o�N�r. Signature of Applicant Date � -�� / ��.Y //� 9- 07 All roof coverings to be Class ��B�� or better O�ner or authorizcd agcnl �� , D� ( � � � �� , ; ' CITY OF �CUPERTINO ��F pERMIT APPI.ICATION FORM CUPEi�TINO APN #� • � V �� t J Date: ! I Y � ' O Building Address: . Mailing Address (if different from building address): a O er's Name: /� W ` Phone�#: ; (. � �'�0 Contractor: � License #: ,,i� �, �7 � � q � � ntac : � Phone: � 0 l��S Cupertino Business License#: � � Q �� Fa.�c: �D�� ) 1�3�v �C l�� I Building Permit Info: �/� ��,�,` �� p ,� � l�' =��GL Bld lect Plumb Mech ❑ Job Description: Residential Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: � Occupanc Group: ��boo, �� Type of Construction: _� Please check this box if the project is a ��'— second-sto addition: � Project Size: Standard � Large ❑ M�'or ❑ Quanti Fee ID Fee Descri tion Fee Grou BAPPLOTHER Other A liances MECHAI�TICAL BBOILERI B��iler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to SOOK Btu MECHANICAL BBOILER3 Bo: ler > SOOK to 1M Btu MECHANICAL BBOILER4 Boiler > 1M to 1.75 M Btu MECHANICAL BBOILERS ]3oiler > 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX vid/Off/Comm/Quasi BUILDING BCONSTAXBQ C��n. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR C��nstax — Resi/Mobile BUILDING BELEC 1000 F lec 600V <= 1 OOOA ELECTRICAL BELEC1001 l.lec 600V > 1000A ELECTRICAL BELEC200 ' Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 CITY OF CUPERTINO CuPE T�NO PE�IT APP]LICATION FORM R. Quanti Fee ID Fee Descri tion Fee Grou BMISCELL Miscellaneous Fee BUILDING BMITIGATC Cc►mm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLLTMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW ��tmos heric Vacuum PLUMBING BPCESSPOOL Cess ool PLUMBING BPERMFEE Bld Permit Fees BUILDING BPFIXTURE Pbl Fixture PLUMBING BPGAS C�as Pi ing System Fee PLUMBING BPINTERCEP ]nd Waste Interce tor PLLIMBING BPLANCHK Plan Check Fee BUILDING ' BPLANCKADD �'lan Check Add Multi BUILDING BPLANCKREP P lan Check Re eat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewa e Dis osal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK L�wn S rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLLJMBING BPTRAP Kitchen Tra PLiJMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER InstalVAlter Water Pi e PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reins ection Fee BUILDING BREMACOVER �JC Unit > 10,000 cfin MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHAr1ICAL BREMBUSWAY Remodel Busways ELECTRICAL L BREMFIXT Lightin Fixtures ELECTRICAL BREMFURN ]Zelocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > lOK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD [nstallation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BRET�INRAFP R�,m Non-Res A liance ELECTRICAL BREMPOLE =?ole/Platform Fixture ' ELECTRICAL BREMPOWER Power Device/A aratus ELECTRICAL BREMRECEPT R�� tl, Switch & Outlets ELECTRICAL ' BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 � � CITY OF �CUPERTINO CUPEI�TINO PERMIT APPI.ICATION FORM Quanti Fee ID Fee Descri tion Fee Grou BREMSIGNAD Rrldl Signs Add Branch ELECTRICAL BREMSIGNS Re:nodel Signs, Mar uee ELECTRICAL BREMTHEATR Tlieatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Sin le Duct MECHANICAL BREMVENSYS `'entilation S stems MECHANICAL BSCBLVD Scb S ecific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL S ecialIns ection BUILDING BSWIM Swimmin Pool BUILDING BTEMP 'Tem ora Power ELECTRICAL BTEMPPERM Te�n ora Bld Permit BUILDING BTEMPSVCS Tem Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical s foot ELECTRICAL EPERMITFEE Etec Permit Issuance ELECTRICAL MPERMFEE :Vlechanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL / PPERMITFEE Pliimbin Permit Issue PLUMBING PPLBG P luxnbin Fee s foot PLiJMBING PLLONGRNGC Plannin LR Comme/ Multi-Fam PLANNING PLLONGRNGR Plannin Lon Ran e Residential PLANNING 3 of 3 CITY OF CUPERTINO 8 ITEMS OF 8 PERMIP RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN ......... 34�13039.00 DATE ISSUED.......: 11/09/2007 RECEIPT #.........: BS�00003207 REFERENCE ID # ...: 07110053 SITE ADDRESS .....: 22�60 STONEBRIDGE ST SUBDIVISION •......: CITY .............. CUPERTINO IMPACT AREA ....... OWNER ............: AL & MARY ANN WEINGARTNER ADDRESS ..........: 22860 STONEBRIDGE CITY/STATE/ZIP ...: CUPERTINO CA, 95014-5238 RECEIVED FROM ....: KAPHLEEN K MCFARLAN CONTRACTOR .......: TBD - TO BE DETERMINED LIC # 00096 COMPANY ..........: TBD - TO BE DETERMINED ADDRESS ........... CITY/STATE/ZIP ...: , TELEPHONE ......... FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 419.04 201.14 0.00 201.14 0.00 BPERMFEE VALUATION 35,600.00 419.04 0.00 419.04 0.00 BREMFIXT N0. FIXTURES 14.00 16.80 0.00 16.80 0.00 BREMRECEPT NO. OUTLETS 3.00 3.60 0.00 3.60 0.00 BSEISMICRE VALUATION 35,600.00 3.60 0.00 3.60 0.00 EPERMITFEE FLAT R.ATE 1.00 40.79 0.00 40.79 0.00 MPERMITFEE FLAT RATE 1.00 40.79 0.00 40.79 0.00 PPERMITFEE FLAT RATE 1.00 40.79 0.00 40.79 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT : 766.55 0.00 766.55 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 766.55 DISCOVER --------------- TOTAL RECEIPT : 766.55 - a r^� ... rc— R'3�'* Txw,:�+�s,r�z'�'�'+""' . ' ""'" f �--^..� •,�-,.. 3 .... .: ' .°t�- "', �.n�� x.s_. - �. �`"'S � -+,'2"� �!5'.' � �. � a F �:.t ,.,cF .;. - .� �- 5 � �- .+e�p, �S._�" 'F�''�-^��"'^u'4" a",� �..�. a^�^�'i ,�' w +;..�&..�„, n'9 �, f..�. �' 1� . i9,ya F*7. ""� :� ,z,�' . �.iy � �� '�'y. �x^� .r °�"` " n ".�'"" -e' �„ _ + @' ._.r ao : �' t � T-� -^-� .z t t .:: �y .Yr i �r � �F ar'.� s� §�c��"�l+c."�''a�.��,^�� r- -�i' �� .�G.` .� ,� "�1'" ,.�' �� ro-a v^6Xi-� tL ts. +"^- a.,,..e, �^� � :. `... �^ . 1"y. r . � : : : 'u . � .N � � �, ��i<r, � y � .*e �,�,�� , .: � . Y _ �� : t � : � CO�� .2. S - � �� .� � .�R�JJ , HE , , M .� r �s, w...�,»: �„ ."'� ��-,�"' f � `R"�;.� r= CITY O '�•'�� ° ._ , �..` �, a,. � T_ d . � '� "�" �� ..�,�� ,`'"a " n"�.�:� 5a . . .. . � � . � .: d�w7s�s � . � x. +.�y a .. s, . • CUPEf�TlNQ °� . ... � . .. . _, _ ,. v.�. .. , . ., Assessor's Parcel Number: — � Name of owner. � �� Project address. �o� �� ' a ' Contact erson. �� Phone. �� g � � � �� p Fax. � ��p�— Net square footage of lot. E�,� Proposed Square footage: First floor: _ - Second floor: �`��_ _ Garage: � TOTAL: oot b 20 foot clear sp aces inside the garage? ��N Are there at lea.st two 10 f y Is privacy protection planting required for the pr oj ect? �� !_ N On what floor(s) is work being done? Brief descri tion of work. �,�t��-� �'� �'► D n�n �� t ��'� c-�! 1 P � l`.c.A� i.�� ,a �- r � C� n;� � Q. �—.� Code editions: 2001 CBC �-1�2001 CFC �- I�2001 CMC �� 2001 CPC � 1�2001 NEC �.�' I� �d0� T;-'r� 2`/ Cr�QC�� ; ��1`�I�� ..��'��l�d ��'�� '+.,�+ �' �� Project Title � � -. INTERIOR ALTER,�TION � .�.t ]east 50% o$ the total r�teti wattaae of perananently insialled lurt�inaires in the kitchen nust be in lumie�aar�s ttaat a,r� high e�c�ey luni�aires �s defined in T�ble I�4-C. Luminaires tlnat are not high efficacy must be switche.zii separate(y, �. ,en L�ghtireg 5ched�le. Provide the following infocmation fcr atl lu�vnaires to be installed in kitchens. ��r��I'V�-IT Hiah E�cacy? Watts x Q�iantitY = Higii Efficacy Watts or Other Watts � Yes AIo a x_ = flr ��. � CaYi _ Yes�' No o . .�+�} : _ x � g = � � `r� aP � ePYtc�C�nn�" Yes ❑ No� �_ x_ �Z _ °r �'O . u.Y1-C_4L� C` �G0. . _�`es R►'a c� 3�__ x—�__ _ �� QH� Yzs n 1Vo ❑ x ° - or To�i: �: 3 y � B= �D ca��.rgs rF �>_ B L� �a o �m� . �� S�C ��a� ;? ` atD �n�� s��o �— �, � �wQ� {. - - _ _. � � � N .� o � `' •A � -. N V1 m Q � � � - ;ii i � j i i "� i i f i � j #I �;� \ __r_ i j , i � \ i; �;ii � !�� - r;i! � i '_-� �_ � _� iii; \ ;�i 7C t ,� I -- `' � �, ,». � i ! " i �.._ � Q� ` � � F ---- -- ---- — -- — / , \ ` � — -- ! �j � � / � � � �� 0 � 't � �l �J� �+ - y � . 3 � +.; i -� ~ -------- ----- -�----------- ---� � G - � ;i�, — i � ;; � ;; ; ,+!� i `; ' ; ( ii�E � � 1 ��' � � �i`E! � N — � � i i = j � `� � � '; -, f . \ � \ o !�; . i — n '!;"r_G' � � \ � v i � ;�; i 11 � �� i � � ��i h C �N � � �° '!i � � \ io ; j i ; `,l � _, / '� � F`1 Z i��! � � t � �i 1 � � ; � I � � � � �_ ��+ . p � I . -_r� _-_ ------ � ,jil � 1 N � i �.% i C NF f a O �! I I _. _ O O � i � ^ � � 1 � � f � �� i � � ��` � o tn � i � _ _ - i s i:I . � T � n � - z — — � � c��i i . --- � __ -- _—.. o� _ __— _ ' - __ - - -- � . ----_--- ---- � - _ z � � „ ,�—��-r. � x �s :. - � � �Jr'r<. '�"�"'"'z '- �-.�' ��''��'S�: � ,' .��"`y' �” i- 6�+� ;s` �. . '�'b*w'"�� '"..`'�."� "��^-* 't�'' '� "� �r� � r ,"�- - � � � �,�� ,� � h� � -� ��. �„ p d.� .� "-: s .�,'S.�" n."4�, ;,.�r ��. � �.` a H ,�',r��-t•��„ � '�, i'� a. �^-r�r ��'x:Y.�r ,�j., �"�+" a, .�. . � �h r � .�k.:s'�: ..3.� �� '" �� ,� . 'w �O .R.�..�SH.L�'�+ �r.�"�.��: ' .� . �. "�`� , � � ` a �_ P a: . .S�a ..L��.� ,� . ' � � . s " � N , ',is � a«.> � "�rtxrr� x...4+�^F , . :. . i ,, '! r �.�u � � �� , , ' p :. �` ,^.. ��^'7 �<��s�,�''�+ �+�i-� �.��:`,�� c V .. , ' . . . . 1 , . . �... .., vE� a.t CUPEf�TlNO . : ,n�� .. � _, _..... . _ � . _,.. r.. �.�� Assessor's Parcel Number: — � Name of owner. � Proj ect address. o�a ��_�� ` Contact erson. � � Phone. �� c� - � � � � � �� p Fax. � �'CQ - l � s� Net square footage of lot. s E� Proposed �j� .�.. Square footage: First floor: Second floor: �`' _ �� Garage: � �' TOTAL: oot b 20 foot clear sp ices inside the garage? ��ZN ,� a� r. Are there at least two 10 f y p�,.° ; � , � 4 � �� ,� � "'� Is privacy protection planting required for the pr �j ect? �� /_N '- �` ;_ f _.� �. On what floor(s) is work being done? '_'�, ^ j' " �� ' �ii�0 � [/ �i ¢! �L� � C.�lf I Brief description of work. �� D� �-► D^�n "�-�- �. � fL9 �,� � X- ir' � ��--� E el - o Code editions: 2001 CBC �- I�2001 CFC �- I�2001 CMC �� 2001 CPC � I� 2001 NEC (� � '� b0� T' ;'�' L 2`1 Er� Qc �� ; ��`�� '�'��I'� �I��'�� +'�' �� o�� r�t� . . i�$� � � -. INTERIOR ALTER��TION �i ]ea SO% o� the toial r2ied wai#age of �erinanently insta�le� lu�r�ig'�aires in the kitchen rlust be in luminaires ttaat ar h�gh e�cscy Iuninaires �s define3 in Table I�4-C. Luminaires t�at are not high efficacy must be switcheci separately, �. .en Ligl�tareg Sched�le. Frovide the following information for all luminaires to be insta.11ed in kitchens. �p�1' -� �. High Efficacy? W�x Qi�antitY — Higt► Efficacy Watts or Other Watts Yes No ❑ x = nr P,�.�. � C�6� _ Yes� No o ��_ x g = � f� `r� a� _ p Pv►[�Q�y� Yes ❑ No pr �_ � _ 02 ° °L �' D . �Yl-�.� t' CtL� _ _ j'es 1+�0 ❑ _ 3 _�___ _� x ____ -�-- — � 4Z} o r Yes n �+la ❑ x = ar Toc�i: A: 3 y g' e_ D C QMPEI�S IF A>_ B Ye�� IVo ❑ o � ��` � • n (D �D�� E o�o (- s 1 ; _ �rNQ� ! — ' - — - — i; . . — �'c �, o � ',"� N N m Q 0 a� � E,;, - � �:,` fi� j��i i -' ! ij _ ,;j; � - i'�` � j� � il4 � � ;;i I ��II � ';;; � ;{ \ � � _ ` ,� �. �� --` � ,� � \ r: ` ; � �:. �, � �� '��j ------- ---- ----- - �-� \ i - � ' i�� : � �i� � � ��-' I i j � " s' o tp �=-± j ; ., p � - � � �, , _ o -s �_� � ; t� ► , � _. 3 `_ � � � I -------- ------ ---------------� G � !;j� j',� — 1 ;ii; � I i � ! i r � � -�- I 1 ';`� �� ' � . :, , � ,,, � ;1 � _ i � � i ^� - � _ � i � '� ;i; \ , \ � c) '`i; ` � � __ � '; !:�6� � � �./ � I � ',� 1 � ' �° � � R '." 1 � � ;E � I � � � � � � \ � � � pf !� `: i � \ �. � �' --� �ry fp � ! i 1 ��l � � Z lili � �`� � � 1 I � � j i-! ` --'�----- , ----- ` - �-- 1 '-� ` o � i�_� � C NF f A I n n I � i � T � p , '; ; �„� � " �1.X � � � { ' '�� '� °� — `=- — — � � i � 1 =` .� n � -- � h4 4- � _ � � � _.,_., ; • e !n � ___ �� — ', _, _ ' . ; , — _ !- ' �� ' ti� -- __-------- ,,: — _ ,r.; __ -- 4 � � t ." :, Community Development k 10300 Torre Avenue ";� . �� :�. ' Cupertino CA 95014 Telephone (408) 777-3228 CITY OF Fax (408) 777-3333 CUPEI�TINO Buildin De artment JOB ADDRESS: a PERMIT #� �� D 5 ,,� g OWNER'S NAME: GC ' PHONE # ��$ -�r9 �7 �8'�� GENERAL CONTRACTOR ,,�;�- � FAX # � � � g� / � I am not using any subcontractors: �� i� � ��z!� �� ` � ` 0 `� Si gnature Date Please check a licable subcontractors and com lete the followin information: SUBCONTRACTOR BUSIZJESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing IIectrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heatin.g Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date